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A Precious Goal

Jewish couples navigate the turbulent waters of infertility.

Ronelle Grier
Special to the Jewish News

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November 17.2005

aura B. never considered she
might not be able to have
hildren of her own. At 33,
after four years of trying, she real-
ized it might not be just "a matter
of time
"My husband and I always
wanted children:" she said. "When
we began to realize that this was
something we couldn't just take
for granted, the longing began to
overwhelm us.
"I would have considered adop-
tion, but my husband wanted to
continue his family's genetic line. I
began to worry that if I was
unable to conceive, I would lose
my husband. It was a constant bat-
tle to maintain my self-esteem:"
Although infertility is a medical
problem, it carries a stigma of
shame and self-blame, which is
why Laura and others requested
that their real names be withheld

Lc

from this article.
"It is every infertile woman's
secret belief that she is somehow
at fault:' said Rabbi Lauren Berkun
of Congregation Shaarey Zedek in
Oakland County: "This is even
reinforced in the Torah, when
Hagar the maidservant criticizes
Sarah, Abraham's wife, for her bar-
renness:'
Laura and her husband persist-
ed. After a disappointing experi-
ence with the fertility drug
Clomiphene, followed by a multi-
tude of tests and medical proce-
dures, including laparoscopic sur-
gery, they decided to try in vitro
fertilization or WE During the
second cycle, she conceived and, a
few years later, Laura repeated the
procedure and had her second
child. For couples like Laura and
her husband, the cost of concep-
tion is high — financially, physi-

cally and emotionally.
IVF procedures run approxi-
mately $12,000, even more for
ICSI, a technique that involves
intracytoplasmic sperm injection
directly into the egg. ICSI has a
significantly higher success rate,
especially when sperm problems
are present. Fertility drugs, espe-
cially the injectable hormones, can
cost upwards of $1,000 per
month. Insurance coverage varies;
some plans pay for diagnostic pro-
cedures and lab tests, but most do
not cover IVF.
Laura estimates they spent
almost $50,000 on infertility treat-
ment, including all the prelimi-
nary work-ups, medications and
IVF procedures for both pregnan-
cies. In addition to several invasive
procedures, she had to go through
12 weeks of painful intramuscular
injections each time.

Emotionally, the constant cycle
of rising and falling hopes each
month as she waited for pregnan-
cy to occur took its toll. She sur-
vived by immersing herself in
work and seeking support from
close friends and a professional
therapist.
"The emotional pain felt most
searing around the High
Holidays:" she said. "Perhaps it was
hearing about God's mercy on the
barren Hannah [giving her
Samuel], or maybe it was the year-
ly ritual of calling all the babies
born in the preceding year up to
the bimah."
The American Fertility
Association estimates that 10 per-
cent of the childbearing popula-
tion in the United States experi-
ences some form of infertility.
About 40 percent of these cases
can be attributed solely to the
male, such as low sperm count or
poor motility. Another 40 percent
are attributable to the woman,
including insufficient or poor
quality eggs, blockages of the fal-
lopian tubes or uterine abnormali-
ties. The remaining 20 percent
involve a combination of male and
female issues or are undiagnosed.
No statistics exist on the incidence
of infertility in the Jewish commu-
nity.
According to Dr. Mersol-Barg, a
reproductive endocrinologist and
fertility specialist in Birmingham,
common treatments include oral
medications, such as Clomiphene
and Metformin, or FSH hormone
injections to stimulate ovulation;
intrauterine insemination (IUI)
using sperm from the husband or
a donor; or surgery to repair inter-
nal scarring around the fallopian
tubes and ovaries.
Because both the quantity and
quality of a woman's eggs declines
with age, Dr. Mersol-Barg urges
women to seek treatment sooner
rather than later,
"A woman under 35 should seek
treatment if her cycle is normal
and she has been trying to con-
ceive for a year',' he said, even
sooner if her periods are irregular.
Women between 35 and 40 should
see a specialist after trying for six
months, assuming they have no
other problems, and women who
are 40 or older should go the
minute they even think about
becoming pregnant."

Precious Goal on page 20

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