A NY Couple's Battle with Infertility

[SherryT]

http://www.nydailynews.com/city_life...p-328698c.html

An exercise in fertility

Couples shut out of the stork club find
that disappointment can bring a new kind of joy

By JENNIFER FRIEDLIN

Jennifer and Anthony Cafero and sons Mark, 5, and Nicholas, 6 1/2 months.
After several unsuccessful procedures, Sue and Irwin Slotnick decided to remain childless.
Aileen and Andy Donato and their adopted daughter, Gina

After getting pregnant on the first try with their son Mark, Jennifer and Anthony Cafero of Larchmont, N.Y., anticipated a repeat performance when they decided to have another baby at ages 35 and 33, respectively. But little did they know it would take four years.

"It's really hard to go on with your life while you're going through infertility," says Jennifer, now 39. "There were periods when I was barely functioning."

She's not alone. According to the Centers for Disease Control and Prevention, the number of Americans beset by fertility problems is on the rise, and the long road to conception is often fraught with sadness, anxiety, physical challenges and financial hardship. Last week, researchers unveiled a new test that might ease some of the struggles and frustrations experienced by couples. Plan Ahead, which predicts how many eggs women have in their ovaries, will help them determine when they should try for a baby (see box, below). But in the meantime, stories like the Caferos' are becoming more common, and couples are speaking out about their experiences, which don't always end with the birth of a biological child.

At long last, a baby boy joins the family

Some people hoping to conceive wind up making choices they never imagined at the outset. After Sue and Irwin Slotnick married, they bought a house in suburban Short Hills, N.J., with the expectation that it would one day be filled with kids. When the couple's pregnancy efforts failed, they went for a fertility check-up. Irwin was diagnosed as sterile.

"While devastating, we at least thought we knew why we weren't getting pregnant," said Sue.

Hoping to maintain a genetic connection to any future child, Sue and Irwin decided to use donor sperm. But after three inseminations failed, Sue went for a workup and was diagnosed with fibroids, a condition that can prevent a fetus from implanting. She had the growths surgically removed, but three more inseminations failed.

Two years had passed since they had started trying to conceive, and Sue, then 37, was aware that her options were running out. The couple had considered adoption, but the urge to try for a biologically related child was still strong. They decided they would pursue one round of IVF. Using hormones to stimulate her ovaries, Sue produced 13 eggs, eight of which fertilized. The doctor transferred all eight embryos, but not one of them took.

"I had started spotting on the day of the pregnancy test," Sue said. "That was devastating. Life doesn't prepare you for this."

After months of soul-searching and counseling, Sue and Irwin eventually decided to remain child-free. "We started thinking, is raising kids that important to us? Is that what we want to do in this life?" said Sue.

Now a family of two, both Irwin and Sue have made significant life changes. Sue traded in a corporate job for a more meaningful public-sector position. She also worked to get legislation passed in New Jersey that requires employers with more than 50 employees to provide coverage for infertility treatment. Irwin gave up a career on Wall Street and now works as a consultant. They travel regularly.

Happy with their life, Sue says the experience of infertility nevertheless lingers. "I don't know that it's ever over," said Sue, now 45. "I'm at peace with my decision, but I'm constantly aware that this is my story."

Adoption: In the end, a joyful solution

Aileen and Andy Donato of Massapequa, Long Island, started trying for a baby when Aileen was 30, but after three years nothing happened. Medical tests told them everything was okay, but Aileen still wasn't getting pregnant.

The Donatos tried intrauterine insemination, a procedure in which the sperm is placed inside the cavity of the womb around the time of ovulation. When several rounds failed, Aileen's doctor put her on ovulation-stimulating hormones, to no avail.

After 12 rounds of insemination over a three-year period, the Donatos were told to try in vitro fertilization, a more invasive procedure that involves extracting the eggs, mixing them with sperm and then transferring the fertilized embryos to the woman. A strict Catholic, Aileen was concerned about the church's view of the procedure and nervous about the increased level of hormones that would be injected in her body.

