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Health Team

Some say in vitro fertilization guidelines should be stricter

Posted March 6, 2009 7:05 p.m. EST
Updated March 9, 2009 11:21 a.m. EDT

— In the quest to start a family, many couples go to great lengths and great expense to get pregnant. Advances in vitro fertilization (IVF) are helping many infertile couples achieve their dreams of a family. However, in some cases, it exceeds their dreams with multiple babies.

Some doctors believe guidelines in the United States allow too many of these high-risk pregnancies to occur.

At Carolina Conceptions, 2601 Lake Drive in Raleigh, women can get eggs harvested.

“That's done under, usually, conscious sedation,” Dr. Bill Meyer, an infertility specialist, said.

Meyer said that only a small percentage of eggs are suitable for fertilization, and there may also be problems with the donor's sperm. With older, standard methods, fertilization might not be possible for many couples.

“Now we can actually inject a single sperm into each egg and that's called ICSI (intra-cytoplasmic sperm injection),” Meyer said.

Using robotic controls under a microscope, an embryologist selects an individual sperm and injects it through the egg's membrane. The fertilized embryos are held at least three days to make sure cells are dividing normally. If they are, they can be transferred to the woman.

“You're completely awake for the procedure,” embryologist Heather Blackmon said.

Sheree Mann, 40, turned to IVF and Carolina Conceptions to help her get pregnant.

Based on her age, the quality of her embryos and her history of infertility, guidelines from the American Society of Reproductive Medicine allowed her to transfer up to four embryos. The hope was that at least one embryo would take, but an ultrasound later revealed four babies.

She felt “just unbelievable joy. But again, this was something I was struggling with for five years,” Sheree Mann said.

Multiple gestations can cause increased health risks to mother and babies. That is part of the reason why, in Europe, there are stricter federal limits on embryo transfers.

“Truthfully, I wish we did. I think it would be great to say – just like they have in Europe, 'Hey, this is how many embryos you can put back in (and) you cannot exceed these guidelines,'” Meyer said.

That would greatly reduce the health risks, but it would also leave many couples' dreams unfulfilled.

“A family is always what we wanted,” Mann said.

Twelve states require insurers to offer coverage for infertility treatments, but North Carolina is not one of them. Each cycle of in vitro fertilization can cost about $10,000, and fertility medications can be costly, too.