IVF: The Silent Treatment

While the number of infertile people in America has skyrocketed in recent years, growth of in vitro fertilization actually has slowed. In 2002, the last year for which figures are available, the Centers for Disease Control estimated that 7.3 million people could not have children, up more than 20 percent since 1995. Yet prescriptions for fertility drugs are decreasing, according to IMS Health, which monitors pharmaceutical sales. Demand for IVF treatments, which climbed exponentially during the past 20 years, has plateaued.

Why the slowdown? The baby-boomer population is aging, and generations that follow might not be optimistic about the future. "People worry the world is an unsafe place for children," says Dr. Jay Nemiro, medical director for the Arizona Center for Fertility Studies. He says the average age of his patients, once 31, is now in the 40s.

But fear isn't the only factor. While IVF has always been an expensive option, for would-be parents it is increasingly an out-of-pocket expense as employers exclude it from insurance plans. (Sixteen states still require employers to provide IVF coverage.) "There are huge economic barriers to access," says Joseph C. Isaacs, president of Resolve: The National Infertility Association. However, some see the trend as a testament to technology. Infertile couples who seek treatment now conceive more quickly, thus requiring fewer procedures, says William Gibbons, president of the Society for Assisted Reproductive Technology. Says Isaacs, "We are victims of our own success."