Friday, January 30, 2009

Note to governments: Just fund the treatments already, will ya??

From this morning's Globe & Mail. Boldfacing is mine for emphasis. Check out the comments… and try not to grind your teeth too much over the use of the term "implant," lol.

*** *** ***

Fertility treatments, older mothers leading to rise in premature births
CAROLINE ALPHONSO
From Friday's Globe and Mail
January 30, 2009 at 4:35 AM EST

More babies are being born prematurely because women are waiting longer to start their families and relying on fertility treatments that can lead to pregnancy complications, a new report indicates.

The rate of premature births climbed a staggering 25 per cent over the past decade, the Canadian Institute for Health Information said yesterday. The figure caught obstetricians and gynecologists by surprise.

In 2006-07, 8.1 per cent of babies in Canada - roughly 29,000 - were born preterm, meaning they were delivered before 37 weeks of gestation. In the early 1990s, such babies made up about 6.6 per cent of births, the report found.

Those in the practice of delivering babies were particularly troubled by the data because human life is fragile at an early stage, and premature babies who weigh very little are at risk for an array of complications, including blindness, deafness and cerebral palsy.

Mothers over 35 were 10 per cent more likely to deliver preterm, the study found. And the rate of preterm births among women having multiple babies was 17 times higher than for mothers delivering single babies. Increased use of fertility treatments has led to an explosion of multiple births.

Annie Janvier, a neonatologist at Montreal's McGill University Health Centre, said the blame lies mainly with "irresponsible" governments that don't encourage women to have families early, allow clinics to implant more than one embryo during an in vitro fertilization cycle, and don't finance fertility treatments. Using one embryo per cycle increases the chances a baby will be carried to term, but the high cost of treatment means some want to improve their odds by implanting multiple embryos.

"This is avoidable," Dr. Janvier said. "But infertility is really not seen as a health problem by our government. It's really too bad."

Laura Bergeron-Blais learned the hard way what it means to implant more than one embryo. She paid for three in vitro fertilization treatments over three years. She became pregnant with a boy and a girl after her second treatment, and after implanting "a lot of embryos."

She delivered prematurely 26 weeks later. Megan, weighing 710 grams, died an hour after birth. Logan, weighing 785 grams, died two months later.

"I wasn't aware of the high risk when it came to twins. I didn't understand that," Ms. Bergeron-Blais said from her home in Montreal. "Because we're paying for this ... we kind of get raped in our situation. We don't care what it takes, just get me pregnant. I put in [embryos] way beyond the norm and I got pregnant with twins."

Seeking to avoid another preterm birth, she had only one embryo implanted during her most recent treatment. But she suffered an ectopic pregnancy.

She and her husband are now looking into adoption.

Of the number of babies born prematurely due to multiple births and fertility treatments, she said: "The government has to step in and start controlling the situation before it gets completely out of hand."

Premature babies cost the health-care system seven to nine times more than full-term babies. A single preterm baby costs a hospital $9,233 compared with $1,050 for a full-term baby.

Jan Christilaw, an obstetrician-gynecologist and interim president of British Columbia Women's Hospital and Health Centre, said would-be parents and hospitals pay a heavy price, and governments should step in.

"We are not there in terms of having the best possible reproductive care," Dr. Christilaw said.

9 comments:

  1. I just read this same article today!

    I'm not quite sure what Bergeron Blais means when she says she didn't understand the risk of having twins or transferring "many embryos". My clinic made it quite clear to me about the risks and I also did some research on my own. In any case, encouraging women to have children earlier in life doesn't change the fact that people in general are also waiting longer to get married and start families for many logical reasons. It also doesn't help that the government continues to stick its head in the sand about the topic of infertility. This should not be a surprise to obstetricians and gynecologists, as you constantly hear about women being transferred out of province/country for deliveries and neo natal care. They out to know because if you graduate successfully from the clinic you go to the ob/gyn.

    I myself went for transferring two embryos to 4 embryos because I was desperate for just one baby to take hold and grow. Do any of these experts ever read blogs? Sigh.

    ReplyDelete
  2. I like Dr. Janvier's quote - "Infertility is not seen as a health problem by our government. It's really too bad."

    It ~is~ too bad. It's not like we're talking about a boob job here. We are women who want a family.

    ReplyDelete
  3. Interesting....have you seen the story over here in my neck of the woods about the octupulets?

    http://www.ktla.com/landing_topstories/?Octuplets-Mother-is-Obsessed-with-Childr=1&blockID=196258&feedID=1198

    Obviously, over here, the government would never fund treatments (HA! HA!) but, the cost is a factor in why people make the choices they do.

    I have a lot of opinions on this and to be honest, I'm not sure I should since I have never personally experienced it. I think losing a baby has deeply affected my feelings on doctors taking chances and possibly not fully explaining the risk of loss.

    ReplyDelete
  4. Hon, I hope so, but I doubt it after they read about that crazy octuplet mother.

    Interesting how they assume it's because of fertility treatment that babies are born prematurely. I think its because women who would normally have miscarried early or late, or even had a stillborn child are being given treatments that now prolong their pregnancies and allow the babies to be born alive, albeit prematurely.

    Take me for example---multiple miscarriages and then I had Julius in a high risk adventure. The difference was the heparin shots, not whether I did IVF. And hey, I think he's better off existing! ;)

    ReplyDelete
  5. Oh no way, I can't read it. I just have to stay away fro things that make me want to allow my brain to explode!

    ReplyDelete
  6. I agree with Aurelia that the assumption that prematurity results from fertility treatments and "advanced maternal age" isn't quite the full story.

    Women younger than age 18 have a high risk of premature delivery, as do women of lower socioeconomic status.

    Prenatal health care, which is not as widely available as some might assume, is a big factor in preventing prematurity.

    Here's the March of Dimes' statement on the rise in premature births in the U.S. It specifically states that multiple births are not the cause.

    http://marchofdimes.com/aboutus/22684_49328.asp

    Excerpt:
    The preterm birth rate continued to rise despite the fact that multiple births, a known risk factor for preterm birth, have begun to stabilize. The rate of twin births was unchanged in 2005 and 2006, and triplets and higher order multiples declined 5 percent in 2006.

    “The health consequences for babies who survive an early birth can be devastating and we know that preterm birth exacts a toll on the entire family – emotionally and financially,” said Dr. Jennifer L. Howse, president of the March of Dimes.

    “We’ve are committed to raising public awareness about premature birth, and we believe there are concrete steps we can take to solve this problem, including ensuring that all women of childbearing age have access to health insurance and expanding our nation’s investment in research into the causes and strategies to prevent preterm birth” Dr. Howse continued.

    ReplyDelete
  7. It's hard to read with a clenched jaw.

    ReplyDelete
  8. Hard to read through clenched teeth.

    ReplyDelete
  9. I agree with you, Aurelia & Ellen, that older mothers & infertility treatments aren't the full story. But I do think that if treatments were fully funded, there would be fewer risks being taken by more IF patients & their drs in the name of saving money.

    ReplyDelete