By Yaron Seidman D.A.O.M.
#Empowering #Women #Fertility #Choices
In Vitro Fertilization (IVF) saw its first commercialization in the early 1980s, but it was not until the mid/late 1990s that it gained popularity. In 2015, as of writing this blog, IVF cycles performed around the world are at epic numbers. Some estimates go as high as 1.5 million cycles per year worldwide. European Society of Human Reproduction and Embryology in 2014 showed the following statistics of IVF cycles: “In 2011, the latest year for which figures are available, 588,629 treatment cycles were reported from 33 European countries. This compares globally (in 2011) with 151,923 cycles from the US and 66,347 cycles from Australia and New Zealand. The number of cycles performed in many developed countries has grown by 5-10% per annum over the last few years.”
According to a leading IVF specialist, Dr. Paul Magarelli M.D. reporting in the IFSymposium in May 2015 “in the past 10 years, and despite many advanced technological developments and acupuncture, the IVF success rate did not increase. In addition, all IVF clinics that use similar technologies have similar success rate.”
The CDC latest 2013 report states that 1.5% of all babies born in the USA are conceived using ART.
The Society for Assisted Reproductive Technologies (SART) provides the following statistics from their member IVF clinics in the USA (467 clinics in 2013):
In 2003 Total IVF Cycles:112,988 (including fresh, frozen and donor cycles)
In 2013 Total IVF Cycles: 174,962 (55% increase from 2003)
The numbers reveal that not only the overall average success rate for IVF in the USA did not increase over a 10-year period, despite many technological advancements and costly new procedures and even acupuncture support in some cycles, but in addition, the demographics have changed. Note that acupuncture is performed on a small portion of IVF cycles compared to the overall number - statistics are not available to demonstrate the percentage of IVF cycles with acupuncture versus without. The stagnating IVF success rate of the 10-year span cannot reflect on acupuncture per-se, since more inclusive studies are needed. Anecdotal studies show some acupuncture benefit for IVF. In Hunyuan medicine we explain that acupuncture during IVF can mitigate the negative side effects of IVF drugs, hence the positive effect evidenced in small scale studies. Acupuncture itself cannot increase egg quality and therefore benefit is limited. Even though, for women struggling with infertility, every little help counts.
So what is the changing demographics of IVF cycles? The following data explains:
Over 10-year span, success rate did not change significantly in each age group, however, the number of patients did. Women older than 42 saw a staggering 80% increase in IVF from 3213 cycles in 2003 to 5744 cycles in 2013, despite a consistent and unchanged low success rate of 4.5%.
What was the reason for this enormous increase in the >42 age group? The following table suggests a clue.
In early 2000s IVF clinics were serving predominantly infertility patients younger than 40, but as the number of clinics increased there was a need for more patients. In addition, alternative fertility options such as Hunyuan fertility medicine and Traditional Chinese medicine produced more fertility specialists in late 2000s and early 2010s, and many younger couples opted for these natural fertility options. In early 2000s the author was one of a handful of Chinese medicine Fertility Specialists, but today, in 2015, there are hundreds of Hunyuan Medicine Fertility Specialists and Traditional Chinese medicine Fertility Specialists such as ABORM.
Hunyuan Fertility medicine and Traditional Chinese Medicine treatment of infertility is on the rise. IVF cycles for Women <40 piqued in 2008 and then declined, while for women >40 it is still on the rise. From personal experience with thousands of IVF patients, the author speculates here that younger women, in recent years, allow themselves more fertility options and disagree with the pressing logic of ‘you are out of time’. It is also evidenced that the IVF industry is targeting now more than ever the >40 group, such as the following donor-egg statistic suggests.
The IVF industry as a whole increased focus on patients >40. In response to the low success rate in this group, donor-egg cycles have increased in an accelerated pace to compensate the shortcoming. From 2003 to 2013 there is a 47% increase in donor egg cycles. According to 2012 CDC report within the donor-egg cycles most recipients are >41. This suggests that the increase in patients’ number over the 10-year span in the >40 group is even larger than the +36% reported above (which excludes donor cycles). In addition, according to CDC 2013 statement ART cycles performed for banking non-donor eggs or embryos has gone up from ca. 1,000 in 2003 to a staggering 27,564 in 2013. This further sets the stage and strategy to increase the pool of women >40 in the future for IVF treatments.
Acupuncture was not introduced to IVF because the IVF clinics wanted it. For example, in 2005 the author participated in a TV segment with an IVF doctor, who, in the back room, exclaimed that he will never allow acupuncture in his clinic. But since 2010 his clinic is using acupuncture regularly to supplement IVF cycles. Women demanded it and the IVF clinic consented.
The future of infertility treatment is at the hands of the patient and especially at the hands of women who need it. To change the landscape of infertility treatment women need to be empowered with more fertility options. Women should not be “told” what to do, but rather they should be informed of more choices and then they can help alleviate the status quo of IVF success rate.
In sum, the following suggestions and observations are made:
Dr. Yaron Seidman DAOM