News: CDC Videos on A.R.T.

Brief news update: The CDC, along with contributions from Aetna, have launched three videos on their site addressing different aspects of A.R.T.

The first video primarily focuses on the importance of being healthy prior to TTC and during pregnancy. Ways to increasing your odds to conceive and sustain a healthy pregnancy. The second video deals with the resources available to patients through the CDC. As I'd explained in an earlier entry, you can obtain SART reports for the IVF clinics in your local area. What this video provides is further understanding on how to read and interpret the data available to you. Lastly, the third video makes the case for single embryo transfers -- dealing with the complications of multiple gestation and the improvement in the technology to be more confident in single embryo transfers.

Despite the relatively poor quality production (Ok, so I'm a bit of a production snob after working in advertising and fashion) and dry delivery, I found the information to be relevant and accessible to those of us who are just getting started on the IF roller coaster. And the fact that the CDC and an insurance company (Aetna) have joined efforts to shed more light on IF treatments gives me hope that we can begin to discuss these issues more openly. Who knows, perhaps our law makers will also be more sympathetic to our struggles and make IF coverage a mandate in all states. One can always hope, right?

The Little Pill That Could

The Pill (I probably don't need to tell you which one) turned 50 last week. It's been blamed by conservatives for the sexual revolution and celebrated by feminists for giving women choices outside of their traditional roles. But as I read this enlightening TIME article, I couldn't help but notice how much irony is packed inside that little thing that over 100 million women systematically take everyday.

Let's start from the beginning. Its inventors Gregory Pincus and John Rock were both devout Catholics and both fascinated with creating life. Rock had 5 children and 19 grandchildren and was the pre-eminent infertility researcher; while Pincus successfully created a rabbit embryo, which became the precursor to IVF. In the mid 1950s, Rock and Pincus experimented with synthesized progesterone (derived from wild yams) to block ovulation. At the time, they were hoping that a few months on the Pill would help jump start a women's fertility (which it did for some women), but as we know today, most women use the Pill as birth control. So it's pretty ironic that  two men whose mission was to help barren women conceive, invented a pill that would actually help prevent conception. Want another twist to the story? Well, the Pill was finally approved by the FDA on May 11, 1960 -- yes, that's Mother's Day! Hmmm... interesting, no?

By all accounts, the Pill can be credited for helping women carve out a significant presence in the work force. In fact, by the 1970s, women were getting married later and wanted fewer children; with that, employers no longer had an excuse to turn women away or relegate them to secretarial jobs. Today, many women devote themselves to their education and careers, and some consciously choose to delay family building. I think most of us look up to successful women, I certainly do, but while I was going through IF, I started looking at those women differently. Don't get me wrong, I still admired them for their drive and intelligence, but I did wonder where they stood in terms of having children. Did they not want kids ever or just now? Had they been fooled into thinking that they could still easily conceive at 40? After all, so many celebrities of a certain age pose on the cover of magazines with their bundles of joy, never disclosing that they either did IVF and/or used donor eggs. Or maybe, these women were also silently dealing with IF and hiding their pain behind the doors of their corner offices.

Being on the Pill has given us so much freedom to define ourselves as sexual beings. We can "test drive" more than a single partner, we no longer have to worry about the condom breaking, we know when Aunt Flow's going to show up and heck, we can even go for 4 months without a visit from Her. But perhaps we got caught up in the excitement of it all and postponed facing our impending infertility. Female fertility begins to decline around 27 and hits a significant drop after 35, but surprisingly, 40% of women think that fertility only begins to decline after 35. That's a lot of women who are postponing the possibility of having children and most importantly, are delaying the realization that they might need ART to conceive.

The causes of IF are countless, but reproductive age plays a significant role in the dramatic rise of couples seeking ART treatments. From the quantity to the quality of eggs retrieved and subsequently the viability of the embryos being transfered, age isn't just a number when it comes to making babies. Now, I know better than to blame the Pill for the millions of people coping with IF or even age for that matter (I was one of countless "younger" IVF patients), but I do wonder if in our pursuit of having it all (and with the aid of the Pill), we are missing out on our primal need to bare children. What do you think?

Worst Case Scenario: True Story of a Wrong Embryo Transfer

Imagine if you will that you are giving IVF one last try. After a grueling month you finally get that dreaded call: Congratulations, you're pregnant! Just as your heart soars, they follow the news with a "but." Oh, and is this a big "but" -- turns out they transferred* the wrong embryos and that this baby to be is not genetically yours (can you hear your heart sinking so fast it hits the floor?). Well that's what happened to the Savages.

After years of trying for another baby and countless miscarriages, Carolyn Savage became pregnant and delivered a healthy baby girl. From that cycle they had some frozen embryos that they saved for a future attempt. After a year, they decided to give it one last try to have another child. And when they thought their dreams had come true, they quickly discovered the unconscionable error their clinic had made.

