The Fertility Industrial Complex

I should acknowledge that I am currently under the care of an RE.  The tools and skills of Western doctors have helped diagnose my adenomyoma, diagnose and treat my hypothyroidism, and have reassured me that my tubes are indeed open.

If I were hit by a bus, I would want to go to the ER, not my acupuncturist's office.

However, I remain skeptical that Western reproductive endocrinology will help me have a baby.

I am skeptical of the profit structure of fertility treatments. Going to my RE's office for what is known as a baseline was really cheap: $90 dollars for his-and-her basic fertility workup, including a semen analysis for him, and cycle day 3 blood work and ultrasound for her. From there, however, the cost of treatment only goes up, culminating in $11,000-15,000 per cycle for IVF. Most people need 2-3 cycles of IVF to conceive: that's up to $45,000 for a chance at having a baby. I suspect that my RE's office offers basic diagnostic tests so cheaply because they make the big bucks on IVF.

So far, I like my RE.  I think she is compassionate and good at explaining things.  She never jumps to conclusions before considering all the data. However, I have noticed that if she can't treat something, she's not really all that interested in it.  For example, the adenomyoma: There is hardly any data out there about whether and how adenomyosis affects fertility. Anecdotally, I see people on fertility forums who have healthy pregnancies with adenomyosis, but it seems like every case would be depend on where and how extensive the adenomyosis is. I wanted an RE to look at my uterus and tell me whether I can conceive.

So during my saline sonogram, I asked her if she saw the adenomyoma. "Well, we weren't really looking for that."  What?  It's a lemon-sized area.  How could you miss it?

I think the answer is that she can't treat it, so it doesn't really matter. Similar with my suspected endometriosis.  Laparoscopy can make diminished ovarian reserve worse, so no matter how extensive the endo is, I'm not having it.  I almost wish I could have a lap, just so I could see whether I have endo.  I've always wondered, and given my family history and painful periods, it's likely, but I don't know for sure.

Is she so lackadaisical about diagnostics because she can offer me the ultimate solution: IVF.  IVF can diagnose the quality of eggs by evaluating the quality of embryos.  IVF can circuit a system that's hostile to sperm, whether its due to cervical mucus, endo, or immune-issues.

The only problem is--actually there are a lot of problems with IVF--A BIG FAT HUGE problem is that it's tens of thousands of dollars with no guarantee of success.

Our next appointment with the RE is May 7th.  It's the last big appointment when she looks at all of my test data and makes a recommendation.  I'll keep you updated.