More IVF Physicians

Corrections or additions?

This article by Kathleen McGinn Spring was prepared for the

December 11, 2002 edition of U.S. 1 Newspaper. All rights reserved.

IVF: The Promise & the Pain

During a phone interview, Belle Degenaars turns away

from the receiver and asks — again and again — for just a

little more time. "I’ll be just another few minutes," she

says firmly, but oh-so-gently. Each time there is grudging

acquiescence,

followed closely by the sound of tiny feet scrambling off to play.

Degenaars, registered nurse, full-time mother, and advocacy chair

of Resolve, an all-volunteer infertility support and information

organization,

sounds just like a typical mom, bargaining for a few more minutes

of phone time. But she is a mom with a difference. The toddler playing

at her feet was conceived "with some help." She declines to

provide further details on her infertility treatments, but makes it

clear that those who suffer from infertility, even those who succeed

in having children, are forever different.

"Only the fertile world thinks about having three or four

children,"

she says, making "the fertile world" sound like a distant

planet. "The infertile are happy to have one. There is an

appreciation

that is so rich. You could be one of those people who never have a

child. It can break people. It does break people. There is a hole

in your heart you can’t fill."

The mother of two children — six years and several miscarriages

apart — Degenaars, a resident of Montvale who holds a master’s

degree in public administration from New York University in addition

to her nursing degree from Adelphi, devoted four years to obtaining

passage of the New Jersey Family Building Act. In effect for just

one year, the act requires insurance coverage for infertility

treatments.

Already, the effects are being felt. On the most intimate level, there

are a number of proud new parents pushing strollers down Garden State

sidewalks. Degenaars says she knows some of them, and knows they would

not have been able to afford the infertility treatments — which

can run up to six figures in extreme cases — that made those

babies

a reality without the mandated coverage.

There have been business repercussions as well. The new law has been

a boon for infertility practices such as IVF New Jersey. The

reproductive

endocrinology practice whose letterhead reads "Making little

miracles

come true," is expanding. Business is up about 30 percent since

the act went into effect. The practice has hired two additional

doctors,

and has opened a new office at 88 Princeton-Hightstown Road in

Princeton

Junction. Some business advocates warn, however, that the Family

Building

Act is bad for businesses overall. The insurance lobby, the main

opposition

to the act, warns that mandates such as this are a prime reason for

the staggering increases in health insurance premiums that are

straining

many of the state’s employers and adding to the already steep cost

of doing business in New Jersey.

New Jersey is one of just 14 states to mandate coverage for

infertility

treatments. It is more generous than some, but falls short of others.

Massachusetts, which imposes no monetary cap or limit on the number

of procedures covered, has the most comprehensive coverage. Illinois

and Maryland come close. New Jersey’s act requires insurance policies

that cover more than 50 people and provide pregnancy-related benefits

to cover the cost of the diagnosis and treatment of infertility. The

law defines infertility as the disease or condition that results in

the inability to get pregnant after two years of unprotected sex

(female

partner under the age of 35) or one year of unprotected sex (female

partner over the age of 35) or the inability to carry a pregnancy

to term.

Coverage includes, but is not limited to, diagnosis, medications,

surgery, embryo transfer, and artificial insemination. Some states

that mandate infertility coverage — including Arkansas, Hawaii,

and Texas — insist that a patient’s eggs be fertilized with her

spouse’s sperm. New Jersey has no such restriction. New Jersey’s act

also includes cutting-edge treatment, including in vitro

fertilization,

gamete intra fallopian transfer, zygote intra fallopian transfer,

and intracytoplasmic sperm injection, but insists that the patient

first "has used all reasonable, less expensive, and medically

appropriate treatments."

The act allows only four completed egg retrievals, the procedure used

in in vitro fertilization, one of the most effective methods of

achieving

conception, per lifetime. The procedures generally cost between

$12,000

and $15,000 each.