On the same day, another call had to be made; that one to the Morells, who were happily raising their twin daughters (yes, IVF miracles) and were oblivious that their frozen embryos had been used without their consent.

This story is an amazing one and it re-establishes my belief that there are some exceptional individuals out there, like the Savages. They were faced with the toughest decisions one could possibly face -- deciding to terminate the pregnancy or keep the baby with the understanding that they would have to give the baby back to his/her biological parents. This case covers so many aspects of the world of infertility. By deciding to keep the baby, Carolyn effectively became the gestational carrier for the Morells. But unlike a gestational carrier case (where a woman agrees to carry the baby to term for you because the genetic mother is unable) Carolyn actually wanted a baby. She wasn't getting paid for this, she wasn't doing it as a business arrangement. Out of pure selflessness, Carolyn Savage cared for this baby for 9 months like it was her own and agreed to say goodbye to him on his first day of life.

Let's not forget what the Morells must have been experiencing -- what if Carolyn Savage had decided to terminate the pregnancy? She certainly would have been in the right to do so in light of the heartache she was facing. But what about the Morells' embryo? It's a life after all and what could be their future child. I'm very pro-choice, but after going through IVF and experiencing the attachment you feel to a microscopic embryo, I look at the beginning of life very differently these days. Within those few cells are someone's hopes and dreams of a family.

Logan is now 7 months and loved by both families. And while Shannon Morell was robed of her pregnancy, my heart truly goes out to Carolyn Savage. As the Savages stated during their interview on the "Today Show" back in September (Carolyn was 35 weeks along at the time), the hardest part was still to come: saying goodbye to Logan and coping with the unimaginable loss.

This case also reminded me of a fascinating book I'd read a few years ago -- Everything Conceivable: How the Science of Assisted Reproduction Is Changing Our World -- and more specifically a section that dealt with genetics vs. biology. Recent epigenetics studies suggest that genes are not immutable, that the biological environment of gestation does affect our genetic make-up. So for instance, while an egg-donor mother might not be genetically linked to her baby, she does affect the genetic development of her child. So with that, I hope Carolyn Savage did pass on some of herself to Logan; her strength and generosity can never be understated.



*Please, please, please, do not confuse an embryo transfer with implantation. The former is the procedure during which embryos are put back into your uterus. Implantation is the physical burrowing of embryos/embryo into your lining, where they/it will spend the next 9 months. The media keeps saying "the embryos were implanted by the doctor." I wish doctors knew how to guarantee implantation, but they have no control over that. So, please use the correct terminology: it's embryo TRANSFER.

Money Talks: Insurance, Health Care and Your Infertility

This Google News Update appeared in my inbox this week and this is a good time to discuss the financial aspects of infertility treatments and how the new Health Care Bill falls short of alleviating this burden.

An IVF cycle will run you around $15,000 (some clinics are a little more or less expensive). Factor in the cost of medications, you've got yourself a big $20,000 bill at the end of your cycle. So it's no surprise that so many couples crumble under the weight of ART treatments. Some deplete their savings, others mortgage their home and many will accrue additional debt. 

While over 7.3 million Americans suffer from infertility, only 15 States have some form of mandate for insurance companies to cover all or part of infertility treatments. Those States are: Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, West Virginia. But, I did say "all or part of infertility treatments." So you can be sure that you will have to jump through hoops in order to get the coverage you need. At the end of your obstacle course, you will either be covered for the diagnostic tests, some of the medications and if you're very, very lucky, they will actually pay for your cycles in full. For those of us whose companies did not opt for infertility coverage, you do not have the option of buying individual coverage; you know, you have that "pre-existing condition" and all.

Well, the new Health Care Bill, taking effect in 2014, will make it mandatory for insurers to accept you regardless of your pre-existing condition. But before you jump for joy, nowhere does it say that insurers will be mandated to pay for your IUI or IVF cycles. And I have a sinking feeling that they probably will do anything they can to deny you coverage. 

Many don't consider infertility to be a disease. Some even say going through IVF is an elective procedure, like plastic surgery. Comments like "Why don't you just adopt or accept that you're not meant to be a parent" have appeared in numerous discussions on infertility. So it's no surprise that infertility coverage is not any where near the top of legislators' agenda. Clearly those who have children or have made the decision to not have children can't even fathom the severe emotional and physical pain you live with 24/7 in the isolation box that is infertility. 

So what can you do? First, we need to start educating people about infertility and not remain silent. Second, you can write your HR department and make your case to include IVF coverage. I guarantee you there are many other couples in the same company who need the coverage as much as you do. Third, you must relentlessly write your local congressmen and senators. It's Infertility Awareness Week and the perfect time to get involved. A great place to start is to get involved with your local chapter of RESOLVE.

As I've said before, do not sit on the sidelines. You MUST take charge of your infertility.