By Molly M. Ginty
Friday, June 18, 2004
A growing number of single women are seeking fertility treatments and finding that persistent problems block their path to parenthood.
(WOMENSENEWS)--All Melinda Millsaps ever wanted was to have a child of her own. During her 20 years as a neonatal nurse in Gainesville, Fla., she helped deliver thousands of babies. After hours and in her spare time, she met scores of eligible men.
But at age 39, with no Mr. Right and no pregnancy on her horizon, Millsaps decided to take matters into her own hands and seek artificial insemination. She was shocked--then horrified--when the very hospital for which sheworked refused to grant her treatment. Heremployer, the Shands HealthCare and Faculty Group Practice in Gainesville, Fla., only reserved donor sperm for married heterosexual couples.
After six years of battling her employer in federal court, Millsaps, now 45, has lost both her legal case (which was decided earlier this year) and her hopes of having a biological child. When Shands refused to offer her care, she sought treatment at other clinics and discovered that her eggs are no longer viable. "If I had just brought a man with me to the clinic six years ago, I would have received treatment," she says. "But I didn't want to have to lie to get health care and I don't think millions of other single women should, either."
Though health agencies have yet to compile solid statistics on the subject, medical experts say a growing number of single women are seeking artificial insemination and other fertility treatments. While women elsewhere in the world are fighting for basic health care, women in the United States are fighting for the technology that will enable them to become parents when and if they so choose. Whether they are among the 6.1 million U.S. women who are infertile--or whether their reproductive systems are fully functioning--these women face discrimination, prohibitive costs and biological clocks that are running out of time.
The Atlanta-based Centers for Disease Control and Prevention reports that 16 percent of reproductive health care providers in the United States routinely refuse to offer treatment to single women. Because there are no laws in the United States that require physicians to treat fertility patients, doctors may turn away single women if they believe children should be raised within the context of a heterosexual marriage.
"When I met doctors who were reluctant to treat me, I argued that I had a stable job and a strong support network," says Millsaps. "I argued that 50 percent of marriages end in divorce, anyway. Even so, Shands and five other clinics flat-out refused to offer me care."
Shands is affiliated with the University of Florida based in Gainesville. All obstetricians and gynecologists who work at Shands are University of Florida personnel.
"However UF physicians will not perform artificial insemination if the patient doesn't suffer from a medical condition, but fertilization/impregnation is not possible solely due to the absences of a male partner," the University of Florida said in a faxed statement to Women's eNews.
In response to discrimination like this, a small but growing number of fertility clinics are marketing themselves to straight single women and lesbians. These include Fenway Community Health in Boston, The Sperm Bank of California in Berkeley and Maia Midwifery and Preconception Services in Orinda, Calif.
For single women who do find doctors willing to help them, the cost of assisted reproduction can be prohibitively expensive. Artificial insemination, in which a woman uses donor sperm to get pregnant, can cost $500 to $5,000. In vitro fertilization, in which a woman's eggs are harvested from her body, fertilized with sperm, then implanted back in her uterus, costs $25,000 to $75,000. Gestational surrogacy, where the embryo resulting from in vitro fertilization is implanted in the womb of a surrogate carrier, costs $50,000 to $100,000.
"Fertility treatments are expensive because the technology involved is very elaborate," says Alina Salganicoff, the director of Women's Health Policy for the Kaiser Family Foundation, a health care policy organization based in Menlo Park, Calif. "And typically, patients must pay for everything out-of-pocket. Health insurers only cover treatments that they consider medically necessary, and they don't define having a child as a medical necessity."
The Washington-based Institute for Women's Policy Research reports that women still earn only 76 cents for every dollar earned by men, a figure that has barely changed since the 1970s. According to the U.S. Census, the median income for women in the United States is $20,000 (compared to $30,500 for men). Due to this financial discrepancy, fertility treatments are often out of reach for women who don't have financial support from a partner. To pay for their treatments, single women may take out loans or second mortgages. They may borrow thousands from friends or family members or rack up credit card bills that they have no hope of repaying.
According to the most recent U.S. Census, more women than ever are electing to remain single (24 percent) and those who do have children are having them later than ever (at the median age of 25.1, versus 21.4 in 1970). Because more women are postponing marriage and children as they focus their careers, many are finding themselves without a partner just as their reproductive capacity is waning.
"If you want to conceive a child on your own, you need to seek treatment as early as possible," says Dr. David Adamson, a board member for the American Society of Reproductive Medicine, a coalition of reproductive doctors based in Birmingham, Ala. "Since fertility declines markedly after the age of 35, you need to act quickly in order to increase your chances of success."
Determined to have children while there is still time, some single women are taking the preventative measure of having their eggs frozen while they are still viable. Called cryopreservation, this treatment is offered at a handful of clinics in the United States and costs an average $9,000.
"Having this procedure gave me a tremendous sense of relief," says Deana Tanner, a 38-year-old single woman from Georgia who had 19 of her eggs frozen at the Florida Institute for Reproductive Medicine in Jacksonville in February. "It has helped me relax and slow down and not worry so much about dating or my reproductive future."
Though they may be racing the clock, single women seeking fertility treatment can take heart in recent medical breakthroughs. For decades, biologists assumed that men make millions of sperm every day, while women are born with all the eggs they'll ever have. But in March, researchers at Harvard University in Boston discovered that stem cells in the ovaries of female mice keep generating new "egg seeds" long into adulthood. Experts suspect that the same may be true of stem cells in adult human females and that science may some day make it possible for women grow extra eggs for their own fertility treatment.
Until this technology and other advances become a reality, single women seeking assisted reproduction must cope with the unique stresses they face. Many are joining support groups run by RESOLVE, an education and advocacy organization for the infertile that is based in Somerville, Mass. Others are reaching out to friends and family members for comfort.
"Trying and failing to get pregnant makes you feel like your heart is falling out," says Sonya Austin, a 22-year-old single mom in Minneapolis, Minn., who conceived her infant son with help from a sperm donor. "If you have a partner, you have someone to share your obsession and help you through the disappointments. I'm just lucky that I had my friends and family supporting me the whole way."
For single women who have yet to successfully achieve pregnancy, persistence remains the best and only hope.
"Reproduction is a biological drive--the greatest drive of any organism," says Millsaps. "Even though I've had no luck with fertility treatment, I still can't imagine life without a child. I want a baby so much that I will continue doing anything I can to have one."
Molly M. Ginty is a freelance writer based in New York City.
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