By cutting equipment costs, researchers find a cheaper path to conception.
Most parents will say their child is priceless, but that doesn’t mean that having one is cheap.
For couples struggling with infertility in the U.S., in vitro fertilization (IVF)—the transfer of fertilized human eggs into a woman’s uterus—adds up to an average bill of $12,400, according to the American Society of Reproductive Medicine.
While that’s a steep cost even for a couple in the developed world, that price tag puts fertility treatments out of reach for much of the developing world. Until now.
In a joint project with the Walking Egg Project, a study published in Reproductive BioMedicine Online found that a cheaper IVF strategy is possible by cutting equipment costs for the insemination and embryonic culture before embryo transfer. The study resulted in clinical pregnancy and live birth rates of 34.2 and 29 percent respectively.
In the U.S., around 40 percent of IVF cycles resulted in a live birth for women under 35 years of age in 2011, 32 percent for women between 35 and 37 years of age, and 21 percent for women between 38 and 40 years of age, according to the Society for Assisted Reproductive Technology.
“The findings suggest that a significant first step has been achieved in the effort to bring advanced assisted reproduction to developed countries using a low-resource but highly effective IVF system,” the study says. The aim of the study is to bring modern reproductive medicine, previously only available to those who could afford it, to infertile couples across the world.
The lower cost treatment addressed bilateral tubal occlusion, or the closure of both fallopian tubes, the most common cause of infertility for couples in low-resource and developing countries.
Surprisingly, the way to cheaper IVF isn’t through any novel approach—it’s just about being excessively cost efficient. Surgical egg retrieval, embryo transfer, laboratory staffing, and egg or embryo freezing are still a part of the more cost-effective treatment, but by using equipment that is less expensive yet yields similar results, it’s possible to cut costs.
However, “exact treatment costs are difficult to predict and are likely to be location specific,” the authors write.
In 2009, researchers began exploring the possibility of a closed culture system that resulted in reliable preimplantation embryogenesis using an inexpensive, disposable, 10 millimeter glass vacuum container (vacutainer).
After testing on mice, researchers initiated a pilot clinical study in 2012 in Genk, Belgium. Thirty-five of the 40 women enrolled in the study underwent single embryo transfers, 23 of which were selected by an independent embryologist unaware of the new, more cost-effective IVF system.
Clinical pregnancies resulted in eight of the 23, with one miscarriage at eight weeks. Of the 12 cases with normal IVF embryos, only two clinical pregnancies resulted.
As of June 2013, seven healthy babies were born from the simplified culture system, four boys and three girls. The routine IVF pregnancies resulted in two healthy girls.
“Although access to IVF is largely commonplace in developed countries, affordability remains the central issue for many in need of treatment,” the study says.
The markup on traditional IVF is based on the need for specialized medical-grade gases or equipment like cultureware, microprocessor-controlled tissue culture incubators, large area air filtration systems, and systems requiring medical-grade gases nitrogen, oxygen, and carbon dioxide. This is on top of replacing and repairing equipment.
High laboratory costs can often add up to approximately 50 percent of the financial burden associated with IVF attempts, the researchers say.
The Walking Egg Project hopes to address the fertility gap in resource-poor countries through studies like this. The project aims to make assisted reproductive technology accessible for a larger population around the world.