July 17, 2014 • 36 mins
In the U.S. alone, more than 6 million people are affected by infertility and science has taken up the mantle of helping them to conceive. Learn about the clever, though intuitive, methods of assisting infertile couples to have a child.
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Episode Transcript
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Speaker 1 (00:00):
Welcome to Stuff You Should Know Fromhouse Stuff Works dot com. Hey,
and welcome to the podcast. I'm Josh Clark with Charles W.
Chuck Bryant y. Yeah, and this is Stuff you should Know.
It sounded uh sardonic, yery yi j a silent yawking, yawking.
(00:27):
I'd never get sick of that movie. No, it's a
good one. I haven't seen the second one. Don't really
intend to, but I'm afraid too, Yeah, because it might
tarnish my love of that character, because I've heard it's
not very funny to just keep it keep it with
the first one. I'm totally gonna watch him just waiting
for cable. Oh yeah, yeah, Yeah, TBS knows what they're
doing with movies that were for the big screen. Yeah,
(00:51):
size them down, best start ever. Uh. So you're doing good.
I'm great, Okay, good. Um. So we're talking today about
IVF in vitro fertilization. Um. And I have to say, Chuckers,
(01:12):
I don't really have by the way, I don't have
an intro for this one to um, although I do
have a bit of one. All right, let's see uh
in nineteen In two thousand thirteen, a lady named Louise
Brown celebrated her thirty fifth birthday, and with her birthday
(01:33):
coming and going, she announced that she was pregnant with
her second child. This is like mind blowing crazy stuff
all over the place, because Louise Brown was the first
human being ever conceived using in vitro fertilization. Yes, they
called them test two babies back then. Remember that. Yeah,
totally test two babies. You don't call it that anymore. No,
(01:55):
we've gotten a little more scientific as a society since
the seventies. Plus. I don't think they use test tubes. Yeah,
if they ever did, I think maybe petri dishes, culture dishes,
not test twos, but you know culture dish baby. It's right,
that's weird. Test tube baby. It kind of rolls off
the tongue. It's got the two T sounds, which makes
it a little funny ish and um intriguing. But that's
(02:19):
what she was. She was the first test two baby.
It was eight in England, um, and she was born July.
I think, um, like just a few days later. I
think the second IVF baby was born in India very
in very short order. For two. I'm sure that their
doctors were like come on, will you give birth already?
(02:41):
I want to be the first. Nobody remembers number two.
And then the following year, in nineteen seventy nine, the
first American IVF baby was born. And that's the history
of IVF, like it just goes back that far. Since then,
I think thirty five more than thirty five million uh
IVF babies have been born a couple of hundred thousand
(03:03):
each year in the US alone. Now, yeah, it was
like in the sixties eighties. Now it's up to like
a hundred and something a hundred and change. I think
I got over two thousands. Do you really really? I
saw two thousand twelve or maybe maybe two d thousand worldwide.
(03:24):
All right, let's just settle on that. I'll bite on
that one. Um. But yeah, that's a lot of babies
that are born through IVF, and it's a it's crazy
how the thing that struck me and finally we're getting
to the end of the intro um is that what
I v F is? It seems so like whiz bang
(03:46):
crazy futuristic. No, it's it's figuring out. We figured out
how a woman becomes pregnant and figured out the ways
that we could possibly best help that process along, and
that's what it is. Yeah, it's really there's no like
crazy new technology. They don't like like buzz her with
(04:09):
like a prey goo laser, nothing like that. It's strictly
like catheters and timing and you know, hormones. It's crazy
how simple it is. But it's also equally crazy that
you know, it's as successful as it is considering what
it What in vitro fertilization consists of. Yes, I guess
(04:32):
we can go ahead and talk about success rates. Um.
In the US, women under the age of thirty five
have a thirty to thirty five chance of conceiving with
ibf uh. It drops between thirty five and forty six
over forty uh. And that is percentages of live birth cycle,
(04:53):
which is yeah, per cycle. So like, if you go
through a cycle of in vitro fertilization, do you have
the percentage chance typically which is pretty much in lock
step with natural birth rates according to age it Yeah, well,
I mean it definitely decreases with age, but I'm not
saying it's like one for one. Sure, yeah, yeah, it's totally,
(05:14):
But I'm saying that I think the depreciation of possibility.
It goes down with age naturally as well with IVF two. Yeah,
and live birth is the key here because many times, uh,
there will be conception and there will be a pregnancy,
but any number of things can go wrong from there.
Oh yeah sure. Chemical pregnancies UM topic pregnant topic pregnancies. Apparently,
(05:40):
some Chinese researcher did a survey of a hundred thousand
plus live IVF births UM and found that there's a correlation.
You were three times likelier to have a major birth
effect if you were born via in vitro fertilization than natural.
And he just found a correlation. Um, not a cause,
(06:01):
but just the numbers. For some reason spit that out. Yeah. Well, now,
one of the new things you can do is up
for at a certain point in the process pg D,
which is preimplantation genetic diagnosis. And this is a test
that will cost you several thousand dollars and it basically UM.
It allows you to root out certain mono genetic disorders,
(06:23):
like you can get PGD testing and find out if
the baby might have like sickle cell or Huntington's disease
or cystic like process or downs and then UM you
can make a decision at that point whether or not
you want to continue with the process. Yeah. You know,
there's a real um concern that there won't be like
that down syndrome, people will be extinct eventually because the
(06:47):
should have gotten so accurate. Yeah, yeah, I don't think
that will happen. Well. And there's also ethical concerns with
pg D about you know, do you do selective termination
if you can find out it's a boy and you
wanted a girl, right or um, oh I didn't want
to give brown eyes? Yeah, and I know there's a
lot of ethical yeah, associated with it, and um, it's
(07:11):
even more basic than that for a lot of people
to like, if you have a fertilized egg, um, or
even just an egg with the potential human life. To
some people, that destroying just the egg that that was
never fertilized is like a moral problem. Yeah. Or let's
say you, um, you have a chance of multiples, um
(07:35):
twins or triplets or quads or more. If you're a
certain age, that is not good and can be dangerous
for you as the mother and for the kids too. Yeah.
So at that point, um, you might have to go
through what they call selective reduction, which is choosing which
ones to go with. Well, there's a lot of pitfalls
this UM, but there's a lot of people who are
(07:58):
helped by it as well, and at the very least
there's a lot of people who seek the help from it.
I saw something like in this article, which I think
was written in two thousands, six or seven. Yeah, it's
a little dated. A head they said six point one
million Americans are faced with infertility, which UM, infertility is
not like Bam, you're infertile. UM, here's what's wrong with you?
(08:24):
Infertility be right, but it isn't always technically infertility. The
definition of infertility is that you have um gotten it
on for a year unprotected and no baby has been
produced for six months. If you're overt okay, But it
depends on the doctor. Like this article talked a lot
(08:46):
about well, if you've gone this far and you've done
these procedures, then they'll move you to this. A lot
of the places are fertility clinics or baby factories and
they'll you can go right to I D F if
you want to. And if they say that they believe
in so's. There's not like any hard and fast law,
you know, that's the impression. After doing this for how
many years have we been doing this? Now, after eighty
(09:09):
years of doing this, um, I've learned that how stuff
works article is like it deals in ideals. It's not
necessarily like this is how it works in the real world.
It's like, this is how it works according to the law.
