Interesting Article..

Hi,

Just thought I'd start a new thread where we could share/discuss interesting articles, studies or tid-bits relating to IVF!

There was an interesting article on the Medical Journal of Australia's web site today about the costs associated with IVF, called:
Assisted reproductive technology treatment costs of a live birth: an age-stratified cost–outcome study of treatment in Australia
(Hope it doesn't scare anyone's bank balance!! 8-[ :shock: )
I don't think I'm allowed to post the web site address - feel free to PM me if you'd like it.

And did anyone see the recent article in the papers about the 50 year old IVF mum who initially claimed her pg was due to Amazonian herbs? :gossip: Pssst I also heard that she used donor eggs - not sure if that's true though.

Cheers
Heather

Great idea Blue, pays to be reliably informed.
Interestingly, I heard on the 6am news on Sunrise this morning something about the average cost for a woman over 40 to achieve a pg through ivf is $98,000? Mind you, I had just woken up and wasn't quite with it and they didn't repeat the story. I'm curious if anyone else heard it, what they actually meant. $98K oop after x amount of attempts to achieve pg? Costs the govt $98K? Just wondering where the figure came from. Maybe they were referring to the same report you are. I'll have the address please.
Hadn't heard about the egg donation bit but think I heard she fibbed about it not being ivf after all.

This was in today's West Australian:

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Forties too old for IVF babies: AMA

MEGAN SADLER

Women should consider having children younger because the high emotional and economic cost of conceiving by in-vitro fertilisation as they age is too great, according to the Australian Medical Association.

WA Federal AMA councillor Rosanna Capolingua said yesterday that a new study which showed how IVF costs grew with the age of the mother meant that limiting access to the treatment should be debated.

A report for release today by the University of New South Wales shows IVF is three to four times more expensive for women over 40.

The report, published in the Medical Journal of Australia, said the direct health cost of non-donor IVF averaged $32,903 for each live birth.

For women under 30, the average cost was $24,809, rising to $97,884 for women 40 or over. For women aged 42 or over, it was $182,794.

Dr Capolingua said women could not afford to rely on IVF if they delayed parenthood until their 40s.

"The dollar value of women embarking on IVF over the age of 42 is significant but the other thing is the emotional cost because the success rate is so low," Dr Capolingua said. "It is time we started looking at it more carefully."

Dr Capolingua said suggestions earlier this year, backed by Federal Health Minister Tony Abbott, for a cap on the number of IVF treatments eligible for Medicare rebates could be seen as discriminatory.

But while many people felt uncomfortable about such a proposal, the report was likely to spark renewed debate about a limit.

Reproductive biologist Bruce Bellinge, from the Concept Fertility Centre, said it was offensive to discriminate based on age.

"If you try to suggest treating older women is less cost-effective and shouldn't be done, then we should seriously consider not doing heart transplants on older people," Dr Bellinge said.

"A lot of women work all their reproductive lives, contributing . . . to the economy, paying taxes and the Medicare levy and are entitled as much as anybody to get something back for their health dollar."

A researcher at the University of NSW's school of women's and children's health and co-author of the report, Georgina Chambers, said debate on IVF funding had been hindered by few economic studies of IVF treatments and outcomes in Australia.

She would not comment on whether a cap should be introduced but said: "Cost is not the sole consideration".

Less than 10 per cent of women over 42 were seeking treatment and assisted reproductive technologies only consumed 0.2 per cent of the nation's private and public annual expenditure on health care.

WA Health Minister Jim McGinty and Mr Abbott declined to comment.

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BTW did I say I love my clinic? Good on ya Concept for being the voice of reason!

love
sushee

Thanks Sue,

I've e-mailed you the link to the article. And I think they were referring to the same study. I believe they're looking at the total cost including clinic fees, pharmaceuticals, hospital costs etc.

I'm not sure that the donor egg part was true (read it on another site...). I kinda understand why she feels as though it wasnt the IVF - if cycle after cycle you're following the same protocol and nothing has worked and then after taking the Amazon herbs (sorry, cant remember what it actually was) and the same protocol that it works - I'd be putting it down to the herbs too.

Cheers!
H

Sushee, I love your clinic. Hooray to Dr Bellinge, especially his second paragraph. I've been working without a break for 25 years. Hmmm, maybe I should add up the tax and medicare levy I've been paying.
Thanks for the article Blue, have just read it. Lucky I've hung up my boots! I had no idea I was "less cost effective". Ha, it's probably true, but gee, I never thought of myself that way.
I wonder if they're going to go through with the funding cuts?

I saw this yesterday in the paper. Sounds like at least some doctors (not the Mad Monk) have their heads on straight.

It makes me cross when people who have abused their bodies their whole lives can get organ transplants and ongoing hospital treatment when they need it and nobody says a word. But because this is about reproduction, it's a real hot potato and something on which everyone seems to have an opinion. Also nobody ever mentions how much IVF patients pay in the way of out of pocket costs so they more than fairly contribute to the cost of their treatment.

