The UCSF Center for Health and Community recently received a grant of more than $11 million dollars from the National Institutes of Health to study infertility and the use of new technologies to become pregnant. In vitro fertilization (IVF), the best known of these technologies, involves removing eggs from the ovary and attempting to fertilize them in the laboratory.
The resulting embryo(s) are transferred into the uterus. Some couples use eggs or sperm from a donor.
The grant, one of largest awarded by the National Institute of Child Health and Human Development to study infertility, will fund four UCSF studies over a five-year period. The researchers will study how couples decide whether to try assisted reproductive technologies (ARTs) or to continue treatment if the initial attempt fails, the psychological effects on the woman and the couple, the economic and social costs of the new technologies, and the medical outcomes for babies that are born as a result of infertility treatments.
"The issue of in vitro fertilization is very complex," said Nancy Adler, PhD, UCSF professor of medical psychology in the departments of psychiatry and pediatrics, director of the UCSF Center for Health and Community, and project director of the grant. "A comprehensive analysis is needed that looks at ARTs from various perspectives and includes enough people that the research can address the different kinds of experiences that people have."
For three of the studies, researchers will interview a group of 600 Bay Area couples who have received consultations for ART and will follow their experiences. A fourth study on medical outcomes for babies born after infertility treatment will compare 5,000 births from fertile women with 5,000 births from infertile women.
In vitro fertilization, an invasive procedure, can be a very stressful experience for both the woman and her partner, said Adler. In addition, the procedure is expensive, is not covered by insurance, and fails a majority of the time, according to Adler.
The goal of the research will be to help patients make better-informed decisions about whether to initiate treatment and when to stop, to provide physicians with information to give to their patients, to help physicians decide whether patients should be advised to receive treatment, and to inform policy makers about policies that may help in the area of infertility treatment, such as insurance coverage.
In addition to Adler, the principal investigators of the studies are Mary Croughan-Minihane, PhD, UCSF associate professor of family and community medicine, Susan Millstein, PhD, UCSF professor of pediatrics, Lauri Pasch PhD, UCSF assistant research psychologist in pediatrics, and Patricia Katz, PhD, UCSF assistant professor of medicine, UCSF Institute for Health Policy Studies.
The UCSF Center for Health and Community is a multidisciplinary center which assesses the challenges of the changing health care delivery environment and identifies policies and interventions to maximize the beneficial impact of the changing health care delivery system. The Center for Health and Community is comprised of programs and individual faculty from all UCSF Schools who have been at the cutting edge of health services and policy-related research for many years, and includes basic social and behavioral scientists in epidemiology, health policy, anthropology, psychology, sociology, history, bioethics, economics, and clinical research.