A Washington area woman gave birth this week to the first test tube baby conceived in this country through a nonsurgical method developed in France that is less expensive and easier to perform than most in vitro fertilizations, doctors at Fairfax Hospital said yesterday.
The 34-year-old mother, identified only as Carolyn D., told a news conference that she and her husband were "ecstatic" over the procedure that allowed her to deliver a healthy 6-pound, 11-ounce girl at the hospital at 6:45 a.m. Monday.
Cradling her pink-clad sleeping baby, Nicole Lorren, in her arms, Carolyn said she and her husband, James, had spent $50,000 during the last decade attempting to achieve pregnancy by a variety of medical techniques. "This was a last resort," she said.
The birth was the first in vitro fertilization success at Fairfax Hospital, which established an affiliated institute where a dozen other women have become pregnant, according to Dr. Joseph D. Schulman, the institute's director. By next year, Schulman said, he hopes to "make a baby a week."
The physician said Nicole's birth was the first success in this country of the transvaginal in vitro fertilization procedure pioneered in Europe -- a procedure that he said costs at least $1,000 less than older methods and that he predicted will become the most accepted method for in vitro fertilization.
Fairfax Hospital charges about $3,000 per attempt for the technique, which employs ultrasound, the high frequency mechanical vibrations used in medical diagnosis, to help remove eggs from a woman's ovaries for fertilization in a laboratory dish. By comparison, the cost is $4,000 or more for removal of an egg by a surgical procedure known as laparoscopy.
Insurance covered the cost in Carolyn's case, but most policies do not cover such operations.
The procedure Carolyn underwent uses a local anesthetic and ultrasound to guide a needle through the wall of the vagina to obtain eggs. Some clinics already use ultrasound to guide a needle through the bladder or urethra.
Schulman said his procedure takes 15 minutes and is more comfortable for the patient than the most commonly used in vitro techniques, which require general anesthesia and use a laparoscope -- a narrow, telescope type of instrument -- inserted into the abdomen via a small surgical incision to retrieve the eggs.
Carolyn described her procedure as "a little bit uncomfortable, but it's not bad and it lasts only a short period of time."
Locally, the George Washington University in vitro clinic also offers transabdominal ultrasound egg retrieval (via the bladder), so far without success, at the same fee as laparoscopy, $4,200 per attempt. It plans soon to offer two other types of ultrasound, including Schulman's method, for $3,400, according to clinic director Dr. Robert J. Stillman.
Schulman cautioned that his technique, like laparoscopy, offers only a 20 percent chance of success on each try. Carolyn's pregnancy was confirmed after the first try, but Schulman said he warns his patients to expect only a 50-50 chance of success after a year of attempts.
Schulman predicted that the greater comfort of his technique will reduce the dropout rate common to women in test tube programs.
More than 1,000 test tube babies have been born worldwide, more than 400 of them in the United States, since the birth of the first, Louise Brown in England in 1978. There are at least 126 in vitro clinics in the United States, according to the American Fertility Society.
About 90 percent of test tube pregnancies now are accomplished by laparoscopy, partly because few doctors are trained in ultrasound methods, said Dr. Martin M. Quigley, director of the Cleveland Clinic's in vitro program. But, he said, "I don't think there's ever going to be one technique that's going to solve all the problems.