Infertility: help for couples trying to conceive

Tracey Robinson-English

YOU know her as "Big Dee Dee Thorne," the wisecracking mom on UPN's hit television comedy Half & Half. In several episodes she's a symbol of motherhood, showing television viewers that a pregnant woman over 40 can be popular and attractive.

The dramatic irony is that actress Valarie Pettiford, who portrays "Big Dee Dee," is still waiting her turn to play her most important role as a mother in real life.

"I didn't only want to play a mom on TV," she says. "I need to be one."

Her overwhelming desire to experience motherhood led Pettiford, 45, and husband/manager Tony Rader, 43, on a five-year, heart-wrenching journey that involved numerous visits to infertility specialists, as well as high physical, emotional and financial costs. The couple already has spent more than $100,000 on out-of-pocket medical expenses. They are now considering an egg donor.

"It's been a journey I wouldn't wish on anybody," Pettiford says. "There were times I just wanted to die--the drugs, the hormones and the weight gain. Every time I got that negative news [that she didn't conceive] ... it's been devastating.

"I felt so isolated and alone," she continues. "It's difficult to talk about, but I want other women out there to know that they are not alone; there is support."

Pettiford and Rader are among thousands of couples who are struggling with infertility, which is defined as a couple's inability to conceive after one year of sex without using birth control. Medical advances and a few headline-grabbing births by women past their prime reinforces the notion that women have plenty of time to bear children. That is usually not the case.

A woman's fertility peaks in her late 20s and then gradually declines from her mid-30s into her 40s as her egg supply ages and diminishes. This process makes it difficult to naturally conceive, medical experts say. At the same time, a woman's risk of miscarriage increases.

"Between ages 35 and 40, there's an accelerated loss of eggs," says Gail Jackson, M.D., an obstetrician-gynecologist in Beverly Hills. "There's nothing magical about 40. The loss already has occurred."

Invasive procedures such as in vitro fertilization (IVF) or the use of donor eggs may be the only options left. "Of course, we all know of a 47-year-old aunt or friend who had a baby," says Maurice Butler, M.D., an infertility specialist in Washington, D.C. "It's the exception."

"When you see those celebrities in their 40s and 50s having babies, what they're not telling you is that they more than likely had a donor egg," adds Robert Collins, M.D., a certified reproductive endocrinologist in Youngstown, Ohio. Dr. Collins, who is the former head of infertility at the prestigious Cleveland Clinic, owns the only independent full-service reproductive clinic in the area.

Today, one in five women in the United States is having her first child after age 35, medical studies show. One in six women of reproductive age has sought medical help to become pregnant. The trend toward women delaying parenthood is contributing to a rise in infertility and related problems such as endometriosis, fibroid tumors and declining ovarian function, Dr. Collins says.

Among Black women, 30 to 35 percent have fibroids, though the causes are uncertain. As women age, fibroids and other health issues may become troublesome and impair conception.

"What we are seeing today is in sharp contrast to what we saw 10 to 15 years ago worldwide," Dr. Butler explains. "As women develop more options and more independence, they delay marriage and pregnancy. Beyond the peak years, there are many issues that may arise."

"I've seen so many of my women colleagues who are now in their 50s without children," Dr. Jackson adds. "They missed that short window of opportunity to have children. I now talk to young women early, while they're in their late 20s and early 30s, about making a decision to have children. I advise them to get into the right relationship leading to marriage so they can get on the path to childbearing by their mid-30s."

And, just as important, let's not overlook the male factor. A man's sperm count decreases with age although fertility may not be affected. Infertility also may be caused by some hormonal changes (in men and women) that are treated with medications. In addition, there may be physical problems with the reproductive organs that require surgery. In 10 percent of infertile couples, no cause sex partners and obesity increase the risks of infertility.

"Obesity is an underappreciated factor," she says. "It can cause problems such as irregular periods or hormonal imbalances that may affect a woman's ability to conceive."

Staying healthy isn't necessarily a safeguard against infertility, cautions Dr. Butler, who sees a number of in fertility patients who were convinced that they would have no problems bearing children as they got older as long as they exercised and did not smoke or drink. "The ovaries are still aging," he explains. "The ability to produce healthy eggs is decreasing. That's the problem."

Among African-Americans, infertility and reproductive treatments are often an avoided and misunderstood topic, experts agree. "You just never think that it could happen to you," Dr. Jackson says. "African-Americans tend to think that it affects other races. We also think that we do not have access or the finances to these medical advances."

