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IVF Doctors Discuss The Future of Fertility Care

March 12, 2015 – Experts Down The Hall – Ronald Feinberg

Source: Forbes – February 28, 2015

Dr. David Sable, a Forbes columnist and retired reproductive endocrinologist, recently wrote about the trends that he believes will define the future of in vitro fertilization (IVF). In his column, he wrote that genetic testing will help prevent disease, procedures will be standardized, and potential cost reductions in IVF treatment will significantly change fertility centers as we know them today. As decision-making for care increasingly shifts to insurance companies and as social scheduling services like ZocDoc become more popular, centers will respond by creating partnerships and mergers to maintain brand quality.

The fertility technology used in the centers will see a great leap forward as well. Techniques used today like intracytoplasmic sperm injection (ICSI) will be replaced with treatments to create egg precursor cells in women with poor ovarian reserve and quality. Other techniques, such as mitochondrial donation, will help prevent mitochondrial diseases from passing from parent to child. With these new techniques, he believes the need for egg donation will disappear as women increasingly use their own eggs to build their family.

While automation and efficiencies of operations are important to lower costs, human interaction between patients and their caregivers will always receive the highest priority.

In this new environment, it will be important for patients to research centers with the latest treatment options and highest success rates. Sable said this is already happening, and has led to what he refers to as medical tourism—patients traveling to other countries outside the United States to bypass its high regulatory barriers. Overall, he hopes that advancements in fertility care will become “safer, more efficient, and less costly.”

From Our Expert, Dr. Ronald Feinberg

“The future of IVF is big and bright, but fertility care will still need to remain private and personal to be successful.”

In general, I agree with many of Dr. Sable’s points. However, one aspect of our specialty that I believe will continue to be paramount will be the patient-physician relationship and the very private and personalized nature of reproductive therapies. While automation and efficiencies of operations are important to lower costs, human interaction between patients and their caregivers will always receive the highest priority.

The overall costs of IVF therapy are actually much less expensive than 20 years ago, taking into account general healthcare inflation and the marked improvement in IVF success. As our specialty responds to the clear need for healthy, singleton pregnancies, the indirect costs of IVF, such as in the care of multiple gestations, will drop dramatically. Employers and insurers are beginning to realize how safe and effective IVF can be, especially if we perform single embryo transfer.

The tools that use sophisticated and accurate molecular DNA testing are rapidly improving. When centers use current methods such as pre-implantation genetic screening (PGS), success rates with a single embryo transfer can often be improved 100 to 300%, especially in patients who are over 34 years old. Miscarriage rates are much lower when PGS is employed. As a maturing technology, DNA testing will prove to be a very important cost-effective adjunct to IVF treatment.

RADfertility’s physicians and professional staff closely evaluate every new reproductive technology, and try to make evidence-based decisions when we consider adopting new advances. To that end, we have very successfully incorporated PGS, the EmbryoScope® incubator, egg cryopreservation and banking, and fertility preservation.

One of our major goals at RADfertility is to help society understand that the right to build a family through effective and safe reproductive therapies should be a high priority in the U.S., and should be available to all who could benefit.

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