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Fertility in the News: Does The Media Have it Right?

Fertility in the newsWhen watching the news, reading an article, or viewing a blog online, you tend to find that the exciting, interesting, and unique stories are the ones that are being told. People don’t want to hear about things that exactly mirror their day-to-day lives. They want something juicy and out of the ordinary. While this trend towards the sensational is a great promotional tool for the media, it sometimes causes people to generalize their knowledge based on what they hear in one or two news stories.

Fertility specialists experience these generalizations first-hand every day, as patients see or read things in the media sphere and assume that they are true for all people. “The only treatment for fertility patients is in vitro fertilization (IVF);” “fertility patients are not eligible for insurance coverage;” and “most fertility patients have twins, triplets, or even more babies at a time” are just a few of the generalities that people assume are facts.

Here are the fictions commonly found in the media about fertility treatment and the actual reality that patients can expect:

Fiction: The only treatment option for fertility patients is in vitro fertilization (IVF).
When talking about fertility treatment, an overwhelming majority of news stories focus on in vitro fertilization (IVF). As a result, many couples considering fertility treatment assume this is the only treatment option available.

Reality: “Most of the patients I see are surprised to learn that there are many options to consider before moving on to IVF treatment,” explains Dr. Stephanie Beall, Ph.D., of Shady Grove Fertility’s Towson and Columbia offices. “Another thing that surprises patients is that I consider IVF treatment to be as significant of an undertaking as they do. It is not something I take lightly, which is why I always suggest the least invasive and most affordable treatment options first.” Not every patient has to start with IVF; in fact, at SGF, about 50% of all treatment performed is a less expensive low-tech treatment option such as timed intercourse or intrauterine insemination (IUI).

Popular blog The Huffington Post frequently features content written by reproductive endocrinologists that shows the full picture for readers. Posted in June 2014, Why Fertility Treatment Doesn’t Necessarily Mean IVF: Testing and Low Tech Options are Helping Women Everyday is a great example of an accurate depiction of fertility treatment options for patients.

Fiction: Fertility treatment is rarely covered by insurance

Another aspect of fertility treatment frequently covered in new stories is the cost. Many stories would lead you to believe that insurance rarely covers treatment and that patients will need to pay tens of thousands of dollars out-of-pocket.

Insurance Coverage ChartReality: Currently, SGF participates with over 30 insurance companies. Of patients with insurance coverage, approximately 90% will have coverage for their initial consultation and 70% of those patients will go on to have some level of coverage for their testing and treatment.

When it comes to insurance coverage there are two big factors that directly impact the ability to access insurance coverage for treatment: your employer and the state in which your employer’s human resources department is located. All benefit packages are employer-driven; as a result, they hand -select the level of coverage for fertility treatment – if any – that is then offered to employees. The second factor is surprising to many: some states have laws on the books mandating employers to provide coverage for infertility treatment. These laws cover employees of companies based in the state, but not all residents who live in the state. This is an important distinction, especially in the D.C. metropolitan area, as it is common to be a resident of Maryland with a job in Virginia or D.C. While Maryland has a state IVF mandate, D.C. and Virginia do not. This past April, during Infertility Awareness Week, media focused on just how “fertility-friendly” each state in the U.S. can be. Two media pieces that can help patients understand their ability to access coverage include a story by Time magazine titled “The Best and Worst States for Infertility and ‘Fertility Scorecard’ for your state by Colorado’s Channel 9 local news station.

Fiction: The majority of women who undergo IVF treatment will have twins, triplets, or even higher order multiples.

In the media, the majority of stories focusing on couples undergoing fertility treatment show twins, triplets, or even more babies being born from a single treatment cycle. This leads viewers to assume that all fertility treatment ends in this manner, when in reality the proportion of singleton births to multiples is heavily in favor of singletons.

Reality: “The increased risk of multiples is equally concerning for reproductive endocrinologists,” explains Dr Beall. “We know how risky and dangerous multiples can be for both the mother and babies and it is for this reason we always strive for a singleton pregnancy.”

Over the past several years, the physicians at SGF have been pioneers and advocates for choosing to electively transfer a single embryo. Our elective single embryo transfer (eSET) program data has shown that transferring a single high quality embryo in a good prognosis patient results in a pregnancy rate similar to transferring two embryos – but with a drastically decreased chance of multiples.

