Jodi Daniels has two daughters, but getting pregnant wasn’t as easy as having a couple of romantic nights with her husband. Daniels is one of many Atlanta-area Jewish women who struggle with infertility.
Not only is the journey an emotional roller coaster, but it also can be a huge financial burden for many couples.
That’s one burden the new Jewish Fertility Foundation hopes to alleviate by offering financial assistance to Jewish couples who must use fertility treatments to grow their families.
“It’s really important,” Daniels said of the financial assistance the foundation will offer. “I know how expensive it was. It shouldn’t be that way. To have a family have to go through something that they can’t control and to have to go bankrupt to start a family is crazy. To have a foundation to help and make a difference, I think it’s really important.”
The foundation responds to a problem that is more common in the Jewish population than the overall American population, at least in part because non-Orthodox Jews tend to start families later. It is an issue that also inspired the Atlanta Jewish community to launch the Wo/Men’s Infertility Support Havurah this year.
In vitro fertilization can cost $20,000 for medicine and procedures, and Shapiro, a reproductive endocrinologist with Reproductive Biology Associates in Sandy Springs, said that only about 15 percent of patients using his practice have insurance coverage for infertility.
“In a state like Georgia, where there’s no mandate for coverage and only 15 percent of patients walking in the door have coverage, that’s an awful lot of people who are going to get stuck with a big bill,” Shapiro said.
Helping Jewish couples start families through fertility treatments will be gratifying, said the foundation’s founder and president, Elana Frank.
Frank, a mother of two who struggled with getting pregnant, did fertility treatments in Israel, where she said she spent a total of 1,800 shekels (now about $463) for private health care and a private hospital. A friend who opted for a nonprivate doctor and hospital paid just $2 for everything, including medicine.
“You use your savings, and then you use more of your savings. You ask your parents for help,” Frank said of couples in America trying to conceive. “My husband and I were fortunate enough to have two jobs. Why should you be in debt to try to start your family? People joke like ‘Oh, this is my $100,000 baby.’ Trust me, I would pay everything for my kids. I was in Israel when I did it, and I did it for (almost) free. I wonder if my stress level was a little lower because I just didn’t have the financial burden.”
The foundation is raising money now to fund the first round of grants, which will vary in amount per couple. One anonymous donor gave $1,500 to the foundation, which already has allocated that money to a Jewish couple.
Part of the screening process will be a review by a panel of reproductive endocrinologists to assess couples’ medical feasibility.
“We are really going to just be looking at the applicants and helping them on a case-by-case basis,” said Frank, whose unrelated day job is handling communications for the Weber School. “If someone has already done IVF 25 times and it hasn’t worked, is that really a case we want to take on?”
It took Lynn Goldman one fresh IVF cycle and three frozen cycles to become pregnant. She carried two of her babies to delivery.
Having a foundation to help with the cost of treatments is huge, Goldman said.
“It’s very expensive,” she said. “Having a foundation, an organization that not only provides financial resources to help people going through it, takes another stress off of you. You’re already under so much stress going through the procedures and emotionally. Taking that financial stress off you is huge.”
Goldman said she wishes a foundation like the Jewish Fertility Foundation had been around when she was going through treatments.
“To take off that financial stressor would have been huge,” she said. “Here’s an organization that will give you education, and that financial support would have been a stressor off of me. People who are going through this not only have to pay to go through the treatments, but when the child is born, the costs continue.”
When it comes to Jewish couples, one in six ages 31 to 35 will experience infertility, Shapiro said. With Ashkenazi couples, one in five carries one of the 19 Ashkenazi single-gene defects, one in 30 carries the Tay-Sachs gene, and one in 27 carries the cystic fibrosis gene.
Those disease statistics are why some couples choose to use IVF to become pregnant, even if there are no fertility issues.
“You do IVF so you can do genetic testing on the embryos to avoid having a baby with one of these devastating diseases,” Shapiro said.
About 15 to 20 couples with single gene disorders do IVF at Reproductive Biology Associates every year.
“They don’t have infertility, but they have a baby who had died or had (cystic fibrosis),” Shapiro said. “They discovered their genetic risk.”
Amniocentesis is another option, but it can be done only when a woman is pregnant. “Then you have to decide if you’re going to terminate or not, and a lot of people don’t want to do that,” Shapiro said. “IVF is a way to avoid Solomon’s decision.”
Also affecting women’s fertility is polycystic ovarian syndrome, commonly known as PCOS. This condition results from insulin resistance, which affects ovulation. Though only about 3 percent of Ashkenazi women have PCOS, the at-risk population ranges from 15 percent to 20 percent.
“There are adaptive reasons to have these genes, but we don’t need them anymore,” Shapiro said. “They protect you against famine. We live in a country where there are calories on every corner. They make you store fat. These genes are active in a great many people of Eastern European descent, Jewish descent in particular. These genes become the enemy because they make what you’re eating store as fat. The more insulin-resistant you become, the more your ovaries produce male hormones. If it gets excessive, it mucks up the system and tricks the brain to think you’re trying to ovulate when you’re not.”
Rabbi Adam Starr, who leads Young Israel of Toco Hills, said he has seen “many, many Jewish couples who are struggling with fertility. It is extremely painful. Whatever we can do to facilitate their dream of having a Jewish family, it’s one of the greatest mitzvahs we can do.”
The only reproductive issue that could conflict with Jewish law is surrogacy, a situation in which it could be questioned whether the baby would be born Jewish. IVF does not conflict with Jewish law, Rabbi Starr said.
“It’s one of the most important mitzvah we have: to be fruitful and multiply,” the rabbi said.
In addition to assistance with finances, the foundation will offer couples emotional support, which is something Frank said she didn’t have as she started going through her treatments six years ago.
“I’m a very loud, vocal person, but when you’re going through this alone, I wasn’t,” Frank said. “I didn’t have the support of my family. My family in Israel said, ‘Oh, go take a vacation, relax, have sex.’ ”
Not only do friends not understand, but it’s hard for a spouse to appreciate what the woman goes through emotionally with daily injections, monitoring and the stress of seeing how each cycle plays out.
“Even your own husband doesn’t get it,” Goldman said. “You going through it and having all the medical treatments done for you and him going through it, it’s so different. You can really lose yourself during this journey.”
Daniels counts herself lucky for finding a support group of women who went through fertility treatments.
“I was really fortunate to be able to have those people to go on my journey with,” she said. “There’s no way I would have made it without having people who really understood what was going on. People don’t talk about fertility. It’s like something that’s evil or not allowed to be talked about. They’re embarrassed or concerned. It’s a disease like any other disease.”
Having friends who seem to get pregnant easily adds to the emotional ups and downs that Daniels said she experienced for six treatment cycles — both intrauterine insemination and IVF.
“I had no one,” she said. “I was alone. No one understood. They say all the wrong things. ‘It will be fine. Oh, relax.’ No one understood the pressures of every three days wondering what would be revealed. You feel like the clock’s ticking.
“You’ve (been) poked and prodded so much hoping it will work, and when (it doesn’t), it’s devastating. You wonder what’s wrong with you. Why is everyone else pregnant? You do all the right things to be good parents, and then you can’t. It’s an absolute emotional roller coaster.”
Even after the birth of a child, the emotional scars from infertility don’t go away.
“I won’t ever be able to say to my husband, ‘Let’s have a baby,’ ” Frank said. “I’m still going through the journey.”