What's interesting in this whole debate is how it's put back squarely in the lap of the woman. There are very few articles that talk about involuntary childlessness ... the situation where a woman would dearly love to have children but cannot because she hasn't met a partner or there are other circumstances preventing it. It's all very well to say we should have children when we're young but sometimes that just isn't possible.

Oh yes a friend told me about the Amazonian herb woman. Apparently it was donor eggs.

I must admit that this topic does get me fired up! :fuming: I'm a case of someone who has never met the right guy to start a family with. It really cheeses me off when they put all women in their late 30's and over in the same 'decided to wait' category. We don't all have a choice. One woman might be waiting for Mr Right, another may have spent years trying to get pregnant with no success, another may have been in an abusive relationship - there are so many different reasons women go through assisted conception in their 30's and 40's.

And I bet the people commenting against it have 'perfect' families and have never had to deal with fertility problems. As already mentioned, I can't believe they would consider putting restrictions on access to IVF and yet not look at other areas like Melbo & Dr Bellinge commented on.

This is such a difficult journey to go through at the best of times - but to take away or limit women's AC options because the Government wants to save a few bucks and obviously think that women with fertility problems are a waste of time, makes me furious!

The Government are quick to offer money as incentive for women to reproduce UNLESS you have a fertility problem & need some assistance and then we don't want to know about you! That's really fair!

And of course there is the argument that the majority of women embarking on AC in their 'latter' reproductive years have paid their taxes and medicare levy for years - don't they deserve to get something back if needed?

Why don't pollie's cut back on all their 'perks' and that would easily cover the cost of IVF treatment across the whole country for years to come!

Okay, I'll get off my soapbox now! :soapbox:

Marg

I won't even start on this topic. Those of your who have been around a while know exactly what a pet hate this is of mine. The decisions about IVF, whether to take on a patient based on age or whether to transfer 1 or 2 embryos, should be one made by the Dr and his IVF patient. It is not a political issue, neither (and more importantly) is it a moral issue. And this is because only someone who has had to battle infertility, and have had to undergo AC, will know how hard it is, and how much you have to sacrifice for it. And until you do, you should not deem yourself capable of passing judgement on it.

Okay, I've started ranting again, so shall shut up now.

love
sushee

That's what I love about this place. People understand!

Marg, seems we have more in common than just the love of a beautiful black cat.

Sush - Don't shut up. Ever.

They may have come to their senses!!
Happy new year girls! \:D/

Taken from The Age:

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Costello dumps IVF Medicare cuts
January 1, 2006 - 5:49AM

Medicare funding will not be restricted for IVF treatment, Federal Treasurer Peter Costello said.

Mr Costello said he dumped the controversial plan to limit Medicare funding for women undergoing IVF treatment, preempting a report on the issue by Health Minister Tony Abbott due next month, the Sunday Age said.

Under a Health Department proposal raised last year, Medicare funding for IVF would have been limited to three treatments for women aged over 42 and three cycles a year for younger women.

The plan would have saved $52 million over four years but the plan was shelved in May, and the inquiry called, following criticism by doctors and some Liberal MPs.

"I'm not planning to revisit that," the newspaper quoted Mr Costello as saying.

"I think we had a debate about that last time.

"I think we came to the right conclusion."

A spokesman for Mr Abbott said the Health Minister was on leave and was still awaiting the report

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I heard that tonight H
I'm glad they got it right!!
Bec

that is good news for many people -thanks for sharing

It is about time they applauded those trying to help him achieve his population growth dreams

MR Abbott might not like it but he go jump (on some other bandwagon)
_________________
Trish :heartbeat:
IVF #2 BFP Twins
DD :angel: Charlotte Rose 1/9/04 26wks

Yes I saw this on the front page of The Age yesterday.

Happy New Year to us all!!

It's not very often you can say 'good news' and 'politics' in the same sentence! LOL! \:D/

Marg

=D> =D> =D>

It's funny but when the IVF cuts story was first leaked, I got all up in arms and remember clearly being told my well-meaning friends and family that one person couldn't change the govt's mind, esp since they had the majority in the senate.

I think that if all the wonderful men and women who wrote in to Tony Abbott and their various MPs, got petitions signed and created the uproar that they did believed those people who said that they couldn't change anything, these cuts would still be on the table.

