Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
News

New self-incubation IVF not yet cheaper

Alison Motluk
CMAJ February 03, 2015 187 (2) E65; DOI: https://doi.org/10.1503/cmaj.109-4949
Alison Motluk
Toronto, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

Hopes that a new in-vitro fertilization (IVF) alternative recently approved in Canada could cut the price of IVF in half are so far unfounded. The only Canadian clinic that offers the self-incubation service charges more for it, not less.

The INVOcell device, approved by Health Canada earlier this year, has been touted as a potentially cheaper IVF option. Jason Broome, CEO of the Canadian Fertility Institute, which holds the Canadian rights to INVOcell, and fertility doctor Kevin Doody, co-head of the Center for Assisted Reproduction in Bedford, Texas, recently demonstrated that a streamlined protocol using the device could be just as effective as traditional IVF but at a much-reduced cost.

The new approach involves scaling down all parts of the process. In traditional IVF, a woman is given drugs to make her ovaries produce extra eggs. She is then monitored every few days using ultrasound and hormone blood tests, and the drug dosage is adjusted. To keep costs down, Doody prescribed the drugs, conservatively, based only on body weight and anti-Müllerian hormone testing, which estimates egg supply. He did a single monitoring ultrasound on day 10, and based on those results, scheduled the egg harvest for day 12, 13 or 14. Retrievals and transfers were timed not to fall on weekends, to further control costs.

Rather than putting eggs and sperm together into a lab-controlled incubator, as with traditional IVF, he allowed the gametes to mingle for an hour or so, then placed the as-yet unfertilized eggs, with shortlisted sperm clinging to the outer shell, along with culture medium, into a device known as INVOcell. This was placed inside the vagina, secured by a diaphragm, and left in place for five days.

Doody presented preliminary results of a study of the new process at the October meeting of the American Society for Reproductive Medicine. The trial sample was small; half the 40 women received traditional IVF and half underwent the new process. Rates of fertilization, pregnancy and live birth were similar in both groups, but the INVOcell process was half the cost.

Figure1

The alternative IVF entails combining unfertilized eggs and sperm in a culture medium, and putting it into INVOcell, which is then placed in the vagina for five days.

Image courtesy of INVOcell

The cylindrical, plastic INVOcell device measures 4 cm by 3 cm. It has an outer chamber to protect against contamination, but is permeable to gas. The mother’s own body maintains optimal levels of oxygen and carbon dioxide, keeps the temperature steady and acts as a filter. “We’re using, essentially, the intended-mom’s kidneys and liver to filter out environmental toxins,” says Doody.

The cost-savings of not using a sophisticated lab, with 24-hour monitoring and quality control, is enormous, Doody says. Costs were further reduced by not needing weekend staff and using fewer drugs. He says he expects to offer the scaled-down treatment for US$6000, half of what he charges for regular IVF.

Broome says he’d like to use INVOcell to make assisted reproduction more financially accessible to Canadian couples. “Lots of patients don’t proceed with IVF because of cost.” IVF can cost upward of $10 000 per attempt in Canada, where, outside Quebec, it is typically not publicly funded. The INVOcell device costs about $450 in Canada.

Both Broome and Doody say they believe INVOcell could make fertility treatment more geographically accessible, too, by bringing it to smaller centres that don’t have access to state-of-the-art fertility labs.

However, even some Canadian INVOcell enthusiasts doubt the device will change much in terms of cost and access. John McNaught, a fertility doctor in London, Ontario, who used INVOcell in an as-yet unpublished trial conducted in 2013, says the real costs are not due to the lab but to the surgical centre required to do egg retrieval under anesthetic. The only cost savings, he predicts, will come from using fewer drugs. “It’s not going to differ in price as much as we’d hoped,” he says.

Robert Casper, medical director of the Toronto Centre for Advanced Reproductive Technology (TCART), agrees. “You still need to have a good set up for egg retrieval, and you still need an embryologist,” he says. Currently, TCART is the only clinic in Canada offering INVOcell as a service. Casper considers it an “add-on” to regular IVF, and charges an additional $500 for it. He points out that some women actually prefer to carry their own embryos.

Roger Pierson, a professor of Obstetrics and Gynecology at the University of Saskatchewan, who specializes in assisted reproduction, agrees that INVOcell isn’t going to make IVF affordable to all, or turn every little Canadian town into a fertility centre. But he calls it “a good step forward” from “an excellent lab with outstanding science.”

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 187 (2)
CMAJ
Vol. 187, Issue 2
3 Feb 2015
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
New self-incubation IVF not yet cheaper
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
New self-incubation IVF not yet cheaper
Alison Motluk
CMAJ Feb 2015, 187 (2) E65; DOI: 10.1503/cmaj.109-4949

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
New self-incubation IVF not yet cheaper
Alison Motluk
CMAJ Feb 2015, 187 (2) E65; DOI: 10.1503/cmaj.109-4949
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • What’s important to know about the new COVID-19 variants?
  • Women experts underrepresented in pandemic coverage
  • Feds update immunization advice with Moderna vaccine approval
Show more News

Similar Articles

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire