Adventures in Fertility?

by Christopher White, CBC Director of Research and Education on November 2, 2015

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Jason Gay, a sports columnist for the Wall Street Journal, had an essay in the weekend edition of the paper on a different sort of game for him: fertility medicine. In a casual and, at times, humorous essay, “Adventures in Fertility,” Mr. Gay discusses the woes of waiting until one’s mid-thirties to begin trying to conceive. Combined with a previous battle with cancer, he soon found out that “the odds of Bessie [his wife] and me conceiving naturally were around that of a Cleveland Browns Super Bowl.”

At times the essay is sober-minded and honest about the realities of assisted reproduction. As Bessie and Jason begin IVF, it’s a trying experience for both of them:

Bessie would lie down nervously in the living room, and I’d sit over her (you may recall John Travolta hovering over Uma Thurman in “Pulp Fiction,” clutching a syringe of adrenaline) as she begged me to count it down—5, 4, 3, 2, 1—before plunging in. One time I hit a vein, and the needle shot back out, blood splattering over me. We both screamed, and I had to do the whole deal all over again—new needle, new shot, new 5, 4, 3, 2, 1.

Happens all the time, the nurse said later.

He’s also not shy about the enormous price tag that accompanies the procedure:

Every IVF treatment cost about the price of a lightly used Honda. I don’t want to talk specific amounts, but know that I now own several lightly used nonexistent Hondas.

After a number of attempts (he does not disclose how many), they eventually become pregnant and a have a successful live birth. In fact, the joy of their first child spurred them to pursue another “IVF production” (his words, not mine) soon thereafter.

There are two glaring areas of oversight that any discussion of IVF deserves mention: First off, the failure rates of IVF are exceedingly high (above 70 perent in the United States, almost 80 percent globally). As a sports journalist who is well versed in statistics, Mr. Gay does a disservice to his readers by not making this clear. IVF is not only an emotionally exhausting and medically fraught journey, it’s more often than not an empirical impossibility.

Secondly, the enormous price tag—referred to by Mr. Gay as nonexistent used Honda’s—is something that only the privileged are able to pursue without consequence. Most IVF cycles cost, on average, about $12,000 per round. Many couples who are unaware of the high failure rates don’t realize how quickly these costs escalate and once they start down this path, it’s very hard to turn back. In some cases, it’s only after they’ve maxed out their credit cards, declared bankruptcy, or destroyed their own marriages that they realize the real costs involved.

So yes, Mr. Gay can refer to his experience of IVF as “adventures in fertility,” but like any other adventure—say, skiing, whitewater rafting, or skydiving—the risks involved are made clear to the participant before they sign off on participating. It’s all the more tragic then that the practitioners of fertility medicine get a free pass in this regard—especially when there is so much at stake.


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