Boomers trying to beat clock

CHARLIE FIDELMAN, Montreal Gazette

Monday, May 27, 2002

"This is the place where babies are made, families are formed, hopes and wishes and dreams are realized."
- Mission statement of a California fertility clinic

There’s a murmur of anxiety among the couples sitting in the pale blue waiting room of the Procrea fertility clinic. Some couples hold hands. Others are so nervous they're sitting apart, not even looking at each other. The world of clinical baby-making can be a brutal one for baby-boomers who are trying to beat the clock. "This is your last chance," a Montreal gynaecologist told a pair of professionals in their early 40s making a second stab at an in vitro fertilization (IVF) treatment. A few days later, the couple got a call from a hospital technician with a brief message: the last chance failed, goodbye. "That was so cruel," said Margaret (not her real name) of the call that marked the end of her and her husband’s hellish road to parenthood. The couple was devastated. It wasn't supposed to happen like that. Both planned for education and career, followed by marriage and a house - and then children. Simple as pie. Only it wasn't.

It’s no secret fertility dwindles with age. Recent research, however, suggests it declines earlier than expected for both men and women. Science devoted to resetting the biological clock shows it starts ticking loudly - at age 27 for women and 35 for men. What’s available for want-to-be parents who are past their best-before due date? The choices are assisted reproduction, adoption or learning to live without children, Procrea gynecologist Louise Lapensee says quietly. But most people making the rounds of fertility clinics aren't looking for adoption. They want their own bundle of joy and they'll pay whatever it takes to get one. In Canada, the average cost of a baby conceived through IVF is $16,000. Add to that the physical and psychological stress - one in three couples split - and the final cost is high. (A psychologist’s visit is included with IVF treatment.) "I’m here to help them go there if they want to go in that direction," said Lapensee, formerly of the McGill Reproduction Centre, which, like Procrea, is among the largest clinics in Canada. Together, the two perform about 130 IVFs a month.

"It’s always a pleasure to say, 'You are pregnant,' but there are limits," Lapensee said. "Some people will pay anything even for a tiny, tiny chance." Despite great strides, science can go only so far, she said: "Women are waiting too long. If I could pass along one message, it’s start earlier. Don't lose precious time." Reproductive technologies are subject to legal and scientific limitations. In Canada, cloning, the sale of eggs or sperm, and commercial surrogacy are illegal. IVF - where egg meets sperm in a petri dish and the resulting embryo is later transferred to the uterus - is rarely performed on women older than age 52.

Andre Gosselin and his wife, Francine Corbeil, found happiness for more than $11,000. "It was all worth it," Gosselin said of their pretty twin girls, born 13 months ago. By then, they had experienced five painful years of high-tech efforts at making babies - and had had enough. The couple canceled plans to start another baby when none of their frozen embryos survived the thawing process recently. "We agreed to stop there because we achieved our goal. The emotional strain was too much," said Gosselin, 48, a school principal on the South Shore. "Each month when it didn't work was like a death. Four years of mourning was tough," he said of failed attempts before IVF. "It’s so difficult that if the IVF hadn't worked, we’d have called it quits then and there." When three years of trying to make a baby the old-fashioned way didn't work, the couple sought professional help. The clinic recommended artificial insemination, the first line of intervention. Seven failed insemination attempts later - at $250 a shot - the couple was desperate. Next in line? IVF. But one try only. Forget the money-saving package of three IVFs for the price of two. "The economic factor is one thing, but the psychological aspect is just enormous," said Gosselin, head of the Quebec Fertility Association, which offers support and counseling. The IVF treatment gave Gosselin and Corbeil four embryos. Two were implanted in utero, two were frozen. Exactly 14 days later, the couple returned for a pregnancy test. But they couldn't handle sitting anxiously in Procrea’s reception room. They went home for the announcement. Gosselin recalled feeling euphoric when the clinic called: "It washed away all the pain and tiredness. We cried, we laughed. We couldn't believe it." A photo of the smiling twins hangs at the clinic, along with other "success stories."

