My wife and I, like millions of men and women in the U.S., had trouble having a child.
When we sought out help from a fertility clinic in San Francisco in 2012, we struggled to make sense of our treatment options and understand the chances of success.
My wife went through two years of diagnostic tests, daily injections, ovulation tests, blood tests, ultrasounds and a failed embryo transfer. We spent roughly $30,000, and we learned a lot about the industry.
In vitro fertilization eventually gave us what we wanted in 2014, a healthy baby girl. Still, I came away from the ordeal concerned about how consumers – people like us, desperate to have a child – can get an accurate understanding of our chances of success and the quality of a clinic’s practices.
Around the same time that my wife became pregnant with our second child through IVF, I began to dig into the multibillion-dollar business of making babies. Together with reporter Bernice Yeung, I spent months looking into major issues and concerns in the fertility industry in the United States.
We interviewed dozens of patients, doctors, academics and medical researchers. We also spoke with men and women who had suffered, those who felt misled and those who dealt with severe health complications as a result of their treatment. We analyzed reams of data, fought with the government for public records and pulled archived documents and microfilm in courthouse basements.
We discovered that this is a field of medicine in which there is little oversight, even though the stakes are so high and the innovation is happening at such a rapid rate. We also learned that infertility patients are at a significant disadvantage when it comes to understanding their treatment options and selecting a quality clinic.
- Fertility clinics’ success rates, the primary way to measure a clinic, are misleading.
Manipulation of success rates regarding IVF procedures is relatively easy. Clinics may manipulate their rates by excluding cycles, pushing patients to IVF, and not offering other treatment options.
Also, the way that the Centers for Disease Control and Prevention calculates a clinic’s success rate increases the pressure on doctors to engage in risky practices.
- The majority of clinics routinely transfer multiple embryos at a time, creating unnecessary health risks.
IVF can be practiced in a way that largely avoids the health risks for mothers and babies that come with carrying twins, triplets or more. Yet nearly 40 percent of all IVF deliveries in the U.S. are twins because, in part, doctors routinely transfer more than one embryo at a time, even in younger women, who have the best chance of becoming pregnant.
The practice increases the chances pregnancy complications, miscarriage, premature delivery and other problems for mothers and babies, and adds significant costs to the U.S. health care system.
- There’s little accountability and oversight of doctors who make repeated mistakes.
Doctors accused of medical malpractice often settle out of court and are not required to report these settlements. Take Dr. Rifaat Salem in the Los Angeles area. He has one of the highest success rates in the country. But he also has another more dubious distinction: He’s one of a handful of doctors nationwide who’s paid out four medical malpractice payments over the past 25 years.
Here’s what you can do if you want to learn more:
- Read the full story.
- Understand what can be done to address these problems.
- Watch our video on the safety of egg donation.
- Subscribe to our podcast now to get a radio version of this story when it comes out Saturday.
Jonathan Jones can be reached at firstname.lastname@example.org.