Some states mandate coverage for small employers as

well as those with at least 50 employees, but Degenaars says there

was no way to extend New Jersey’s act. "I would love to have small

employers covered," she says. "It was not possible. We had

trouble passing it as it was." The bill was introduced in 1998,

and Governor Whitman let it die on her desk in 2000. She referred

the issue to a task force at which 20 experts testified in favor of

the act. "Then," recounts Degenaars, "she (Whitman)

resigned,

and the task force never issued a report."

Sounding as if she could be speaking of the travails of an infertile

couple, Degenaars says of the bill, "If something could go wrong,

it happened to us." Finally, though, with strong support in the

legislature and a new governor in office, the bill passed. There was

no way to add a rider to cover small employers, though, says

Degenaars,

explaining, "the insurance lobby was against us."

Health insurance is becoming a crisis in this country. The number

of Americans without insurance now stands at 41 million and includes

a fast-increasing number of people who have full-time jobs and above

average incomes. Some employers, socked with year after year of

double-digit

premium increases, can no longer afford to offer health coverage.

Their employees, faced with family policies that can easily run to

$800 or $900 a month, are often forced to just do without.

The insurance industry rises up at the mention of any new mandated

coverage. Degenaars says that adding infertility coverage adds just

$7 to $15 to each employer’s policy per year. Dale Florio, a lobbyist

with Trenton-based Princeton Public Affairs Group, which represented

the NJ Association of Health Plans in opposing the bill, was quoted

in an article in the New Jersey Jewish News as saying the figures

would be "much higher" than Resolve indicated. But even if

the number proved to be true, he continued, "it is not the only

bill proposing mandating benefits. They keep adding up; each group

who supports a mandated benefit says it is only so much." (Florio

did not return calls seeking comment for this article.)

Proponents of the act say, however, that the health insurance industry

is being short-sighted in opposing coverage for infertility

treatments.

Even the even the most expensive procedures, they point out, are cheap

compared with the cost of just one birth of four, five, six, seven,

or more babies.

Births of four or more babies are almost always the result of the

least expensive type of fertility treatment — stimulation of egg

production through drug therapy followed by artificial insemination.

If the cost of in vitro fertilization — generally $15,000 to

$60,000,

depending on the number of procedures required before pregnancy occurs

— is out of reach, many couples will go with the less expensive

procedure. The result in some cases will be the birth of many,

low-birth-weight

babies, whose short and long term medical care can easily add up to

millions of dollars.

Given access to any and all infertility treatments, women are far

more likely to conceive just one child. Dr. Susan Treiser, co-founder

and managing partner of IVF New Jersey, which has its main facility

just off Route 27 in Somerset, explains why. "With injections

(to increase egg production) you have no control," she says.

"With

in vitro fertilization, you have much more control." In in vitro

fertilization drugs are given to stimulate egg production, and then

the eggs, perhaps six or eight or ten of them, are harvested.

The husband provides fresh semen. After a process called sperm

washing,

somewhere between 50,000 and 1,000,000 sperm are mixed with the eggs

and allowed to incubate for 14-18 hours. The fertilized eggs (embryos)

are then transferred to a new growth medium. The embryologist looks

for embryos that have two pronuclei, indicating normal fertilization

has occurred. Thirty-eight to 40 hours later, the embryos are examined

and assessed to determine how many blastomeres, or cells, are present

and how even the blastomere’s walls are. After about three days some

of the healthiest-looking embryos are transferred to the mother’s

uterus.

Here economics enters the picture again. Chances are great that not

every embryo placed in the mother’s uterus will develop into a fetus.

Couples whose insurance does not cover infertility treatments may

be able to save or borrow enough for one treatment, but not more.

In that position, they sometimes pressure a doctor to transfer many

embryos. Reproductive endocrinologists, who are judged first and

foremost

by success rates, are under pressure to go along. The result can be

seen in the fact that it is no longer unusual to pass a triple

stroller

in the mall.

In her practice, Treiser has moved beyond simple in vitro

fertilization.

"For the past four years," she says, "we’ve been doing

blastocyst." This is a new technique through which embryos are

kept in the petri dish for an extra two days. Those that survive and

are healthy after five days are more likely to result in a pregnancy

than are those that are transferred after three days. Therefore,

generally

only two are used. Success rates are high — up to 69 percent for

women under 35 — and most births are of a single child.

