In vitro fertilization (IVF) in addition to various forms and developments of it (ICSI, ZIFT, GIFT) is another solution.
They all include that the fertilization takes place outside the body. On the other hand, an insemination can make a fertilization inside the body. Other techniques are e.g. tuboplasty, assisted hatching and PGD.
Costs
Not everyone in the U.S. has insurance coverage for fertility investigations and treatments, especially when a couple already has children. Many states are starting to mandate coverage, and the rate of utilization is 277% higher in states with complete coverage.2005 approximate treatment/diagnosis costs (United States, costs in US$):
- Initial workup: hysteroscopy, hysterosalpingogram, blood tests ~$2,000
- Artificial insemination ~ $500- 900 per. trial
- Sonohysterogram (SHG) ~ $600 - 1,000
- Clomiphene citrate cycle ~ $ 200 - 500
- IVF cycle ~ $10,000 -14,000
- Use of a surrogate mother to carry the child - dependent on arrangements
In the UK all patients have the right to preliminary testing, provided free of charge by the National Health Service. However, treatment is not widely available on the NHS and there can be long waiting lists. Most patients therefore seek help from private clinics.
Most health insurance plans do not cover the cost of IVF (in vitro fertilization). Since IVF treatment is expensive and not often covered by health plans the InterNational Council on Infertility Information Dissemination, Inc. (INCIID -- pronounced "inside") created the first and only national (USA based) scholarship program for those without insurance and with financial need for the procedure.
The first "Heart Baby" was born program on October 31, 2005. There have been numerous pregnancies and births since being launched in late 2004. The program is called "From INCIID the Heart" and details, application and criteria can be found on the INCIID website: http://www.inciid.org
Ethics
There are several ethical issues associated with infertility and its treatment.- High-cost treatments are out of financial reach for some couples.
- Debate over whether health insurance companies should be forced to cover infertility treatment.
- The legal status of embryos fertilized in vitro and not transferred in vivo.
- Anti-abortion opposition to the destruction of embryos not transferred in vivo.
- IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems.
- Religious leaders' opinions on fertility treatments.
- Infertility caused by DNA defects on the Y chromosome is passed on from father to son. If natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation.
