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In Vitro Fertilization: Is It Being Overused?

Dr. Sami David was part of the medical team that performed the first successful in vitro fertilization in New York State in 1983. Now he is speaking out against overuse of IVF and championing alternative ways to get pregnant. “The most important lesson for my colleagues is to be more thorough, looking for alternative treatments instead of ‘one size fits all,’” said David in an email interview. He estimates that 50 percent of couples using IVF could find success through other avenues.

IVF Isn’t Easy

Even if you’ve only just begun researching IVF, you can see it’s not a simple solution. Each round costs about $15,000-$20,000 and the success rates vary widely depending on the patient and the treatment. According to the Society for Assisted Reproductive Technology, for women under 35, the live birth rate is approximately 41 percent per IVF cycle. For women over 40, it’s about 4-12 percent. IVF also increases the chance of multiple births, which are more likely to result in early labor and low birth weight than a single birth.

The Bigger Pitch

Dr. David isn’t saying that IVF is the bad choice for everyone. He says in certain cases — like serious, untreatable semen deficiencies, damaged pelvic organs, or when thorough testing can’t explain infertility — IVF makes sense. “My problem is that 90 percent of the patients that I see in my office have not had all the testing done, yet their specialists still label the couple “unexplained,”” says Sami.

He also takes issue with the fact that IVF has become the first resort for women who are looking to get pregnant when they’re older. It is true that the older a women is, the more likely she and her partner are going to have difficulty conceiving but many factors can affect fertility, not just complications relating to the age of the female partner. Overall, approximately 40 percent of infertility problems are from the female, 40 percent are from the male, and 20 percent result from a combination of the partners’ characteristics or are of unknown origin. So, putting all the burden on a woman and her aging eggs is misleading.

What Dr. David Suggests

There are some straightforward steps David advises for people looking to increase their fertility. David says any woman in this situation should keep a record of her basal body temperature for a month or two to figure out her fertility window. Where a partnered relationship is involved, both partners should evaluate their lifestyle habits and those of their partner. David also says that, if people want to get a semen analysis, it should be done by a specialty lab, rather than a routine commercial lab. Lastly, David says that women should avoid fertility drugs if their cycles are regular because these drugs only increase the number of eggs released.

In David’s own practice, he has helped couples conceive using an individualized mix of Eastern and Western medicine. Depending on the people, treatments may include acupuncture, vitamins, and herbal supplementation. More generally, David recommends people take a good look at their lifestyles for simple changes they can make to boost their chances for conception. Common lifestyle factors that David says can interfere with fertility:

  • Smoking
  • Not enough sleep
  • Alcohol consumption
  • Recreational drug use
  • Caffeine
  • Environmental toxins
  • Medications, even over-the-counter brands
  • Not enough exercise
  • Poor diet

woman stretching during fertility yoga

Related story: Can Yoga Help Fertility?

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