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Living for Two

Lehman and Shanelle Best listened to soothing classical music as they anxiously drove from North Raleigh to the infertility clinic in Cary. They sat quietly in a love seat at the N.C. Center for Reproductive Medicine, waiting for a nurse to call their names. They came to Dr. Sameh Toma to get help them pregnant. They’ve been through one cycle of in-vitro fertilization in their former home of Indianapolis, and it hadn’t worked. This time around they were confident they could conceive.

They were both young and healthy, he’s 27, she’s 28. Most couples would try to conceive for years before they finally seeked help from fertility treatments. IVF was typically a last resort for infertile couples, but more today are choosing IVF as their first option when it comes to infertility. “It has gone up year after year” since he opened the center in 1992, Toma says, seeing 130 new patients a month. There are around 62 million American women of reproductive age in 2002, and 10 percent of them had had an infertility-related medical visit at some point, according to the Centers for Disease Control and Prevention. Infertility is not rising, but more young couples is becoming more available to couples, and it is becoming more normalized.

Toma charges $5,500 for the procedure, plus $3,000 to $5,000 for the drugs the woman must take before and after the procedure. Duke’s fertility clinic charges about $10,000 for the procedure and $1,500 to $3,000 for drugs, said Susannah Copland, a doctor in the clinic. Copland, whose clinic has not seen an increase in younger couples, said younger women save money on the drugs because they don’t need as many as older women.

Some, like the Bests, have medical insurance that pays for IVF treatments. Toma offers a shared risk plan: After three unsuccessful IVF cycles, the patient gets her money back.

Typical problems

The younger women who face infertility usually have problems with their uterus or have obstructions in their fallopian tubes. In many cases, the problem is with the male partner. The men normally have a low sperm count, which means they have sperm but not at the numbers needed to get pregnant naturally. These cases make for an excellent candidates for IVF. With these cases, doctors implant the man’s sperm directly into the woman’s egg in a petri dish. Then the embryo or embryos are implanted into the woman’s uterus or Fallopian tubes.

Toma said IVF has a 51 percent success rate with his female patients who are under 35. The rate falls to 37 percent for those 35 to 37. For his patients in their early 40s, only three of 14, or 21 percent, get pregnant using their own eggs and give birth.


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