Facing The Facts Of Infertility
Forty percent of the patients who come to Dr. Richard Marrs, one of the most respected fertility specialists on the West Coast, are women from 40 up to age 50. They don’t have a child. And they’re desperate.
The following scene is emblematic. A 45-year-old filmmaker is sitting across from Marrs in his Santa Monica office. She is thin, rich and reasonably famous. She is not happy.
“I’ve done everything,” she says. “Tell me what more I need to do to have a baby.”
“There’s nothing more we can do,” the doctor says gently. “It’s your eggs that are not allowing this to happen.”
The woman is stunned. “How can that be? I feel wonderful. I’m in great shape. Look at me: Don’t I look 35? I feel 35. What do you mean, my eggs are too old?”
“I’m afraid we can’t change the genetics of those eggs,” the doctor says.
The patient insists she wants to keep going with high-tech treatment.
“The answer is no,” the doctor says. “There is no chance that in vitro fertilization will work after age 44. The only other thing we can do is change your eggs.”
“You mean use some other woman’s eggs with my husband’s sperm?” The woman wrinkles up her nose like a teenager. “I don’t want to go through all this for a child who won’t even have my genes.”
“Then this is where we have to stop treatment.”
No one can control her ovaries. No amount of money can buy back the magic of fertility.
At New York Hospital-Cornell’s Center for Reproductive Medicine and Infertility, directed by Dr. Zev Rosenwaks, 42 is the “quasi-cutoff” age for accepting patients for assisted reproductive technology. The center, which can boast of one of the highest success rates for in vitro fertilization in the country, now has over three years’ data on a total of 2,668 in vitro fertilization cycles. For women aged 37 to 39, the success rate is slightly better than 30 percent. At age 40, it drops to 22 percent. Beyond age 43, there were only three deliveries out of 44 attempts. National statistics are even lower.
The fixation on prolonging fertility has created a new breed of fertility specialists. Some of these fertility gods - almost uniformly male - are madly competing for market share. Some are financing their own private chains of fertility clinics. Here are some of the facts:
Fertility is a $2 billion-a-year business.
There are 250 to 300 fertility clinics in the United States.
A standard in vitro fertilization procedure costs $8,000.
In vitro results in 4,000 births annually in the United States.
There is essentially no regulation.
Dr. Mark Sauer runs the largest egg-donor program in Los Angeles, at the University of Southern California. Sauer, who will treat a woman of almost any age, talks about “doing the 50-year-old woman” as if he were doing an eyelid lift.
Sauer has what he calls a “stable” of egg producers - young donors who are given massive doses of hormonal therapy to stimulate multiple egg production, which is then fertilized by the sperm of the husband of the infertile couple. The egg donors are repeatedly stimulated, with no regulation and no apparent thought given to the longterm health consequences of these powerful hormones.
But the combination of desperate women and hustling male fertility doctors has drowned out any meaningful debate on the ethics of reproductive medicine.
If the need to have a child becomes overwhelming in the 40s or 50s, there are other options - adoption, becoming a literacy volunteer, Little League coach, or devoting time and energy to the children of family members or friends.
We all have to accept realities at each stage of life. It is very hard to give up the magic of fertility, but when we do, like any sacrifice - if it is consciously made - we have the opportunity of replacing whatever has been sacrificed with something better.
xxxx
The following fields overflowed: CREDIT = Gail Sheehy Universal Press Syndicate