According to the 2009 Assisted Reproductive Technology report by the Centers for Disease Control and Prevention (CDC), “1.2 million women of reproductive age in 2002 had an infertility-related medical appointment in the prior year, and 10% of those women received infertility services at some point in their lives.” Assisted Reproductive Technology (ART) has been used in the U.S. for over 30 years as a means for couples with fertility struggles to start a family. ART includes a variety of fertility treatments, such as in vitro fertilization (IVF). Fertility treatments can be very costly, but when successful, result in the birth of a biologically related child—which is one reason parents may choose IVF over adoption.
In vitro fertilization offers a unique experience impacting couples financially, emotionally, and physically. “A single cycle IVF…costs from $7,000 to $15,000….” This may not include necessary medications or additional treatment options such as freezing embryos or sperm. In some cases IVF is also emotionally and physically draining. Like most infertility treatments, it does not offer instantaneous results, and many treatment cycles may be necessary. The New York Times reports, “…Sixty percent of couples who enter into infertility treatment come away with a biologically linked baby.”
But what about the other 40%, those couples may never conceive a child through in vitro? For many, adoption offers a welcome alternative and another chance to become a parent. However, the process of adoption also can be costly and time consuming. As MSNBC reports, “The reality of adoption is that, even under the best of circumstances, it can take years to bring a child home. And there’s the possibility of even further delays.” Sometimes, even in the most promising situations, adoptions fall through due to legal conditions or unexpected complications such as the birth mother’s deciding to parent or emotional strains, common for both adopted children and adopting parents.
Doctors and would-be parents constantly debate, and even agonize over, the question of when it is time to stop IVF treatments and to turn other options like third party reproduction choices or adoption. Assisted reproductive technologies today offer additional services beyond IVF. Third party arrangements like egg or sperm donation allow couples to use a healthy donor egg or donor sperm, coupled with their own egg or sperm to produce a child. These procedures can be useful when one of the parties is deemed infertile, has a genetic disorder, or is undergoing treatment that hinders the chances of pregnancy. Donation can also be used in conjunction with surrogacy when carrying the child is risky. The CDC reports an average life birth rate per transfer of 43% for all egg donor programs (asrm.org/factsheet).
Gestational surrogacy is also on the rise. With this ART method, parents transfer their embryos, created through IVF, to a surrogate to gestate and, hopefully, to carry the pregnancy. This is a great way to avoid attachment issues for the surrogate, as she is not genetically linked to the child. Meredith Olafson, gestational surrogate for 11 children, recently expressed her feelings about this type of ART solution to ABC News. “It is easier on families, too, knowing they are their kids—and for my family, knowing they are not related to them.” As with all surrogacy arrangements, legal agreements and financial obligations should be addressed during the matching process to simplify the process.
Ultimately, the decision falls primarily to the parent or couple, who must take into consideration their unique set of circumstances. For thousands of parents for whom adoption once would have been the only option, assisted reproductive technology offers new avenues to parent a biologically related child. ART solutions are on the rise. The Society for Reproductive Technology reports U.S. success rates for some types of ART in excess of 55% in 2010. As the CDC reports, “The number of ART cycles performed in the United States has increased… In 2009, 60,190 infants were born, which was nearly two times higher than the 35,025 born in 2000.” (cdc.gov/ART2009.pdf) The bottom line: assisted reproductive technology strategies and adoption are equally valid routes to becoming a parent, and a deeply personal choice that only the prospective parent or parents can make.