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Making Babies : The Boom in the Infertility Business Is Raising Hopes, and Increasing Criticism

March 06, 1994|Nancy Wartik | Nancy Wartik, who lives in Brooklyn, N.Y., is a contributing editor for American Health magazine

In his spotless embryology lab at the Center for Reproductive Medicine at Century City Hospital, David Hill is peering into the viewer of a formidable-looking microscope, trying to make a baby. On a monitor next to the scope is the vastly magnified image of a woman's egg--smaller, in reality, than a tiny speck of dust--and of the microscopic suction rod holding it in place. Right now, Hill's attention is on the semen sample next to the egg. With his right hand, he's manipulating controls that send a needle far finer than a hair chasing after what looks to be a batch of teeny, wriggling long-tailed polliwogs.

"The best sperm tend to go off to the edge and go around and around the drop like little race cars," Hill says as he hunts down a pack of them. "It's very fortuitous for embryologists."

When he's zeroed in on the sperm he wants, Hill draws them up into the needle by sucking on a rubber mouthpiece that's connected to a slender hose and clenched between his teeth--an oddly low-tech note in this whole sophisticated operation. After he's drawn some 50 sperm into the needle, he moves it over to the egg and presses down against its translucent outer shell (the zona pellucida ). Under the pressure of the needle, the egg squashes in on itself alarmingly, like a beach ball poked with a stick. But as soon as Hill punctures the zona pellucida , deposits a fraction of the sperm and retracts the needle, the egg springs back into shape. Beneath its cloudy shell, the sperm buzz madly about like trapped insects.

The procedure he's just completed is a subzonal insertion, usually known by its friendly acronym, SUZI. Eggs and sperm that Hill manipulate in this way can't, for one reason or another, achieve fertilization on their own. So he's helping them bypass the arduous trek to conception. The sperm-injected eggs (usually a total of seven or eight for each couple) go into an incubator and are maintained at body temperature for 14 to 18 hours. Depending on the number that make the leap to embryo status, about four of the best quality will be loaded into a catheter and inserted into the woman's womb.

"I can't wait to come into the lab, open up the incubator and see whether any of our efforts have resulted in decent embryos," says Hill. "It's just like opening a little Christmas present. I never get tired of it." In Hill's sterilized lab, surrounded by the tools of his trade, it's easy to lose sight of what's actually happening. For couples who come to Century City, as to a fast-growing number of similar clinics around the country, these procedures represent a last chance to achieve a desire as old as human history: that of giving birth to a child. On behalf of these couples, Hill is waging a daily battle of technology against nature. And despite a swelling arsenal of controversial new techniques and procedures, nature usually wins.

THREE YEARS AGO, JOHN TAYLOR (this name and those of the other patients have been changed) got the call from his doctor, just before a weekend business trip to New Orleans. After months of trying unsuccessfully to conceive, John and his wife, Leslie, had sought medical help. Now they were awaiting results of his sperm test. The voice at the other end of the line had bad news. "The doctor told me I had absolutely no sperm," recalls Taylor, 36, a television lighting designer.

"The two of us stood in the kitchen and bawled our eyes out. I was destroyed. I felt emasculated. I come from a large family, and the fact that I'd never be able to have my own children--never, there wasn't a hope in hell--was devastating."

At the end of his weekend trip, in a bizarre twist of events, Taylor returned to hear that there had been a mix-up at the lab, and he did have a sperm count. But it was low, the doctor warned him; pregnancy would still be problematic. "If the guy had been standing there, I'd have decked him for putting me through all that," he says. "But I was also pleased. At least he'd given us back some hope."

Today, $20,000 poorer and their insurance coverage for infertility exhausted, the Taylors wonder whether there was much point in those hopes being raised. Both partners have undergone surgery to correct reproductive-tract problems; each has tried fertility drugs. They've tried timed insemination, with John's sperm inserted directly into Leslie's uterus when ultrasound scanning showed she was ovulating. Twice they've attempted, and failed at, "test tube" conception at Century City. To cut costs on the pricey medication a woman takes during such attempts, they've journeyed to Tijuana to purchase their drugs at cut-rate prices.

Running the gantlet of these treatments has "put an incredible strain on our marriage," says Taylor. "Frankly, I'm surprised we're still together. In many aspects, our lives have been on hold with this thing for three years."

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