Eight Babies for the Price of One?
Commenters on my posts about the Suleman octuplet situation and on Madeline Holler’s post about the problem of fertility clinics breaking the rules pointed out that a big elephant in the room of this discussion is healthcare, insurance and the cost of fertility treatment in the United States. In countries that more carefully regulate the number of embryos doctors can transfer into women, healthcare is universal and access to at least some fertility treament is covered by it. In the United States, it is rare to find a health insurance policy that covers fertility treatment of any kind, rarer still to find a policy that covers IVF, which can run from $7,000 to $15,000 per try depending on the drugs needed and procedures used.
When couples have double-mortgaged their houses to come up with the cash out of pocket for a round of IVF, it must be awfully tempting to increase their odds by transferring more than one–or two—or three embryos in a single cycle.
Guess what? No one is particularly hoping for high order multiple pregnancies. In fact, research conducted by a well respected fertility center in Maryland found that when cost is not a factor, couples prefer to transfer one or two embryos and that pregnancy rates are not effected significantly by the lower transfer numbers, though multiple birth risk is significantly reduced:
“[This study] showed that patients prefer to transfer one embryo when freed from financial pressures to transfer multiple embryos, which can occur when patients have limited or no insurance to pay for treatment.”
When you weigh the costs of care for high order multiples born prematurely against the cost of trying for an extra round or two of IVF, the IVF starts looking like a bargain. So as we enter a national conversation about how to get every U.S. citizen covered with health insurance and what to cover, it would be a good idea to keep fertility treatment in mind. With one in seven couples now seeking some form of treatment to help them conceive, a certain amount of coverage for these treatments needs to be part of the package. What society pays in IVF costs, it will save many times over when those treatments result in healthy singletons, rather than children who need weeks of NICU care and possibly rehabilitation and special care for many years after birth.
See Also:
Nadya Suleman’s Gift to Society: A Cautionary Tale
Really Wanna Let Octomom Have It? Leave Her Alone
Octo-Doc Not the Only One Breaking the Rules
No Great Outpouring of Support for Sudanese Mom of Quintuplets
I think it’s all about what the inquiries are, and what rules are used to take this information and make clinical decisions about it. Some questions or rules could be too intrusive, discriminatory, and inappropriate, others actually helpful.
Sheri, there is often quite a bit of resentment from adoptive parents that bio-parents are never examined at all, let alone to the depth prospective adoptive ones are. We can argue about the irony or fairness of it all, but society–and even adoptive parents–have come to expect some kind of background research is necessary when people seek to adopt. It may not be “fair” but that doesn’t mean it is unacceptable to add some inquiry to to the process of ART as it has been added to adoption. I really fail to see how this could seriously threaten someone who is confident about her ability to become a parent. Such a process might well have prevented the Suleman octuplets.
Again, I am skittish about regulating who can and can’t be a parent, but realistically, we have to accept some perimeters when these extra measures are taken (like adoption or ART). It’s just reasonable. We can all be bitter about the unfairness of life. But there you go. Life is, in fact, unfair.
I know the clinic I went to asked why we were there but since I had already given birth once, I’m guessing they assumed they knew I knew what I was doing.
I’m wondering why I should even be asked this question or questions….If I could have gotten pregnant just by having sex, really, no one is saying much of anything to me, but should I require help??? Then anyone is allowed to ask anything???
I’m all for children being born or given to people who want and love them, and know what they are doing. But take the most financially stable decent people and spring a newborn on them, and I’m betting they’d be surprised by it all too.
I’d like a moratorium to be put on the word “Octomom.” She has a name! “Octomom” is wrong on so many levels. Please, babble, stop.
Thanks, Shannon, for refraining.
Merle said:
I wonder whether any questions were asked like “what means do you have to support your child? How many other children do you have at home? And what parental plan do you have?”
As an adoptive mom, I will tell you that this is just the tip of the iceburg when it comes to adoption home studies and other preparation. So it is extra strange to me that people seeking highly interventive ART like IVF get a no-questions-asked policy.
Lori,
I don’t disagree with you about this individual case. I assumed medicated IUI along with most people who know anything about ART. But I want to shift this discussion away from this solitary case. It’s distracting to pick on this case and this family when the issues are so much broader and the energy people are putting into talking about “octomom” could so much more productively be turned towards real discussions of the need for real reforms in this industry.
Excellent post, Shannon. But, I think the problem goes back to the collateral damage from Reaganomics–regulation. The fact that insurance companies aren’t regulated has created this entire vortex of those who play poker with their life savings in the name of parenthood. And then there’s the issue of regulating who gets to buy from this invitro clinics. I wonder whether any questions were asked like “what means do you have to support your child? How many other children do you have at home? And what parental plan do you have?” Parenthood, as you and I both know, isn’t an activity you engage in on a wing and a prayer. It requires a vision, a flexible one at that, but a vision nevertheless. I’m not so certain Suleman had one other than wanting to be a mother and to have a family.
I have long heard this argument and buy it… to some degree.
I still think that this high profile case is the exception. Most high rate multiples are a result of medicated cycles with IUI or simple BMS (baby making sex) I think this doctor was playing mad scientist and would have done this regardless of insurance, possibly regardless of government regulation.
I will be the first to admit, even if insurance had paid for my one feeble IVF attempt I would have wanted to put at least two back. I have always been in love with the idea of twins.
I also think couples need to get away from their desperation to be pregnant and focus on a productive path to becoming parents.
When we were TTC I was very, very comfortable putting three back. I did a lot of research, talked to a lot of well educated experts. If I did it again I would still be really comfortable with three. I would hate for the industry to become so regulated women go form having too much say to too little.
Money aside those fertility drugs are hard on the body. Even if finances had not limited our attempt I don`t know how many attempts would have been good on my body. Money is not the only reason to play the odds.
Changing the topic, but I STILL think there is more to the story. A lot of things simply do not add up. I am sure her medical records are fudged, we may never know the full story. I strongly suspect more than 8 embryos were put back.