美国国家公共电台 NPR Seeking Fertility Treatment Means Facing High Costs And Low S

 

DAVID GREENE, HOST:

Fertility treatment is a multibillion dollar industry, and it is growing. People spend thousands of dollars on procedures. And there's no guarantee of success. One Indianapolis woman found out just how tricky¹ this is to navigate².

Lauren Bavis and Jake Harper from the podcast "Sick" have the story.

LAUREN BAVIS: Heather Woock always imagined she'd struggle to get pregnant because her parents did.

JAKE HARPER: A couple years ago, she and her husband tried to start their family.

HEATHER WOOCK: We were doing, like, all of the calendaring and special whatevers. Like, everything that is out there to help you get pregnant, we were doing that. And nothing was working.

BAVIS: Six months later, Heather still wasn't pregnant. So she went to a fertility clinic for some tests.

WOOCK: And I had to fill out all of this paperwork. And there's a slot that says kind of, like, is there anything else you'd like to share?

HARPER: There was something. When Heather's mom went through fertility treatment in 1985, her doctor told her he would perform artificial insemination using anonymous³ donor⁴ sperm⁵. The doctor's name was Donald Cline.

WOOCK: We now know Cline used his own sample and squirted it into my mom.

BAVIS: In the '70s and '80s, Cline deceived dozens of patients that way. He used his own sperm to impregnate them. He has more than 60 biological children and counting. Heather found out in 2017 she's one of them.

WOOCK: I went through an identity crisis. I mean, I couldn't look in the mirror and think about where did my eyes come from? Where did my hair color come from? I didn't even want to think about any of that.

HARPER: Cline's deception⁶ was, understandably, on Heather's mind when she went to a fertility clinic. New allegations of doctors using their own sperm keep coming to light in states like Ohio, Colorado and Arkansas. But those inseminations happened decades ago. Could it happen today?

BOB COLVER: It's a very fair question.

BAVIS: That's Bob Colver. He's a fertility doctor in Indiana. He says it's unlikely because there are more people involved, and in vitro fertilization happens in a lab, not an exam room.

COLVER: You know, unless you're in a small clinic where there's absolutely no checks and balances, I can't even imagine that today.

BAVIS: It's now illegal in Indiana, Texas and California for a doctor to use his own sperm. But there's no national law.

HARPER: And there are other gaps in regulation. For example, sperm banks may not get accurate medical histories from their donors⁷. And there's no limit on how many times a donor's sperm can be used.

BAVIS: Another major issue - maybe the biggest one - is that fertility treatment can be really expensive. And patients may start treatment with unrealistic expectations. That's because success rates are complicated. And some clinics only use the best numbers in their advertising⁸. When Heather's doctors told her she needed IVF, she felt pretty optimistic.

WOOCK: I'm thinking, going into this, that our chances of success are 70, 75%.

BAVIS: Clinics advertise fertilization rates that high. But 70% doesn't mean 70% of eggs turn into babies. Plenty can go wrong after the lab combines egg and sperm.

HARPER: Success depends on your age, your clinic and the type of procedure you need. But most of the time, assisted reproduction, like IVF, doesn't work. The Centers for Disease Control and Prevention says only about 24%, a quarter of attempts result in a baby.

BAVIS: Heather gave herself shots, a couple of day. They stimulated⁹ her ovaries to get multiple eggs ready at once so doctors could surgically¹⁰ retrieve¹¹ them. Multiple eggs means more chances for fertilization. The drugs gave her headaches, made her moody¹², less patient.

WOOCK: I was actually allergic¹³ to one of the medications, which means you keep taking it and deal with the itching¹⁴ and rash.

BAVIS: But Heather hung on until it was time for egg retrieval when patients can face even more choices. For example, the clinic offered to use a special device to help pick the best sperm.

WOOCK: We were kind of like, yeah, why wouldn't you? Like, if it's going to give us a better chance, do it.

HARPER: That's called an add-on. Add-ons are often new, described as cutting edge, which can appeal to patients. Jack¹⁵ Wilkinson is a biostatistician at the University of Manchester. His research shows add-ons can increase costs and they may not work.

JACK WILKINSON: Really, we quite often see there's no benefit at all, but possibly even worse, that there's a disadvantage of using that treatment.

HARPER: That device Heather's clinic offered, Wilkinson says it could work, but the evidence is thin.

How long did it take to find out?

WOOCK: They call you the next morning.

HARPER: Oh, OK. So it's really quick.

WOOCK: Yeah. It's really quick. They immediately saw that there was something wrong with my eggs. So my eggs are just total crap.

BAVIS: None of Heather's eggs fertilized¹⁶. They tried again, same result.

WOOCK: Getting that news the second time, that there was, again, complete fertilization failure, felt even more set in stone that this was going to be a very long, challenging road.

HARPER: How much does all this cost?

WOOCK: (Laughter) A lot.

HARPER: Most states, including Indiana, don't require insurers to cover fertility treatment. Without insurance, a round of IVF can cost more than $10,000 - even more than 20,000. Heather was lucky. Her insurance covered a lot, but it still wasn't cheap. She had to pay for some drugs.

WOOCK: Plus you have to pay lab and facility fees that insurance doesn't pay.

