Given the enormous amount of attention that our recent “I Believe” Video “contest” attracted, the numerous comments made on our website and on Facebook, and the article posted on TIME Magazine’s website entitled “Baby Contest: Couples Compete for Free IVF — Is This Exploitation or Generosity?” , I feel compelled to add my own commentary.

First of all let me congratulate the three winners, two of whom I will be treating personally here in Las Vegas and one who will be treated by my partner, Dr. Saleh at SIRM-Dallas.

A little history is perhaps appropriate here. In the late 80’s we were struck by the fact that while IVF provided the only hope of having a baby to many couples, most of them could not afford the out of pocket expenses. So we started (at first randomly) to give away a few free IVF cycles to those in need. In order to remove ourselves from the selection process, we formed a “hardship” committee comprising couples that had been benefactors of prior free cycles through our program. I notified several infertility support groups such as Resolve in Northern California that they should advise potential candidates to apply to our hardship committee for participation. We did not in any way promote or advertise this service. The payoff for us was the fulfillment and enrichment that came through the act of giving.

Subsequently, upon moving from Northern California to Las Vegas, and becoming a member of the board of INCIID (InterNational Council on Infertility Information Dissemination), I helped the organization’s founder, Nancy Hemenway, to establish the “INCIID the Heart Program.” This program provides donated IVF treatment through participating clinics (including SIRM) to couples who couldn’t otherwise afford it. SIRM has never promoted or leveraged their participation in this program, instead letting INCIID have the spotlight. This program is still very much alive and thriving, and many of our doctors provide donated IVF cycles through it.

For many years, we contemplated the ethical and perceptual implications of donating IVF cycles directly to patients, and in 2010, we initiated the first cycle donations to patients at our educational seminars. Since then, we have granted approximately 30 donated IVF cycles at our seminars through a random drawing process. Many of these patients have subsequently gotten pregnant and given birth. Thus babies have been born through these donations – the ultimate payoff for all of us.

It was not until December 2011 that we launched “contests” through the SIRM Website and Facebook page that would provide donated IVF cycles. The first was an essay contest, in which each candidate was asked to detail their struggle to start or add to their family. Both SIRM patients and non-patients were eligible for participation, and three couples were awarded donated IVF cycles (we are happy to note here that that one of the IVF recipients from this contest is currently pregnant with twins).

So positive was the feedback we received from the essay contest that we decided to initiate a video contest in May 2012. As with the essay contest, both SIRM patients and non-patients were eligible to participate. The 45 entries were reviewed by a panel of six outside judges, from which six finalists were selected. These videos were posted on our website and Facebook Page with voting open to any and all visitors (with just one vote allowed per visitor).

The voting was close, and ultimately we decided to award IVF cycles to three couples rather than just one. Their videos can be viewed on our homepage at www.haveababy.com.

This contest was thoughtfully covered by Time Magazine writer and infertility advocate Bonnie Rochman, in the aforementioned article titled, “Baby Contest: Couples Compete for Free IVF — Is This Exploitation or Generosity? ” The article raised several questions regarding the motivation and intent surrounding the contest. While the response (as evidenced by numerous postings on the SIRM Facebook Page and website) was immediate and almost universally supportive, it is fair to say that some of the points raised in the article and by the naysayers were valid.

The article raised the question as to whether any judge would be equipped to assess “worthiness” based upon a four minute video alone, and (probably correctly) suggested that aesthetics and production skills, rather than merit alone were involved in choosing the winners.

Other comments suggested that a lottery system would have been more fair and questioned whether or not it might have been preferable to judge couples in categories based on age, reproductive history, primary or secondary infertility, sexual orientation, marital status, etc. One comment suggested that selection of winners might even include a face to face interview. Another questioned whether women with repeated miscarriages should be allowed to participate since they appeared to have no trouble conceiving and thus wouldn’t necessarily need IVF.

While all of the above and many others such comments certainly have merit, there are constraints under which such a contest can be conducted.

One comment suggested that the contest was purely self-serving and performed as a marketing ploy. This I would like to address further. It would be disingenuous to say that we didn’t consider the marketing and publicity merit for SIRM. This is a routine consideration in running a medical practice – or any business. A comment on our Facebook page by Terri Davidson put it well:

“Of course, they were going to use this contest for marketing and publicity. Every health care provider markets; it’s naive to think they don’t. But marketing also promotes education and public awareness. Marketing is not a dirty word…But here we are debating about the nuances of this so-called controversy, when instead we should be focusing on why only 14 states in the United States have mandated infertility insurance coverage and why residents of the other states have to enter contests, lotteries, giveaways, instead of being able to access the infertility treatment they deserve. That’s the real controversy.”

Yes, we hoped that the contest would promote SIRM and expand public awareness of the quality and diversity of our services, as well as the compassion of our staff and doctors who donate their time to perform these IVF cycles.

Was this “generosity or exploitation” and did SIRM exploit patients by giving away 3 cycles in the process of promoting our services? I accept that this is open to debate, but I would argue that we did not.

Another issue raised, was that while this “contest” benefited the winners, it also worsened the plight of the majority that did not win. Based upon most of the responses we received and also on feedback that I’ve received directly, it is in fact quite the contrary. Many of the applicants stated that they had gained a great deal from the “contest” even though they didn’t win. They expressed the fact that they felt, based upon the empathy received by so many others, that they were not alone, and that there was a great deal of support accessible to them.

Others stated that the “contest” made them aware that there is expertise available to help them to, perhaps “better address” their problem and that it created “an appreciation of the struggles others go through”.

One person informed me that even if they’d have known from the beginning that they would not win a free cycle, but that they would have access to such a support system, they would have gone ahead anyway.

Finally, while this is relatively uncharted territory, my experience over the years in donating treatments and discounting services through non-profit organizations, has convinced me that as long as we do this with the proper intent, with humility and with empathy, we are doing the right thing. And if in the process it attracts infertile couples to SIRM, this is not a bad thing. In the final analysis I would refer to the old adage ….. “What goes around comes around.”