You may have heard about the forum organised in New York last month for women struggling to conceive who had experienced unsuccessful IVF. It is an important subject because it is so often ignored but looking at a review of the forum this morning, I was interested to read about an apparent “Generation IVF” of women who “were raised to believe that science can surpass Mother Nature in the tricky dance of conception”.
I know there are women who will leave it until they are approaching 40 to try to get pregnant and hope that fertility treatment will help if they’re too late – but I think most women in this situation are there by circumstance rather than by the assumption that IVF offers miracle solutions to reproductive ageing. I wonder whether the situation is slightly different in the US where the marketing of fertility treatments does seem to be more aggressive and where there is not the same regulation around clinics and the reporting of success rates.
Here, the HFEA publishes the IVF success rates for each age group nationally, and for each clinic – and so it is quite clear to anyone considering IVF that the success rates for a woman of 43-44 are 5% and for a woman of over 45 drop to just 2%. The age cut-off for treatment in the NICE guideline also sends a message that IVF is not advised for women who are over the age of 42, and would only be suggested for women aged 40 – 42 who still have a good ovarian reserve. For women in this age bracket the national success rate is 14%.
So what does drive women who are given very low odds of success to try IVF over and over again? The report says that the women at the forum talked about the pressure to keep trying even when the odds were very low, but where does that pressure come from? Should we blame clinics for agreeing to treat women who have a low chance of success? Or the media for hyped headlines about how fertility treatment can work and stories about celebrities who have had babies in their forties? Or is it something more fundamental to do with human instinct and the desire to reproduce?
Interestingly, the report says that the women of this Generation IVF have grown up with “the reproductive freedom to delay pregnancy” as if this is a given. Of course, women are free to prevent pregnancy, but they certainly don’t have the freedom to confidently delay it. I have never come across a fertility expert who would suggest that fertility treatment gives women the freedom to delay pregnancy either. Education is obviously key here – we need to work harder to get the message across that IVF cannot turn back the biological clock – but can we lay the blame for hope against the odds at any one door? I’d be interested in your thoughts..