Perhaps the least discussed and supported health problem affecting Georgians today is not AIDS or cancer, but infertility.
Infertility affects 6.1 million people in the U.S., which is 15 percent of reproductive age couples attempting to have a child. But unlike cancer or any other major disease, infertile people often receive little compassion or support from friends or family.
"(Infertility) is not seen as cancer or anything as horrendous as that," said Janet Eason, former president of Resolve Georgia, a national nonprofit infertility association serving couples dealing with fertility issues. "People don't see it as a disease, just as 'tough luck,' yet it can be so devastating to a marriage, family and one's self esteem."
It's stressful to be infertile in a fertile world. Many men may end up struggling with masculinity issues while women may feel their bodies aren't capable of fully functioning and are inadequate, said Sandra Fricks, a licensed marriage and family therapist who practices privately in Lawrenceville and through Covenant Counseling Center.
"When people decide to get pregnant, they're ready and no one expects to have to consult an infertility specialist for the most part," Fricks said.
Before couples seek fertility counseling, experts concur they should attempt a pregnancy with unprotected intercourse for anywhere between six months and a year. There are many factors that can contribute to infertility, such as smoking, drinking, acquiring sexually transmitted diseases and being overweight, said Dr. Slayden, a physician with Reproductive Biology Associates with offices also at Gwinnett Medical Center.
Although not an issue with men, a woman's age is a factor, too. From birth, women lose eggs each year, so by the time she tops her cake with 35 candles, a woman's egg bank is markedly less than that of a 21-year-old's.
Once a couple decides to visit a fertility specialist there are a few options and a few hurdles.
One of the hurdles is insurance. Insurance often will refuse to cover any procedures, especially in Georgia said Slayden. Thirty percent of his patients have coverage for routine therapy, such as fertility pills while 20 percent have coverage for intrauterine insemination. And while those therapies are better than nothing, the pregnancy rates are lower and don't help everyone.
"It's just not practical for some people," Slayden said. "If a woman's tubes are blocked or she's 38 years old, pursuing intrauterine insemination is not the best thing, medically speaking. So you have the tools you can pull out of a tool chest, but you can't (always) use them and that's frustrating."
In vitro fertilization is the ideal method in many cases for couples who want a biological baby as opposed to an adopted child. It's a process of fertilizing eggs outside the body in-vitro, which is Latin for "in glass."
During IVF many tries are often necessary for a successful implantation and resulting pregnancy, Slayden said. Unfortunately that treatment carries a hefty price tag, starting around $1,500.
"Medicines are very expensive and it is often dependent on age," Slayden said. "Someone older would need more medicines. At least 15 states mandate insurance coverage for fertility." But not all states, and Georgia is not one of them.
However, the lure of IVF is its success rate. More than 70 percent of women get pregnant successfully and have a baby through IVF, making it the most sought-after fertility procedure.
Maria Masi, an Alpharetta resident, and her husband began trying for children in their early 30s, but after one year had no success and sought a specialist. She subsequently went through five years of infertility therapy. She underwent surgery, endured a miscarriage, changed her career by quitting her high-stress job to focus on researching fertility options and spent at least $25,000 in fertility treatment and $18,000 in medications. Fortunately Masi's insurance paid for most of the procedures, but there was a $25,000 ceiling, so with each failed IVF not only did she endure a painful and emotionally draining experience, she also endured the depletion of her limited funds.
The added pressure and financial strain also took a toll on their marriage.
"During 9/11 my husband and I hit a new low," Masi said. "You look at family more and you think about the things that are most important, and we were reminded how important family is and how we wanted to grow our own family."
Masi and her husband reached Resolve Georgia.
"I called the help line, and right away I immediately felt I was in a comfort zone," Masi said. They began attending monthly meetings, peer support groups and through Resolve were able to network with friends and receive information about treatments and doctors.
"Infertility is hard on a marriage because when you go through long periods of infertility it becomes a strain on your sex life," she said. "You're reminded procreation isn't for fun anymore and you lose the fizzle in the bedroom pretty quickly."
Masi also found the camaraderie between women she met at Resolve was helpful because she share sensitive medical information with them, since they shared in her experiences, instead of only having her husband as an outlet.
Five years later and four IVF procedures later, she and her husband celebrated their son's first birthday Oct. 25.
"I had such an amazing journey and I felt in my heart I was meant to continue," she said. "I was given a five percent chance of conceiving, but despite that I conceived at age 39."