Treiser is now, in a sense, "mother" to more than 1,000

children.

"We used to hold an annual Christmas party," she says,

"but

at the last one we had something like 700 or 800 children." While

each one is an especially cherished child, that many "miracle

babies" in one room became a tad overwhelming.

IVF New Jersey was founded in 1990 by Treiser and her

partner, Dr. Michael Darder. The two met when they were doing their

residencies at Columbia. A resident of North Brunswick and the mother

of two boys, Treiser wanted to open a practice near home. Darder was

a year behind her, and when he finished his residency the two opened

the practice.

Treiser was raised in Montreal, the daughter of two Holocaust

survivors.

Her parents, Fay and Bernard Lebovic, were taken from their homes

in Czechoslovakia to concentration camps when they were barely

teenagers.

Fay Lebovic lost her parents and one brother in the Holocaust and

Bernard Lebovic lost his mother. Upon being released, both returned

to their village, where Fay Lebovic’s eldest brother was married to

Bernard Lebovic’s eldest sister. "They all took care of one

another,"

Treiser says. "Eventually three from one family married three

from the other."

Treiser’s parents emigrated first to Israel, where they were married,

and then to Canada, where her father opened a knitting mill. "He

didn’t know the language, the culture, anything," Treiser marvels.

Her parents taught her and her sister, a marketing executive with

Coke in Canada, "to live life, to enjoy." And to value

education

as "the one thing that can not be taken away from you."

Heeding her parents’ advice, Treiser went to McGill, where she

received

a science degree and married. Upon graduation she and her husband,

from whom she is now divorced, moved to Washington D.C., where she

earned a combination M.D./Ph.D. While in medical school she had her

two children, Matthew, a senior at Columbia University who is now

applying for M.D./Ph.D. programs in bioengineering, and Adam, a 19-

year-old student at George Washington University.

"When I was pregnant, no one was married, let alone pregnant,"

Treiser recalls. "The majority of my friends waited until they

were through with their residencies." In the biology/culture clash

that is at the heart of many a failure to conceive a child, the wait

became a problem for many of her friends. "A lot needed help,

in vitro," she says. "It didn’t work for everybody."

Humans are programmed to conceive young. Eighteen is a prime age.

Early 20s would be nearly as good. At the same time, there is

virtually

no place for a pregnant woman among the ranks of associates at

prestigious

law firms, junior financial analysts, or fast track CEOs-in-training.

A woman with a desire to achieve in many professions knows she had

better get a good ways up the ladder before beginning a family. This

tactic not only eases concerns about her seriousness of purpose, but

is often a help when she does have children. Established in a career,

the mature new mother often is in a good position to negotiate a

part-time

schedule, or alternatively may have made enough contacts to go out

on her own, creating a business that fits well with attendance at

school plays.

But, feeling great physically — skiing, rock climbing, kayaking

— and moving up in demanding jobs, most thirtysomething women

consider themselves young. And, in fact, in a society where reaching

90, 95, or even 100 is becoming common, they are young. Yet, their

reproductive years are fast slipping away.

At birth, a woman has something like 300,000 eggs — all she is

ever going to have. Each month one matures, and about 1,000 more cease

maturation and are reabsorbed. By age 40, only several thousand are

left, and they tend to respond poorly to signals from the pituitary

trying to get them to mature. In her early-20s, a woman has a 25

percent

chance of conceiving in each month of unprotected sex. By her

late-30s,

the percentage is down to 15 percent, and by her late-30s, it is down

to 10 percent. Furthermore, an older mother who does manage to

conceive

has a far greater chance of miscarrying. Women in their 20s miscarry

12 to 15 percent of the time, while women in their 40s have a 50

percent

chance of miscarrying. In older women, there is also a greater

incidence

of gynecological disorders — including pelvic inflammation and

endometriosis — that can interfere with conception.

Talk about pressure! Career women are in a tough spot.

