Michelle Obama has experienced something many women and couples have a hard time discussing: infertility.
The 54-year-old former First Lady said in an interview with ABC’s “Good Morning America” that she had suffered a miscarriage 20 years ago, and that she and her husband Barack Obama turned to in vitro fertilization (IVF) for both daughters, Malia, 20, and Sasha, 17.
She said she felt “lost and alone” after the miscarriage. “I felt like I failed because I didn’t know how common miscarriages were because we don’t talk about them,” she said. “We sit in our own pain, thinking that somehow we’re broken.”
“It is soul-crushing for many people,” said Susan Hertzberg, chief executive officer of Prelude Fertility, a network of fertility centers across the country. “Women feel ashamed, and feel as though they’ve failed because they can’t do something their bodies were intended to do. There is a cloak around it all.”
Infertility arises when couples experience ovulation disorders, endometriosis, genetic disorders or impaired sperm function, among other health issues, the Mayo Clinic said.
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About 10% of U.S. women between 15 and 44 years old (or 6.1 million) have difficulty getting or staying pregnant, according to the Centers for Disease Control and Prevention. In about 8% of couples’ infertility, the problem lies with the male, whereas in 35% of infertility cases, it is both the male and female.
The entire process, including the medications, freezing the eggs and other procedures, could cost between $15,000 and $20,000, depending on the woman’s age and where she lives. Many insurance plans do not cover IVF, though some companies are starting to help their employees pay for the procedure.
Fertility declines as men and women age, though aging affects women much more than men. Women are born with all of the eggs they’ll ever have — about 2 million — and naturally lose them through life. As they get older, the ratio of healthy eggs versus unhealthy eggs also increases, which means even if a woman has 400,000 eggs left in her mid-to-late 30s, she’ll only get pregnant if a healthy egg fertilizes.
IVF has been used for 20 years and has accounted for 8 million births. In vitro fertilization is the process of fertilizing an egg outside of a woman’s body. Women receive injection shots, something Obama said she did by herself while her husband was out of town for work, to bring an egg to maturity.
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A “vacuum” is used to take as many of the eggs as possible out of the patient to be fertilized. A single embryo is transferred into the patient, who will then proceed with pregnancy as she otherwise would, Hertzberg said. There is a two week wait, called “TWW,” to see if the process worked, the National Infertility Association said.
The Obamas are not alone. Supermodel Chrissy Teigen has been honest about the struggles with fertility and motherhood, as have singer Mariah Carey, actress Angela Bassett and late-night host Jimmy Fallon. NBC’s hit show “This Is Us” has also highlighted the IVF process, including the shots and the mixed emotions that come with it.
Now, Obama’s honesty may also help other women and couples after they infertility diagnoses, Hertzberg said. “She’s a role model for so many people,” she said.
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