In vitro fertilization is one of the most amazing scientific accomplishments of all time. The concept- that you can extract a human egg, allow it to be fertilized by a sperm, nurture it in a Petri dish for several days, and then transfer a living dividing embryo into a uterus, all hopefully resulting in a healthy baby nine months later- is nothing short of miraculous. Yet this particular miracle happens every day, and about four million of these miracles have been born thus far. I have been counseling infertile women, men, and couples for 23 years In fact, I was drooled upon by one of these miracles just last week since her ecstatic grateful parents brought her in a visit.. And she is really really cute.
But one of the reasons she is a miracle, in addition to the science of IVF which created her, is that her parents live in Massachusetts which has an insurance mandate to cover infertility treatment, including IVF. If her parents had lived in any of the 41 states which don't have IVF coverage, she would not exist because her parents could not afford to pay for it out of pocket. There are hundreds of thousands, if not millions, of individuals in this country who will never have a biological child because they can't afford to pay for treatment.
There are no Federal laws to mandate infertility coverage. In fact, on June 15, 2009 , Senator Kirsten E. Gillibrand (D-NY) introduced S 1258, the Family Building Act of 2009 in the U.S. Senate. As of March 25, 2010 , the bill does not have any co-sponsors*. This makes no sense to me. If the Nobel committee feels that IVF is a significant enough accomplishment to give Dr. Edwards the coveted Nobel Prize, why do the Federal government as well as the individual states not include it into basic coverage?
I lurk on some of the message boards online and know the answers that some will give. Here are my responses:
Having a child is not a right. Why should fertile people have to subsidize the treatment for infertile ones?
Procreation is the strongest instinct in the animal kingdom-males of most species will kill for a chance to mate, and females will die to protect their young. Most human beings want to have children of their own. I would far rather "subsidize" infertility treatment for individuals and couples than pay for the medical care of smokers who get smoking-related diseases, or for the care of car accident victims who weren't wearing seat belts. You choose to smoke or not buckle up. You don't choose to have infertility. It is a disease, not a lifestyle factor.
Why don't they just adopt? There are millions of children without a home.
Adoption is not as easy, or as cheap, as you might think. Adopting a healthy infant can either take years (literally, 7 or 8) or be extremely expensive, in the range of $40,000. Adopting older children involves more risk, since many of these children have been exposed to emotional, physical, or sexual abuse. The younger the child when adopted, the fewer issues they tend to have. With many foreign countries clamping down on adoptions, it has become far more expensive and takes far more time to adopt domestically.
Just live with it. Not having a child is not the end of the world. There are far worse things which can happen to you.
Absolutely. People are hit with tragic events all the time. But that doesn't make infertility any easier. Imagine being infertile in a fertile world. You never get to tell your parents that they are going to be grandparents, you never get to feel your baby kick inside of you, or put your hand on your partner's belly and feel your child's first kick, you never get to be the guest of honor at a baby shower, you never get to see a crib in your home, you never get to talk about your pregnancy/labor/delivery when all of your friends do, you never see your child's first smile, or feel those little arms hugging you tight, you never get to hear the words "mom" or "dad" meant just for you, and you never get to experience that unbelievable unconditional love you feel for your child. And you know what? Infertility doesn't protect anyone from any of those "far worse things". I have had infertile patients get cancer, watch their partner die, lose their jobs, file for bankruptcy, hold a parent's hand as they die, and lose siblings, friends, and nieces and nephews. Women with infertility have the same level of anxiety and depression as do women with cancer, HIV+ status, or heart disease. Not being able to conceive is absolutely devastating.
I am blessed to practice in Massachusetts , which has the best insurance mandate in the country. So my local job is somewhat easier, since most of my patients in fact don't need to worry about money when making decisions about their medical care. But I travel across the country giving talks on the relationship between stress and infertility, so I meet lots of folks who have to make very difficult decisions about infertility treatment and money. Do they borrow money to pay for a cycle? Do they each take on second jobs? Do they sell their home? Do they move in with their parents?
The choices they have to make are ridiculous. We have the science that most of them need to allow them to reach their dream- to have and hold a healthy baby.
If the folks in Stockholm are wise enough to prioritize IVF, why aren't we?