Is Infertility a Lifestyle Choice?

Dawn Davenport


Do women deserve to be infertile?

I went to dinner with a group of friends a while back—some I knew well and some only in passing. I intentionally sat next to a woman I didn’t know so we could get to know each other better. We chit chatted the usual getting to know you talk and got around to what each of us did. When I told her that I headed up a nonprofit that provided education for infertility and adoption, her interest picked up because both her sister and cousin had struggled with being unable to easily get pregnant.

As often happens with any discussion of infertility (with me at least) the topic turned to the finances. (My poor family and friends suffer through my personal mission of educating the world about what I perceive as the unfair financial burden of infertility.) I mentioned that insurance seldom covers fertility treatment.

She responded: “Well, to be honest, I’m not sure insurance should cover infertility. After all, it’s a lifestyle choice that these women made.” She hastened to add, probably when seeing my jaw hit the floor, that she wasn’t trying to be uncaring, and that she really felt for her sister and cousin. Her perception of infertility, which is shared by far too many, is that infertility is the logical consequence of being the stereotypical over-35 career woman who married late. Not wanting to get into a drawn out discussion of the causes of infertility, both medical and social, I simply shared that infertility could affect women at any age, and then moved the discussion to our mutual love of arugula. Her words stayed with me, however, long after that evening.

Is It All About Age?

This woman is neither ignorant nor callous, but she is misinformed, at least partly. As with any persistent myth, there is an element of truth. Age is by far the #1 risk factor for infertility. Some of us who rail against the financial injustice of infertility often try to down play this fact, but it remains the unfortunate truth. But it is only part of the truth.

Infertility can affect women and men of any age. There are many causes of infertility in women in the 20s and early 30s, including premature ovarian failure (also known as early menopause, primary ovarian insufficiency, POF, premature ovarian aging, premature ovarian syndrome, premature ovarian insufficiency) and male factor infertility. Among 30 year old women trying to get pregnant, 75 percent will conceive within a year. (That number falls to 66 percent at age 35, and 44 percent at age 40.) That means that 25% of 30 year olds who are trying to conceive will struggle with infertility. That’s a lot of relatively young women who will have this disease.

Sure, if they had started trying in their early 20s, they probably would have conceived more easily, but most of us would assume we’ll be in the 75%. Each of us walks in grace, and neither deserve our luck to be in the majority, not our bad luck when we draw the short straw.

Infertility is So Darn Unfair

I think the reason my new friend’s comment stuck with me so long, is the inherent unfairness of it all. Even for those women who are infertile because they waited, it seems so unfair to “blame” them for the choices that they made when in many ways these decisions were abetted by our society.

It’s true that our fertility peaks at age 22, but how many of us in our culture are ready to parent at that age? In the past, most 22 year old women were married and their husbands had a job that paid enough to support the family. In the past, few women had career options that required education and long years of paying your dues in the form of long hours in order to work up the ladder. That is not, however, the world of today or the near past.

Today’s infertiles who waited until after age 35 to have a child came of age in a world of burgeoning career options for women and an expectation that we would grab for the ring. The average age of first marriage crept up to the mid 20s, and the divorce rate skyrocketed, accompanied by later second marriages and the desire to have a child with this new husband. There was precious little talk 10 years ago about the risk of waiting to have a child.

Reproduction Issues for the Millennials is More Complicated

While I think we are making great strides in educating today’s 20 somethings about the risk of waiting too long to have children, their options are even more complicated–lousy job opportunities, expectation of graduate school, college debt (student loan debts have surpassed the $1 trillion mark, with 68% of 2016 graduates with an average of $30,000+ in loans), extended adolescence and young adulthood (for better or worse), and an even greater delay in marriage (the average age at first marriage for men is 28.7 and for women is 26.5).

And this doesn’t address the quandary faced by single women who dream of becoming a mom when they are in a stable committed relationship preferably with at least some version of their Prince Charming. What should they do if they are 32 and haven’t found him yet?

While I think egg freezing offers hope, it comes at a steep cost both financially (approximately $7,500 to $10,000) and medically (weeks of injecting ovulatory stimulation medications and minor surgery for egg retrieval), and no guarantees of success. In an ideal world I’d like to see professions acknowledge that young woman and men need to be able to have both a career and a family. I’d love to see more options for parental leave and high quality convenient day care. In the meantime, I’ll continue to preach to the younger set that fertility doesn’t last forever, but I won’t blame those who thought it did.

