Trying To Conceive
The Little Known Fact Every Black Woman Needs to Know |
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Trying to Conceive The Little Known Fact Every Black Woman Needs to Know
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Throughout our country, good medical care access varies according to region and social standing. This disparity occurs in spite of wide varieties and standard forms of medical insurance coverage to diverse groups of people and in spite of the presence in many areas (i.e., inner cities), of large medical centers that offer a variety of medical services. Part of the reason for the inability of the medical system to deliver high quality care to everyone is the lack of accessibility in some communities of good information regarding the scope of medical services that are available. Nowhere is this truer than in the case of treatment to combat infertility. There are many spoken and unspoken myths in regard to African Americans and infertility. One prevalent spoken myth revolves around the African American not having a problem with infertility; the unspoken premise is that if a problem does exist, it is never acknowledged. |
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A rare occurrence for our IVF treatment program is the visit by an African American couple. Most are employees of the Saint Barnabas health care system, and the remainder of couples are generally referred by a physician associated with the hospital. This referral pattern is unusual because we are a tertiary care center that specializes in the treatment of difficult cases. Our other patients come to IRMS in a variety of ways; more than a third of our patients come to us from other states or countries, many are self-referred, and others are referred by physicians, family, or friends in other locals. The small percentage of African American patients that we see in our program, coupled with the fact that those that we do see are largely “in-house” referrals leads me to believe that we as a people are unaware of the resources that are available for individuals that are having difficulty achieving pregnancy. Several research studies conducted have reached the same conclusion. |
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There are not many African Americans who are known for their involvement in the area of pregnancy assistance via in vitro fertilization. The number of African American Reproductive Endocrinologist is pretty low compared to their Caucasian counterparts. In fact, because of the traditional and totally incorrect stereotype of “the hyper-fertile African American who is perceived as impervious to fertilization issues,” the only recognition that our race gets tends to be when there are anomalies and/or freak mishaps in this area. This is an unfortunate tragedy and one that influences the apprehension of our people to speak out about this problem amongst us. African Americans perceive themselves in a certain light – not impervious, but definitely not infallible. We try not to exhibit chinks in our collective armor; we’re taught to be mindful of displaying certain emotions in public lest we be perceived in a weaker light. With this in mind, the uninformed equate infertility with weakness, making it difficult to come to terms with the medical facts of infertility. |
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fact, because of the traditional and totally incorrect stereotype of “the hyper-fertile African American who is perceived as impervious to fertilization issues,” the only recognition that our race gets tends to be when there are anomalies and/or freak mishaps in this area." _______________________________________________________________
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The
prevalent perception is that infertility is a “female” problem—of course, this is not completely accurate. Some of the more unfortunate sentiments my male patients have communicated range from blaming the female partner—“It must be her fault because I already have kids”—to all out denial: “It can’t be my problem, I’m completely healthy.” 40 percent of all infertility cases involve male-based problems. Men are eager to project the problem upon the woman because she is the one who carries the baby. We need to acknowledge that this is a problem for both parties. More importantly, we also need to acknowledge that even if the female partner is primarily affected, the solution will involve both partners—both physically and emotionally. |
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Advanced medical treatment is available for those who can afford it, because it can be an expensive endeavor. This is one of the biggest obstacles faced by a couple searching to start a family. There is hope, however, as New Jersey, as well as a growing number of states, now provide mandated infertility treatment coverage. The highest levels of infertility treatment coverage are now accessible to millions of couples. In many cases, a visit to an infertility specialist – a Reproductive Endocrinologist – opens up a whole new set of treatment options, as well as some real hope. |
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Infertility is a problem that is not well addressed amongst African-Americans. There are numerous support groups that provide inspiration to infertile couples. These support groups are extremely helpful in providing information on a range of family-building topics, including ways to support the cost of medical procedures. There is not a high level of participation in these groups by African Americans. To my knowledge, there is no group dedicated to the support of infertile African Americans. Now, there could be many reasons why we don’t have or participate in support groups but one reason I won’t believe is that we don’t have an infertility problem. Everyone knows someone who is attempting to have a baby or who is having a problem with conceiving and I don’t believe we know which way to point them to get the right kind of care. If I’m approached by Women (professionals, Greek-Letter Organization members and the like) who ask questions about infertility they will often tell me about their general practitioner who has been their OB/GYN since early childhood. This general practitioner will often tell them that IVF is extremely expensive; why not try an Intra-Uterine Insemination (“I.U.I.”) procedure that is more cost-effective (approximately $300 – $400) and can be done in the gynecologist’s office. What they may not be telling their patient is that the success rate of this procedure is less than 20% per pregnancy cycle and sometimes much less. What then happens while a six to twelve month period passes without success and mounting costs (upwards of $2,000) is all too predictable: discouragement and the acceptance of what they believe is a hopeless situation. In this all-too-common scenario, the patients may never be aware of a myriad of advanced procedures that may help them in their effort to build a family. Organization members and the like) who ask questions about infertility they will often tell me about their general practitioner who has been their OB/GYN since early childhood. This general practitioner will often tell them that IVF is extremely expensive; why not try an Intra-Uterine Insemination (“I.U.I.”) procedure that is more cost-effective (approximately $300 – $400) and can be done in the gynecologist’s office. What they may not be telling their patient is that the success rate of this procedure is less than 20% per pregnancy cycle and sometimes much less. What then happens while a six to twelve month period passes without success and mounting costs (upwards of $2,000) is all too predictable: discouragement and the acceptance of what they believe is a hopeless situation. In this all-too-common scenario, the patients may never be aware of a myriad of advanced procedures that may help them in their effort to build a family. |
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A variety of factors can delay a woman’s chances of having a baby, including her age, duration, cause of infertility and the number of previous unsuccessful attempts at treatment. The selection of an appropriate treatment is dependent on the infertility diagnosis. Therefore, it is of the utmost importance that the couple chooses an IVF program based on the couple’s research of the knowledge, training, and expertise of the clinical and laboratory staff of their choice. |
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The causes of infertility are numerous and complex. Effective treatment requires a detailed examination and history of both male and female partners. At IRMS, where we perform both clinical IVF treatment and conduct basic and applied research related to human infertility, we provide a full range of infertility treatment; everything from basic work-ups and minimally-invasive treatment to In Vitro Fertilization (IVF) with the latest Preimplantation Genetic Diagnosis (PGD) analysis. Our scientific program has two components: the development of new and improved laboratory technologies and participation in research protocols to test new medications and approaches to infertility treatments. Our scientists are recipients of national and international awards. In the past, our scientists have been responsible for developing breakthrough technologies such as Assisted Hatching, Blastocyst Culture and Freezing, as well as the first attempts to use micromanipulation to assist the fertilization process. I can proudly illustrate the features of the program that I’m a part of so that a prospective couple knows what to look for when they search for an IVF program. It is important to consider recommendations by physicians, friends, and family; however, it is more important to evaluate the capabilities of an IVF program through careful research and individual consultation. The Centers for Disease Control (CDC) publish a listing of outcomes of all major U.S. IVF programs. It is important to make inquiries beyond simple pregnancy rates; regarding pregnancy rates, it is important to focus on delivery rates for a group of patients that are similar in age and diagnosis. |
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I will be happy to answer any questions so feel free to contact me: J. Kendall Smalls, Embryologist, email KennyS@SBIVF.com; website www.sbivf.com or www.Embryos.net . Good Luck; don’t be afraid to inquire. |