By:Jonann Brady
For infertile couples, discussing the "birds and the bees" can quickly turn into an encyclopedic catalogue of pharmaceutical names, medical procedures and the minute fluctuations of bodily functions. To the uninitiated, it can be overwhelming, but for the couples themselves, the physical nitty-gritty is often the easy part. It is the emotional toll of infertility that is the most painful, they say.
Over 6 million people in the United States are infertile, according to the Centers for Disease Control, and the number of people receiving treatment for infertility is on the rise. Between 1996 and 1998, the number of medical procedures to treat infertility jumped 27 percent.
Women putting off childbearing until later in life is certainly a factor, but often times, medical or environmental factors come into play. Either way, infertile couples, especially women, often feel guilty, desperate and isolated when they can't conceive a child.
Kathy Tenenbaum, the outgoing president of Long Island Resolve, a national non-profit organization that provides support, education and advocacy for infertile people, says that couples, and particularly women, need to connect with people going through the same thing.
"You have to educate yourself and find emotional support outside your husband," said Tenenbaum. "You need to find like-minded women and couples."
The 45-year-old Merrick woman dealt with the pain of infertility for several years, and has been active in Resolve since 1994. She conceived her children - an 11-year-old son and 7-year-old twin girls - with the help of medical procedures, but Resolve does not try to push medical solutions over other options, such as adoption or living child free, she said.
The majority of couples turn to doctors or clinics at first when trying to conceive, said Tenenbaum. A smaller number turn to adoption, often after becoming exhausted by rigorous and expensive medical treatments. Very few opt to remain child free, she said.
The pain of childbirth
Deborah Reigel of Woodmere was 27 when she and her husband Michael began trying to have a child. They waited six months before seeking the advice of a doctor. Deborah, who calls herself "impatient by nature," said, "I knew in my heart of hearts something wasn't right."
The couple was devastated when they learned each of them had medical issues that contributed to the problem - he a problem with his sperm and she a hormone imbalance.
The couple began a crash course in modern medicine. Initially, they tried artificial insemination, where sperm is injected directly into an egg. After two cycles with no luck, Deborah began taking the hormone Clomid, meant to boost ovulation. During the second month, she began having hallucinations, a very rare side effect of the drug.
"I came out of a movie theater in April and...I was witnessing a full-blown snowstorm," she said.
The couple then dove headlong into in vitro fertilization (IVF), a process in which eggs are extracted from a woman, fertilized in a petri dish and implanted back in her uterus.
IVF is no guarantee for pregnancy. About 60,000 IVF procedures are performed annually in the U.S., with a birthrate of 25 percent. At up to $20,000 per attempt, the procedure is also extremely expensive.
Deborah was subjected to daily blood tests for six weeks and a cocktail of hormone injections which made her ovaries sprout over a dozen eggs the size of grapes.
"I was emotionally so shaken by the process," said Deborah. "You say, 'What if this doesn't work? Would I do it again?'"
Though Deborah and Michael describe IVF as very painful, financially absorbing and overwhelming, they were one of the lucky ones who met with success on the first try.
Deborah had been implanted with three strong embryos - two with eight cells each and one with seven cells. Two of these embryos became Sophie and Jacob, their 16-month-old twins.
Despite a difficult pregnancy that included months of bed rest, Deborah and Michael consider themselves blessed to be parents. Now volunteering for the Resolve Helpline, Deborah says their ordeal "pales in comparison to what others go through."
Adoption as an option
Dealing with infertility is fraught with difficult choices. While the Reigels say IVF was right for them, other couples are not ready to subject themselves to such grueling treatments. Some have ethical reservations. Still others have gone through a cycle or two of IVF and simply can't take feeling like "guinea pigs."
One Massapequa woman who asked to remain anonymous said that as a Catholic, she was morally opposed to IVF, although she had tried hormones and insemination. After dealing with infertility for over five years and leaving her full-time job at a women's magazine, she was exploring both holistic medicine and adoption as an option.
With so many children who need loving, stable homes, adoption seems like an obvious choice for childless couples. But many say it took a great deal of time for them to accept the decision they would not be biological parents.
Mariann Rubin, a Merrick social worker who specializes in infertility and adoption issues, went through five years of medical treatments, including two IVFs. She got pregnant a couple of times but then miscarried.
After feeling like a "pincushion" and depressed by her treatments, Rubin was ready to adopt, knowing she would have a child by the end. Her husband, on the other hand, was harder to convince. Because he was adopted himself, Rubin said the idea of having a biological child was a "big deal" to him.
In 1999, Rubin and her husband adopted their son, Sam, from a Russian orphanage in 1999, a decision neither of them regrets for a moment, she says.
Matt and Denise Dienna of Huntington also turned to adoption after trying for three years with a combination of Clomid and intrauterine insemination. After suffering a miscarriage and feeling pushed around by doctors, the Diennas were looking for another option.
After signing up to be foster parents, the Diennas found the group Families Through International Adoption, which helps couples navigate the process of foreign adoptions.
"We saw their web site and a light went on," said Matt, 48.
Denise, 33, said that when they decided to adopt a "weight was lifted off. There was so much pressure on me to conceive."
After traveling to Guatemala and bringing home Maria, now seven months old, the Diennas said they wouldn't have it any other way.
"When I was growing up and people said they were adopted I almost felt sorry for them. I thought of adoption as a last resort. But having Maria has been a gift from God. The feeling is exactly the same as having your own child," said Denise.
Adoption, which costs tens of thousands of dollars as well, is fraught with its own perils. Domestic adoptions can take years, and parents can suffer the same heartbreak as losing a child when adoptions fall through.
The bottom line, say advocates, is that infertility can cause depression that can quickly turn to desperation, and unscrupulous people will happily take advantage of fertile opportunities to make big money. Many couples, unwilling to seek treatment, turn to the Internet for information.
"The Internet is a very good way to lose all your money," said Rubin, who said that some Internet adoptions can cost upward of $50,000. "First, it's illegal [to adopt via the Internet] and it's foolish." But, having counseled scores of infertile couples and going through it herself, she added, "I understand the desperation."
And with so much money on the line, Rubin and others also caution couples to seek a reputable reproductive endocrinologist or fertility clinic.
No matter what their choices, people who have suffered through infertility agree that both men and women need to break free of the isolation they may feel.
"You have to deal with the emotional, not just the physical and seek a support group or a therapist," said Rubin. "It's a much clearer way to make a decision. Otherwise, you might do desperate things."