That's true. We do our best. Yeah. Um. So, apparently
about seven point three million people UM are faced with
infertility and they turned to IVF, and IVF is far
(09:31):
and away the most popular form of what's called UH
assisted reproductive technology, which, as we said, sounds whiz bang
and futuristic but not necessarily Yeah, about fifty of a
r t UM methods are what they call low tech,
which is maybe we'll put you on some hormones. UM
(09:53):
Antibiotics apparently are a huge one, a huge stream of
for infertility. Yeah. They supposedly especial the unexplained infertility, which
affects something between ten to thirty percent of infertility cases
are just unexplained. Yeah, they're like, we there's nothing structurally
wrong with you. Your husband's sperm is fine, Like there's
we can't figure it out. Well, it made getting pregnant
(10:16):
isn't the easiest thing in the world. It seems that
way in the movies, but there's an explanation for things
even when it's unexplained. And because there's this whole unexplained thing, Chuck,
there's like a lot of suggestions as to you know,
what's at play. Yeah, but you're but you're right. It
is kind of like, uh, man, woman, get together, have child,
(10:38):
have another child, maybe a third, and like it's no problem,
like you said in the movies. Well, and especially when
age comes and you know people are getting married later.
Uh you see, you know, sixteen year will have a
baby without any problem. It's sort of weird that we've
we haven't. Things haven't changed reproductively speaking, Like people are
(11:00):
getting married in their mid thirties, but you can still
get pregnant when you're thirteen, And it's like has shifted.
It's not going to shift within cultural attitudes. No, no,
which is why we're like, okay, well we need technology then, right, right,
But like I said, um, about half the assisted reproductive
technology methods are low tech. Um. Klomad is a big
(11:23):
probably the most popular fertility drug treatment. They've been using
that since like the fifties, right, I don't know, they
say fifties, either fifty years or since the fifties. Okay,
Well it's um. It's an oral medication and it is
used to induce ovulation. And actually now men have seen
have used it to increase testosterone. Um. Because an NFL player,
(11:44):
UH just got banned for using chlomad for fertility because
they said it increases testosterone. So it was a performance
enhancing drug, but he was using it to try to
get pregnant. That's what he said. Oh that's not fair. Um. Yeah,
Robert mathis of the cult, so he was suspended. Um.
(12:05):
But clomad, with clumbad alone, you have a chance of
ovulation success and about a forty three percent chance of
pregnancy success over three cycles. And after three cycles that
number goes way down. UM. So really like it becomes
less and less probable that you'll conceive after three cycles. Yeah,
(12:25):
it's the same through three and then and that's just
with clomad and then after that, like what people generally
do is try a few different methods before moving on
to IVF, like just the hormones UM or what we'll
talk about now, which is uh artificial insemination, right, and
that that like um assisted reproductive technology with an umbrella term.
(12:46):
Artificial insemination is an umbrella term underneath the a R
t umbrella. Yeah, and it's basically any time you UM
try to give the sperm a leg up and its
race toward the egg. Yeah, it's it's inseminated artificially. In
other words, it doesn't come directly from the penis into
the vagina. Right. Why does that make you laugh? Still?
(13:08):
I just felt like I was in the kindergarten class
cop class. Uh. Yeah, it's when the sperm is harvested
in UM for for AI for artificial insemination, it's either
implanted intravaginal or interest cervical, so in the vagina, in
the cervics. But if you're going to put it directly
into this service or the uterus, you have to wash them. Yes,
(13:32):
you can't put untreated sperm into directly into the uterus
because you will have what's called uteral contraction, which apparently
is extraordinarily unpleasant. The sperm have some sort of um
it's called proto glandings. I think, yeah, that you have
(13:53):
to wash off the sperm. If you don't, protoglandings will
set off these contractions in the uterus exactly. So they
and I said, you or I think of at uterine
contractions they're pretty violent. Uh so yeah, you wash the
sperm and um. Not only does it remove those protoglass stuns,
it's um. It eliminates any substance it will get in
the way and make the sperm motile. And motile means
(14:16):
they're good swimmers. Right. That's another another advantage of using
artificial inscimination, as you can say, uh, you're cut, you're cut.
You made the team, you're cut, and then you put
together this dream team of the best firm and you say,
go get them. That's right. Right, So, if you're using
the wash sperm and directly onto the uterus, that's called
(14:37):
I ui intra uterine instimonation. Uh. And that's just kind
of one step further than Hey, I like artificial instimination.
You can do the turkey based method at home, sure
if you want. So that's a thing. Yeah, like they
have kids. That's a form of artificial insemination. That is
artificial instamonation. Yeah, but I mean it's an umbrella term.
(14:58):
Well yeah, if you're using the key based her at home,
you're you're artificially inseminating but you're probably inserting it directly
into the vagina. Maybe the cervix. You're not doing intra
uterine you can't do unless you have a sperm washer, right,
which you can afford one of those these days, you know,
that's right. So if those fail, then your next step
(15:20):
is is probably gonna be IBF. But like I said,
depending on your age and what's going on, you can
skip straight to ib F if your doctor says that's okay,
well we'll skip straight to IVF after a message break.
How about that? All right, So let's talk about the
(15:44):
IVF process. Huh yeah, again, pretty low tech, high tech stuff.
It's neat. Yeah, it will cost you about twelve grand
I saw. Yeah. I mean that's a I hate the
ranges for these procedures because it really it depends on
where you are and if you have insurance. I think
fifteen states require insurance to cover it. Um. You know.
(16:07):
Let me interject here. There's an argument that the lack
of standards in pricing for medical procedures is the single
problem for why the health care system in the US
is broken. Yeah, that it's not necessarily insurance, that it's
not necessarily chronic disease that it is. If you came
(16:31):
up with standard pricing, yeah, you could solve quite a
bit of the car mechanics. Yeah, that's supposed to be
a standard. Yes, I always I never knew that with
car mechanics. If you um, when they say how much
time it takes, it's really not how they don't time
how long it takes. There's a manual that says, you know,
changing a carburetor is one point five hours. I didn't
(16:52):
know that. Yeah, I just know that Mr Goodbrand's posts
is on the board him like McDonald's what like oh
a menu. Yeah. Anyway, I agree with you about the
medical standards, and it makes a lot of sense. I mean,
chronic disease is a huge problem, especially preventable chronic disease.
(17:12):
But that's not the only issue here. It's the fact
that you can be charged almost literally in arm and
a leg depending on where you go. That's rights. It
will cost you some money, but if you have good
insurance then that will help out. Uh. So here are
there are basically five steps. The first is ovarian stimulation. Um,
(17:33):
this is when you're gonna be taking fertility drugs. Uh.
It's could be a couple of weeks of that um.
Some are oral. Sometimes you're gonna be given shots to
your wife, or if the ladies on our own should
be given shots to herself. Because the good thing about
ib F is you don't need a live man necessarily. No,
you just need the sperma. So a lot of the
(17:53):
could come from anywhere. Yeah, single ladies are all the
single ladies or ladies in the l g BT community.
