New Resources For Couples Struggling with Infertility
Miryam Z. Wahrman, Ph.D.
"Yom Tov was hard, but not as bad as I thought it would be. I always felt that Simchas Torah is the hardest time of the year for infertile people...." writes Yehudis, a Lakewood resident. Yehudis, who uses a pen name to protect her privacy, writes a column in A T.I.M.E., the newsletter of the support group, A Torah Infertility Medium of Exchange. A T.I.M.E. is a non-profit organization which "supports and educates those in the Jewish community experiencing infertility." The organization provides a telephone help line, peer support network and has organized infertility support groups for Jewish couples, mostly situated in New York.
"There are no Jewish support groups in New Jersey. We really need someone to organize one," reported Dr. Sara Barris, a clinical psychologist. Barris is a director of support groups for RESOLVE, NYC, a non-profit, self-help infertility organization that provides access to medical information and moral support for infertile couples. "A few New Jersey couples are using a group in Monsey," she observed.
Although support groups specifically addressing Jewish issues in infertility are hard to come by in New Jersey, a new piece of legislation, The Family Building Act, puts New Jersey at the forefront in terms of support for infertile couples. The bill, just passed by both the Senate and the Assembly, requires insurance companies to cover costs associated with infertility. Advocates of the infertility-coverage bill now anxiously await Governor Whitman's approval.
"I think it's fantastic. It sets a good precedent for New York, where there's a bill waiting to be passed," remarked Barris.
The passage from Genesis (1:28), "Be fruitful and multiply, fill the earth and subdue it", commands humankind to populate and control the world. Nowadays, most rabbis agree that because the obligation to populate the world is so important, many modern scientific developments for assisting infertile couples are permissible under Jewish law.
According to Barris and Dr. Joel Comet, writing in Be Fruitful and Multiply (ed. R. Grazi, Feldheim Publishers, 1994) "This commandment has become one of the most pivotal and precious values in Jewish life, that of building a family."
However, many of the modern fertility treatments are prohibitively expensive. Some couples simply can't afford the cost and thus remain childless even though methods are available which would enable them to conceive.
One resource in the Jewish community which addresses this problem is a non-profit organization called Doros, which helps couples obtain interest-free loans to assist with medical treatments for infertility. However, this assistance is not available to all who need it. In addition, many couples do not want to borrow tens of thousands of dollars for the In Vitro Fertilization cycles they might require in order to conceive.
The New Jersey Assembly bill, "Requires health insurers to provide coverage for medically necessary expenses incurred in diagnosis and treatment of infertility." The requirements are limited to companies with more than fifty employees, exclude self-funded insurance plans, exclude women over 45 and limit a woman's coverage to four egg-retrieval procedures. An egg-retrieval involves surgically recovering mature eggs from the ovary, fertilizing them in a petri dish, and either freezing them for later use or immediately replacing them in the uterus.
Infertility procedures which would be covered by insurance include: "diagnosis and diagnostic tests; medications; surgery; in vitro fertilization [IVF]; embryo transfer; artificial insemination; gamete intra fallopian transfer [GIFT]; zygote intra fallopian transfer [ZIFT]; [and] intracytoplasmic sperm injection..." Stipulations of the bill include that the more expensive techniques, namely IVF, GIFT and ZIFT will be limited to couples who have already tried less expensive treatments without success.
"[The bill is] life-saving for couples," Barris observed. "There's high-tech out there and it's frustrating when it's just available for people who have great insurance or are wealthy."
The bill, sponsored by Assemblyman Neil Cohen (District 20, Union) was cosponsored by 12 other legislators, including Loretta Weinberg (District 37, Bergen).
"I think it's an important piece of legislation," said Weinberg. "We have, by virtue of the way society's going, more and more couples going through infertility treatments. And they're very expensive to undergo."
"You have to really want to have a child to go through the medical requirements as well as the financial requirements of these infertility treatments," Weinberg continued. "I think it's important that while we talk about family values, that we put our money where our collective mouths are and help pay for things, like helping those people who really want to have children to be able to have them. So by requiring insurance coverage to pay for it, this will go a long way toward helping young families who are having problems conceiving."
While Jewish families reportedly suffer infertility at the same rates as the general population, with 10-15% of couples unable to conceive by natural means, Jewish culture may impose unique stresses on these couples.
Barris and Comet have written about some of the special issues religious women deal with regarding infertility. "Whatever other professional or social roles women see themselves playing in society, being a mother remains an integral part of a religious woman's female identity... No woman expects to be infertile..."
Regarding observant men, they note, "The Torah clearly defines a man's role in the context of his family. It is the man who has the religious obligation to reproduce... the infertile man may ...believe that he is disappointing his wife and feel like a failure... In addition, the religious man may be plagued by the thought that he cannot fulfill his religious obligation to reproduce."
Relating to the Jewish community can become painful for infertile couples. "The synagogue used to be a place to relax and enjoy the joy of Sabbath. Now it has become a weekly reminder of how set apart the infertile members are from the rest of their peers," observe Barris and Comet. "Synagogues are filled with children and pregnant women who enjoy discussing childbirth and child-rearing issues. The child-oriented festivals like Simhat Torah, Hannuka, Purim and Pesah make it painful for the infertile couple to participate, which leads to an increasing sense of isolation."
"Reaching out and connecting to others is probably the most significant action that the infertile couple can take to help themselves cope in more positive and productive ways." conclude Barris and Comet, recommending the use of support groups such as RESOLVE.
"I think [infertility] seems to be a rising problem, and certainly as much of a problem in the Jewish community as in any other," Weinberg observed. "But in the Jewish community, with the respect we have for family, and desire to populate our numbers, it becomes an even more important imperative for many families. I think anything we can do to enable people who really want to have children to have them, the state should be doing its part."
"The last step is, it's up to the Governor to sign it," concluded Weinberg.
According to Belle Degenaars, a spokeswoman for the New Jersey chapter of RESOLVE, Inc., if the Governor does not sign the bill within seven days (by January 17) or chooses to veto it, the bill does not become law, and the legislative process must begin again.
A T.I.M.E. can be reached at (718) 437-7110 and on the web at www.atime.org. Information on infertility support groups for Jewish couples can be obtained from Dr. Sara Barris at (718) 544-0932. RESOLVE can be reached at (212) 764-0802 or on the web at www.resolve.org. Doros, Inc. can be contacted at (718) 854-4341. To contact Governor Whitman, call (609) 292-6000 or e-mail her through the N.J. State website http://www.state.nj.us/governor/contact.htm