Image credit: HighwaysagencyAlexSeattle Municipal Archives

05/06/2017 | by Dawn Davenport | Categories: Blog, Infertility, Infertility Blog | 63 Comments

63 Responses to Is Infertility a Lifestyle Choice?

  1. Avatar Katie F says:

    My story is very similar to yours. My mom was 37 when she had me, and I’m 37 now. I, thankfully, just gave birth to my 2nd son. Growing up I had a “plan” and I was going to be done having children by 30-31. I didn’t start dating my husband till I was 31. I also knew him for a few years prior and we didn’t want to wait on something we knew was right, so we were married shortly later (I was 32). I was never diagnosed with anything, but suffered infertility in staying pregnant at first, then getting pregnant, then both. It was hinted at that maybe my age was a factor, but it wasn’t my choice to have issues!! I didn’t want to get pregnant without a partner, and for me, that took longer than I thought. I had a successful job and enjoyed what I did, but always wanted to be a mom. Thankfully, I got my dream, but it wasn’t without heartache and my heart hurts for everyone in the same or similar situations. I would NEVER say infertility was a lifestyle choice. Wanting to live without children is a choice, not being able to have them is not, and it’s cruel to imply otherwise.

  2. Avatar Ladysmokeater says:

    Holy hell! My lifestyle did NOT include PCOS (it runs in my family) nor did it include the unknown cause of my husband’s infertility. Holy freaking-A. This pisses me off SO much. People have “suggested” this is my fault because we choose to wait until we had jobs with insurance to even try to start a family. I did not CHOOSE to be infertile anymore than I choose to be white, red haired or middle class. It simply is the way the cards were dealt. I didn’t wait to have a kid because I was being selfish, we waited (not that it would have mattered) because I lost my job and our insurance. We barely made rent and “made too much” for government assistance…
    My body and his body dont work. It is the most devastating diagnosis short of a terminal illness. My entire life was completely changed, dreams crushed and my whole purpose dashed when we were told this couldn’t happen without tens of thousands of dollars and even then maybe not.
    I regret every single decision that brought me to the point where we had to walk away from the treatments we could afford. We are still paying off medical bills and thats just on testing.
    Maybe we should take the same approach with cancer or depression or diabetes. After all if you were “perfect” you wouldn’t need medical coverage… You have a curable disease? Sorry we cant cure you because its “your fault”. You have PTSD from your time in the service? You chose to serve, so nope… Absurd, yet we treat infertility that way.
    My family doesn’t believe infertility treatments should be covered either. They know better than to say anything to me now that I’m where I am.

  3. Avatar Renee says:

    Sometimes it might be…when someone intentionally waits till 40 to even try, despite having means and opportunity and, generally speaking, a desire for parenthood…but infertility in general, across the board, no.
    I married at 22 (so no age issue) and tried for 11 years. Only did ivf this year (when age might factor in) because we couldn’t afford it earlier.
    That might be another aspect of it not being a lifestyle choice as well…the cost

  4. Avatar KC says:

    I dont see how. If your body doesnt work it is nothing you did wrong.

  5. Avatar Shana says:

    This article wasn’t offensive to me – because in my case IF likely was a choice of wanting to get ahead in my career before having children. Age WAS the biggest factor. Did that stink? Yes. But sometimes our choices don’t turn out how we envisioned.

    For those with conditions that presented early, genetic, illness, etc – that is totally different and I can see how this article rubbed you the wrong way.

  6. Avatar Heather Burns says:

    I find this more than a tad insulting from her point of view. I have done everything suggested to correct my condition, even having a very expensive surgery that I paid for out of pocket because my insurance wouldn’t cover it. I’ve lost 70 pounds, eat extremely clean, work out, take vitamins, etc. and after all of this I still struggle with infertility. I’m 33, and the realization that 35 is right around the corner and things aren’t going to get any easier looms over me like an ugly cloud.

  7. Avatar c says:

    Where I live, IVF is covered by insurance but there are age restrictions. Problem solved.

  8. Carolyn Hawkinson-Pruett Osci Artist Carolyn Hawkinson-Pruett Osci Artist says:

    Those IF issues could have other health impacts as well. My husband has a birth defect that causes extremely low testosterone. It makes a man’s morphology terrible and can affect bones and heart as well. It’s linked to type II diabetes and inability to lose weight. Of couse the insurance deemed it “fertility” and wouldn’t cover HCG which thanks to the diet craze was about $800/mo in the qty he needed. The OTHER alternative is testosterone which ironically makes a man sterile. They wouldn’t cover fertility but they would cover something that in our case was “birth control”. He was on Clomid for a while (so was I – 2 raving bitches, wheeee! @@) but there’s no studies of long term effects. Now he’s taking nothing (still has the problem and we’re done TTC.)

