The flitter of a heartbeat on an ultrasound. The internal somersaults that provide reassurance of the growing life within. The wail of a healthy newborn. These are the dreams that millions of hopeful parents-to-be long to become reality. And for women, couples, or birthing people struggling to conceive, Assisted Reproductive Technology (ART) provides the possibility that a long-desired baby will one day be on the other side of treatment. A possibility, for some, that is pursued almost relentlessly. And at crippling costs.
Since the first birth using in vitro fertilization (IVF) in 1981, it has become the most common and successful form of Assisted Reproductive Technology (ART). Based on data from the CDC, there were 326,468 Assisted Reproductive Technology (ART) cycles performed at 449 reporting clinics during 2020, resulting in 79,942 live-born infants. And approximately 2.2% of all infants born in the United States every year are conceived using ART, the most successful being IVF. As such, IVF has become an increasingly viable route to parenthood for many women and birthing people facing fertility challenges.
But while the popularity and success of IVF seem to have skyrocketed, the treatment is still largely inaccessible for the average American hoping to conceive. For one, IVF treatments are not usually covered by insurance. And they are expensive. According to Fertility IQ, the average cost of a single cycle of IVF is over $20,000.00, depending on where the treatment is performed. In New York, the base cost is around $24,000. And in L.A. $26,000. Those figures can quickly double, or even triple, considering that the average IVF patient undergoes at least 2 cycles, and when extra costs like medication, lab fees, and storage are added on. And like access to all clinical treatments hampered by systemic racism, Black women are disproportionately affected.
Perhaps, though, the heaviest burden of IVF is not the financial one. IVF treatments are notoriously demanding, both physically and mentally. A successful cycle of the treatment entails 1-4 daily injections of medication for up to 14 days. The medication stimulates the development of multiple eggs, helps eggs mature, and prevents premature ovulation. Then if enough eggs reach maturity, they are retrieved in an outpatient surgery before they are fertilized and if all goes well, a healthy embryo will be implanted into the uterus in hopes that it will one day be delivered as a baby. But more often than not, it takes sever cycles to produce a viable pregnancy. And many women and birthing people carry physical and emotional scars long after the treatments have ended. One study from the UK revealed that half of the women who undergo infertility treatment experience PTSD. Sometimes, even after the desired result of a baby.
And while the success rates of IVF have certainly gone up since 1981, most first cycles of the treatment do not result in a birth. In 2017, only 33% of treatments in a first cycle resulted in a birth. And according to a CDC success rate calculator, a 34-year-old woman would have a 34% chance of a live birth after a first cycle. That chance increases to 70% by cycle 3. But as for older women, those percentages dip significantly. A 2015 publication from the Journal of the American Medical Association indicated that it would take 6 cycles for a 31% chance of a live birth for a 40-year-old woman. But it is still a possibility, albeit slim, that for some is worth the hefty price tag.
In recent years, there has been an increase in the demand for regulation of the fertility treatment industry. In 2020, a report published by NBC called for an independent government body “to regulate the fertility industry” amidst concerns that clinics are exploiting the hopes of hopeful parents for profit. And with the cost of treatments almost completely privatized and rising, the infertility treatment industry is booming. IVF accounted for $4,905.46 million of the market in 2020 and is expected to reach $5,563.06 million by 2027. A sign that even despite the exorbitant financial, physical, and mental tolls, women, birthing people, and couples will continue to look to IVF to help them realize their dreams of conceiving, and having a baby.