Go Directly to IVF - Do Not Pass Go?

A new study seems to suggest that couples suffering from infertility should not waste their time or money on less invasive fertility treatments, but instead should con sider going straight to in-vitro fertilization:

So it makes sense that some researchers are pushing to skip the middle step and go straight to IVF when the first-round effort fails. In a study presented last month at the annual meeting of the American Society of Reproductive Medicine, doctors from Dartmouth Medical School and Boston IVF concluded that women who were fast-tracked to IVF got pregnant three months faster on average, and spent $10,000 less than those who went through the usual preliminaries.

Considering how many couples I know who tried most or all of the less invasive treatments before finally being successful with IVF, this study would seem to be recommending the exact opposite approach. What's particularly interesting is that I had a conversation with a close friend regarding the halachic parameters of fertility treatments, and her halachic authority was definitely recommending that she and her husband try other treatments before approaching IVF, and seemed to treat IVF as pretty much a last resort (short of treatments such as surrogacy and sperm/egg donors, which can raise more complicated halachic questions). One of the reasons seemed to be a psychological - that the couple should not pull out all the stops treatment-wise, and then be dejected if the holy grail of fertility treatments doesn't show immediate results. While I can understand the motivations behind that, this study would seem to show that such waiting, considering the lower rate of success from the less involved treatments, might be more of a cruel and unusual psychological punishment in and of itself, as the article notes:

Shorter waits bring welcome psychological relief. One study claimed that women going through infertility treatment were as distressed as women diagnosed with cancer, heart disease, or HIV. Fast-tracking can mean fewer episodes of dashed hopes. That could lead to less depression, anxiety, and stress, which hurts marriages and, some claim, may lower one's chances of conceiving.

Another reason seemed to be because her Rav was concerned about the supposed higher rates of multiple births with IVF, and the fact that such multiple pregnancies entail a higher risk for both mother and children - however, that IVF does have a higher propensity for multiple births seems to be disproved from the study noted above.

The first is the potential to prevent higher-order multiple births—triplets, quadruplets, and beyond, which carry a greater risk to the mother's and babies' health. Women who get pregnant from injections with insemination face a 10 percent to 15 percent chance of carrying litters because the drugs can make them release six or more eggs. There's no way to control how many get fertilized. With IVF, by contrast, doctors create embryos in a lab and choose how many to transfer back to the womb, bringing the risk of triplets and beyond down to 2 percent to 4 percent. (The odds of conceiving triplets naturally are between 1 in 6,000 and 1 in 8,100.) That IVF figure is likely to decline further as doctors increasingly transfer fewer embryos.

So the question is, will the halachic recommendations change as a result of these findings, as the medical recommendation is hopefully going to - if they haven't already? Feel free to chime in with your experience as to whether halachic guidance given to infertile couples jibes with this medical recommendation to fast-track IVF. Though I know a few people who received halachic guidance to wait on IVF until other treatments have been tried, I know of at least one friend, living in Israel, who received a psak to go straight to IVF - but that obviously might have been complicated by her specific situation. So I'd love to hear some weighing in - anecdotal though it might be - on what seems to be the halachic consensus at this moment.

More on halacha and infertility here, from the indefatigable Chana's excellent notes from a medical ethics conference she attended at YU.