Infertile couples have been warned by a non-partisan congressional research agency of the low success rates of many of the more than 169 in vitro fertilization programs now operating in the United States.

This so-called "test-tube fertilization" ( process by which an egg is removed from a woman, fertilized with sperm in a laboratory dish, then reinserted into the uterus) is on the increase. But the Office of Technology Assessment says many programs providing this service "have had little or no success to date."That means that a lot of couples, who have paid a lot of money, are going home with no baby.

The University of Utah Health Sciences Center is an exception.

Dr. William Keye, chief of the division of reproductive endocrinology and associate professor of obstetrics and gynecology, said 49 women have completed the in vitro program at the U.'s Fertility Center during the past five months. Seventeen, or 34 percent, became pregnant. Three had miscarriages, but 14 women (9 percent) took home babies - including four sets of twins.

No triplets were born among this group, but last year a woman participating in the program had quads.

The U.'s success rate, one of the highest in the nation, has been remarkably consistent for the past three years. "It's not a flash in the pan; we have been doing something right for some time," Keye said.

Many of the other in vitro clinics can't make that claim.

Tim Condon, an analyst for the Office of Technology Assessment in Washington, D.C., told the Deseret News that 70 to 80 of the U.S. medical teams have established a record of some success with in vitro fertilization, but the remainder of the 169 in vitro programs have produced few babies.

Based on their findings, the agency recommends that childless couples be "good consumers" and do some serious investigation into a center before enrolling in an expensive program.

The warning is directed at a large segment of the American population.

The agency estimates that between 2 million and 3 million American couples need medical help to have a baby. Last year alone, Americans spent about $1 billion on medical care to combat infertility.

Because of the enormity of the problem, the Subcommittee on Human Resources and Intragovermental Relations of the House Committee on Government Operations and the Senate Committee on Veteran Affairs asked the agency to study infertility in the United States.

What resulted was a 402-page report presented to Congress, with no specific recommendations, but options for government action based on the agency's extensive findings.

The Office of Technology Assessment found that there hasn't been an increase in the incidences of infertility in recent years, but Condon said demands for infertility services has dramatically increased. Annually between 300,000 and 1 million couples are seeking assistance.

Eighty-five to 90 percent of these couples, Condon said, can be treated by more traditional approaches - drug and hormone therapy, surgery, and techniques like artificial insemination. Another 5 to 10 percent would be candidates for in vitro fertilization.

At the U., in vitro fertilization is considered the "procedure of last resort."

"We don't have a very large in vitro program; we do 50 to 100 treatments a year because most all of the couples who come through our program have done all the conventional things first," Keye said. (arge clinics provide 800 to 1,000 treatments per year).

"We offer a full-service fertilization program, including laser surgery, insemination of the husband's sperm into the uterus, medication to induce ovulation, plus microsurgery of the reproductive track."

Keye said in vitro is considered the last resort because the success rate, while respectable and certainly better than most programs in the country, still isn't great.

Plus, the procedure is expensive. It costs an average of $5,000 - a bill many couples end up paying themselves.

"Cost is a very big concern because the insurance coverage for techniques like in vitro is very spotty," Condon said. "The majority of insurance companies don't cover it. But there are a lot of infertility procedures covered by third-party carriers."