Efficacy and Suffering (Ch. 6 & 7)

1. physicians inflate success rate

1.1. lack of regulation of IVF industry in Egypt

1.1.1. Egyptians are less likely to question success rates

1.2. physicians may only treat the "easy" patients

1.2.1. young and mild problems

2. 20% success rate in the best IVF centers in Egypt

2.1. lower than Western countries, but not much lower

3. Physicians sell hope

3.1. God's decision

3.2. Suffering

3.2.1. "necessary evil"

3.2.2. Global pricing structure limits IVF medications in Egypt

3.2.2.1. restricts reproductive agency of third world

3.2.3. Men suffer too

4. Factors affecting IVF success

4.1. characteristics of patients

4.1.1. fertility in women declines after mid-thirties

4.1.2. religious women prohibited from accepting egg (or sperm) donation

4.1.3. had unnecessary and iatrogenic surgeries

4.2. # of transferred embryos

4.2.1. multiple babes = more risk

4.2.1.1. need for therapeutic/selective abortion

4.3. need to repeat IVF

4.3.1. cumulative success rate that incorporates numerous IVF cycles is "overly optimistic"

4.3.2. many women cannot afford multiple IVF cycles

4.4. early-stage dropouts

4.4.1. success rates do not take into account patients that have dropped out in earlier stages