I always want to mix up those letters. Oh yeah,
like they doesn't need to be a man involved. No,
I mean at some point, I guess if you could
(18:14):
grow sperm in a lab from stem cells. Not directly
technically you could do that, but no, it doesn't have
to be involved in harvest sperm from a sperm bank,
anonymous donor friend of a friend, transient who's just passing
through town, whatever your standards are. You could conceivably get
(18:34):
your hands on some sperm and then bam, you don't
need a man. I was it from the besket I
could get you some sperm by three pm. That is
a great movie. Man. I saw that again for the
first time in a while recently. Oh man, I think
he's talking about a big toe. I can get you
a big toe by three pm. Um. But yes, you
will need sperm if you're the husband and it's uh,
(18:55):
just your regular old husband and wife trying to conceive,
or just a man and woman. Then the hus and
will deposit that sperm and a little room designed to
make that happen, and then they will take the sperm
and wash it and hold it. Uh, and it's all
timed out, you know appropriately. Of course they can't hold
(19:15):
them to it forever. And so that's the ovarian stimulation.
Like you're trying to get the eggs to come along,
and not only are you trying to get that an
egg to come along, you're trying to get several to
come along. Yeah, that's the whole point is you want
multiple eggs, right. So you know, a woman is born
with all of the approximately four hundred thousand eggs she'll
ever produce in her life. Um down right, during her
(19:38):
menstrual cycle, one of those eggs enters a fallopian tube
and um it becomes mature. Right. So what these hormones
do is get a bunch of those eggs into their
fallopian rappers and get them to mature over time. And
the doctor um, I guess pays attention to how they're maturing,
and when he decides these eggs are ready to get
(20:00):
that's when you hit step two, which is the egg
retrieval step. That's right, and that is not super complicated either.
It's called the name sounds complicated, transvaginal ultrasound aspiration, but
what it really is is a mild sedative and a
suction device that sucks out the eggs and that's really
(20:23):
all there is. Do it. It's pretty amazing. Um. If
you cannot use the um TU a method, you will
have to undergo a more involved procedure called laparoscopic surgery,
which isn't super involved either. It is also a short process,
but there's a small incision in the abdomen to locate
your ovaries. Yeah, they put a little video camera in there.
(20:46):
So um more involved obviously because it is a surgical procedure,
but it's not like you're staying in the hospital for
a week or even right. Yeah, it's just more involved
because you have to use more anesthesia to which automatically
increases risks exactly with the other one aspiration. Yeah, uh
the uh, I guess you just need a mild seditive.
It sets here. Yeah, it's like like twilight sleep alright.
(21:10):
So step three, you've got your eggs. You've got your
multiple eggs. They're all looking good. Then you yeah, because
they go through and they look at them and ye
and say this one looks good. This one looks good, man,
not this one. Yeah, And I'm not sure when pg
D can take place. I think after would think yeah, yeah,
I guess it would have to be yeah, okay, that
(21:30):
makes sense. Um. So then you've got your insemination. And
like I said, you're you've got your sperm. However you
got it. We ain't asking whatever it was a transient
on the street, More power to you. Um. They examine
the eggs and say these look robust and juicy and full,
and these are the best ones. So we're going to
(21:52):
use these. And that's when the sperm is at it
and the best sperm um is picked and then it's
in a culture and it's doing its thing right. And
depending on the sperm um, they might injected directly into
the egg, which is called um oh intra citoplasmic sperm injection.
(22:12):
They could also just right, that's like the sperm doesn't
have to go into the egg, it gets put into
the egg um. But more traditional methods are just inserting
it into the near the egg in the culture, right,
and the culture can be artificial, but um it's also
often made of the endometrium from the woman or um
(22:34):
some in addition to possibly like her um uh cervical fluids.
So like it's it's basically mimicking what will what would
be going on in like the fallopian tube or something.
That's all they're doing is taking the process that normally
happens inside the woman's body and outside for a little while.
And so you've got the egg and the sperm in
the same culture and it's within possibly an hour, fertilization
(22:59):
might have taken place. There's an open bar, everyone's getting
to know each other, everyone's getting friendly. Little icebreaker happens,
and like you said, it can be hours when they
are doing the fertilization dance. And the next day your
doctor is gonna confirm visually that there are two pro
nuclei and that is the basis of your embryo right there.
(23:23):
You see that, then that means things are ahead in
the right direction because the pro nuclei from the sperm
and the pro nuclei from the egg you're gonna fuse
to make a single nuclei and that becomes the embryo,
which divides into well, that becomes the zygote I'm sorry,
which divides into two cells, and then I think by
(23:43):
the time it's either two or four cells, it becomes
an embryo, right, yeah, and then that's a couple of
days after fertilization. Is when you get to that stage. Yeah. Yeah,
the cell division is very slow at first, but then
it starts to pick up time. By the time you
reach day five or six, you've got what's called the
asked the system. By this time, there's um fetal tissues
(24:04):
growing in like uh, embryonic fluid cavity, and this thing
is yeah pretty much. Um this the doctor is not
normally gonna see this. They're gonna observe the egg, the
fertilized egg or embryo for maybe a couple of days
to make sure everything is progressing normally, and then they'll
put it back into the mom. Yeah. I mean that
(24:26):
can be done after one day, but um, your your
doctor that they'll have a plan of when they think
the best time is. And you're being monitored and all that.
Not you with the man, but the woman is being
monitored they don't care about the man. And then depending
depending on where they put it, that that's the type
of UM assisted reproductive technology that's being used. Right, So,
(24:51):
like if you're using IVF, the thing has been fertilized
outside of the womb, outside of the body, and then
introduced into the the uterus. Yeah, it's called the transfer. Yeah,
and they basically just usually catheter right, Yeah, it's UM.
It's it's suspended in fluid um to I guess, just
make it easier to get in there. It's like those
(25:13):
UM peanuts, the foam peanuts for shipping. It's that version exactly.
So it's suspended in the drop of fluid and it
is a long, thin cafeter and it's um placed into
the vagina, pass the cervix right there in the uterus
and squirt there it goes. And it's really that easy.
There's another process called um zygo introphallopian transfer where UM
(25:40):
it's the same process, but instead of depositing the fertilized
egg into the uterus, they put it into the fallopian tube. Right,
And I think that has not as great a chance
as as ib F. Is that right, I think you
try ZIFT is what it's abbreviated as UM before IVF okay,
but again all those rules are subthing to change depending
(26:02):
on your doctor in your situation. UM. And then your
embryo hopefully well attach to the uterine wall, uh if
it attaches. I think we said at up topic, pregnancy
is when it does not attached to the uterine wall,
but outside of the uterus, but usually the Filippian two
I think, right, it like never descends into the uterus,
(26:25):
and so you can't get pregnant that way, or you
can't have a kid that way. No, you can't, like
even if the kids starts to develop, you have to
terminate the pregnancy because it will kill you, that's right.
Or you can get what's called a chemical pregnancy, which
is basically just a really early miscarriage, super early in
the process chemical pregnancy. Yeah. Uh, And those are just
(26:45):
a couple of things that can go wrong along the way. Uh.
You know, it's a stressful time for the couples because
they're probably at there it's probably their last step towards
having a natural as they call them UM. And then
the woman is also getting injections for hormones throughout that
can be rough on on the lady as well. I
(27:06):
can imagine so um, in addition to being infected with hormones,
having your eggs harvested, getting laproscopic surgery like um, your
husband being in a room where he has to ejaculate
into a cup and like all of this stuff, Um,
there are actual risks involved, like physical risks. So like
(27:26):
we said with if you get the laproscopic surgery, when
your eggs are harvested, UM, like you have the risk
that comes from any kind of anesthesia, any kind of
surgery like that. So um there are things like chest pains, um.
