Thursday, April 14, 2011

Article: Tighter In Vitro Rules Would SAVE Babies

The front page of the Ottawa Citizen today featured an article that contains statistics that most infertiles are already aware of, and that most lawmakers and politicians in Canada need to become aware of.

Apparently, the University of Montreal has conducted a study that has been published in the Journal of Pediatrics. The findings raise the alarm about the birth of multiples as a result of in vitro fertilization or ovarian stimulation. The health issues that these babies, and their mothers, face are mind-boggling, to say nothing of the soaring costs of treatment and care.

Because the fertility industry is largely unregulated in Canada, doctors routinely transfer two, three or more embryos back into the uterus in the hopes that at least one will implant and pregnancy will result. And by the time most couples reach the stage of requiring IVF to create a family, they have been completely drained emotionally and financially, often suffering miscarriages and enduring years of medical intervention and testing, just like Hubby and I did. Those couples are more than ready and willing to accept the risks that multiple embryo transfer carries. After all, two babies for the price of one is quite appealing! God knows, I would have welcomed the opportunity... and I almost did before one of our embryos succumbed to Vanishing Twin Syndrome. Alas, here we are a few years later, having to go through it all again, and pay again for the hope and privilege of undergoing IVF, praying that we can have a second child. But as I mentioned to Liberal candidate, David Bertschi back in December when he knocked on my door, "Do I have to mortgage my home to have a child?" Or maybe I just need to move across the river to Quebec... because they have seen the light and they now fund up to three cycles of IVF.

The Montreal study looked at transfers that encompassed from 2 to 6 embryos. According to the paper, the unregulated practice is leading to "enormous unacceptable human, emotional and financial costs." "Multiples are almost always born prematurely and underweight. They're more likely than singletons to die in their first year of life and are at greater risk of severe, lifelong health problems." Yet in 2009, only 13% of the 9000 embryo transfer procedures included one embryo. Canada's 28 ART facilities transferred two or more embryos in 87% of IVF procedures.

The researchers found that

  • Nearly 100 fewer babies would die or suffer severe brain injury every year in Canada if tighter controls were placed on process.

  • Nearly 1 in 5 babies (17%) admitted to the NICU at Montreal's Royal Victoria Hospital over a two-year period were from multiple births resulting from artificial reproductive technologies (ART).

  • Among these 82 babies, 75 were twins or triplets whose mothers used IVF; the others were the result of ovarian stimulation.

  • 20 of the IVF babies were born after less than 29 weeks gestation: 6 died; 5 developed severe bleeding in the brain (a complication that can lead to cerebral palsy and other lifelong consequences); 4 developed a potentially blinding eye condition requiring surgery.

By contrast, if you only transfer a single embryo each time in a regulated industry, it would lead to

  • 30 to 40 fewer infant deaths every year nationwide

  • 34 to 46 fewer severe intracranial hemorrhages

  • 840 fewer babies admitted to intensive care

  • up to 42,488 fewer days of intensive care (at a cost of $1000 per day, per infant)

This would save the Canadian government approximately $40 million per year.

And what of the mothers who are pregnant with or who deliver multiple babies instead of a singleton?

  • those pregnant with twins are 5 times more likely to experience complications

  • 7% of mothers who delivered multiples also developed high blood pressure (requiring more monitoring, testing and more appointments during pregnancy)

  • 10% developed gestational diabetes (more monitoring, testing, appointments)

  • 72% delivered via caesarean section (thus a longer hospital stay)

  • 4 mothers required a blood transfusion

As I've mentioned before on this blog, last August, the province of Quebec began funding up to three IVF treatment cycles. In most cases (depending on maternal age, previous history, etc.), one embryo must be transferred at a time. As a result, in the first three months this policy was in effect, Quebec saw a drastic drop in the rate of multiple pregnancies from 27% to a mere 3.8%. That's nothing to sneeze at.

Canada is about to have a federal election, because our own Prime Minister was found in contempt of Parliament. On May 2, I will go to the polls and cast my vote. And I'll be brutally honest, if any of the parties have information about funding and regulating IVF in their platforms, I can't find it. I've been looking. I guarantee that I will cast my vote for any political party that includes that support for IVF and fertility regulation in their platform In my own riding, I call upon the candidates to be aware of this situation and I welcome any discussion on the matter. As I said, if your party will look at the facts and finally commit to families in Canada by funding/regulating ART procedures, you WILL have my vote. And likely, many, many more.

So to the candidates: Royal Galipeau (Conservative Party -- incumbent), David Bertschi (Liberal Party, with whom I spoke briefly earlier this year), Martine Cénatus (New Democratic Party) and Paul Maillet (Green Party), I call upon you to act on the numerous studies and recommendations.

It was Mike Harris' heavy-handed tactics withdrew funding (and thus regulation) for infertility procedures and cut funding to hospitals. It's time to right that wrong. By doing so, you save money, you increase the population rate, you help reverse the now inverse pyramid of population, thus helping social programs in the long run, you decrease the rate of multiple births, you SAVE mothers and babies. It's time to put the recommendations of the Expert Panel on Infertility and Adoption into practice. As always, I would welcome the opportunity to speak to any of the candidates in my riding on this issue.


Kakunaa said...

So, here is my question...did the actual pregnancy rate drop when transferring only 1 embryo? Goodness knows multiples can be scary on many fronts. I just wonder about success rates, though...

marilyn said...

this post has helped me in volumes. I am have torn between one or two embryos. I was choosing for selfish reasons, but I must think about the child that I am bringing into this world. There are so many problems that can occur. I am picking one embryo!

Anonymous said...

I hope all of the political parties read this post and do something to help with this.

loribeth said...

Don't know if you saw this article in the Toronto Star -- I haven't had time to blog about it myself yet, but it alternately had me cheering & booing. It suggests that SETs should be mandated... without the government actually paying for IVF, of course. Boo, hiss. Also confirms my suspicions that the government is promoting adoption, as well as fertility awareness, but trying its best to ignore the issue of funding IVF. In essence, our own government is telling us to "just adopt." :p