Yay for the govt coming to thier senses and what incredible news for infertile women in Australia. With everything that we already go through, this, at least, is one less thing to worry about!

love
sushee

Hi everyone.
Thought I'd dust off this thread started by Heather. A friend found this Cochrane Review on an American Endo.org site and I thought it was interesting:
A Cochrane review has found that endometriosis patients who use gonadotropin-releasing hormone (GnRH) agonists in the run-up to IVF have improved outcomes.
GnRH Agonist = Synarel, Lucrin, Lupron, Buserelin etc.
In a systematic review of the existing literature, reviewers, led by Professor Hassan Sallam, from Alexandria University in Egypt, found that giving GnRH agonists to women with endometriosis for 3-6 months before fertility treatment increased their chances of becoming pregnant more than four-fold.
"The chances of having a live birth are also increased, though currently the data are not strong enough to show how great that increase is," said Sallam.
Overall, the chances of pregnancy are lower for fertility patients who have endometriosis than for those who have problems with their fallopian tubes.
It has been thought that endometriosis may impair egg development and prevent the ovaries producing viable eggs, but Sallam says there are currently no data to show whether the treatment leads to better eggs or whether it facilitates implantation.
In addition, there are no results to show whether one particular agonist is superior to the others, or whether the effects of therapy differ in women with mild or severe endometrial disease, the reviewers explain.
SOURCE
Sallam HN, Garcia-Velasco JA, Dias S, Arici A. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis. Cochrane Database of Systematic Reviews 2006; 1.

In response to Keen's post and Sue's suggestion to move back in here...

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Quote:
Study Finds How Embryo Sticks To Uterus
January 16, 2003
WASHINGTON (AP) -- In research that could lead both to new ways to treat infertility and new types of contraceptives, scientists have identified molecules that help embryos stick to the wall of the uterus.

Timing is everything, the study shows.

By analyzing carbohydrate molecules on the surface of the uterus during different times of the female cycle and by identifying a protein, called L-selectin, on the surface of the embryo, researchers at the University of California, San Francisco, learned for the first time how the embryo sticks to the wall.

Susan J. Fisher said coatings on the uterus and on the surface of the embryo act like puzzle pieces that touch and quickly lock.

"One piece of the puzzle is a protein on the embryo and the other is a very specialized carbohydrate sugar structure," said Fisher.

The sugar molecule on the surface of the uterus is secreted for only a short time during a woman's monthly cycle and the embryo, with its L-selectin coating, must arrive at the uterus during this time.

"It has to take place in exact synchrony or you don't get pregnant," said Fisher, noting that failure to implant on the uterus is one of the most common causes of a failed conception.

"Only 50 to 60 percent of all conceptions advance beyond 20 weeks and of pregnancies that are lost, 75 percent represent a failure of implantation," she said.

With this understanding of implantation, researchers may find new ways to help women time their efforts to get pregnant, both naturally and in fertility clinics.

Fisher said it may be possible in fertility clinics to coat embryos with the sugar molecule and help uterus adhesion.

"If we can launch the implantation (process) in the culture dish then you might be able to implant fewer embryos and have greater certainty" of a successful pregnancy, she said. Currently, fertility clinics can prompt successful pregnancies 25 to 40 percent of the time. By more precisely timing implantation, based on the readiness of the uterus to adhere to the embryo, these chances could improve, said Fisher.

......

Dr. Phyllis Leppert, chief of the reproductive science branch of the National Institute of Child Health and Human Development, said the discovery by Fisher and her co-authors "is a breakthrough" that may lead to fundamental new treatments for pre-eclampsia and for a major cause of infertility, poor adhesion to the uterus after conception.

"This is a new lead that we can pursue," she said.

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This is a subject that has been really on my mind, and even more so since my last failure. I've been trying to do a bit of research on this type of thing and other endocrine abnormalities.

Thanks Keen for posting this. I'm going to ask my FS about this when I see him on 26th.

I hadn't heard of this but had been trying to find out more about beta3-integrin which some clinics test for. Apparently if you don't have beta3-integrin the embryo can't implant. I'm still trying to find out more about this test and others that might help with diagnosing this kind of problem.

Apparently the lining is only ready for 2 days each month and that 2 days can be really out of whack with your ovulation if you have a luteal phase defect.

Has anyone had tests for this type of thing? My clinic just seems to go on the thickness of the lining.

Hi Kar
I was never tested for that.
My clinic for my last two cycles were looking for a triple lined uterus (I think that's what they called it)? I asked about thickness and they told me they just look for the triple line. Still not sure what that means as the scientist didn't give a very good explanation.
Sue

Sue
I seem to recall that term being used as well.

One of the nurses at my clinic also called it the leaf shape.

I think the triple line may refer to how the endometrium looks on the ultrasound. The three lines refer to the lining on the walls of the uterus and the infitessimal gap between. Sort of the two slices of buttered bread thing, only leaf shaped or with the appearance of three lines.

Not sure though... could just be one of my imaginary theories.

Hi All
I have a growing collection of articles about the (favourable) effect of accupuncture and now even one on hypnosis and ET.

Most are from this year so they are very recent.

If anyone wants copies PM me and I'll send you the PDFs.

EDITTED TO ADD: I have now put the articles on my webpage (well most of them! there are heaps so I'll keep updating it from now on) - the site is listed in my profile.

I also have a number of recent medical journal articles about the cumulative probability of pregnancy through a number of cycles - some break this down by age, type of subfertility, icsi/ivf or other categories that can be insightful.

If you want something PM me.

I'm going to try to list them more comprehensively on my website when I get that up and running.

EDITTED TO ADD: I have now put the articles on my webpage (well most of them! there are heaps so I'll keep updating it from now on) - the site is listed in my profile