The silver lining in stories highlighting high order multiples is that reproductive endocrinologists now have a platform and opportunity to explain the true risk of multiples. It also gives them the chance to debunk a common myth associated with fertility treatment: that the chance of multiples is higher than the chance of a singleton pregnancy when undergoing fertility treatment. “When it comes to transferring embryos, in many cases less is more,” explains Dr Beall. “Women electively choosing to participate in SGF’s eSET program by only transferring  a single high quality embryo have approximately a 1-2% chance of twins – which is the same as a woman’s natural chance of spontaneous twinning.”

2013 Success Rates for Elective Single Embryo Transfer (eSET) vs.
2 Blastocyst Embryo Transfer (2BET)

IVF Using Own Eggs IVF Using Donor Eggs
eSET 2BET eSET 2BET
Transfers (ET) 1138 730 531 264
Clinical Pregnancy (%ET) 661 (58%) 427 (58%) 321 (60%) 150 (57%)
% Twins 8 (1%) 184 (43%) 5 (2%) 53 (35%)
% Triplets 0 (0%) 5 (1%) 0 (0%) 1 (<1%)

 

As the tides continue to turn, news outlets are starting to follow suit when it comes to their reporting on the realities of multiples and fertility treatment. One such example showing the realities of fertility treatment and multiples comes from a late 2013 article from the LA Times: “Risks of twins, triplets may prompt IVF patients to opt for singletons.”

Fiction: Pregnancy can happen at any age.

Across magazine stands all over the world, you can frequently find celebrities of all ages donning the perfect baby bump. Many of these ladies are in their 20s and 30s, which is certainly not something you would find surprising, as most pregnant women you already know fit this demographic. But it seems that for every pregnant twenty-something, there is a woman in her mid-to-late 40s expecting as well. While some, like Marcia Cross, have come out sharing their experience with fertility treatment, most have not. If a celebrity uses fertility treatment, does that mean they should automatically disclose such personal information? No, absolutely not, but the problem with their silence is the perception that it creates.

ChartReality: “Many of my own patients are surprised to learn that their age is affecting their ability to conceive. They go on to cite numerous examples of celebrities in their mid-to-late 40s that have conceived on their own and understandably ask “If they can, why can’t I?” explains Dr. Beall.

Dr. Beall goes on to explain, “In reality, the chances of natural conception each month – once a woman enters her 40s – is less than 5%; with the chance of miscarriages steadily increasing. These trends continue into a woman’s mid-to-late 40s, where her chances of natural conception fall to nearly zero.” The good news though is that advanced age doesn’t necessarily mean that pregnancy is no longer an option. Technological advances such as donor egg treatment, the most successful of all treatment options for women in their 40s to early 50s, offer the opportunity to continue building a family safely and effectively.

“When it comes to age, we aren’t trying to rush women. We want to make sure that they are informed of their options so that they can plan for future family building,” explains Dr. Beall.  Recently, there have been many articles from popular bloggers like The Huffington Post and The Daily Mail to hard-hitting news outlets like the Wall Street Journal exposing the impact age has on the ability for a woman to conceive.

 

Fiction: Apple and Facebook are paying for egg freezing because they want women to focus on their careers instead of on family planning.

eggsJust a few weeks ago, the news broke that tech giants Facebook and Apple would be offering their employees coverage for egg freezing and the media was atwitter. At first, the news brought a sense of promise that the tide was changing and that more women would be able to proactively plan for their future, parenthood included. Not long after the announcement, the backlash started. Women’s groups criticized the companies for selfishly offering their employees the ability to hold off on family to focus on their career; something they felt directly benefited one group… the employer.

Reality: Given the headlines, this backlash is understandable. But missing from the exciting headline was the full scope of what the companies were offering their employees: the ability to not only access up to $20,000 for egg freezing through their insurance benefits, but coverage for IVF and donor sperm treatment as well. The reality is that if the entire story had been told from the beginning, the backlash wouldn’t have been so drastic, as critics would have acknowledged that Facebook and Apple were offering immediate family building options to employees as well. Online tech blog Wireless Week provided readers with the most comprehensive coverage of the announcement.

It’s always beneficial to remember that while the media is not presenting news stories to be malicious or disingenuous, they are always going to tell the most extraordinary stories. Whether it’s a discussion of Octomom, a 48-year-old celebrity having twins, or highlighting IVF over low-tech treatment options, the facts are present, but they’re also obscuring that those situations are not the reality for most fertility patients. At SGF, we have many resources for patients to discover the realities of fertility treatment, including physicians, nurses, social workers, financial counselors, and more. ShadyGroveFertility.com can also be a great informational source for those who want to find out more information but may not yet be ready to schedule an appointment.

If you would like to schedule an appointment with a fertility specialist, please speak with one of our New Patient Liaisons at 877-971-7755.


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