What else. Well, there's one risk called o h s
S Ovarian hyper stimulation syndrome, and that's when you're overari
(27:49):
swell up, which is super painful and about of patients
UM experience that. But it can range from mild cases
where you just take over the countermens two more severe
cases UM moderate to severe where you know gas and
alge and vomiting and no appetite. Uh. And I think
only one to two of women experienced severe ohss. That
(28:13):
means you're probably gonna gonna go to hospital, gain a
lot of weight, like things that women don't like. And
and that's the result of those fertility drugs, like the ovaries. Like, whoa, whoa,
I did not sign up for this. You're over stimulating
me and I'm fighting back pretty much. Um. But yeah,
it's it does sound like it's fairly common, at least
(28:34):
in a mild form, and it's in the mildest form
apparently it clears up on its own. Um. So then,
like I said, with a retrieval, you have the general
anesthetic issue. Um. And then even with the lighter aspiration procedure, Uh,
there's still problems. Like you can get an infection, Um,
(28:54):
you can have structural damage. But speaking of structural damage, um,
in addition to in vido fertilization, you could also try surgery.
That's another avenue that some people try to UM solve
their infertility. Like if you have if your fallopian tube
is blocked or whatever, they can go in and yeah, yeah,
like if you have a physical problem. Yeah. So chuckers,
(29:18):
we already mentioned ZIFT. Have you heard a gift? I
have gamme eat inter phallopian transfer similar to IVF, but um,
it's in the fallopian tubes. Now, what's the difference between
XIFT and GIFT? Then okay, I'll explain. Oh wait, wait,
Ziff is in a lab. Gift is in the Philippian tubes. Yeah,
(29:39):
like you go in and and artificially inseminate the egg
in the fallopian tube. Okay, that makes sense. Yeah, but
if you have damage phallopian tubes, you can't use the
gift method. But that the Gift method, the advantage of
it is much much more closely mimics natural birth or
natural pregnancy because the egg is inseminated in the fallopian
(30:02):
tube and then it just goes about its normal process
from there. Yes, so aside from having sperm introduced through
a needle, it's totally natural. But it's not used. It's
only like two of cases, and I think Ziff is
only one percent. Yeah, I saw even less than I
saw that. Both of them are less than one percent.
And the big blockbusters in vitro fertilization. Uh. And then
(30:23):
there's something called I C S I UH intra cytoplasmic
sperm injection and that's a treatment that you'll do alongside IBF.
Remember I was saying like, depending on how the sperm
is introduced, that's one way that it might work. Yeah.
At about cases, I think they use the the I
C S I method, and that's just injecting the sperm
(30:45):
basically into vegg. Well, a single sperm that's like your
sperm has problems, and so we're gonna pick out one, dude, hercules, hercules. Uh.
And the cool thing about IVF is literally, yeah, if
you have multiple eggs um that are really great, um,
(31:06):
you can freeze the ones you don't use, and if
you want to go back for round two, you can
skip the first part of the harvesting and go directly
to uh, the next steps. Yeah, I guess you could
skip all the hormones and all of the possible over
stimulation of ovary. Yeah, the initial hormones, but you still
have the ones on the backside. That it's being able
to skip that that first bed is a big relief
(31:27):
to a lot of women, I can imagine. Yeah. Yeah,
I'm sure it's worth the expense too. Ut freezing Yeah yeah.
So um. What's crazy about all this chuck is that
not all insurance covers this. A lot of insurance treats
UM IVF procedures as an elective procedure. UM. As a result,
(31:48):
some states, I think fifteen states have laws on the
book saying if you're an insurance company operating in our state,
you have to at the very least cover infertility treatments. Yeah,
and I mean just check with your insurance if you're interested.
They may cover some but not all. UM, but you'll
probably get some assistance, you hope. Yeah, Or you can
(32:10):
just move to a state like Massachusetts that has like
UM law. Yeah. Basically the law is like you cover
ivfly they have right, they have the best some of
the best IVF doctors up there. Yeah. I read an
article that interviewed this one couple and they were like,
what some state that didn't have any insurance laws about
(32:32):
IVF and they moved to Massachusetts, and they said it
was like going from a place, going from a hospital
that didn't even have X ray technology going into like
the most cutting edge type of hospital you could possibly imagine,
just because because it's required there. The doctors by nature
are all just experts at it because they've done so
(32:52):
much work on it. They're trying to make little baby liberals, right,
little take Kennedy tone and around you anything else. I
got a thing else. So let's speed the couples out
there going through this stuff. Yeah, God's being good luck. Yeah,
we wish you well. Um, and if you want to
learn even more about this, you can type in vitro
fertilization in the search part how stuff works dot com
(33:14):
and that brings up listener mail. I'm gonna call this,
uh work surveillance. Good. We did that one people employees
spying on you, the employers spying. That's just true. Hey, guys,
I work for blank company on a large shipping corporation
let's call ship Co. Yeah, ship Co for seven years.
(33:38):
When I started, I love the company and the job.
As things shifted more towards the bottom line oriented attitude
with the company, I start to get pretty burnt out
began looking for something else to do with my life.
I always had an intense I'm sorry, in interest, we'll say,
an intense in an electric guitars, not just as a player,
but something I studied from a historical standpoint and always
(33:59):
enjoy taking apart and messing with my guitars. At some
point it became interested in lutheriory and decided to become
a guitar maker. So what I ended up happening doing
Luther Yeah, like a luthier. As a guitar maker, like
a cooper makes the barrels. Yeah, wine barrels in it. Yeah,
(34:19):
a luthier makes a guitar. I did not know that,
l U t h I e er Uh what ended
up happening. I would finish up my workload for the
day and tidy up the store, and if there were
no customers I would work on my guitar designs at work.
For a while, the management didn't care, but as the
pressure started being put on them, they had to tell
me to stop. But I didn't because I found my passion. Finally,
(34:42):
one day I was pulled into the office and handed
screenshots that I hadn't taken of my guitar design work
that I was doing on the clock. So they had
a program that wasn't just sending keystroke information of their
security team, sending actual screens of everything going on on it. Yeah.
We talked about that one. Yeah, I don't remember. It's
called man. I would freak out if someone handed me screenshots. Uh.
(35:03):
Needless to say, I was put on disciplinary probation. Didn't
make it to the end of that because I quit
to pursue my dream and I'm happy to say that
I've been a full time professional luthier ever since. It's
one of my guitars. Is even on the cover of
a recent issue of Premier Guitar magazine that's like the
Premier Guitar Magazine. There's a second story about a robbery
(35:24):
that happened while I was on that probation period, but
I'll leave that for anyone curious enough to google my name.
Tantalizing all right. That is from Paul Roney R H
O N E. Y. And he says, if either one
of you guys once a handmade USA electric guitar by
a company that doesn't spile and some employees and hit
(35:44):
me up, I will hook you up. Wow. And I
checked them out and they're sweet. Yah. Yeah, I'm gonna
see what hook you up means and when you stuff, yeah,
we'll see. But yeah, that is from Paul Roney. And
good for you for fighting ship co. Yeah and pursuing
your dreams. Mr Roney, congratulations and you're doing a good
(36:06):
job that since you're beautiful. So uh, if you want
to let us know about how you stuck it to
the man, you can tell us via Twitter at s
Y s K podcast on Facebook dot com slash stuff
you should know, uh, through email. It's stuff podcasts at
how stuff Works dot com and check out our website
while you're at it, Stuff you Should Know dot com
(36:32):
for more on this and thousands of other topics. Is
it how stuff works dot com.
