Little Miracles?

by Molly M. Ginty

Whatever stage of life you’re in, and whether you’re physically fit or living with chronic illness, you can find ways to be a wise steward of your health and well-being. Our health and wholeness are important keys to responding to God’s call for us and acting boldly on that call. That’s why Women of the ELCA have embarked on a new health initiative for the 2005-2008 triennium: Raising up Healthy Women and Girls. This ongoing column represents our commitment to the issue of women’s health.

Just the sight of a baby was enough to make Nancy De Persis cry. After struggling to conceive for four years, de Persis was beginning to lose hope — and to shun baby showers and baptisms that only deepened her sorrow. De Persis and her husband, Orlando, who live in Long Island, New York, eventually sought help from a doctor who specializes in reproductive medicine.

"I had two rounds of in vitro fertilization (IVF), in which our eggs and sperm were united in a lab dish and the resulting embryo was implanted in my uterus," says de Persis. "It took nine months of trying and cost more than $50,000, but when our son Matteo was finally born, it was the happiest moment of my life."

According to the New York–based American Fertility Association, 10 percent of Americans suffer from infertility (defined as the inability to conceive after a year of trying). More than 2.6 million U.S. couples like the de Persises have sought help for this problem. Thanks to recent advances, two–thirds of these couples eventually bear children — a success rate that is steadily rising as treatments become more advanced.

Since the first "test–tube baby" arrived in July 1978, more than a million children have been born through assisted reproductive technology. And in recent years, breakthroughs in this field have shifted into high gear. Last January, a 66-year-old Romanian woman became the oldest woman to give birth in recorded history. And in June, an infertile Alabama woman bore a healthy baby girl after receiving an ovarian tissue transplant from her twin sister. Stories like these give hope to older would-be mothers and to female cancer survivors who want to have children even after chemotherapy has permanently damaged their ovaries.

Across the United States, reproductive medicine has become a $2 billion business offering services of every sort. In Jacksonville, the Florida Institute for Reproductive Medicine is freezing single women’s eggs for future use. In Fullerton, California, a program called Snowflakes is helping infertile couples "adopt" embryos from other couples’ IVF treatments and bear and raise the resulting children.

In this age of high–tech baby–making, it seems conceivable that anyone can conceive. But health advocates warn that complications abound. The hormone treatments associated with IVF can increase the risk of ovarian cancer, breast cancer, and bone loss. In 35 to 40 percent of cases, multiple embryo implantations lead to multiple (and thus high–risk) births. And then there is the emotional strain of fertility treatment: undergoing painful procedures with no set deadline or guaranteed pregnancy in sight.

Even more daunting than these physical and emotional stressors can be the cost: $500 to $5,000 for artificial insemination, $25,000 to $75,000 for IVF, and $50,000 to $100,000 for gestational surrogacy.

"Fertility treatments are expensive because the technology involved is very elaborate," says Alina Salganicoff, director of Women’s Health Policy for the Kaiser Family Foundation in Menlo Park, California. "And typically, patients must pay for everything out of pocket. Health insurers only cover treatments that they consider medically necessary, and they don’t define having a child as a medical necessity."

Insurance coverage for reproductive medicine is mandated in only fifteen states, according to Resolve: The National Infertility Association, a patient advocacy group based in Bethesda, Maryland. And in many cases, insurance will only pay for 15 to 25 percent of total care.

What can you do if you’re trying to have children and hope to do so without depleting your body and your bank account?

Health advocates say you can help protect your fertility by staying fit, getting regular exercise, and eating a healthy, protein-rich diet. They recommend that you avoid smoking (which causes eggs to deteriorate earlier) and heavy drinking (which can cause irregular ovulation).

"If you suspect you’re infertile, seek treatment as early as possible," says David Adamson, M.D., the director of Fertility Physicians in Palo Alto, California. "Since fertility declines markedly after the age of thirty–five, you need to act quickly in order to save time and money and increase your chances of success. Seek help from the best experts you can afford, and make sure your doctor belongs to the Society for Assisted Reproductive Technology (SART) and has special training in reproductive technology."

For women like Nancy de Persis, seeking fertility treatment meant fulfilling a life–long dream. "Matteo, now two, is the love of our lives," she says. "And in 2006, with help from our specialist, we hope to welcome a second child into our family."

Article published in Lutheran Woman Today, December 2005