Dr. Melissa Yih, who joined IVF New Jersey less than

a year ago to head up the practice’s Princeton Junction office, is

34. A graduate of Wellesley, she has maintained close friendships

with five classmates. "Only one is married with children,"

she says.

This is what Yih is hearing from her college chums: "`I’m 34.

It’s harder to meet someone, and now I’m really nervous.’" Her

friends include a Boston banker, a California teacher, a North

Carolina

doctor, a Long Island publisher, and a Washington, D.C. museum

administrator.

Three are in relationships, two have not yet found a partner, several

know a lot of great gay guys, and all — especially since they

know about Yih’s work — are in panic mode over the time they have

left to start a family.

In this, Yih’s friends mirror her practice. While she, along with

every other reproductive endocrinologist, sees many patients whose

infertility has nothing to do with age, she also sees a number of

patients who put off childbearing. "We see a lot of women who

used to live in Manhattan trying to make partner or working their

way up in banking," she says. "They didn’t meet and marry

until recently."

"Women think it goes on longer than it does," she says of

fertility. "It plummets at 35. Drastically. They don’t realize

that." Many of her patients married relatively late. "How

do you even meet someone if you’re working 14 hours a day?" she

asks.

Yih did make time to meet someone. She is married to Douglas Lenart,

an investment banker who commutes to New York from their Princeton

Junction home. They have two children, Andrew, who is 2 1/2 years

old, and Alexandra, 10 months.

Yih grew up in Hyde Park, New York. Her father, Robert Yih, just

retired

from IBM after a stint with the company in China. Her mother, Judy

Yih, designs jewelry. Her parents grew up in Shanghai and Hong Kong,

but met in the United States. Yih says she came to her career via

a love of science. She considered becoming a cardiothoracic surgeon,

but chose reproductive endocrinology instead because she was drawn

to the "meticulous, fine surgery" and to the chance to combine

that surgery with lots of patient contact in a fast-evolving new field

of medicine.

It is hard to imagine a more empathetic doctor than Yih. Poised and

professional in her white coat, she breaks down — just a little

— when she tries to explain what it feels like to see a patient

hold a baby in her arms. This feat — while always a major order

miracle to every patient — is now more easily accomplished, even

for women who are well into their 40s.

One reason, Yih explains, is egg donation. "People do get pregnant

(using their own eggs) over 40," she says, "but it’s

rare."

Once a woman hits 42, it is probably a good idea to use a donor egg.

In 2001, three-fourths of the 78 IVF New Jersey patients who used

a donor egg became pregnant.

Theoretically, a woman of almost any age could become pregnant with

a donor egg. However, IVF New Jersey has made age 50 the cut-off.

This is an interesting bit of social engineering. Yih explains the

cut-off by saying that the practice thinks it is a bad idea for a

baby to be brought up by a mother any older than that, by a mother

who would be well over 65 when her child was going to the prom. But

is that fair? What about Tony Randall, breeding well into his eighth

decade? Randall and his ilk do have young wives, Yih points out,

leaving

unsaid the fact that it is unlikely that a 75-year-old woman would

be fooling around with a 35-year-old man.

For women 50 and under, Yih says IVF New Jersey has one of the biggest

egg donor programs in the country. "We have no wait," she

says, emphasizing that this is highly unusual. "Most

programs,"

she says, "have a one year wait." A reason would-be parents

readily find an acceptable egg donor at IVF New Jersey is that the

practice devotes considerable resources to lining up donors. It

advertises

for donors in campus newspapers, holds seminars for potential donors

in its Somerset office, and has a full-time psychologist to talk with

donors and with families.

"University students are a target group," says Yih. Potential

donors give health, family, and genetic histories. They are screened

for drug use and for sexually-transmitted diseases. The fee paid to

an egg donor is $7,000, which, says Yih, is standard in New Jersey.

(Insurance will pay for the IVF procedure when there is an egg donor,

but will not pay for the egg.) A young woman can give eggs five or

six times.