That includes IVF. Simply put, IVF involves harvesting eggs from a woman's ovaries stimulated by potent drugs. In a laboratory, medical experts fertilize the eggs with the partner's sperm. The embryo is then inserted into the mother's uterus. Egg donation involves harvesting healthy eggs from another woman, who is usually paid a fee for the service, and in most cases, the fee is not covered by medical insurance.

Donor eggs are fertilized with the husband's sperm and inserted into the mother's uterus. The remaining embryos may be frozen for future attempts. "There's the perception that the child will not be theirs if a donor egg is used," notes Dr. Collins. "Couples think that the child will have different sources of parents, but there's still a genetic link to the father and a biological link to the mother."

Dr. Collins recommends that infertile couples over age 35 seek a certified specialist immediately if they have not been able to conceive on their own for more than a year. "Most people spend more time searching for a new car or buying a refrigerator than they do looking for a good doctor. Make it a priority," he advises.

Paying the high cost of infertility treatment is daunting. One IVF cycle, for example, ranges from $7,000 to $15,000. "I've seen some patients who have taken out second mortgages or borrowed from their parents to cover the costs of infertility treatments," says Dr. Collins.

"You see a lot of deserving, married couples forgo having a child because they can't afford the procedures," adds Butler. "It's heartbreaking."

Some couples are willing to consider extreme options to become parents. When Camille Hammond, a resident at Johns Hopkins Hospital, struggled with infertility, her mother decided to give her daughter the gift of motherhood by becoming impregnated with Hammond's eggs. Her mother gave birth to triplets.

"We did a lot of praying and a lot more talking before moving forward," Hammond says. "When my mom turned out to be pregnant with triplets, several doctors suggested taking one of the babies so that she would only bear twins ... but from the moment I knew mom was pregnant, I thought of them as my babies."

"I've reconciled that God knows best," says her mother, Tina Cade.

Demetria and Jermaine Holden of Farrell, Penn., conceived twins after the first IVF cycle with Dr. Collins. Included in the infertility treatment was surgery to correct endometriosis. Sons Jaiman Lee and Trian Leon are now 14 months old.

"I highly recommend it [IVF] as a treatment, keeping in mind that God is in control of each person's destiny to become a parent," Demetria says.

For Lenora and Rodney Hill, M.D., of Youngstown, Ohio, the journey on the infertility roller coaster involved seven miscarriages over five years. On the eighth in vitro fertilization attempt, the couple had a successful pregnancy. In 2003, the couple became parents of Rodney II.

"Folks think that it was an overnight success," says Dr. Hill, the proud father and himself an obstetrician-gynecologist. "People just don't know what you're going through--the timed intercourse, miscarriage after miscarriage. It's very time-consuming and it takes a lot out of you."

Dr. Hill, 42, says husbands and male partners also bear emotional strain when a couple is undergoing infertility treatment. After seven years of marriage, both Lenora and Rodney underwent a battery of tests before discovering that there were reproductive issues. They tried medication, followed by potent injections of fertility drugs, multiple cycles of artificial insemination and in vitro fertilization. Each time, Lenora would conceive, but she would also miscarry in the first trimester. The financial costs loomed upwards of $50,000.

"I felt it would never happen," recalls Lenora. "We were about to consider a donor egg, and then it happened [she became pregnant again]. We were very calm, not excited, because we knew what could have happened. We took it one day at a time.

"At times, I also felt very alone," Lenora continues. "I can't tell you how many times people would say 'go on a vacation,' or that 'you need a rest' or 'just relax.'"

Through it all, Lenora says her husband was very supportive. "Our relationship has become stronger," she says. "None of this 'you can't have my baby.' It was always 'our' problem."

Infertility can take a heavy toll on marriages, minds and bodies, making couples feel as though their lives are on hold. To help cope with the stress of infertility, some couples join support groups; others consider alternatives such as adoption.

Healing for TV star Pettiford came from women support groups and prayer. "There were days I just felt totally lost like God was punishing me for all of my mistakes," she says. "It's been a true test of faith."

But despite her failed efforts to conceive, there is still the possibility that Pettiford's prayers will be answered. With the medical advancements being made in the area of infertility, she and her husband, and thousands of other couples, might still realize their dream of being parents.

COPYRIGHT 2005 Johnson Publishing Co.
COPYRIGHT 2005 Gale Group