  9. Christi Tipton Christi Tipton says:

    Heather, YOU can say it all you want, but the PURPOSE of insurance is to FIX what is WRONG with a person’s body. And for your information, I have experienced being told that I could NOT be treated for the underlying causes of my infertility (PCOS) because it could be viewed as infertility treatment. I also know MANY women who have been told they would NOT have coverage for an hsg (to determine blocked tubes, or a uterine anomaly – which was also a cause for my repeated miscarriages) So, believe what you want all you want, but it doesn’t make your version of reality true for everyone else. Your insistence, in the long run, means nothing to people who actually know the truth of the matter.

  10. Misty Snow Misty Snow says:

    Then it shouldn’t be the job of MEDICAL insurance to pay for birth control pills/patches/shots, tubal ligations, or vasectomies either.

  11. Carolyn Hawkinson-Pruett Osci Artist Carolyn Hawkinson-Pruett Osci Artist says:

    AMEN ^ Infertility (and in my case also the stilllbirth of my only bio children) affects EVERYONE…. saint and sinner alike. Our 2nd pregnancy was a fatal diagnosis pregnancy (incompatible with life) and a family member intimated it was punishment b/c DH still plays Dungeons and Dragons. (We had also had 4 years and 10 IUIs and 1 IVF due to secondary undx’d MFI after stillbirth #1. Many people hold the Duggar family (19 kids and counting) as religious role models and when their last baby was a miscarriage/stillbirth, it really brought the reality home of it can happen to “saints or sinners”. They prayed for their baby as I prayed for mine. They were still lost. Had either of my babies lived, we would have never adopted our Chinese son…..

    • Avatar Dawn says:

      Your baby deserved to die because your husband plays Dungeons and Dragons?!? That takes the cake and I thought I had heard it all. What type of God do these people believe in? I would hate to go through life with such a vengeance filled belief system.

    • Avatar Ladysmokeater says:

      We have religious nutters in our family too. The favorite they like to throw at us is “if you went to church more… or if you tithed more… or if you had faith God would give you a baby”…. We also play D&D and I am in the Eastern Star, both hell-worthy sins according to his family (mine not so much, but my younger sister who is a NURSE PRACTIONER told me that “faith” would fix this issue. She is a medical professional and thinks that if I believe hard enough God will give me a baby. Yea, I believe, but I also know thats not how it works God isn’t a Genie.

  12. Christi Tipton Christi Tipton says:

    I bet that Ms ‘different’ Heather up there would be the first to gripe and complain if her car insurance didn’t cover fixing her car (and her own injuries) if she was at fault in an accident. It is insurance and the principle is the same. Hopefully they’re unintentional hypocrites, but people like her are hypocrites all the same.

  13. Whole Child Whole Child says:

    With the amount of serious depression infertility causes…the number of marriages it breaks up…the billions of dollars spent every year to treat it and to adopt b/c it can’t be treated…you would think people would understand that no one CHOOSES infertility. Duh.

  14. Christi Tipton Christi Tipton says:

    To this last Heather, I’d say you’re mistaken. The ability to have a child is a basic biological ability and NEED for many woman and men. When you can’t conceive it affects your health. Your stress levels rise exponentially, and negative levels of stress always affect one’s health negatively. Besides that, some reasons for infertility DO affect one’s life. They DO affect one’s health and can lead to significant health problems. Medical insurance has a responsibility to cover medical issues and things relating to health. My migraines are caused by my hormonal issues that also cause my infertility problems. Perhaps we should just ignore the cause of the infertility and just treat the migraines, since those happen to fall into the spectrum of what YOU think should be treated? Thank goodness you’re not my doctor and don’t run my health insurance plan!

  15. Christi Tipton Christi Tipton says:

    And I beg to differ about things like infertility not being life threatening. Depending on the cause of infertility, it can put you at higher risk for certain cancers and other health risks. In addition, some other health issues put you at higher risk of infertility and sometimes infertility is the thing that leads you to getting it figured out. Thank you Catherine for saying what I was thinking – adoption isn’t medical so it’s ridiculous to assume that people would start insisting medical insurance should pay for it. Infertility IS medical – it SHOULD be covered.

  16. Catherine Tucker Catherine Tucker says:

    Well said Heather.

  17. Catherine Tucker Catherine Tucker says:

    Adoption is not a medical condition and does not involve medical treatment, so it is silly to say that medical insurance should cover adoption. Alternative financing methods for adoption–such as tax credits–are a more appropriate way for society to help families handle the costs of adoption.

  18. Jen Tang Jen Tang says:

    Wow, I definitely would not have been able to continue the conversation. I was the “perfect IVF patient” that the staff all said would have twins – started IVF at 28 yo, made many many eggs and embryos, guess what – 3 cycles and no baby. I watched many of my friends get married while I was still ttc, get preg and have 1-2 babies while I was still ttc. being in your 20s with IF has its own special type of suckiness – you have to endure all the preg announcements and baby showers and you also get the “don’t worry – you’re still young” comment in response to both IF and miscarriage. Fun times. 😉

  19. Misty Barthel Misty Barthel says:

    Sometimes it is a medical condition and not a choice. (Says the 20 something that didn’t get pregnant.)