The staff psychologist matches donors with families. And what do most

prospective moms most want in a donor? "Someone who looks like

them," says Yih. Would-be parents also are interested in donors’

religious backgrounds. Interestingly, no IQ tests are given to donors,

but parents often do specify that a donor be a college graduate. In

some practices, parents look at photos of donors, and sometimes even

meet the donors. Not at IVF New Jersey. "It’s all anonymous,"

says Yih. Prospective parents can, however, see the donors’ baby

pictures.

Most of IVF’s clients are married women, but, increasingly, it is

helping single women and lesbian couples to conceive a child.

Degenaars,

of Resolve says it is unclear whether New Jersey’s Family Building

Act covers these treatments because a requirement is a year or two

— depending on the mother’s age — of unprotected sex that

did not result in pregnancy. If a single mother meets this criteria,

Degenaars says she probably would qualify for coverage. A lesbian

with a medical condition that makes conception impossible might also

be eligible.

Jill Tabor, an East Windsor resident and IVF patient,

presented a far more clear-cut case. She conceived before the act

became law, but her condition would have been covered for sure. An

unusually centered, self-confident woman, Tabor illustrates both the

agony and the joy of conceiving through IVF.

Tabor, 29, a graduate of Stockton State (Class of 1995) and of the

Rutgers School of Social Work (Class of 1996), met her husband, Daniel

Tabor, in college. The two married in April of 1997 and did nothing

to prevent a pregnancy. The following year, they moved to East

Windsor,

where Daniel Tabor works from home in technical support for Micromuse,

a San Francisco-based computer support company. At that point, Tabor

quit her job as a social worker at Bergen Pines hospital to

concentrate

full time on having a family.

A year later, despite being well under the age at which fertility

problems generally start appearing, she was not pregnant. She went

to see her gynecologist, who told her to chart her temperature and

track intercourse. After doing that for a couple of months, she

started

on Clomid, a drug commonly given to women to induce development of

many eggs.

"It was a nightmare!" Tabor exclaims. "I had mood swings

and hot flashes. I was definitely moody. Like a lunatic moody. I got

crazy." She says she and her husband fought. She yelled at him,

he became defensive, and yelled back. She laughs when she recalls

the point at which she hit emotional bottom. "The McLaughlin Group

was on television during that whole Bush/Gore thing that was making

me crazy anyway. I was screaming at him to turn it off."

In addition to the mood swings, the whole Clomid routine was, says

Tabor, the worst, the most stressful. "It was wake up, take your

temperature, and don’t move. You have to plan intercourse." This last

is a problem with a spouse who needs to travel. Before long the

newlywed

was exhorting her husband: "You better be home! If I’m going

through

all this, you had better be here." Not romantic. Not pleasant.

And, after five months or so, not tolerable.

Tabor decided to see a specialist. She went to IVF New Jersey.

"Usually

I do more research," she says, "but I just called them and

went." She adds, "I think we were lucky." She sings the

praises of the practice, and says the fact that everyone knew her

name after her first visit was extremely important. IVF has an office

in Manalapan, and that is where she went for a good part of her

treatment,

but she also made many visits to Somerset.

Touring the Somerset facility, which is where IVF New Jersey performs

all of its procedures, it is easy to understand the importance of

a friendly staff. The offices are large, a veritable mini-medical

center. There are long corridors, and tables with stirrups everywhere.

The rooms where husbands come up with sperm are sterile, the stark

hospital linoleum look relieved not one wit by the vinyl easy chairs

and little televisions, complete with VCR slots ready to receive adult

videos.

There is an operating room, complete with its own waiting room, more

than a dozen offices, and an entire insurance department. There is

also a large lab suite staffed by two endocrinologists. Lined up

against

one wall are no fewer than six, four-foot-tall metal containers on

casters that look ready to be beamed up into a space ship.

Endocrinologist

Dave Slawny, a 1990 graduate of Virginia Tech, explains that each

contains frozen sperm and frozen embryos, which, for the most part,

are the leftovers from IVF procedures. Liquid nitrogen keeps them

at minus 190 degrees celsius. Some of the embryos will be used in

future procedures, others will be donated or discarded. Patients have

to check boxes indicating what they want done with any embryos if

they are not needed after a certain period of time.

