The Wyden Bill and Infertility: Where are the Patients?

With both male and female infertility on the rise, IVF success rates have been subjected to public reporting since the passage of Wyden Bill in 1992 which intent was to help infertility patients by informing them of the relative success of different IVF programs. There problem occurs of course because sometimes the best IVF statistics and pregnancy rates are many times not what is in the best interest of the mother, child, family and society. Where is the catch?

Fertility programs are under pressure to produce and report the best pregnancy rates because future patients compare pregnancy rates of different fertility treatments. There is a competitive pressure on fertility programs to transfer more embryos in order to increase the pregnancy rate as reported. This consequently means that patients with lower chances of successful pregnancy are also less likely to be offered IVF retrievals and are therefore diverted to IUIs or donor egg cycles. Additionally, clinics that have reported the highest success rates also have the highest triplets rates which leads us to conclusion that despite the fact that there is an evidence that a fertility program can achieve similar live birth rates by transferring a single embryo each time, the Wyden Bill creates a disincentive to do so, causing clinics to transfer multiple embryos to enhance their success rates.

This does presents a pressure on fertility clinics to strive for best result possible despite the fact that by transferring multiple embryos they are risking a chance of successful pregnancy since the risks of prematurity and pregnancy complications are far higher in multiple pregnancies than in single pregnancies. It is a fact that multiple pregnancies result in longer hospitalizations, neonatal admissions, and many times in complications that can result in disabled children and sometimes death. Fertility treatments themselves are emotional, causing many stress and often financial problem, and situations like this often do not have a happy ending, and are many times a cause of increasing the incidence of divorce.