  20. Leah Welsh Lowe Leah Welsh Lowe says:

    Well done. I think she’d have had to pick up my jaw from the floor.

  21. Sue Taylor Sue Taylor says:

    Oh, and just an FYI – egg freezing in Europe can be as low as around $2500 per cycle – I recently blogged about it here:

  22. Sue Taylor Sue Taylor says:

    Great post Dawn – I agree that infertility really isn’t a “lifestyle” choice IMHO. But, following that mentality, there wouldn’t be insurance coverage for disease related to smoking, cancer that can be attributable to lifestyle choices, diabetes or obesity resulting from poor food/lifestyle choices, etc. Or, to take it a step further, if being pregnant is a choice, then insurance might not cover pregnancy either? I think people really just don’t think these things through.

  23. Christi Tipton Christi Tipton says:

    wow, I think you handled it far better than I might have – depending on my mood. I fall into several of the categories you mentioned. I didn’t get married until I was 31. I didn’t even meet him until I was 30! Was that a lifestyle choice? I guess so, since I figured I should have a potential father for my future children. I also knew for years that I have PCOS. I knew something was wrong from my teenage years. Even so, I had 4 miscarriages before we adopted our oldest daughter (I guess those were the result of my ‘lifestyle’? Oddly, the only time I got pregnant was without fertility treatments (which were a dismal failure). My 3 yr old daughter is the only one of 7 pregnancies to make it past 2 months pregnancy (including her, three of them were after the age of 40). Yep, lifestyle choices indeed. I don’t think she and I would have left dinner as new friends!

  24. Avatar Melissa says:

    I wrote an essay but it was getting me so fired up writing it I started to go in a direction that I didn’t need to go but it is ridiculous that we don’t have insurance coverage OPTIONS and infertility is NOT a choice. My husband had childhood cancer and that’s why we have infertility. There was no way for us to prevent that and there was no way to fix it. it would’ve been nice to be able to get some help the last five years even if it meant we had higher co-pays or a higher monthly rate. We have done our part helping others with many things I would rather my money (tax dollars) not go towards but when it came time for us needing help there was none to be found.

  25. Avatar Joanie Joy says:

    I am in the same category as Jen Tang who commented. Got married when I was 26 because that’s when I met the right guy (not because I was focused on career). We started trying just two years later. Doctors all told me, with just a little help (chlomid was supposed to be a for sure thing) we’d totally be able to get pregnant. Both of us did all the testing they require, and then some, and all came back totally normal. We were classified as “unexplained”. We did 10 rounds of IUI, cycle 4 we did get pregnant but miscarried at 7 weeks. did six more with no success. That pregnancy was over a year ago and nothing sense. I think this goes back to the duty I feel people dealing with infertility have, to educate others, help them see beyond their narrow view. I try to remind myself that I too was once totally uneducated and probably said insensitive things. I’m sure I’ve done that in other categories for which I have no experience as well. I think, rather than taking things like that lady said and being bitter and racking her over the coals about it, we have an opportunity to help her and others be more aware so they can be more sensitive. Because this is such a big deal for us, so heartbreaking so sad, we are naturally going to be very sensitive about it. That’s just natural, but how do we want to proceed from there? How do we help improve things? Do we just sit in our own sensitiveity and let that be our identity? Or do we recognize the hurt we feel and then move forward to do something more positive? I want to do the latter. Not ignore how I feel or pretend it’s o.k. but to tell others how difficult it is and give them good information. I do believe because we know it first hand, we are then responsible to inform others.

    • Joanie, I like your attitude and you are so right on this point. [I try to remind myself that I too was once totally uneducated and probably said insensitive things. I’m sure I’ve done that in other categories for which I have no experience as well. I think, rather than taking things like that lady said and being bitter and racking her over the coals about it, we have an opportunity to help her and others be more aware so they can be more sensitive.]

  26. Avatar Shalisa says:

    I wonder if these people would be just as hurt if one day insurance policies decided that becoming pregnant was a lifestyle choice. Therefore, no coverage for maternity care.

