Breeder Reaction: Does everybody have the right to have a baby? And who should pay when nature alone doesn’t work?
by Elizabeth Weil
Guadalupe Benitez and her partner, Joanne Clark, had been buying frozen sperm at a bank in Los Angeles and trying to get pregnant at home for two years when Benitez finally sought out the services of a fertility specialist. Not at all uncommon—infertility affects more than 6 million Americans, and about 20 percent of them seek help through assisted reproductive technology, or ART. At that point, 1999, Benitez was 27 years old, Clark was 40 years old, and the couple had been together for eight years, since Benitez emigrated from Culiacán, Mexico. Benitez, a medical assistant, had some infertility benefits at a nearby OB/GYN clinic, the North Coast Women’s Care Medical Group. There, Dr. Christine Brody put Benitez on a hormonal drug called Clomid, to treat her polycystic ovarian syndrome, and also told her that she was willing to oversee her treatment but not to perform inseminations because, as a Christian, she disapproved of lesbians having children.
“When she said that,” Benitez told me, “I was so upset, but she made it better by saying the other doctors would do it for us.” Benitez and Clark tried home inseminations for a few more months, and Brody even did some exploratory surgery. But when the time came to schedule a more effective in utero insemination—a procedure that involves injecting sperm directly into the uterus—an assistant from North Coast Women’s Care called to inform Benitez that no one in the practice would do the procedure, nor would they refill her prescriptions. Benitez demanded to speak with the head of the clinic, who responded by telling her that he, too, objected to helping lesbians have children and would not further her care. “They had just lied and lied to me, trying to brush me aside to do inseminations at home as some form of excuse. But once they found themselves against the wall, they had no choice but to tell me they flat-out wouldn’t do it.” So Benitez sued.
Benitez’s is far from the only case brought by a woman turned down for fertility services. Kijuana Chambers, a single blind woman living in Denver, Colorado, was eventually turned away from her fertility clinic. Among the reasons cited at trial by one of the clinic’s doctors: She was prone to emotional outbursts; she had dirty underwear. Chambers lost her trial in the U.S. District Court in Denver in November 2003. Last summer, the 10th Circuit Court of Appeals declined to rehear her case.
Screening at fertility clinics is not just a concern for gays, lesbians, and the disabled. Women over 39 and women with severely compromised fertility are commonly turned down for services or told they won’t be treated unless they agree to use donor eggs. This is largely a matter of economics. Assisted reproduction is a $4 billion-a-year business. The average cost of a single cycle of in vitro fertilization, including medications, egg retrieval, sperm washing, fertilization, incubation, and embryo transfer, is $12,400. Given all the failures and repeat attempts, the average amount spent per baby born through IVF in the United States is much higher: $100,000. Few insurance companies pick up the tab, so patients themselves decide where to spend their considerable money, and they do this largely based on a clinic’s success rate. As a result, many doctors try to game the system, producing high “live birth” success rates by cherry-picking patients. Before being accepted by a clinic, a woman must submit to a battery of tests to determine things like the level of follicle-stimulating hormone on day three of her menstrual cycle. Get a number over 12, and she’s out of luck.
According to Dr. Geoffrey Sher, founder and medical director of the Sher Institute of Reproductive Medicine, the largest chain of privately owned fertility clinics in the world, almost any clinic that can afford to turn down patients does. “I’d like to think most doctors try to be honest. The problem is, you’re confronted with the reality that if you don’t get high success rates, patients don’t come to you.”
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