Such stories are great inspiration for Isabelle Ouimet and Alain Hebert, who have everything ready: a suburban house within walking distance of an elementary school, a big back yard, a dog, a van. All they need is a child. Ouimet, 27, and her partner have been trying for a baby for eight years. Doctors can't explain their infertility. "My good luck I didn't wait until age 35 to start," said Ouimet, a television producer. She reels off the names of fertility drugs like they're candy bars: Puregon, Profaffi, Lupron, Humegon, Gonal, Progesteron. With every injection, she complains that medicare covers abortion but not infertility treatment: "I can't believe that it’s so easy for some people (to get pregnant) - and they don't even want to have children, whereas we have to spend so much money to produce a future taxpayer." The couple opted for the three-package IVF deal. Ouimet had three embryos transferred as part of the second IVF. The first one failed. The pregnancy test is next week. And if that fails, too, there’s always one more cycle of IVF to go. But the money has run out. "I might have to put aside my dream - for a baby, for a family," she said with regret. Reproductive technology has made huge strides since Louise Brown, the world’s first test-tube baby, made her debut in 1978. Today, an IVF baby is hardly remarkable, unless born to celebrity parents like Celine Dion and Rene Angelil. An estimated one in eight couples in Canada are sterile, defined as the failure to conceive over 12 months of unprotected sex. Infertility is creeping up slightly because people are waiting longer to start their families, said Dr. Norman Barwin, head of the Infertility Awareness Association. "But the perception is that it’s higher because of greater awareness of clinics and technologies." And even more would seek treatment if government insurance plans covered costs, fertility groups contend. "We have two-tiered medicine," Barwin said. "Those who can have access and those who can't."

By the time a Canadian couple knocks on the door of a U.S. clinic seeking a surrogate mother, they’ve usually been through the fertility medicine mill. Most have been told there’s no hope; they can't have children. After eight miscarriages, Lenore, a Montreal photographer, knew she had to try something else. After her first unsuccessful IVF at age 35 in 1995, Lenore and her husband flew to Chicago’s Beer Clinic for testing then not available in Canada. Results were discouraging, but at least they knew the cause: Lenore’s immune system was killing off the fetuses. But none of the subsequent treatments - drugs in Chicago to counter the immune problem, combined with IVF treatments in Toronto - worked. "I did it all. Meanwhile, the clock is ticking. When I lost the last pregnancy in 1997, I decided that was it. We’d have to look for a surrogate," said Lenore, who called the Centre for Surrogate Parenting, considered the Cadillac program for surrogacy in the United States. "This was all-out guerrilla warfare to try to have a baby," Lenore said. About three Canadian couples a month use the facilities' services, said centre director Karen Synesiou, paying between $60,000 to $75,000 U.S. each - travel and hotel not included. "You need a medical reason to do surrogacy," said Synesiou, who recently refused an Olympic athlete who didn't want to take time out to have a baby. Commercial surrogacy is illegal in Canada. Also, not-for-money deals require adoption because the person giving birth is legally the mother. Intended parents who, like Lenore and her husband, supplied the embryo through IVF would have been obliged to adopt their own biological child. In California, the intended parents are the legal parents. No adoption is needed. Still, it wasn't an easy decision, said Lenore, who abhors the term "rent-a-womb." "A woman is devoting time and energy to care for your child that she will then return to to you," she explained. "You're paying for services. It works out to less than working for McDonald’s. It’s a 24-hour job. It’s not like she can get away. If there’s an emergency, she’s in charge. You have to trust her." Suddenly, at week 29 of the pregnancy, the surrogate mother started bleeding. Lenore and her husband left Montreal and rented an apartment near the hospital, later haunting the intensive-care unit for the three months their baby was inside. "Every night at midnight, we’d mark the calender with X. We’d gotten through another day," said Lenore of the last agonizing weeks of pregnancy. Baby Adam was born two months early but viable. "Whatever I achieve in my life, that will be the greatest achievement ever," Lenore said of Adam, now 21/2. "That child beats it all."

The Infertility Awareness Association of Canada can be reached through Anna Maria Henderson at (514) 842-1231 Ext. 34507.

The Web site for California’s Huntington Reproductive Centre is www.havingbabies.com, while

Zouves Fertility Centre is www.goivf.com

(both work with the Centre for Surrogate Parenting at www.creatingfamilies.com or 1-818-788-8288).

Charlie Fidelman’s E-mail address is [email protected].

In Vitro Fertilization On average, in vitro fertilization (IVF) treatments will cost about $16,000. This consists of a basic IVF package (three cycles) costing $9,000, plus $7,000 for medication. But you can expect to pay more if you're an older woman who requires more doses of fertility drugs, or additional procedures including egg or sperm donation, embryo freezing, storage and subsequent transfer.

Typical costs of treatment

One IVF cycle where sperm is injected into the egg	$5,500
One IVF cycle with donor egg	$6,500
Embryo freezing	$1,000
Assisted hatching	$350
IVF consultation	$300
Drugs	$2,500

Other costs: (when it’s male-related infertility)

Sperm aspiration	$1,000-$2000
Semen analysis	$120
Insemination	$275-$575
Sperm freezing and one year storage	$500 (each additional year) $200

Frozen Embryo Transfer Costs

Hatching	$350
Five ultrasounds	$800
Five bloodtests	$450
Five daily visits	$223
Administration fees	$515

If you are willing to bear the cost, experts say a successful pregnancy can easily set you back $40,000 or more.

Source: Fertility Awareness Association of Canada

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