April 26, 2000 -- Susan is a 39-year-old mother of three who lives in metro
April 26, 2000 -- Susan is a 39-year-old mother of three who lives in metro Atlanta. These days, she's caught up in the day-to-day experience of family life. But once, she says, her life revolved around her elusive quest to become pregnant.
For Susan (who spoke on condition that not her real name not be used), this quest was, for years, practically a full-time job. "I wouldn't wish this on anybody," she tells WebMD. "For a while it was my identity."
Susan and her husband tried for about seven years to get pregnant. They tried artificial insemination, fertility drugs, and surgery -- laparoscopies, biopsies, dye injected into her uterus -- not to fix the problem, but to find out what was causing it. They got no definite answers, Susan says. The most plausible possibility was something called "immunologic infertility." Essentially, she believes, her body had antibodies that killed the sperm before it could fertilize the egg.
Next, Susan tried to bypass the antibodies by having a doctor inject her husband's sperm directly into her uterus. She tried about seven times, to no avail. She was then 32 and felt she was running out of options.
"At the time, I thought this is the worst awful thing that could happen to me. This sounds crazy, but I used to think I'd rather have heart disease, I'd rather have cancer, I'd rather just have something where I'd die, than have to go through this," she tells WebMD.
Doctors told her the only remaining option was in vitro fertilization (IVF), in which her eggs could be surgically removed, fertilized in a lab with her husband's sperm, then replaced. The eggs, they said, could first be "washed" to remove the antibodies. She contacted a respected reproductive clinic near her home.
The clinic sent her a packet of information. "When I started reading it, there were pages and pages of what you have to go through each day, with instructions," Susan says. "I put it in a drawer and probably left it there for a year, just saying, 'I'm never going to do this,' then finally came back to it and said, 'I guess I have no choice.'"
Susan says her initial fear of surgery faded in light of her desire for the end result. As for the possibility of multiple births, "I used to wish for them," she says. Actually, the first big hurdle was insurance. The process costs thousands of dollars, and Susan's insurance company balked at paying. But after she got her doctor and the personnel director of her company involved, and made some calls herself, the insurance company agreed to pay about 80% of the costs.
That was seven years ago. "There's no way I could get it done today -- with my insurance I have now, there's absolutely no way," Susan says. There is no federal law requiring insurance companies to cover infertility treatments, but 13 states have enacted some kind of infertility coverage law, according to a national infertility association.
For Susan, what lay ahead next was the rigor of the procedures: the hormone injections, the doctor visits, and the possibility of failure.
"I think ? it's desperation that leads people to do these things," Susan says. "I mean, my husband would give me these injections; we had to do it twice a day. And then at nights he would be working, I'd take the stuff for the injection, and we'd go in the men's restroom [at his workplace] and lock the door or go in a broom closet so he could give me a shot."
Once, Susan says, she was working out of town at a medical convention. When she needed an early morning injection, she couldn't find a doctor willing to make a house call to her hotel. Finally, she paid a paramedic to meet her at the convention center at 7 a.m., before her flight.
"So there I was, standing in this convention center room with my pants hanging down, so he could give me a shot in my hip at a doctors' convention," she says. "But that was the only way I could do it."
Then there was the roller-coaster schedule. IVF wreaks havoc with work, Susan says, because daily ultrasounds are required during the crucial portion of the woman's reproduction cycle. You can't plan when you'll need time off, she says, because it's dependent on the almighty cycle. And even if everything works well up to that point, "you may get into the operating room and they say, 'Well, we didn't get any eggs; go home,'" she tells WebMD.
Even if eggs were successfully retrieved during the procedure, "I didn't know whether the sperm would fertilize the egg, so you still have this unknown, waiting for the call the next day telling you whether they fertilized, " Susan says. "And then the next day, waiting for the call: are the cells multiplying, or did they stop, did they fertilize?"
If at any point there is a failure, the whole process begins again; you wait for a couple of cycles before starting over, at a new emotional and economic cost. The process, Susan says, is "like buying a new $20,000 car and wrecking it on the way home, but you're still left with the payments."
Susan went through the IVF process four times without getting pregnant, at a total cost that she estimates at $55,000. She finally decided to pursue adoption. "When the doctor basically tells you not to come back, you know that it's over," she says.
But as it turned out, Susan was one of the lucky few. Within a month after completing the last cycle, she became pregnant by natural means. That put her emotions on another roller-coaster ride. "I was happy," she says, but "I just couldn't believe it."
While pregnant, Susan went to a lactation specialist who told her to get a stool for breastfeeding, which, the specialist said, would come in handy as a step to help the girl brush her teeth when she got older. "I thought, oh my gosh, do you really think she's going to live to brush her teeth? I just couldn't imagine her living; I just thought I was going to lose her," Susan says.
The girl is 5 now. Another girl, now 3, and a boy, now 2, followed. Though they're rare, natural births occasionally occur after discontinuing fertility treatments of any kind.
Of course, this is just one woman's experience. Couples considering infertility treatment should rely first and foremost on professional guidance.
But Susan has some advice for other women considering IVF. She says she counted on educating herself about the procedure, and she relied on the support of a group called RESOLVE, which has chapters nationwide (visit www.resolve.org for information). She suggests that women determine before beginning IVF how many cycles they're willing to try, or how many they can afford. And remember, she says, there's always adoption.
When all is said and done, she tells WebMD, "I would do it again."
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