Consider the predicament of the modern educated woman. She goes to school until she's in her 20s. She spends the next 10 years establishing a career. She settles on a guy, and they save up to buy a house. They are responsible and prudent. At last, it's time to have a family!
Unfortunately, she's now 38, or maybe 40. To her shock, she discovers her eggs are past their sell-by date. Time to go the high-tech route. Now she discovers that, at $10,000 for a single round of in-vitro treatment, plus assorted drugs and extras, high-tech babies don't come cheap.
Who pays for her effort to get pregnant? If the infertility lobby has its way, we do. It's putting heavy pressure on Ontario's government to fund in-vitro fertilization for women up to 42. It has a battery of arguments for why this is in the public interest: Having children is a basic human right. Infertility is a disease, and treating it is so expensive that people shouldn't have to pay for it themselves (even though many do). Finally, public funding of fertility treatments will save the system money.
This task force, which included people from every conceivable interest group, lacked only someone to speak for the silent, suffering, taxpaying public.
The infertility industry is doing its best to expand our concept of both human rights and medical necessity. "Everybody should have the right to a family," says Marjorie Dixon, a fertility specialist at the First Steps fertility clinic in Toronto. She says women feel "cheated" because, even though they pay taxes, the government won't help them. The Infertility Awareness Association of Canada defines infertility as "a reproductive health disease." Infertility is to blame for our falling birth rates and shrinking population (who knew?), as well as for "terrible emotional anguish."
The causes of infertility are complex, of course, and people's choices to postpone reproduction until middle age are just one part of the story. But among the chief customers for fertility treatment are educated women who've been deluded into thinking that technology can help them whenever they want a child.
Bowing to the pressure, Quebec has now agreed to fund as much as three rounds of in-vitro treatment for infertile women. (Quebec is obsessed with its low birth rate.) Britain and Australia fund in-vitro, too, and, last summer, a high-profile task force urged Ontario to follow suit. This task force, which included people from every conceivable interest group, lacked only someone to speak for the silent, suffering, taxpaying public.
Is having a family a human right? Well, sure, of course. But I don't think that having a family under any circumstances, or expecting the public to pay for your in-vitro treatments, is a human right. Life's unfair, and health care is a bottomless pit, and some of these procedures have wretched outcomes. After 40, a women's chance of taking home a baby after IVF sinks to one in 10 or less (to say nothing of the risks). What other elective treatment would we cover that had a failure rate that high?
With health-care budgets under acute stress, the infertility lobby is strongly pushing the cost-benefit argument. It argues that, because of the high costs of treatment, women opt for two, three or four embryo implants at a time to save money. The result is a high rate of multiple births, with expensive medical complications. Public funding would more than pay for itself by encouraging more conservative procedures and fewer multiple pregnancies.
But public funding is an open-ended commitment. And if multiple pregnancies are so undesirable, then why not regulate the industry more tightly on medical grounds alone?
If we really want to reduce the anguish of infertility, here are a couple of cheap ideas. Stop peddling phony hopes to desperate couples almost certainly doomed to fail (no matter whose money they're spending). And post the basic statistics about fertility and pregnancy in big red letters in every doctor's waiting room. I can't tell you how many women would have acted differently if they'd only known.