Burwinkle said that in his early days in the field, a seven to nine percent success rate was the norm. Today the rate is more than 40 percent. He also said costs have held the line.
“When I first started, a cycle would cost as much as a new car — about $13,000 back then. Now it’s $10,000 or less. IVF has certainly gone under the rate of inflation and has afforded many more couples an opportunity to become pregnant.
“We are still behind Europe,” he said. “Europe has over three percent of their births from technology such as IVF. In the U.S., it is just a little over one percent.”
There is a wide range of ages on the patients.
“We’ve seen patients as young as 19 up to about 50 who are trying to get pregnant,” Burwinkle said. “Most of the patients that we see are in the 30 to 40 age group.”
“A lot of couples delay child-bearing but, unfortunately, the natural fertility really begins to decline after the age of 35,” said Steven Lindheim, MD, of the University of Cincinnati Center for Reproductive Health. “A couple of decades ago, the average age of first delivery was about 21. Now it is into the mid-to-late 20s as an average.”
There are a multitude of problems that may cause infertility.
“The male and the female each counts for about a third of the infertility problems,” Lindheim said. “About 25 percent of the time it will be both and 20 percent will be unexplained infertility.”
IVF is not the only solution. “Purely losing weight will often improve fertility,” Lindheim said. “In women and now in men, studies are showing that losing weight will actually improve sperm parameters.
“There are simple therapies for women who don’t ovulate regularly,” he said. “We also do a lot of advanced laparoscopic work. I am doing tubal reversals and can repair the fallopian tubes.”
He added that medications are also sometimes effective and even alternative therapies such as acupuncture show signs of success.
Both centers start with complete workups for the couple. X-rays, ultrasounds and blood work may be ordered. Quality of the sperm and eggs can be examined as well.
Every case is different so there is no cookie-cutter cure. Recent advances in techniques have boosted the success rate. One such technique is called ICSI.
“It stands for Intra-Cytoplasmic Sperm Injection,” said Erica Behnke, Ph.D., Lab Director for Kettering Reproductive Medicine. “If we have a case where the gentleman has poor sperm quality, we can literally pick up one sperm and inject it into the egg so it bypasses the need to have a lot of sperm. It bypasses the need for strong motility. It bypasses the need for the sperm to have the enzymes necessary to burrow through the shell.”
Burwinkle said many military men will have sperm frozen so their wives can try to conceive while they are deployed.
Freezing of eggs is a coming technique, according to Lindheim, who said that patients who are single or those who may have cancer and don’t yet have a significant other may freeze eggs for a later pregnancy attempt.
Freezing fertilized eggs is a technique allowing for several impregnation attempts. Burwinkle said the embryos are frozen at minus 70 Celsius.
The water is extracted and liquid nitrogen replaces the water so ice crystals that would damage the embryo cannot form. He said that in one case, a successful pregnancy occurred with an embryo that had been frozen for 25 years.
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