  27. Avatar MJ says:

    I was thinking (again) about this blog entry and I couldn’t resist submitting a way that someone with more courage than I could respond to such a question-Is infertility a lifestyle choice? A possible response to this question: “If IF is one person’s choice (One in Eight according to statistics), at what point in their lives did the other seven make the conscious choice to not be IF? When did they choose to be FERTILE? At what point in these lucky peoples’ lives did they make up their minds that yes they wanted to be able to have children through simple non-invasive reproductive methods-is there a certain age when a young man or woman says to themselves-I’m going to be a mom/dad one day and I’m going to do it all by myself, with no help or intervention from anyone else? The sad part is that until you are diagnosed with IF, you are no different in your belief that your reproductive system will not let you down if and when you decide to call upon it to help you to become a parent. The only difference between those of us with IF and those who are fertile is that we who suffer from IF received the rudest of wake up call-the one that tells you that your deepest dreams of parenthood may remain always just out of your reach because of something that lies beyond your control. When you discover you are IF, you really lose your innocence-in some ways, it feels like the saying “you are innocent until proven guilty” except in this case, you are fertile until you are proven IF. IF IS NOT A CHOICE!!!!! It is a problem that we must learn to survive and find a way out of in a way that we can live with. These ways should not remain out of reach if they provide hope to those who need it.

    • Avatar Dawn says:

      MJ: I loved how you turned the question on its head. [at what point in their lives did the other seven make the conscious choice to not be IF] YES!

  28. Avatar a different Heather says:

    Just to show I’m not the evil bitch some may think based on this comment thread, the Dungeons and Dragons thing us unfathomable. Who says that?!

    Of course insurance will cover birth control and vasectomies – it saves them money from having to cover more babies. As for viagra – I don’t have an answer. I don’t think that should be covered, either. But it is.

  29. Avatar Jennifer says:

    Ok, you don’t like the comparison to cancer, but you’ve ignored the question about why insurance should cover birth control or vasectomies. And what about Viagra? Most insurance covers that. It is not life threatening and I think there are some suggestions that it is being used when not really necessary. I’m not asking for a handout. I’m saying insurance should cover the medical condition infertility.

  30. Yes. Well said, Heather. I also have to add that cancer survivors deal with infertility caused by cancer treatments. If a breast cancer patient can have her breasts reconstructed after her mastectomy (a necessity for some to feel normal again, but something that, in a callously technical way, one could say she can live without) then why can’t she have her fertility “reconstructed” through IUI or IVF if she so chooses?

  31. Avatar a different Heather says:

    Clearly we are never going to agree. I’m not going to keep rehashing my opinions. And you clearly are never going to accept that there is a BIG difference in facing cancer and not having a child. I find it offensive that so many people make that comparison.

    So many people lately think they are entitled to everything and that society should foot the bill for it. (in fact Dawn says so explicitly) If you can’t get something you want, expect society and/or the government pay for it. If you don’t like something, sue somebody. Sitting around with a hand out expecting someone else to pay for it. Sad.

  32. Avatar Jennifer says:

    Fortunately, Heather, there are states that disagree with you. Several states mandate insurance coverage for infertility treatment for companies in their state. Illinois is one of them. You can have up to 4 IVF cycles covered by insurance.

  33. Avatar Jennifer says:

    There are medical

  34. Avatar MJ says:

    A different Heather-I’m sorry to have caused you upset, but I do not agree that the only option that a IF person or couple should be left with upon diagnosis is a childfree life, as if they have done something to deserve this fate. When the natural unassisted way proves to be closed, any and all other options should be made available to those who wish to use them. If I were diagnosed with cancer, should the only option for me be death, or should I given access to treatments that might give me hope of saving my life? If I am diagnosed with IF and I still choose to find a way to be a parent to a child, I believe that I should not have to shrug my shoulders and say “oh well, it’s just not meant to be-first because my body has conked out on me, and second because all of my options are out of reach, financially or otherwise”. I have already been denied something so fundamental through IF, I do not wish to be denied any and all hope that I might find a way out of this condition that I can find a sense of peace with in my lifetime. I also bristle at the question that was the genesis of this article, because it effectively condemns young men and women for making what is in the minds of some the responsible choice-putting an emphasis on getting an education, a job, finding a person to share their life with-BEFORE even thinking about conceiving and raising a child. Why should people who have made responsible choices all along-some choices which may have been made with their future children in mind all along-waiting until they could provide a stable home for them to grow up in, for example-be judged as having done the wrong thing solely on the basis of being unfortunate enough to have been diagnosed with this disease? I don’t believe that IF should be allowed to rob people of the opportunity to become parents if that has been their intention all along, just because they have followed a path that they believed to be the responsible way to lead their lives. That is my opinion, and I hold firm to my stance on this. I honour your right to hold your stance, and I respect it, please offer me the same respect to hold my stance. Thank you

    • Avatar Dawn says:

      MJ: [it effectively condemns young men and women for making what is in the minds of some the responsible choice-putting an emphasis on getting an education, a job, finding a person to share their life with-BEFORE even thinking about conceiving and raising a child.] Yes! I don’t think these choices were irresponsible either. I think our society has to find a way for career conscious people to still achieve success and have children before age 35.