Welcome to Stuff You Should Know Fromhouse Stuff Works dot com. Hey,
and welcome to the podcast. I'm Josh Clark with Charles W.
Chuck Bryant y. Yeah, and this is Stuff you should Know.
It sounded uh sardonic, yery yi j a silent yawking, yawking.
(00:27):
I'd never get sick of that movie. No, it's a
good one. I haven't seen the second one. Don't really
intend to, but I'm afraid too, Yeah, because it might
tarnish my love of that character, because I've heard it's
not very funny to just keep it keep it with
the first one. I'm totally gonna watch him just waiting
for cable. Oh yeah, yeah, Yeah, TBS knows what they're
doing with movies that were for the big screen. Yeah,
(00:51):
size them down, best start ever. Uh. So you're doing good.
I'm great, Okay, good. Um. So we're talking today about
IVF in vitro fertilization. Um. And I have to say, Chuckers,
(01:12):
I don't really have by the way, I don't have
an intro for this one to um, although I do
have a bit of one. All right, let's see uh
in nineteen In two thousand thirteen, a lady named Louise
Brown celebrated her thirty fifth birthday, and with her birthday
(01:33):
coming and going, she announced that she was pregnant with
her second child. This is like mind blowing crazy stuff
all over the place, because Louise Brown was the first
human being ever conceived using in vitro fertilization. Yes, they
called them test two babies back then. Remember that. Yeah,
totally test two babies. You don't call it that anymore. No,
(01:55):
we've gotten a little more scientific as a society since
the seventies. Plus. I don't think they use test tubes. Yeah,
if they ever did, I think maybe petri dishes, culture dishes,
not test twos, but you know culture dish baby. It's right,
that's weird. Test tube baby. It kind of rolls off
the tongue. It's got the two T sounds, which makes
it a little funny ish and um intriguing. But that's
(02:19):
what she was. She was the first test two baby.
It was eight in England, um, and she was born July.
I think, um, like just a few days later. I
think the second IVF baby was born in India very
in very short order. For two. I'm sure that their
doctors were like come on, will you give birth already?
(02:41):
I want to be the first. Nobody remembers number two.
And then the following year, in nineteen seventy nine, the
first American IVF baby was born. And that's the history
of IVF, like it just goes back that far. Since then,
I think thirty five more than thirty five million uh
IVF babies have been born a couple of hundred thousand
(03:03):
each year in the US alone. Now, yeah, it was
like in the sixties eighties. Now it's up to like
a hundred and something a hundred and change. I think
I got over two thousands. Do you really really? I
saw two thousand twelve or maybe maybe two d thousand worldwide.
(03:24):
All right, let's just settle on that. I'll bite on
that one. Um. But yeah, that's a lot of babies
that are born through IVF, and it's a it's crazy
how the thing that struck me and finally we're getting
to the end of the intro um is that what
I v F is? It seems so like whiz bang
(03:46):
crazy futuristic. No, it's it's figuring out. We figured out
how a woman becomes pregnant and figured out the ways
that we could possibly best help that process along, and
that's what it is. Yeah, it's really there's no like
crazy new technology. They don't like like buzz her with
(04:09):
like a prey goo laser, nothing like that. It's strictly
like catheters and timing and you know, hormones. It's crazy
how simple it is. But it's also equally crazy that
you know, it's as successful as it is considering what
it What in vitro fertilization consists of. Yes, I guess
(04:32):
we can go ahead and talk about success rates. Um.
In the US, women under the age of thirty five
have a thirty to thirty five chance of conceiving with
ibf uh. It drops between thirty five and forty six
over forty uh. And that is percentages of live birth cycle,
(04:53):
which is yeah, per cycle. So like, if you go
through a cycle of in vitro fertilization, do you have
the percentage chance typically which is pretty much in lock
step with natural birth rates according to age it Yeah, well,
I mean it definitely decreases with age, but I'm not
saying it's like one for one. Sure, yeah, yeah, it's totally,
(05:14):
But I'm saying that I think the depreciation of possibility.
It goes down with age naturally as well with IVF two. Yeah,
and live birth is the key here because many times, uh,
there will be conception and there will be a pregnancy,
but any number of things can go wrong from there.
Oh yeah sure. Chemical pregnancies UM topic pregnant topic pregnancies. Apparently,
(05:40):
some Chinese researcher did a survey of a hundred thousand
plus live IVF births UM and found that there's a correlation.
You were three times likelier to have a major birth
effect if you were born via in vitro fertilization than natural.
And he just found a correlation. Um, not a cause,
(06:01):
but just the numbers. For some reason spit that out. Yeah. Well, now,
one of the new things you can do is up
for at a certain point in the process pg D,
which is preimplantation genetic diagnosis. And this is a test
that will cost you several thousand dollars and it basically UM.
It allows you to root out certain mono genetic disorders,
(06:23):
like you can get PGD testing and find out if
the baby might have like sickle cell or Huntington's disease
or cystic like process or downs and then UM you
can make a decision at that point whether or not
you want to continue with the process. Yeah. You know,
there's a real um concern that there won't be like
that down syndrome, people will be extinct eventually because the
(06:47):
should have gotten so accurate. Yeah, yeah, I don't think
that will happen. Well. And there's also ethical concerns with
pg D about you know, do you do selective termination
if you can find out it's a boy and you
wanted a girl, right or um, oh I didn't want
to give brown eyes? Yeah, and I know there's a
lot of ethical yeah, associated with it, and um, it's
(07:11):
even more basic than that for a lot of people
to like, if you have a fertilized egg, um, or
even just an egg with the potential human life. To
some people, that destroying just the egg that that was
never fertilized is like a moral problem. Yeah. Or let's
say you, um, you have a chance of multiples, um
(07:35):
twins or triplets or quads or more. If you're a
certain age, that is not good and can be dangerous
for you as the mother and for the kids too. Yeah.
So at that point, um, you might have to go
through what they call selective reduction, which is choosing which
ones to go with. Well, there's a lot of pitfalls
this UM, but there's a lot of people who are
(07:58):
helped by it as well, and at the very least
there's a lot of people who seek the help from it.
I saw something like in this article, which I think
was written in two thousands, six or seven. Yeah, it's
a little dated. A head they said six point one
million Americans are faced with infertility, which UM, infertility is
not like Bam, you're infertile. UM, here's what's wrong with you?
(08:24):
Infertility be right, but it isn't always technically infertility. The
definition of infertility is that you have um gotten it
on for a year unprotected and no baby has been
produced for six months. If you're overt okay, But it
depends on the doctor. Like this article talked a lot
(08:46):
about well, if you've gone this far and you've done
these procedures, then they'll move you to this. A lot
of the places are fertility clinics or baby factories and
they'll you can go right to I D F if
you want to. And if they say that they believe
in so's. There's not like any hard and fast law,
you know, that's the impression. After doing this for how
many years have we been doing this? Now, after eighty
(09:09):
years of doing this, um, I've learned that how stuff
works article is like it deals in ideals. It's not
necessarily like this is how it works in the real world.
It's like, this is how it works according to the law.