HARPER: Donor sperm and eggs aren't generally covered either. Those can be tens of thousands of dollars. Heather had a hard choice. After two failed attempts, did she want a kid enough to go through IVF again?

BAVIS: She did, so she did a third round and then a fourth. When that didn't work, she gave up on using her own eggs.

WOOCK: What I expected as I was growing up and picturing my children is not what I will see.

BAVIS: Heather and her husband decided¹⁷ to try donor eggs. If all goes according to plan, she could still carry a child.

For NPR News, I'm Lauren Bavis.

HARPER: And I'm Jake Harper.

(SOUNDBITE OF THE ALBUM LEAF'S "LIGHT")

1 tricky   

adj.狡猾的，奸诈的；(工作等)棘手的，微妙的

参考例句：

• I'm in a rather tricky position.Can you help me out?我的处境很棘手，你能帮我吗？
• He avoided this tricky question and talked in generalities.他回避了这个非常微妙的问题，只做了个笼统的表述。

2 navigate   

v.航行，飞行；导航，领航

参考例句：

• He was the first man to navigate the Atlantic by air.他是第一个飞越大西洋的人。
• Such boats can navigate on the Nile.这种船可以在尼罗河上航行。

3 anonymous   

adj.无名的；匿名的；无特色的

参考例句：

• Sending anonymous letters is a cowardly act.寄匿名信是懦夫的行为。
• The author wishes to remain anonymous.作者希望姓名不公开。

4 donor   

n.捐献者；赠送人；(组织、器官等的)供体

参考例句：

• In these cases,the recipient usually takes care of the donor afterwards.在这类情况下，接受捐献者以后通常会照顾捐赠者。
• The Doctor transplanted the donor's heart to Mike's chest cavity.医生将捐赠者的心脏移植进麦克的胸腔。

5 sperm   

n.精子，精液

参考例句：

• Only one sperm fertilises an egg.只有一个精子使卵子受精。
• In human reproduction,one female egg is usually fertilized by one sperm.在人体生殖过程中，一个精子使一个卵子受精。

6 deception   

n.欺骗，欺诈；骗局，诡计

参考例句：

• He admitted conspiring to obtain property by deception.他承认曾与人合谋骗取财产。
• He was jailed for two years for fraud and deception.他因为诈骗和欺诈入狱服刑两年。

7 donors   

n.捐赠者( donor的名词复数 )；献血者；捐血者；器官捐献者

参考例句：

• Please email us to be removed from our active list of blood donors. 假如你想把自己的名字从献血联系人名单中删去，请给我们发电子邮件。
• About half this amount comes from individual donors and bequests. 这笔钱大约有一半来自个人捐赠及遗赠。 来自《简明英汉词典》

8 advertising   

n.广告业；广告活动 a.广告的；广告业务的

参考例句：

• Can you give me any advice on getting into advertising? 你能指点我如何涉足广告业吗?
• The advertising campaign is aimed primarily at young people. 这个广告宣传运动主要是针对年轻人的。

9 stimulated   

a.刺激的

参考例句：

• The exhibition has stimulated interest in her work. 展览增进了人们对她作品的兴趣。
• The award has stimulated her into working still harder. 奖金促使她更加努力地工作。

10 surgically   

adv. 外科手术上, 外科手术一般地

参考例句：

• Unsightly moles can be removed surgically. 不雅观的痣可以手术去除。
• To bypass this impediment an almost mature egg cell is removed surgically. 为了克服这一障碍，通过手术，取出一个差不多成熟的卵细胞。

11 retrieve   

vt.重新得到，收回；挽回，补救；检索

参考例句：

• He was determined to retrieve his honor.他决心恢复名誉。
• The men were trying to retrieve weapons left when the army abandoned the island.士兵们正试图找回军队从该岛撤退时留下的武器。

12 moody   

adj.心情不稳的，易怒的，喜怒无常的

参考例句：

• He relapsed into a moody silence.他又重新陷于忧郁的沉默中。
• I'd never marry that girl.She's so moody.我决不会和那女孩结婚的。她太易怒了。

13 allergic   

adj.过敏的，变态的

参考例句：

• Alice is allergic to the fur of cats.艾丽斯对猫的皮毛过敏。
• Many people are allergic to airborne pollutants such as pollen.许多人对空气传播的污染物过敏，比如花粉。

14 itching   

adj.贪得的，痒的，渴望的v.发痒( itch的现在分词 )

参考例句：

• The itching was almost more than he could stand. 他痒得几乎忍不住了。 来自《现代汉英综合大词典》
• My nose is itching. 我的鼻子发痒。 来自《简明英汉词典》

15 jack   

n.插座，千斤顶，男人；v.抬起，提醒，扛举；n.（Jake）杰克

参考例句：

• I am looking for the headphone jack.我正在找寻头戴式耳机插孔。
• He lifted the car with a jack to change the flat tyre.他用千斤顶把车顶起来换下瘪轮胎。

16 Fertilized   

v.施肥( fertilize的过去式和过去分词 )

参考例句：

• The study of psychology has recently been widely cross-fertilized by new discoveries in genetics. 心理学研究最近从遗传学的新发现中受益匪浅。
• Flowers are often fertilized by bees as they gather nectar. 花常在蜜蜂采蜜时受粉。

17 decided   

adj.决定了的，坚决的；明显的，明确的

参考例句：

• This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
• There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。