While the lab is large and barren-looking, betraying no outward hint

of the life-altering alchemy going on around the clock, its miracles

are portrayed along the office corridor in exceptionally arresting

photos. They are pictures — magnified millions of times —

of the development of a fetus. The first, showing a torpedo-like sperm

ripping apart the moon-like surface of an egg, is truly amazing. But

not warm. Baby-motif decorations of any kind are out, reflecting the

cruel fact that the thing any reproductive endocrinology client most

wants, she wants with such deep, fierce longing that any reminder

of its absence is intolerable.

This is a medical facility after all, and one that infertility

patients

— a uniquely stressed group — visit on a daily basis

throughout

parts of their treatment. So it is indeed a good thing that, according

to Tabor’s report, every employee is kind and solicitous.

Upon starting treatment at IVF, Tabor was given tests. She then

underwent

three artificial inseminations with her husband’s sperm. After those

three tries, her doctors determined that more most likely would be

futile, and they proceeded to in vitro fertilization.

She started preparing for IVF by taking birth control pills to quiet

her ovaries for a month. Then she began taking drugs to stimulate

development of follicles, in which eggs grow. The drugs have to be

injected, and she says she had no problem injecting herself. "It’s

just like the needle a diabetic uses," she comments. During this

period, she went in for blood and hormone level tests every day. She

also had sonograms, which enabled her doctors to monitor the eggs’

growth.

"When the follicles reach a certain size," Tabor says,

"you

get another medication. Then they get the eggs out just before you

ovulate." She was "put under" while her eggs were

harvested.

Afterwards, she was uncomfortable for a day or so. Transferring the

embryos to the uterus after they were fertilized "is nothing,"

she says, comparing the procedure to an OB/GYN examination.

From the time the eggs are harvested to between week nine and week

12 of a pregnancy — or until it is determined that there is no

pregnancy — an in vitro fertilization patient has to have

intramuscular

shots of progesterone once a day. These shots were considerably more

uncomfortable than the ones used to stimulate egg production. Tabor’s

husband gave her the shots when he was home, and when he was away

a neighbor who is a nurse took over. Some in vitro fertilization

patients

complain mightily about these shots, but Tabor says they were not

so bad — not nearly as bad as the Clomid treatment.

What was bad was the disappointment when the first — and then

the second — in vitro fertilization treatment did not create a

pregnancy. Two eggs were transferred to her uterus the first time,

and three on the next two attempts. Treiser, the director of the

practice,

says it was unusual that the number was upped to three, and said the

reason probably was a determination that the eggs did not appear to

be optimal candidates for taking hold.

Tabor, a Catholic, says IVF New Jersey explained the possibility of

multiple births to her. She says she would have been thrilled with

twins, and in no case would have agreed to a reduction, a practice

through which one or more babies are destroyed in utero in a multiple

pregnancy.

In any case, reduction was never an issue. Tabor did not get pregnant

after the first IVF procedure, or after the second. After the second

try, she was told that she was pregnant, but the level of hormones

in her blood was low, indicating that the pregnancy might not last.

"They told me they were cautiously optimistic," she says.

But she guessed otherwise. After spending so much time in her doctors’

offices, she could read tones of voice and body language. She knew.

And, she says, "it was pretty devastating."

IVF entails a tremendous commitment — of time, money, and, most

of all, of emotion — and it demands it of people who, in many

cases, have already been disappointed at the appearance of each spot

of menstrual blood for years, often for many years. Young,

straight-headed,

healthy, and balanced though she was, Tabor nearly threw in the towel

after two IVF tries.

But she decided to try one more time. If it didn’t work, she says

she would have walked away feeling peaceful, knowing she had done

everything she could. She had already done considerable research into

adoption.

After her third try, exactly a year to the day after she walked into

IVF New Jersey’s door, the staff told her to wait around while they

looked at the results of her pregnancy test. "`Stay, just

stay!’"

they urged. She wanted to leave. To sit in the parking lot. She did

not think she could face another disappointment. But she did stay.