That's true. We do our best. Yeah. Um. So, apparently
about seven point three million people UM are faced with
infertility and they turned to IVF, and IVF is far
(09:31):
and away the most popular form of what's called UH
assisted reproductive technology, which, as we said, sounds whiz bang
and futuristic but not necessarily Yeah, about fifty of a
r t UM methods are what they call low tech,
which is maybe we'll put you on some hormones. UM
(09:53):
Antibiotics apparently are a huge one, a huge stream of
for infertility. Yeah. They supposedly especial the unexplained infertility, which
affects something between ten to thirty percent of infertility cases
are just unexplained. Yeah, they're like, we there's nothing structurally
wrong with you. Your husband's sperm is fine, Like there's
we can't figure it out. Well, it made getting pregnant
(10:16):
isn't the easiest thing in the world. It seems that
way in the movies, but there's an explanation for things
even when it's unexplained. And because there's this whole unexplained thing, Chuck,
there's like a lot of suggestions as to you know,
what's at play. Yeah, but you're but you're right. It
is kind of like, uh, man, woman, get together, have child,
(10:38):
have another child, maybe a third, and like it's no problem,
like you said in the movies. Well, and especially when
age comes and you know people are getting married later.
Uh you see, you know, sixteen year will have a
baby without any problem. It's sort of weird that we've
we haven't. Things haven't changed reproductively speaking, Like people are
(11:00):
getting married in their mid thirties, but you can still
get pregnant when you're thirteen, And it's like has shifted.
It's not going to shift within cultural attitudes. No, no,
which is why we're like, okay, well we need technology then, right, right,
But like I said, um, about half the assisted reproductive
technology methods are low tech. Um. Klomad is a big
(11:23):
probably the most popular fertility drug treatment. They've been using
that since like the fifties, right, I don't know, they
say fifties, either fifty years or since the fifties. Okay,
Well it's um. It's an oral medication and it is
used to induce ovulation. And actually now men have seen
have used it to increase testosterone. Um. Because an NFL player,
(11:44):
UH just got banned for using chlomad for fertility because
they said it increases testosterone. So it was a performance
enhancing drug, but he was using it to try to
get pregnant. That's what he said. Oh that's not fair. Um. Yeah,
Robert mathis of the cult, so he was suspended. Um.
(12:05):
But clomad, with clumbad alone, you have a chance of
ovulation success and about a forty three percent chance of
pregnancy success over three cycles. And after three cycles that
number goes way down. UM. So really like it becomes
less and less probable that you'll conceive after three cycles. Yeah,
(12:25):
it's the same through three and then and that's just
with clomad and then after that, like what people generally
do is try a few different methods before moving on
to IVF, like just the hormones UM or what we'll
talk about now, which is uh artificial insemination, right, and
that that like um assisted reproductive technology with an umbrella term.
(12:46):
Artificial insemination is an umbrella term underneath the a R
t umbrella. Yeah, and it's basically any time you UM
try to give the sperm a leg up and its
race toward the egg. Yeah, it's it's inseminated artificially. In
other words, it doesn't come directly from the penis into
the vagina. Right. Why does that make you laugh? Still?
(13:08):
I just felt like I was in the kindergarten class
cop class. Uh. Yeah, it's when the sperm is harvested
in UM for for AI for artificial insemination, it's either
implanted intravaginal or interest cervical, so in the vagina, in
the cervics. But if you're going to put it directly
into this service or the uterus, you have to wash them. Yes,
(13:32):
you can't put untreated sperm into directly into the uterus
because you will have what's called uteral contraction, which apparently
is extraordinarily unpleasant. The sperm have some sort of um
it's called proto glandings. I think, yeah, that you have
(13:53):
to wash off the sperm. If you don't, protoglandings will
set off these contractions in the uterus exactly. So they
and I said, you or I think of at uterine
contractions they're pretty violent. Uh so yeah, you wash the
sperm and um. Not only does it remove those protoglass stuns,
it's um. It eliminates any substance it will get in
the way and make the sperm motile. And motile means
(14:16):
they're good swimmers. Right. That's another another advantage of using
artificial inscimination, as you can say, uh, you're cut, you're cut.
You made the team, you're cut, and then you put
together this dream team of the best firm and you say,
go get them. That's right. Right, So, if you're using
the wash sperm and directly onto the uterus, that's called
(14:37):
I ui intra uterine instimonation. Uh. And that's just kind
of one step further than Hey, I like artificial instimination.
You can do the turkey based method at home, sure
if you want. So that's a thing. Yeah, like they
have kids. That's a form of artificial insemination. That is
artificial instamonation. Yeah, but I mean it's an umbrella term.
(14:58):
Well yeah, if you're using the key based her at home,
you're you're artificially inseminating but you're probably inserting it directly
into the vagina. Maybe the cervix. You're not doing intra
uterine you can't do unless you have a sperm washer, right,
which you can afford one of those these days, you know,
that's right. So if those fail, then your next step
(15:20):
is is probably gonna be IBF. But like I said,
depending on your age and what's going on, you can
skip straight to ib F if your doctor says that's okay,
well we'll skip straight to IVF after a message break.
How about that? All right, So let's talk about the
(15:44):
IVF process. Huh yeah, again, pretty low tech, high tech stuff.
It's neat. Yeah, it will cost you about twelve grand
I saw. Yeah. I mean that's a I hate the
ranges for these procedures because it really it depends on
where you are and if you have insurance. I think
fifteen states require insurance to cover it. Um. You know.
(16:07):
Let me interject here. There's an argument that the lack
of standards in pricing for medical procedures is the single
problem for why the health care system in the US
is broken. Yeah, that it's not necessarily insurance, that it's
not necessarily chronic disease that it is. If you came
(16:31):
up with standard pricing, yeah, you could solve quite a
bit of the car mechanics. Yeah, that's supposed to be
a standard. Yes, I always I never knew that with
car mechanics. If you um, when they say how much
time it takes, it's really not how they don't time
how long it takes. There's a manual that says, you know,
changing a carburetor is one point five hours. I didn't
(16:52):
know that. Yeah, I just know that Mr Goodbrand's posts
is on the board him like McDonald's what like oh
a menu. Yeah. Anyway, I agree with you about the
medical standards, and it makes a lot of sense. I mean,
chronic disease is a huge problem, especially preventable chronic disease.
(17:12):
But that's not the only issue here. It's the fact
that you can be charged almost literally in arm and
a leg depending on where you go. That's rights. It
will cost you some money, but if you have good
insurance then that will help out. Uh. So here are
there are basically five steps. The first is ovarian stimulation. Um,
(17:33):
this is when you're gonna be taking fertility drugs. Uh.
It's could be a couple of weeks of that um.
Some are oral. Sometimes you're gonna be given shots to
your wife, or if the ladies on our own should
be given shots to herself. Because the good thing about
ib F is you don't need a live man necessarily. No,
you just need the sperma. So a lot of the
(17:53):
could come from anywhere. Yeah, single ladies are all the
single ladies or ladies in the l g BT community.
I always want to mix up those letters. Oh yeah,
like they doesn't need to be a man involved. No,
I mean at some point, I guess if you could
(18:14):
grow sperm in a lab from stem cells. Not directly
technically you could do that, but no, it doesn't have
to be involved in harvest sperm from a sperm bank,
anonymous donor friend of a friend, transient who's just passing
through town, whatever your standards are. You could conceivably get
(18:34):
your hands on some sperm and then bam, you don't
need a man. I was it from the besket I
could get you some sperm by three pm. That is
a great movie. Man. I saw that again for the
first time in a while recently. Oh man, I think
he's talking about a big toe. I can get you
a big toe by three pm. Um. But yes, you
will need sperm if you're the husband and it's uh,
(18:55):
just your regular old husband and wife trying to conceive,
or just a man and woman. Then the hus and
will deposit that sperm and a little room designed to
make that happen, and then they will take the sperm
and wash it and hold it. Uh, and it's all
timed out, you know appropriately. Of course they can't hold
(19:15):
them to it forever. And so that's the ovarian stimulation.
