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?
201, Princeton Junction 08550. Susan Treiser MD. 609-799-5666; fax,
609-799-1661. Www.ivfnj.com
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3100 Princeton Pike, Building 4, Suite D, Lawrenceville 08648.
609-895-0088; fax, 856-988-7308. Home page:
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:
Suite 505, Hamilton 08690. Dr. Grace Lee, medical director.
609-587-9192;
fax, 609-587-9193. Www.hamiltonreproductive.salu.net
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.
303 George Street, Suite 250, New Brunswick 08901. David Seifer MD.
732-235-7300; fax, 732-235-7318. Www.fertilityucref.com
Corrections or additions?
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