"I went for a consultation for IVF and I just knew I didn't want to do it," Aileen said. "I had this feeling if it's meant to be I'll do it on my own."

Finally, Aileen and Andy decided to adopt.

"I really wanted to be pregnant, not so much for the genetic connection. It was all about being pregnant," Aileen said. "But then I realized that more than anything I wanted to be a parent. After seven years, I was ready."

The couple turned to an adoption agency that promised them a newborn within nine to 18 months, charging $50,000 for the service. On Christmas Eve 2003, the Donatos received a call that a woman was about to give birth in California. Three weeks later, the Donatos picked up their baby girl. Today, their daughter, Gina, is about to turn 2 and Aileen says she could not be more thrilled, but the experience is never far from her mind.

"As happy as I am, when I hear that someone is pregnant, there's a twinge of envy I wish I didn't have," said Aileen. "Infertility is always with you."

In fact, experts who counsel infertile couples describe infertility as a life-altering trauma. People who once considered themselves young and healthy are forced to deal with their bodies' failure to perform as anticipated.

After initially seeking medical attention, people tend to feel optimistic about the prospect of a quick resolution. But, if a round of treatment fails or a pregnancy ends in miscarriage, a profound sense of grief and loss often ensues.

"You want people to believe there's enough of a chance for a treatment to work so they can endure the treatment, but if they get too hopeful and optimistic and it doesn't work, they crash and burn," said Dr. Alice Domar, director of the Mind/Body Program at Boston IVF in Massachusetts.

Given the fact that only 20% of Americans have insurance that covers in vitro fertilization, financial obstacles to building a family often compound the anxiety. One round of in vitro fertilization costs an average of $12,400, while alternatives like donor eggs, surrogates and adoption can cost tens of thousands of dollars.

Joseph Isaacs, president and CEO of Resolve, a national advocacy and support organization for people affected by infertility, said that people having problems conceiving should familiarize themselves with their options and pace themselves both emotionally and financially for the choices they may confront.

"People who say they want their own [child] exhaust their funds and then they don't have money for adoption," Isaacs said. "You need to consider all your options."

How many eggs in the basket?

A new test that predicts how many eggs women have in their ovaries, helping them determine when they should try for a baby, could be on drugstore shelves later this year, British scientists said recently.

The test, called Plan Ahead and available now only by mail-order, will sell for about $315.

It measures three hormone levels in the blood and assesses the number of eggs in a test-taker's ovaries compared to levels expected for other women the same age, researchers at the University of Sheffield in northern England said.

Because the test forecasts how many eggs will be in the woman's ovaries for the next two years, women can "make an informed decision as to whether, or how long, they can potentially delay before trying to conceive," a news release from the researchers said.

They warn, however, that Plan Ahead is not a fertility test; rather, it's a tool women can use to help determine if they may need professional help to conceive.

"When you get your report back after you do the test, it's been written very clearly that women shouldn't forget about the dignity of the fallopian tubes, the health of the womb and the partner," said Bill Ledger, a professor of obstetrics and gynecology at the university. "It's not a fertility test in that sense."

Dr. Stuart Lavery, a consultant gynecologist at London's Hammersmith Hospital, who was not associated with the product's development, said he thought the test could assist fertility experts as they try to help women have babies.

"The biggest challenge we face is that people come to us too late," Lavery said. "I think anything that gets people thinking about babies and trying to conceive early is good. If it alerts people to things that might not be straightforward and gets them to seek medical intervention, that's good."

But Lavery also said he was concerned that the test might give women a false sense of security, when a number of other factors could prevent them from conceiving.

The new test follows on the heels of findings last year that the number of eggs women have is not fixed at birth. Researchers say that women, like other mammals, may have germ cells that stimulate the growth of new eggs.

The test requires a small amount of blood, which must be drawn by a doctor or nurse practitioner on the second or third day of the woman's period, the researchers said.

The blood is mailed to a lab, which returns results in two weeks along with a guide-to-fertility booklet.