  35. Avatar a different Heather says:

    I will say it over and over that infertility sucks and it’s unfair. There are a lot of misconceptions. It’s a taboo subject. I GET that. I FACED it. I was told I would never get pregnant on my own. But I hold firm in my stance that it’s not the job of MEDICAL insurance to fix a “broken heart” (as MJ called it) from not being able to have children. Insurance should (and it most cases DOES) treat the MEDICAL conditions causing infertility… PCOS drugs, endo treatment, fibroid surgery, blocked tubes, etc. But it is not the responsibility for insurance to make the baby. *Lack of baby* is not a medical condition.

  36. Avatar MJ says:

    Thank you for this article, Dawn. Education about the myriad and complex causes of infertility is what will change people’s stereotypes and assumptions about how people become infertile. I am very active in my church and I shudder everytime a scripture reading is read that contains the words “so and so could not have children because God closed her womb”. How can a 21st century society that has properly outgrown the outdated ideas that all other illnesses were caused by some divine punishment-i.e. mental illness was caused by demon possession, blindness was a direct result of some wrongdoing of a person or their parents, physical illness is a result of personal sin-still persist in believing that infertility can only come about as a result of something that a person did or did not do during the course of their life. Of course in scripture infertility is often being used to teach a lesson about the importance of personal faith or as a condition brought about as punishment for the ‘choices’ someone made during their life.Such attitudes help and heal no one-they just perpetuate our ignorance and apathy. Infertility will never be resolved or cured if we continue to place all of the blame for it on those who suffer from it, or by denying those who live with it the resources that they need to overcome it in a life giving way. And for those who comment that not having a child is not an impairment to your life, I say this-infertility is not a fatal condition, but that doesn’t stop someone who suffers from it from dying of a broken heart if they cannot find a way to resolve it that they themselves can live with-and these ways should be made fully accessible to all who wish to access them-through things like tax credits for adoption and insurance coverage for any and ALL ART treatments. Infertility is enough of a stumbling block on the path to building a family without having to deal with the arrogance and ignorance of those who refuse to understand what it is about in our lives-this just adds salt to an already aching wound. Thank you for articles like this, and the sensitivity present within it. I hope that your friend went away from your conversation a little smarter and a LOT more compassionate. Thanks again

  37. Avatar Elizabeth says:

    @Heather- Well said! My thoughts exactly!

  38. Avatar a different Heather says:

    Acne isn’t life threatening but can be fixed with medication. Medical insurance doesn’t cover the plastic surgery/laser therapy to repair acne-damaged skin. Migraines impair one’s ability to function and live. A sprained ankle impairs one’s ability to walk. Not having a child doesn’t impair one’s ability to function or walk. It is unfortunate and unfair. But it is not the responsibility of insurance to provide a baby.

  39. Avatar Anon AP says:

    Well, I don’t know about anyone else, but for me it was entirely a lifestyle choice. From the first time I learned at 13 that my incapacitating monthly cramps could be an indication of reproductive system malfunction, I knew. I knew that I could not be so close to having a chance to gain the label of “infertile” without giving it a good try. After all, we all know that the infertile people of the world are viewed with overwhelming jealousy by those who can have children without medical or social system assistance, right? Then, when I learned that infertility ran in my family, my heart leaped for joy. I could do this! I really could!

    I was single-minded in my focus, careful to bury myself in coursework and to only skirt the dating scene during high school and college. Not because I was an introverted nerd, oh no, but because I wanted that label, and finding that special someone early would really have cramped my style. Then, in grad school, it happened before I knew it: I met my future husband. Damn, I thought! I know that age is a major factor in infertility, and this could really mess with my plans. Luckily for me, my husband shared my life’s goal and believed that infertility could bring us joy and adventure. What luck!

    Our first hurdle to our success came in my surgery. What if they were able to fix me? That would be a crushing blow! Things looked a bit hairy for us after the doctor assured us that things “looked good” afterwards. After healing time had passed though, we really dug in and worked towards our diagnosis. I have to confess that this began in our early thirties. I know what you’re thinking, was I serious about wanting to be declared infertile? Wouldn’t it have been better if we’d waited until our mid- or late-thirties? Well, all I can say is yes, we were quite serious. We knew there was a risk that we might not be successful, but we just couldn’t hold back any longer.

