23 Oct Pay it Forward Fertility mentioned in NY Times Article
Clinic Raffles Could Make You a Winner, and Maybe a Mother
By DOUGLAS QUENQUA
“That’s right, one lucky woman will win the ultimate chance at starting or building her family,” said a contest announcement issued in April by Long Island I.V.F., a clinic in Melville that offers in vitro fertilization to women who are having difficulty conceiving.
Contestants were asked to submit “the most emotional or entertaining essays and homemade amateur videos” explaining why they wanted a free round of I.V.F. “Make us laugh with you or cry with you,” the announcement said. “Tell your story straight from the heart.”
The winner, Jessica Upham of West Babylon, N.Y., submitted a video that showed her repeatedly injecting her abdomen with hormones and later weeping on her bed as a clinician delivered bad news. When she found out that she won the contest — a doctor holding balloons knocked on her door the day after Labor Day — she “just lost it,” she said in an interview.
“I feel inadequate that I can’t provide this to my husband the natural way,” said Ms. Upham, 37, who has a son conceived through I.V.F. and is receiving the free embryo implant this month. The prize, she said, is “a wonderful opportunity that I wouldn’t otherwise have.”
Fertility clinics around the country have found that such promotions, which can include random drawings and essay contests, can be an effective way to raise their profiles and crowd their mailing lists with potential customers. While larger and better-known clinics have no problem filling their waiting rooms with women who can pay $10,000 to $15,000 for a round of I.V.F. — and who know the odds against their success — smaller clinics say they must do what they can to compete, despite the ethical concerns critics have raised.
“It is against the law to raffle off a puppy, but we’re allowed to raffle off the opportunity to have a baby?” said Pamela Madsen, a founder and former executive director of the American Fertility Association, a nonprofit organization based in New York City. “What if they were raffling off chemotherapy? Would we be O.K. with that?”
The people who stage the raffles say that both sides benefit: one woman gets free treatment, and the sponsor gets publicity.
“I hesitate to use the word ‘marketing,’ but we wanted to get our name out there,” said Robin Musiak, the executive director of Reproductive Health Specialists, a Pittsburgh clinic that has conducted several raffles. “It worked really well.”
Still, medical ethicists worry that the contests exploit vulnerable people and trivialize human conception. British authorities have condemned the giveaways and an Australian government official has proposed banning them, yet they have become increasingly common, particularly in the United States.
Some people are fine with the contests — particularly infertile people who see them as adding some fairness to a system that favors the wealthy.
“If a doctor is willing to donate his services that way, I think that’s amazing,” said Ramsi Stoker, 32, of Holladay, Utah, who last month won a round of I.V.F. donated by the Utah Fertility Center as a raffle prize at a 5K race. She has spent more than $25,000 over four years trying to conceive, without success.
“I don’t know what a better prize could have been,” she said. Besides, she added, “it’s not like they were raffling off a baby.”
The Utah race, which drew 550 participants, was staged by a group called Footsteps for Fertility, which said it raised $35,000 for a fertility charity in North Carolina. Race registration cost $35 to $40 per couple and came with one raffle entry; Ms. Stoker and her husband, Brian, had 90 people running on their behalf.
But the Stokers seem happier than the head of the North Carolina charity that benefited, who regretted that the raffle did not screen entrants for financial need or insurance that might cover the procedure. Fifteen states have laws that require insurance companies to offer coverage for infertility diagnosis and treatment, which often — but not always — includes in vitro fertilization.
“The issue becomes, is it really a person in need putting their name in that raffle?” said Lori Moscato, a co-founder of the charity, Pay it Forward Fertility. She said she was grateful for the donation but questions whether she would get involved again, adding, “Who wouldn’t want to receive a free treatment?”
In some ways the contests mirror how I.V.F. has become mainstream. Its use has nearly doubled among American women in the past decade as it has grown more effective. Today about 1 percent of infants born in America are conceived through I.V.F., according to the Centers for Disease Control and Prevention.
Many raffles strike a discreet, respectful tone. An online lottery won in 2009 by a schoolteacher in Forest Hills, Pa., required only that she share her e-mail address and fill out a survey.
“I belonged to an online message board for people suffering from infertility, and someone posted about a clinic that was raffling an I.V.F. cycle away,” said the teacher, 32, who asked that her name not be used because her job requires her to abide by Roman Catholic teachings, which condemn the procedure. “Six months later, I got a call saying we were the winner. Now we have a 2-year-old girl.”
Such success stories are powerful advertisements. “Our angle on it was to reach more people to make them aware that fertility treatments existed,” said Ms. Musiak of Reproductive Health Specialists, the clinic that awarded I.V.F. services to the schoolteacher. “Our hope was that whoever we chose, and it was just a random drawing, was somebody that would not have been able to afford this treatment had they not won this contest.”
The teacher’s success runs counter to the odds. Despite improvements in technology that have increased fertilization rates, the chances of becoming pregnant in a single round of in vitro fertilization are about 40 percent for women under 35 and about 20 percent for those at 40; rates continue to drop among older women. Multiple rounds per woman are not uncommon, which often inflates the price to well over $40,000 for one pregnancy.
“I think it’s a good parody of the unfair system in which important medical services are only available to those who can afford them,” said Nir Eyal, a professor at Harvard Medical School who specializes in ethics. “Nevertheless, sometimes these raffles exploit the despair of couples or their misunderstanding of statistics to extract money from them.”
Jessica Wilen Berg, a professor of law and bioethics at Case Western Reserve University, said many people found the notion of raffling off a chance to have a baby to be jarring.
“We’re used to paying for medical services, so while we’re not thrilled that you would have to pay to create a life, it’s not so bizarre for us anymore,” she said. “But raffles are the most commercialized notion of it. Something about this is supposed to be sacred.”