MGH seeks bigger slice of brisk fertility market

Massachusetts General Hospital is looking to raise the public profile and expand the market share of its in vitro fertilization program, which is dwarfed by much larger clinics in the region.

In an emotionally charged advertising campaign, Mass. General will showcase its successes -- some of the state's highest pregnancy rates. Until now, it has remained largely out of sight in a market crowded with heavily advertised infertility care options.

Mass. General ''isn't necessarily the first place that people think of for women's care," said Daniel A. Ginsburg, president and chief operating officer of the Massachusetts General Physicians Organization.

The hospital's campaign to increase its standing began last month with an advertisement airing on Boston radio stations. It's targeted at career women. An actress portrays a professional woman flying home from a business conference who is transfixed by an infant on the plane.

''The whole flight I couldn't keep my eyes off her. I knew that's what I wanted more than anything in the world," she says, before explaining that she and her partner have not been able to conceive a child. ''Who could we turn to without losing any more precious time?"

A male narrator, accompanied by upbeat acoustic guitar music, provides an answer: Mass. General's in vitro fertilization clinic, where outcomes are ''among the most successful and safest in the country."

The kicker: the baby on the plane is named ''Hope."

The radio spots will be supplemented by Internet ads. Such advertising for in vitro services is common because it is the type of nonessential care that tends to encourage shopping by couples. Comfort and privacy are frequently emphasized. Some clinics, Mass. General's included, offer meditation and other services to help women cope with the intense emotions involved.

Business is particularly brisk in Massachusetts because it is one of about a dozen states in the country that require health insurance companies to cover infertility treatments.

Massachusetts had the third-highest number of in vitro fertilization cycles performed in 2003, behind New York and California, with 8,740, said Dr. Mark D. Hornstein, director of reproductive endocrinology and infertility at Brigham and Women's Hospital.

Even though the state's high concentration of patients in just a few large clinics is unique, Hornstein said, the competition has been collegial. Brigham and Women's has a collaborative relationship with Mass. General, he said.

''It's not really the kind of cutthroat competition that exists in other parts of the country in this specialty," Hornstein said.

Mass. General can back up its advertising boasts with statistics. For instance, 42.6 percent of its patients age 35 to 37 became pregnant after in vitro treatment there in 2003, the latest year for which data are available, according to a website maintained by the US Centers for Disease Control and Prevention.

That compares to in vitro fertilization pregnancy rates nationally of about 38 percent for 35-year-olds, 37 percent for 36-year-olds, and 30 percent for 37-year-olds, according to the CDC data. Mass. General's rates also were the best among Massachusetts infertility clinics for that age range.

The lowest success rates for that same age group in Massachusetts were at the Fertility Center of New England, in Reading, which had a 28.4 percent pregnancy success rate, according to the CDC. The clinic said it improved its rate to 42 percent in 2004 after recruiting a new laboratory director and revamping its laboratory procedures.

Boston IVF, the largest clinic in Massachusetts by a wide margin and one of the largest in the United States, had a success rate of 29.4 percent for patients age 35 to 37 in 2003. Dr. Alan S. Penzias, the clinic's surgical director, said Boston IVF is willing to treat women whose likelihood of getting pregnant is low, which results in lower scores overall.

''If a 30-year-old couple comes in, and she has only a 10 percent chance of getting pregnant, we believe in giving that couple a chance," Penzias said. ''Even if it makes our numbers look lower, that couple has a right to try."

Boston IVF, which is affiliated with Beth Israel Deaconess Medical Center, has an additional advantage, said Penzias: Its large population of patients is attractive to drug companies that sponsor clinical trials. That creates more opportunities for patients to receive free care by enlisting in trials.

In the field of infertility care, pregnancy attempts are tracked as individual five-week cycles. Each cycle includes administration of drugs, removal of eggs, implantation of fertilized eggs, and the anxious days waiting to see if a pregnancy occurs. Patients frequently undergo two or more cycles before getting pregnant.

Dr. Thomas L. Toth, who has headed the Mass. General clinic since its creation in 1992, said the five physicians there work as a team. Patient care frequently involves consulting with doctors from other specialties, he said. Current research is focused on freezing female eggs. The eggs are more fragile than sperm and embryos, which are routinely frozen now.

The program does not have any specific market-share targets, but it does have increased capacity in its new laboratory and patient-care areas on the 10th floor of the Yawkey Center, which it has occupied for a year, said Toth.

''It's not whether we are the biggest; it's can we be the best and safest," he said during a recent tour of the facility. In his office, he held a card and picture of a baby sent by one of his patients. ''It's more complicated than what is the size of our market share," he said.

Christopher Rowland can be reached at crowland@globe.com.