January 26, 2005

Cash Strapped American Infertility Docs Cry Out for Mercy

New York Times news service is spreading this story all over the place:
A bride at 49, Kathryn Butuceanu longed for children. But at her age, her best hope lay in fertility clinics and an egg donor, a quest she soon found could easily cost up to $72,000 for repeated tries. That figure seemed like a deal breaker. Ms. Butuceanu (pronounced boo-tuh-CHAH-noo), an administrator at the College of William and Mary in Williamsburg, Va., and her husband, Cornel, a doctoral student, lived on about $55,000 a year.

But help came through a call to Dr. Sanford Rosenberg, a fertility specialist in Richmond, Va., who had started a program capitalizing on lower medical costs overseas. By using an egg donor from Romania and having the eggs fertilized in Bucharest and shipped back to the United States, the Butuceanus cut their costs to $18,000, including enough fertilized eggs for repeated efforts.

Yes, Romania. Paradise for late-life birth and, it appears, for egg donation. The article discusses a term that you hear more and more over drinks at the ASRM conference these days: "fertility tourism," in which a patient can get a vacation in a tropical wonderland and infertility treatment (IVF - a full cycle) for the price of IVF alone in the US. Or to put it more pointedly, eggs, medication, and medical care for IVF cost a fraction of the US price when purchased in developing nations.

The best thing about this article is the position that IVF docs take on the matter. Guess what they worry about? A lack of regulation oversees. You couldn't write comedy that good. Here are the practitioners of probably the least regulated field in all of American medicine, raising

... substantive concerns about regulation of overseas clinics, genetic testing, standards for egg donors and language barriers, not to mention the difficulty in comparing pregnancy rates in American clinics with those abroad.
But wait it gets much much better. According to Sean Tipton, spokesman for the American Society for Reproductive Medicine, the cost of fertility medicine abroad is lower - in part - because of a lack of "research involving human embryos" there. Boy howdy does the average IVF clinic here do a lot of expensive research! Somebody remind me - how long was it before anyone in IVF conducted and published any kind of serious study on the effects of ovarian hyperstimulation medications on women's health? I forget. Two decades?

But there are all those expensive studies on outcomes for IVF - you know, studies about how IVF affects families. Oh, wait, that's right, those were almost all done in other countries. Hmm. Well, anyway, there must be some reasonable explanation as to why IVF costs a fortune here. It can't just be a seller's market. Right? - Glenn McGee

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