A new device, the INVOcell, is now available for many women seeking infertility treatment at one-third of the cost of traditional in vitro fertilization.
"We call the program 'Affordable IVF,'" said Karen Hammond, DNP, CRNP, at America Institute of Reproductive Medicine (AIRM). "We have so many patients who would be amazing parents, but the thought of coming up with $10,000- $15,000 is overwhelming to them, and they can't afford to do the procedure. INVOcell takes the cost in our program down dramatically.
"It is a small device with an inner chamber that holds eggs and sperm. Fertilization and development occurs inside that device," she said. "It is placed in an outer chamber and then into a woman's vagina. After five days we take it out and see if embryos have really formed. Generally they do, and we take those embryos and place them in the woman's uterus. It kind of takes the place of the IVF lab."
Cecil A. Long, MD
"The mother actually incubates the embryo," said Cecil A. Long, MD, reproductive endocrinologist at AIRM. "Because of the fluctuation of the temperature in the mother throughout the day, this may be key to developing better embryos than we can achieve in our incubators. In incubators, there's hardly any variation in temperature or O2 or CO2 gasses. There's going to be some fluctuation as the device is incubated in the mom's vagina."
"The procedure requires ovarian stimulation and egg retrieval, which is guided by transvaginal sonography, where a needle is placed just inside the vagina into the ovaries and the eggs are aspirated from each developing follicle," Hammond said. "Then the eggs are placed inside a little dish, inseminated with washed sperm from the husband or donor, and five to ten minutes later, we load the inseminated eggs into the inner chamber of the INVOcell, put that into the vagina where it's held in place with a retaining device kind of like a diaphragm. The woman can do any normal activities, except intercourse, swimming or tub baths."
Long said the device was FDA approved in 2015, and fewer than 40 programs in the U.S. are using it. "But people are hearing about it and starting to use it more," he said. AIRM is starting to use the procedure with about a dozen patients this month.
Hammond said patients don't need a referral for INVOcell. "They can call us. We're happy to talk over the phone to see if it's an appropriate avenue for them."
"It's not for everybody," Long said. "The ideal candidates are the couples where the wife has severe tubal disease, because we really are just bypassing the fallopian tubes. Maybe they've had previous tubal ligations and don't want to have surgery to reverse the tubal ligation. Candidates that would not be appropriate would be couples with a severe male factor requiring Intracytoplasmic Sperm Injection (ICSI) or when pre-genetic screening is required. That's not to say you couldn't do it in these cases, but the goal of INVOcell is to have an affordable way to do IVF. Once you start doing ICSI or pre-genetic screening, you are tagging on expenses and defeating the reason for INVOcell."
Still, Hammond said INVOcell will work for a large percentage of infertile couples. "We use a much more gentle ovarian stimulation so the medication is less expensive, and the procedure itself is less expensive," she said. "I would say a majority of infertile couples will qualify for this option."
Long and Hammond attended training in Dallas for the procedure. "They have been doing the INVOcell for about two years, and it was nice to have their input. Every time you do something there's a learning curve, and it's nice to be trained by someone who has been through that," Long said. "It's just a variety of in vitro, so if you have a good IVF lab, there are just a few little tricks to making this as efficient as possible. When the FDA had trials, compared to routine IVF, the results were actually comparable to using INVOcell."
A comparable result at one-third of the price makes INVOcell a promising option for infertile couples. "This expands access to care," Hammond said. "It gives people who otherwise couldn't afford IVF a really good chance at getting pregnant."
Cecil A. Long, MD