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The world's first "test tube baby" turns 40 next year. As she's grown up, so has the medical specialty that produced her: in vitro fertilization. It's a big business addressing a big demand.  On this episode of Reveal, we examine the stakes – and high costs – of IVF.

Malissa and David Pineda offer one searing example. Reveal's Bernice Yeung and reporter Jonathan Jones follow the Pinedas' story as part of a larger investigation into America's $3 billion IVF industry. Malissa went to a doctor seeking fertility treatments. She wound up lying on an exam bed as she felt the doctor using an instrument to scrape the interior of her uterus. How could that happen?

Yeung and Jones try to find out more from – and about – that physician: Dr. Rifaat Salem. His clinic advertises some of the highest success rates in the nation, based on data the federal government collects from clinics. That information is supposed to help guide would-be parents through the complicated, expensive and emotionally volatile process of assisted fertility. The reporters discover how doctors can interpret success rates to mislead and manipulate customers.

The pursuit of high success rates in the fertility business can also lead doctors to implant more than one embryo at a time, even if there's no good reason to – sometimes without explaining to patients how that practice puts mothers and babies at risk.

Illustration by Helen Tseng/Reveal



Al Letson