Like you're trying to get the eggs to come along,
and not only are you trying to get that an
egg to come along, you're trying to get several to
come along. Yeah, that's the whole point is you want
multiple eggs, right. So you know, a woman is born
with all of the approximately four hundred thousand eggs she'll
ever produce in her life. Um down right, during her
(19:38):
menstrual cycle, one of those eggs enters a fallopian tube
and um it becomes mature. Right. So what these hormones
do is get a bunch of those eggs into their
fallopian rappers and get them to mature over time. And
the doctor um, I guess pays attention to how they're maturing,
and when he decides these eggs are ready to get
(20:00):
that's when you hit step two, which is the egg
retrieval step. That's right, and that is not super complicated either.
It's called the name sounds complicated, transvaginal ultrasound aspiration, but
what it really is is a mild sedative and a
suction device that sucks out the eggs and that's really
(20:23):
all there is. Do it. It's pretty amazing. Um. If
you cannot use the um TU a method, you will
have to undergo a more involved procedure called laparoscopic surgery,
which isn't super involved either. It is also a short process,
but there's a small incision in the abdomen to locate
your ovaries. Yeah, they put a little video camera in there.
(20:46):
So um more involved obviously because it is a surgical procedure,
but it's not like you're staying in the hospital for
a week or even right. Yeah, it's just more involved
because you have to use more anesthesia to which automatically
increases risks exactly with the other one aspiration. Yeah, uh
the uh, I guess you just need a mild seditive.
It sets here. Yeah, it's like like twilight sleep alright.
(21:10):
So step three, you've got your eggs. You've got your
multiple eggs. They're all looking good. Then you yeah, because
they go through and they look at them and ye
and say this one looks good. This one looks good, man,
not this one. Yeah, And I'm not sure when pg
D can take place. I think after would think yeah, yeah,
I guess it would have to be yeah, okay, that
(21:30):
makes sense. Um. So then you've got your insemination. And
like I said, you're you've got your sperm. However you
got it. We ain't asking whatever it was a transient
on the street, More power to you. Um. They examine
the eggs and say these look robust and juicy and full,
and these are the best ones. So we're going to
(21:52):
use these. And that's when the sperm is at it
and the best sperm um is picked and then it's
in a culture and it's doing its thing right. And
depending on the sperm um, they might injected directly into
the egg, which is called um oh intra citoplasmic sperm injection.
(22:12):
They could also just right, that's like the sperm doesn't
have to go into the egg, it gets put into
the egg um. But more traditional methods are just inserting
it into the near the egg in the culture, right,
and the culture can be artificial, but um it's also
often made of the endometrium from the woman or um
(22:34):
some in addition to possibly like her um uh cervical fluids.
So like it's it's basically mimicking what will what would
be going on in like the fallopian tube or something.
That's all they're doing is taking the process that normally
happens inside the woman's body and outside for a little while.
And so you've got the egg and the sperm in
the same culture and it's within possibly an hour, fertilization
(22:59):
might have taken place. There's an open bar, everyone's getting
to know each other, everyone's getting friendly. Little icebreaker happens,
and like you said, it can be hours when they
are doing the fertilization dance. And the next day your
doctor is gonna confirm visually that there are two pro
nuclei and that is the basis of your embryo right there.
(23:23):
You see that, then that means things are ahead in
the right direction because the pro nuclei from the sperm
and the pro nuclei from the egg you're gonna fuse
to make a single nuclei and that becomes the embryo,
which divides into well, that becomes the zygote I'm sorry,
which divides into two cells, and then I think by
(23:43):
the time it's either two or four cells, it becomes
an embryo, right, yeah, and then that's a couple of
days after fertilization. Is when you get to that stage. Yeah. Yeah,
the cell division is very slow at first, but then
it starts to pick up time. By the time you
reach day five or six, you've got what's called the
asked the system. By this time, there's um fetal tissues
(24:04):
growing in like uh, embryonic fluid cavity, and this thing
is yeah pretty much. Um this the doctor is not
normally gonna see this. They're gonna observe the egg, the
fertilized egg or embryo for maybe a couple of days
to make sure everything is progressing normally, and then they'll
put it back into the mom. Yeah. I mean that
(24:26):
can be done after one day, but um, your your
doctor that they'll have a plan of when they think
the best time is. And you're being monitored and all that.
Not you with the man, but the woman is being
monitored they don't care about the man. And then depending
depending on where they put it, that that's the type
of UM assisted reproductive technology that's being used. Right, So,
(24:51):
like if you're using IVF, the thing has been fertilized
outside of the womb, outside of the body, and then
introduced into the the uterus. Yeah, it's called the transfer. Yeah,
and they basically just usually catheter right, Yeah, it's UM.
It's it's suspended in fluid um to I guess, just
make it easier to get in there. It's like those
(25:13):
UM peanuts, the foam peanuts for shipping. It's that version exactly.
So it's suspended in the drop of fluid and it
is a long, thin cafeter and it's um placed into
the vagina, pass the cervix right there in the uterus
and squirt there it goes. And it's really that easy.
There's another process called um zygo introphallopian transfer where UM
(25:40):
it's the same process, but instead of depositing the fertilized
egg into the uterus, they put it into the fallopian tube. Right,
And I think that has not as great a chance
as as ib F. Is that right, I think you
try ZIFT is what it's abbreviated as UM before IVF okay,
but again all those rules are subthing to change depending
(26:02):
on your doctor in your situation. UM. And then your
embryo hopefully well attach to the uterine wall, uh if
it attaches. I think we said at up topic, pregnancy
is when it does not attached to the uterine wall,
but outside of the uterus, but usually the Filippian two
I think, right, it like never descends into the uterus,
(26:25):
and so you can't get pregnant that way, or you
can't have a kid that way. No, you can't, like
even if the kids starts to develop, you have to
terminate the pregnancy because it will kill you, that's right.
Or you can get what's called a chemical pregnancy, which
is basically just a really early miscarriage, super early in
the process chemical pregnancy. Yeah. Uh, And those are just
(26:45):
a couple of things that can go wrong along the way. Uh.
You know, it's a stressful time for the couples because
they're probably at there it's probably their last step towards
having a natural as they call them UM. And then
the woman is also getting injections for hormones throughout that
can be rough on on the lady as well. I
(27:06):
can imagine so um, in addition to being infected with hormones,
having your eggs harvested, getting laproscopic surgery like um, your
husband being in a room where he has to ejaculate
into a cup and like all of this stuff, Um,
there are actual risks involved, like physical risks. So like
(27:26):
we said with if you get the laproscopic surgery, when
your eggs are harvested, UM, like you have the risk
that comes from any kind of anesthesia, any kind of
surgery like that. So um there are things like chest pains, um.
