How often does IVF succeed, and how much does it cost?
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More than 9 million babies have been born using assisted reproductive technologies like in vitro fertilization. But the treatments, which can be expensive as well as physically and emotionally challenging, aren't always successful.
This week, Jennifer Aniston spoke with Allure magazine about her unsuccessful efforts to get pregnant through in vitro fertilization. Aniston told the magazine she "would've given anything" to have had someone tell her to freeze her eggs when she was younger.
In vitro fertilization is a medical procedure that involves retrieving eggs from ovaries and fertilizing them with sperm outside the body, forming embryos that are then transferred to the uterus.
While IVF is the most effective solution for someone having trouble conceiving a child, the process is intensive, and the treatment can cost tens of thousands of dollars. The Washington Post interviewed reproductive endocrinologists and infertility experts about in vitro fertilization, the treatment, the costs and the likelihood of success.
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How often does IVF succeed?
The success rate for any individual going through IVF depends on their age, the number of cycles they go through to develop viable embryos and their overall health.
In a national report from 2019, the Society for Assisted Reproductive Technology (SART) found that 55 percent of women under 35 had a live birth after a cycle of egg retrieval. The number was 4.3 percent for women over 42.
Valerie Lynn Baker, the director of the division of reproductive endocrinology at the Johns Hopkins University School of Medicine, describes IVF as a helping hand for people who want to have children.
"Some people assume it's a cure for all infertility, but there is no guarantee," Baker said. "It's a humbling field to work in, and many times I wish I could do more."
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How long does IVF take to start and complete?
The timeline can vary, but one cycle of IVF can take two to three weeks from the start of hormone injections to implantation of the embryos into the uterus. If genetic testing is performed, it can add another two weeks or more to the process.
"After you learn the details of the IVF cycle, it can be pretty foreboding," said Dan Lebovic, a physician at Washington University who specializes in fertility and reproductive health. "But this is amazing technology that has been developed in the past decades to enable someone who otherwise would not be able to get pregnant."
Patients first undergo self-administered hormone injections for anywhere from eight to 12 days. The injections stimulate egg production. During this time, patients will complete bloodwork and ultrasounds to check the maturity of the eggs.
Within a few weeks of starting the injections, a woman's eggs will be harvested using a needle typically inserted through the vagina using guided ultrasound, and sometimes the abdomen. Allison K. Rodgers, a physician and fertility specialist at Fertility Centers of Illinois who went through IVF herself, said patients usually need to take one day off from work after the initial procedure to retrieve the eggs.
"You wake up and, you know, someone stuck a needle in your ovaries," Rodgers said. "So, it feels pretty crampy."
Once the eggs are harvested, the egg is fertilized with the sperm. It takes about five or six days before the embryo is ready to be transferred into the patient's uterus. Preimplantation genetic testing can add additional weeks to the process.
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Is IVF painful?
IVF can be mentally, physically and emotionally painful. In many cases, one of the biggest complaints is bloating and pain some women face during the ovarian stimulation process, where hormones are injected to produce multiple eggs for retrieval.
Some women feel positive during the process because "they know that they are doing the most proactive treatment," Baker said. "It can be especially difficult if the chance of success is not high or if a person has experienced prior failure of IVF treatment."
Treatments often compound estrogen levels, causing some people to become anxious, irritable and moody.
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What does IVF cost?
A cycle of in vitro fertilization can cost anywhere from $10,000 to $25,000, but the total cost varies, depending on whether patients decide to pay for genetic testing or other procedures to increase the likelihood eggs develop into healthy embryos.
The process of freezing your eggs, which can provide someone more time before they start a family, will cost patients "around $8,000 or so," said Ashley M. Wiltshire, a reproductive endocrinologist at Columbia University's Irving Medical Center.
Depending on your state and the company you work for, your insurance may cover some or all of the costs associated with IVF.
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How long after trying to get pregnant should someone consider IVF?
For women younger than 35, doctors advise trying to conceive naturally for at least a year before starting IVF. For women over 35 years old, the guidance is to consider IVF after six months of trying to conceive. People with a hormonal disorder, such as polycystic ovary syndrome or endometriosis, might be advised to consider reproductive technologies sooner.
In one lifetime, a woman ovulates around 360 eggs, said James Grifo, the director of the NYU Langone Fertility Center. Meanwhile, men produce new sperm every three months. And the biological disparity has led to fewer options as women get older.
"The older the eggs are, the fewer of them make healthy embryos that make babies," Grifo said.
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Are there ways to increase your chances of success with IVF?
Patients are advised to stop smoking and limit alcohol consumption during IVF treatment. But doctors say there is little a person can do to increase the odds of getting pregnant.
"It's really frustrating," Grifo said. "We're used to being in control of things."
Age is the single most important determinant of success with IVF, so starting sooner can improve your odds. Doctors advise patients to exercise and eat a healthy diet, but there's no way of knowing the "true impact" of diet and lifestyle on someone's fertility, Wiltshire said.
Schon added there is not enough research supporting diet changes or adding supplements to your routine. "We don't have rigorous data that supports any particular diet or medication that can make egg quality or egg numbers better," Schon said.
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Are there other options for infertility?
Drug treatments can stimulate ovulation to help couples conceive naturally. Intrauterine insemination (IUI) is a procedure in which the sperm is filtered into "a small concentration of the best swimmers" and placed in the uterus, getting the sperm "closer to where they need to go," said Samantha Schon, a professor of reproductive endocrinology at University of Michigan.
Surrogacy, adoption and choosing to live child-free are also options.
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