    Knowing that our label wouldn’t be considered credible without a real try, we did it all. Scheduled sex? Check. Obsessive hormone monitoring? Check. Dietary changes? Check. Receiving plenty of well-meaning advice on how to become pregnant? Check. I won’t go into all the details, but I hope you can trust that we went all out in our efforts. Then, with sweaty palms and nervous knees, we went to the doctor a year later and made our case. Would it pass? Oh, we were so close! Referred to a specialist! Happily, that specialist made our diagnosis unassailable. From the hysterosalpinogram (I love how it just rolls of the tongue! to say nothing of the associated vasovagal response – wondrous!) to the multi-day blood work, it was all so reassuring that our label was just in reach. I know my husband treasures the memory of providing his sample for examination. And then, after so many years of effort and planning, there it was: Infertile with low odds of IVF success. Of course it’s couched in various medical terms, but that’s the summary. And so, with tears of joy, we left the office clutching our paperwork with plans of framing it when we got home.

    After all this, I must say, some things are a bit odd in this tale. Specifically, though I and my spouse certainly consider our pursuit of infertility a lifestyle choice, it sure took a whole lot of medical support to define the characteristics of that choice. It’s almost as though, and correct me if I’m wrong, wanting children (or not) in your family might be a lifestyle choice but that infertility is a medical, often treatable reality. Weird.

  40. Avatar Heather says:

    Acne isn’t a life-threatening disease, but my insurance company pays to treat it, along with migraines, warts, sprained ankles, vasectomies, birth control pills, IUDs and tubal ligations. In some diagnosed diseases that cause infertility, the only treatment is advanced ART. Maybe PCOS can be treated with a pill, but there is no pill that will “cure” endometriosis, DOR or POF or some cases of MFI. Couples that have to pay OOP for treatments might be more likely to transfer more embryos or risk high-order multiples with an IUI because they can’t afford to continue treatments and want more than one child. And we all know that high order multiples are far more costly to insurance companies than covering IUIs and covering single-embryo IVF transfers.

  41. Avatar a different Heather says:

    I struggled to conceive my first child and was diagnosed with “unexplained infertlity, possibly PCOS.” But I don’t think insurance should cover advanced fertility treatments. Maybe the diagnosis and simple drugs (clomid, metformin, etc) But not IUI and IVF. It’s an unfortunate turn of events that some of us face. But it’s not a life threatening disease.
    Some people naturally have nice boobs and flat stomachs. Some people that don’t have them can afford to pay for boob jobs and tummy tucks. But that doesn’t mean insurance should cover it for those that want it but can’t afford it. Say insurance covers IVF but it doesn’t work… are people are going to start saying insurance should cover adoption, too?
    Medical insurance is to cover illnesses and injuries. Not to fix things that are unfair.

  42. Avatar Anon says:

    My sister whom I love dearly said similarly insensitive things to me early in my infertility journey, before I knew enough or had the confidence to respond with anything but silence. My rational brain has made a lot of progress in accepting that this condition is not my fault, and not blaming myself for the choices I made in the past (all of which are choices that millions of women have made with no negative consequences) but in the dark parts of my mind I still blame myself and my sister’s comments still ring in my mind, probably because she is someone who matters to me and because ‘just because’ is not a satisfying answer to ‘why has this happened to me’. I’ve gotten much better at dismissing ignorance from random strangers although calling infertility a lifestyle choice might take the cake.

    • Avatar Dawn says:

      Anon, your point about “not blaming myself for the choices I made in the past (all of which are choices that millions of women have made with no negative consequences)” is exactly my point. Not only were these choices that millions of other made without infertility as the result, but they were also choices that were being strongly encouraged by our society. To blame yourself, or to have others blame you, doesn’t make sense.

  43. Avatar Heather says:

    Hmmm…I would have side-eyed her more than you did. One could argue that heart disease is a “lifestyle” choice as well. It affects mostly older people, many of whom live a sedentary life. As far as I know insurance companies are all covering those heart attacks, bypass surgeries and angioplasties no questions asked. I suppose some cancers might also fall into that category as well. I haven’t heard it suggested that smoking-related lung cancers not be covered. My infertility was the result of a DISEASE that affects women of ALL ages.

  44. It also surprises me that insurance companies don’t take into account the increased risk of cancer to women who don’t have children. Surely the cost of covering some infertility treatments & possibly pregnancy for someone is less than paying for their cancer treatment later on because they couldn’t afford those treatments themselves??? Not too mention the mental healthcare costs associated with long term unresolved infertility. That can’t be cheap… But maybe I’m just not scaling the costs correctly in my mind…

  45. Kelley, now that’s a point I’ve not heard made when people talk about the advantages and disadvantages of older parenthood. Really good point. Sorry you lost your mom at such a young age. That had to be really hard.

