THE VIRGINIAN-PILOT
Copyright (c) 1994, Landmark Communications, Inc.
DATE: Saturday, November 12, 1994 TAG: 9411120147
SECTION: FRONT PAGE: A6 EDITION: FINAL
SOURCE: BY DEBRA GORDON AND DIANE TENNANT, STAFF WRITERS
DATELINE: SAN ANTONIO LENGTH: Medium: 68 lines
Australian doctors say an in-vitro fertilization technique that uses no fertility drugs could cut costs by a third and reduce medical risks for women undergoing the procedure.
However, the process has a low success rate and other costs associated with the technique could eliminate any savings, according to the Jones Institute for Reproductive Medicine.
The technique was discussed in San Antonio this week at the American Fertility Society meeting.
The procedure, in which immature eggs are collected from a woman's ovaries and then matured in a petri dish, fertilized and implanted in her uterus, negates the need for fertility drugs. Recent studies have shown the drugs may contribute to ovarian cancer.
But pregnancy rates are much lower using this technique, and the cost of fertilizing the eggs may offset the savings from less drug use, said Dr. Suheil Muasher, director of advanced reproductive technologies for the Jones Institute of Reproductive Medicine in Norfolk.
Most women who undergo in-vitro fertilization (IVF) must take fertility drugs for up to two weeks to stimulate their ovaries to produce several mature eggs at once, instead of the one egg typically produced each month.
The drugs, Pergonal and Metrodin, are typically not covered by insurance and cost from $2,000 to $3,000 of the $8,000 to $10,000 cost of the IVF.
``It would increase women's access to IVF while reducing the cost significantly,'' said Alan Trounson, deputy director of the Institute of Reproduction and Development at Monash University in Australia where the procedure was developed. Monash has had two successful births in women using this procedure, Trounson said. Four pregnancies using the technique have been reported in Sweden.
In the United States, IVF America, a chain of Connecticut-based infertility clinics funding Trounson's research, has used the procedure on three women.
One became pregnant, but miscarried early. One did not get pregnant, and the third women will know if she's pregnant next week.
``My main problem is the fact that you can do it doesn't make it better,'' Muasher said. Jones has also cultured immature eggs and implanted them, but pregnancy rates have been low, Muasher said.
``When you transfer embryos that only come from immature eggs, the chance for a live birth to occur is, in our experience, under 5 percent,'' he said.
``The main difference with this technique that the Australians are proposing is that there will be no fertility hormones.''
Trounson said the procedure results in a pregnancy rate of less than 10 percent, about one-third the success rate of traditional IVF. But, he said, that rate should increase dramatically as research refines the procedure. He pointed to the procedure's success in cows, where pregnancy rates exceed 25 percent.
``If we can match the success rate to that in cattle,'' he said, ``we've got a terrific system.''
Trounson said the new procedure allows fewer fertilized eggs to be placed in the uterus, reducing the risk of multiple pregnancies. That, coupled with reduced cost, should make IVF more attractive to private insurers who have been loathe to cover it, Trounson said.
But, Muasher said, the cost savings may be offset by the need to use micromanipulation, such as direct injection of a single sperm into the egg, to fertilize it. Immature eggs that are cultured in a petri dish often develop harder-than-usual shells, requiring extra effort to fertilize them. by CNB