And she learned that she was pregnant.

When did she relax? When did she begin to enjoy the thought of

impending

motherhood? Weighing the question, Tabor says that after the first

trimester she began to relax a little. Toward the end, she did buy

some baby things. "I was a little less anxious," she says,

"but I didn’t relax. Not really." Not that is, until Cecilia

appeared two weeks early, but, at 7 pounds, 14 ounces, completely

healthy.

Cecilia is now 10 1/2 months old, crawling, pulling herself up on

furniture, happy, easy-to-please, and so passionately attached to

her stuffed rabbit that Tabor is afraid to wash it.

What about a sibling for Cecilia? Would Tabor go the

in vitro fertilization route again? Probably not, she says. For while

she tolerated the in vitro fertilization procedures well, probably

better than most, it is an arduous route to pregnancy. And her

husband’s

insurance pays for a lifetime maximum of four in vitro fertilization

procedures. She used three on her first pregnancy. Had she not been

insured, she and her husband would have spent close to $50,000 for

the treatment. "I have just one left," she says. At this

point,

she thinks it would be too painful to know that if the first treatment

failed, there could be no other.

Tabor’s infertility is of the kind that is most likely to draw a

sympathetic

response — even from those not generally in favor of mandating

insurance coverage for infertility treatments. This is so because

Tabor clearly made starting a family the first priority in her life.

She married young, did not use birth control, and left her career

well before she was 30 to concentrate on conceiving a child.

But what of the career women, the ambitious souls who set out to rise

in business and the professions through their 30’s, which in all but

the most unusual cases is the only time when the opportunity is

granted?

Having made partner at 35, full professor at 37, or CFO at 40, and

finding themselves unable to get pregnant, why should these women’s

quest for a child be subsidized by their employers’ insurance

policies?

Why should their lifestyle decisions drive up insurance costs for

everyone?

"I don’t pass judgment on 40-year-old smokers with Type A

personalities

who work 80 hours a week and need bypass surgery," says Degenaars.

Doctors Yih and Treiser give similar answers. So many medical costs

are driven by negative lifestyle decisions — smoking, drinking

to excess, passing up exercise, eating Big Macs and Twinkies, driving

80 miles per hour while eating Big Macs and Twinkies. If we provide

treatment for the results of these negative decisions, why not cover

treatment for those trying to combine two of the top values our

society

preaches — career success and family?

IVF New Jersey, 88 Princeton-Hightstown Road, Suite

201, Princeton Junction 08550. Susan Treiser MD. 609-799-5666; fax,

609-799-1661. Www.ivfnj.com

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More IVF Physicians

Delaware Valley Institute of Fertility and Genetics,

3100 Princeton Pike, Building 4, Suite D, Lawrenceville 08648.

609-895-0088; fax, 856-988-7308. Home page:

www.startfertility.com

Delaware Valley OB/GYN and Infertility Group PC,

3131 Princeton Pike, 3C, Suite 202, Lawrenceville 08648. Also

Princeton

Meadows Office Center, Suite 1-C, Plainsboro. Scott Evan Eder

MD. 609-896-0777; fax, 609-896-3266. Home page:

www.delvalobgyn.com

Hamilton Reproductive Medicine PA, 2279 Route 33,

Suite 505, Hamilton 08690. Dr. Grace Lee, medical director.

609-587-9192;

fax, 609-587-9193. Www.hamiltonreproductive.salu.net

Princeton Center for Infertility & Reproductive

Medicine,

3131 Princeton Pike, Building 4, Suite 204, Lawrenceville 08648.

Althea

O’Shaughnessy MD, director. 609-895-1114; fax, 609-895-1196.

Www.princetoncenterforinfertility.com.

Robert Wood Johnson Medical School IVF Program,

303 George Street, Suite 250, New Brunswick 08901. David Seifer MD.

732-235-7300; fax, 732-235-7318. Www.fertilityucref.com


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