  46. Jen: [being in your 20s with IF has its own special type of suckiness] Oh how true.

  47. Sue, you raise a good point. Actually, there is some similarities with cancers attributed to lifestyle such as lung cancer. A good friend of mine had lung cancer. She was a nonsmoker. She talks about how lung cancer is the ugly stepchild of the cancer world, and research money and sympathy are slow in coming because people “brought it on themselves”. I hate to admit this, but before she was diagnosed, I did have less sympathy for lung cancer b/c of similar thoughts. I was sympathetic to the people who were suffering, but …. Hummm, I sound a lot like the woman talking about infertility. {squirm}

  48. Christi, well I wouldn’t say we are BFFs. 🙂 I didn’t take my frustration out on her personally since she was speaking from her (limited) experience and she seemed educable.

  49. I’m a weird case to fall into that category, but in a way, I might end up a forerunner to another group of infertiles to come: those busy taking care of dying parents during their 20’s. I actually married young (21) but that marriage fell apart quickly (nothing like immaturity to kill a marriage) :(. So, I started out the way some people think you should, but by my mid 20’s when many of my friends were meeting their spouses and starting their families, I was busy rebuilding my life after divorce (financial devastation) and taking care of my mom who was diagnosed with ovarian cancer. She died when I was 25. My mind wasn’t on dating & kids. It was on getting her to chemo, hooking up her TPN line (tube feeding) on schedule, colostomy stoma care, searching for a job in the middle of a tech industry recession, and eventually on hospice care & funeral arrangements. I didn’t meet my current husband until I was 28. Didn’t marry again until I was 32. I didn’t know I was too late. I thought I had at least 3 yrs and probably a few more after that. I didn’t know I had stage iv endo. He didn’t know he had cancer. I didn’t make a lifestyle choice to experience most people’s middle age experiences in my mid 20’s and I don’t begrudge getting to be there for my mom when she needed me. That’s just the hand I was dealt. Sometimes you play what you’re given. However, as the average age of parenthood creeps up, I do fear that my case won’t look so odd in a few years. More people will be caring for aging & dying parents in their mid-20’s. Are we, as a society, really going to blame them for the lifestyle choice of making their parents’ care a priority instead of dating/marrying/having kids?

  50. Avatar Crystal says:

    Great blog! I’ll testify to the fact that IF affects all ages. My husband had cancer as an adolescent and the treatments almost destroyed his sperm count. So, despite the fact that we started ttc at 25, we had that major issue to deal with. For us, infertility was not a “choice,” it was a result of life-saving treatments. Thankfully, we have insurance coverage for that here in Massachusetts. My heart goes out to those who don’t have that benefit.

  51. Avatar Kimberly says:

    Great article! I married at 26, started trying to have kids months before our wedding cause we said “we live together and we’re getting married, why wait?” And now we are 4 years in, still trying. We spent years fighting with doctors, trying to convince them that something was wrong before we got our referrals to our RE. I’m only now going through my HSG and first round of cycle testing.

    Just last night I had a similar conversation with my fellow dart ladies. Many are older, retired, with grown kids. So this concept of treatments is foreign to them. I was surprised by their reactions only because they assumed *I* was the cause of our infertility. It hadn’t even entered their minds that we were dealing with MFI and a very low sperm count. They were even more sickened by the sheer cost of everything. they really assumed it would all be covered under our Canadian health care plan. they were left speechless by the costs of treatment, our choice to move forward with donor sperm because it would actually cost less and the costs that are associated with adoption.

  52. Avatar Elizabeth says:

    We started TTC when I was 25 and my husband was 27! And over 2 years later and we still have not gotten pregnant. So, even well under 30 year olds have infertility. I should also mention that we are VERY healthy, hardly eating processed foods, and both healthy weights with ZERO other health issues. There is absolutely NO history of infertility in the family. However, we are dealing with severe MFI and just got unlucky in the fertility department. We are grateful for our infertility because it brought us our son (who we adopted), but whenever I think about it, it’s still confusing that we are so unable to conceive, let alone bring a pregnancy to term. It is 100% not ANY kind of lifestyle choice for us. Careers were not put first and that breaks my heart that someone would say that. :/

  53. Avatar Kris says:

    Bravo, Dawn! Well said.

    Certainly patients with insurance are not denied cancer treament even if it developed due to a suspected lifestyle choice…beause truthfully as with most dieases we cannot prove how or why they develop.

    So much of infertility is a ‘guess’ and an unknown. To me premature ovarian failure usually means “I’m not sure why your eggs are tired.” My point is you might not be able to conceive at age 36 & it has nothing to do with age–especially if your mother had children through her 40s. There is no promise to anyone. How about the couple that starts trying in their 20s and finally has children in the mid 30s? Was that a lifestyle choice or bad luck.

    Your point well taken–it shouldn’t matter. It’s a disease that needs treatment.

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