What else. Well, there's one risk called o h s
S Ovarian hyper stimulation syndrome, and that's when you're overari
(27:49):
swell up, which is super painful and about of patients
UM experience that. But it can range from mild cases
where you just take over the countermens two more severe
cases UM moderate to severe where you know gas and
alge and vomiting and no appetite. Uh. And I think
only one to two of women experienced severe ohss. That
(28:13):
means you're probably gonna gonna go to hospital, gain a
lot of weight, like things that women don't like. And
and that's the result of those fertility drugs, like the ovaries. Like, whoa, whoa,
I did not sign up for this. You're over stimulating
me and I'm fighting back pretty much. Um. But yeah,
it's it does sound like it's fairly common, at least
(28:34):
in a mild form, and it's in the mildest form
apparently it clears up on its own. Um. So then,
like I said, with a retrieval, you have the general
anesthetic issue. Um. And then even with the lighter aspiration procedure, Uh,
there's still problems. Like you can get an infection, Um,
(28:54):
you can have structural damage. But speaking of structural damage, um,
in addition to in vido fertilization, you could also try surgery.
That's another avenue that some people try to UM solve
their infertility. Like if you have if your fallopian tube
is blocked or whatever, they can go in and yeah, yeah,
like if you have a physical problem. Yeah. So chuckers,
(29:18):
we already mentioned ZIFT. Have you heard a gift? I
have gamme eat inter phallopian transfer similar to IVF, but um,
it's in the fallopian tubes. Now, what's the difference between
XIFT and GIFT? Then okay, I'll explain. Oh wait, wait,
Ziff is in a lab. Gift is in the Philippian tubes. Yeah,
(29:39):
like you go in and and artificially inseminate the egg
in the fallopian tube. Okay, that makes sense. Yeah, but
if you have damage phallopian tubes, you can't use the
gift method. But that the Gift method, the advantage of
it is much much more closely mimics natural birth or
natural pregnancy because the egg is inseminated in the fallopian
(30:02):
tube and then it just goes about its normal process
from there. Yes, so aside from having sperm introduced through
a needle, it's totally natural. But it's not used. It's
only like two of cases, and I think Ziff is
only one percent. Yeah, I saw even less than I
saw that. Both of them are less than one percent.
And the big blockbusters in vitro fertilization. Uh. And then
(30:23):
there's something called I C S I UH intra cytoplasmic
sperm injection and that's a treatment that you'll do alongside IBF.
Remember I was saying like, depending on how the sperm
is introduced, that's one way that it might work. Yeah.
At about cases, I think they use the the I
C S I method, and that's just injecting the sperm
(30:45):
basically into vegg. Well, a single sperm that's like your
sperm has problems, and so we're gonna pick out one, dude, hercules, hercules. Uh.
And the cool thing about IVF is literally, yeah, if
you have multiple eggs um that are really great, um,
(31:06):
you can freeze the ones you don't use, and if
you want to go back for round two, you can
skip the first part of the harvesting and go directly
to uh, the next steps. Yeah, I guess you could
skip all the hormones and all of the possible over
stimulation of ovary. Yeah, the initial hormones, but you still
have the ones on the backside. That it's being able
to skip that that first bed is a big relief
(31:27):
to a lot of women, I can imagine. Yeah. Yeah,
I'm sure it's worth the expense too. Ut freezing Yeah yeah.
So um. What's crazy about all this chuck is that
not all insurance covers this. A lot of insurance treats
UM IVF procedures as an elective procedure. UM. As a result,
(31:48):
some states, I think fifteen states have laws on the
book saying if you're an insurance company operating in our state,
you have to at the very least cover infertility treatments. Yeah,
and I mean just check with your insurance if you're interested.
They may cover some but not all. UM, but you'll
probably get some assistance, you hope. Yeah, Or you can
(32:10):
just move to a state like Massachusetts that has like
UM law. Yeah. Basically the law is like you cover
ivfly they have right, they have the best some of
the best IVF doctors up there. Yeah. I read an
article that interviewed this one couple and they were like,
what some state that didn't have any insurance laws about
(32:32):
IVF and they moved to Massachusetts, and they said it
was like going from a place, going from a hospital
that didn't even have X ray technology going into like
the most cutting edge type of hospital you could possibly imagine,
just because because it's required there. The doctors by nature
are all just experts at it because they've done so
(32:52):
much work on it. They're trying to make little baby liberals, right,
little take Kennedy tone and around you anything else. I
got a thing else. So let's speed the couples out
there going through this stuff. Yeah, God's being good luck. Yeah,
we wish you well. Um, and if you want to
learn even more about this, you can type in vitro
fertilization in the search part how stuff works dot com
(33:14):
and that brings up listener mail. I'm gonna call this,
uh work surveillance. Good. We did that one people employees
spying on you, the employers spying. That's just true. Hey, guys,
I work for blank company on a large shipping corporation
let's call ship Co. Yeah, ship Co for seven years.
(33:38):
When I started, I love the company and the job.
As things shifted more towards the bottom line oriented attitude
with the company, I start to get pretty burnt out
began looking for something else to do with my life.
I always had an intense I'm sorry, in interest, we'll say,
an intense in an electric guitars, not just as a player,
but something I studied from a historical standpoint and always
(33:59):
enjoy taking apart and messing with my guitars. At some
point it became interested in lutheriory and decided to become
a guitar maker. So what I ended up happening doing
Luther Yeah, like a luthier. As a guitar maker, like
a cooper makes the barrels. Yeah, wine barrels in it. Yeah,
(34:19):
a luthier makes a guitar. I did not know that,
l U t h I e er Uh what ended
up happening. I would finish up my workload for the
day and tidy up the store, and if there were
no customers I would work on my guitar designs at work.
For a while, the management didn't care, but as the
pressure started being put on them, they had to tell
me to stop. But I didn't because I found my passion. Finally,
(34:42):
one day I was pulled into the office and handed
screenshots that I hadn't taken of my guitar design work
that I was doing on the clock. So they had
a program that wasn't just sending keystroke information of their
security team, sending actual screens of everything going on on it. Yeah.
We talked about that one. Yeah, I don't remember. It's
called man. I would freak out if someone handed me screenshots. Uh.
(35:03):
Needless to say, I was put on disciplinary probation. Didn't
make it to the end of that because I quit
to pursue my dream and I'm happy to say that
I've been a full time professional luthier ever since. It's
one of my guitars. Is even on the cover of
a recent issue of Premier Guitar magazine that's like the
Premier Guitar Magazine. There's a second story about a robbery
(35:24):
that happened while I was on that probation period, but
I'll leave that for anyone curious enough to google my name.
Tantalizing all right. That is from Paul Roney R H
O N E. Y. And he says, if either one
of you guys once a handmade USA electric guitar by
a company that doesn't spile and some employees and hit
(35:44):
me up, I will hook you up. Wow. And I
checked them out and they're sweet. Yah. Yeah, I'm gonna
see what hook you up means and when you stuff, yeah,
we'll see. But yeah, that is from Paul Roney. And
good for you for fighting ship co. Yeah and pursuing
your dreams. Mr Roney, congratulations and you're doing a good
(36:06):
job that since you're beautiful. So uh, if you want
to let us know about how you stuck it to
the man, you can tell us via Twitter at s
Y s K podcast on Facebook dot com slash stuff
you should know, uh, through email. It's stuff podcasts at
how stuff Works dot com and check out our website
while you're at it, Stuff you Should Know dot com
(36:32):
for more on this and thousands of other topics. Is
it how stuff works dot com.
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Chuck Bryant
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