Thursday, February 27, 2014

Too much IVF ?


Many doctors believe that IVF specialists are now doing too much IVF. A friend, who is a gynecologist, pointed out that he is seeing patients who went to an IVF specialist who advised them to do IVF, who then promptly got pregnant in their bedroom the next month !

He felt that we are seeing an epidemic of IVF overtreatment , simply because there are too many IVF clinics around , and each one wants to do as many IVF cycles as possible. It is true that IVF is an effective treatment for infertility , but he was very critical of the fact that specialists are advising IVF left, right and center, even for couples who could get pregnant with simpler treatment options . He felt that this was unfair on patients .

The problem is that IVF specialists have a jaundiced view. Because he is a specialist in doing IVF , he is quite likely to recommend IVF treatment – after all, this is what he does for a living ! When patients are confused, and go for a second opinion to another IVF specialist , he provides exactly the same advise – the only difference being that he suggests that the patient do IVF in his clinic, rather than the other doctor’s
clinic !  Patients are completely confused as to whether they really need IVF or not – after all, IVF is expensive .

The paradox is that while poor infertile patients don't get enough IVF treatment because they cannot afford it, rich infertile couples get too much IVF treatment , simply because they can ! However, a lot of this may be unnecessary .

It’s hard to judge in retrospect whether IVF treatment was really needed or not. After all, when infertile patients go to a doctor, they are basically looking for a baby, and if IVF treatment can provide them with one, they are more than happy to do this, even though they understand that there maybe simpler and less expensive treatment options available.

It’s not true that all IVF specialists are just out to make a lot of money by doing IVF for anyone who walks into their clinic ! The reality is that IVF is the most effective infertility treatment we have available today, and lots of infertile couples are focused on results , rather than the treatment path which gets them to their final goal.

While it’s true that IVF treatment is expensive , for lots of patients it's actually much more cost-effective to do IVF , because of its high success rates. It actually saves them time , rather than following the traditional path of doing scans with timed intercourse, followed by IUI treatment cycles.

At the end of the day , it's important that patients make these decisions for themselves , so that they can select the treatment which is right for them . This is the best way of solving the problem of overtreatment. A well-informed patient will be aware of the less expensive treatment options available , and if she decides that IVF will be the most cost effective option for her, than I would not consider IVF to be overtreatment for that patient.

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