In a little over a decade, the number of foreign children adopted by Spanish parents has plunged from 5,541 to 531, representing a drop of more than 90%.
The effects of the economic crisis, the refusal by some countries to...
Virtus Health is an Australian company that owns and operates 36 fertility clinics, and provides more than a third of the in vitro fertilization (IVF) cycles performed in the country last year. Together with its partner, the private-equity firm Quadrant, Virtus Health made financial history recently when it became the world’s first IVF provider to go public – to the tune of nearly half a billion dollars.
Chief executive Sue Channon nonetheless has a tough job promoting Virtus’s business and medical portfolios. On the corporate front, Channon is quelling investors’ fears that improvements in assisted reproductive technologies might mean fewer cycles for clients – and therefore dwindling revenues. But she assures shareholders not to worry: To attract more customers, Virtus plans to reduce the costs of some fertility treatments, and to expand into new markets in the Middle East, China and India, where U.S. and European demand for commercial surrogacy, in particular, continues to grow rapidly.
On the medical supply side, Virtus, like most IVF companies, enjoys lucrative growth driven in large part by a steady stream of panicked women in their thirties and forties who, for a variety of reasons, believed it both safe and feasible to delay motherhood. They turn to clinics like Virtus’s for last-minute miracles, unaware that, for those beyond the age of 35 years, the vast majority of their IVF cycles will fail.
Data from the European Society for Human Reproduction and Embryology indicates that global IVF failure rates were as high as 77 per cent in 2012. In the United States, the Centers for Disease Control reports an overall failure rate of 69 per cent for 2010 (latest year of full data), with failure rates as high as 68 per cent among women ages 35-37; 78 per cent in women 38-40; 88 per cent in women 41-42; and 95 per cent in women 43-44.
The customer base on which Channon and others in the fertility field rely for corporate earnings would undoubtedly shrink if more women were made aware of these high IVF failure rates, and were reminded of the natural limits of biological fertility. Most would likely reframe the trajectories of their educational and professional advancement, and plan for children much the way women did before the conversation about “biological clocks” was nudged off the table by sensationalized headlines touting the “miracles” of reproductive medicine. After three decades of overly enthusiastic media endorsements, millions of women have succumbed to the seductions of a science that purports to have trumped Mother Nature in the reproductive arena.
Research conducted among college students in Sweden (2005), Canada (2010), and Israel and the United States (2012) all point to a pervasive lack of knowledge about women’s fertility and over-estimations of the success rates of reproductive technologies (1, 2). A full one-third of the Swedish men thought a woman's fertility did not sharply decline until after the age of 45, and the Canadian study of undergraduate women found that “they significantly overestimated the chance of pregnancy at all ages and were not conscious of the steep rate of decline for women in their thirties.” In the 2012 U.S. survey, two-thirds of women and 81% of men believed that female fertility did not markedly decline until after the age of 40. One-third of women and nearly half of men believed this decline occurred after the age of 44 – an age at which an IVF cycle is almost certainly destined to fail.
The combined end result of these fertility misperceptions and high IVF failure rates is a growing population of older couples who are now coping with the emotional shock of involuntary biological childlessness. In August 2008, the U.S. Census reported that the number of women aged 40 to 44 without children had doubled in a generation, going from 10% to 20% in the 30 years since fertility treatments have come to be seen as a fallback option. Though some are perfectly happy without children, many others are still trying to conceive or to accept that they will not be able to do so.
Reproductive endocrinologists are experts in fertility and the efficacy of the treatments available in the marketplace. Many of them likely cringe at the level of inaccurate information streaming through the media. Yet few, if any, IVF doctors or clinics have stepped forward to protect patients’ interests by publicly countering this misinformation. Might conflicts of interest be playing a role here?
If the Virtus half-billion dollar public offering is any indication of things to come, we are likely to see less accuracy and transparency from clinics, not more. For an IVF industry at that scale, downplaying the real numbers helps to secure the profits that investors expect.
Judy Norsigian is the Executive Director of Our Bodies Ourselves and a co-founder of the California-based Pro-Choice Alliance for Responsible Research. Miriam Zoll is the author of the new book, Cracked Open: Liberty, Fertility and the Pursuit of High-Tech Babies (Interlink, June 2013).