Louise Brown, the world's first test-tube baby, was born 35 years ago today, revolutionizing the field of reproductive medicine and giving infertile women hope that they could become mothers.
Now, the procedure is so common that more than 5 million around the world have conceived babies through in vitro fertilization or IVF.
Brown was born at Oldham General Hospital in Britain on July 25, 1978. Her mother had blocked fallopian tubes, still one of the most frequent causes of infertility in women. But Brown herself, who has a 6-year-old son, never required IVF and just revealed she is expecting a second child.
Infertility affects 7.3 million people in the U.S, or one in eight couples, according to RESOLVE, the National Infertility Association.
Today, thanks to the efforts of British Nobel Prize winners Dr. Patrick Steptoe and biologist Robert Edwards, who pioneered the procedure with the birth of Brown, IVF is performed successfully around the world.
Live birth rates using non-donor eggs are as high as 40 percent in couples under the age of 35, according to the Society for Assisted Reproductive Technology (ART).
ART accounts for slightly more than 1 percent of all U.S. births, more than 61,000 births in 2008, the last year for which there are statistics from the Centers for Disease Control and Prevention.
But despite advances in medical technology, society still stigmatizes women who cannot conceive, according to RESOLVE's president and CEO Barbara Collura. Insurance coverage varies from state to state, and infertility is often treated as a non-medical condition.
"We've had really amazing medical breakthroughs, but I don't think that 35 years later the discussion of infertility is much more mainstream," said Collura. "That's because public understanding is not quite there."
"A lot has changed," she said. "But a woman being told right now that she's having trouble conceiving is going to have the emotions and feelings of loss."
Many women do not have access to IVF because insurance companies do not cover the costs or they require riders that result in higher premiums. That's because in many policies it is considered an elective procedure, like plastic surgery.
TRICARE, the company that insures active duty soldiers, and the Veterans Administration (VA) only cover treatments leading up to an infertility diagnosis.
Two bills are currently pending in Congress to bridge the gap for couples who cannot afford the price of IVF. One would allow couples a tax credit, much like the adoption credit for out-of-pocket costs.
A second bill would require the VA to provide IVF and adoption assistance to those whose wounds have rendered them infertile.
One cycle of IVF, which includes medications and all procedures, including cryo-preservation of embryos, can cost anywhere from $12,000 to $20,000, according to Collura.
Using a donor egg can be as much as $35,000 to $40,000. Surrogacy, which in some states includes compensation for the carrier as well as her health care, can exceed $80,000.
Since the 1980s, 15 states have passed laws that require insurers to either cover or offer coverage for infertility diagnosis and treatment, according to the National Conference on State Legislatures.
Amanda Dodson lives in Dayton, Ohio, a state that does not mandate coverage of IVF. The 29-year-old suffered from several miscarriages due to polycystic ovary disease, and her husband has abnormal sperm.
Thanks to IVF, they now have a 2 1/2-year-old son, Elijah. But the procedure cost upward of $16,000. She works in home care and her husband is a call-center supervisor, so money is tight.
"The insurance company only paid for treatment up to diagnosis, so we put a lot of it on the credit card," said Dodson. "We are still paying it off."
Two other subsequent attempts were unsuccessful, so just this week, they are attempting IVF again with the last of the frozen embryos.
If that fails, she said, "I don't know how we are going to come up with the money for another cycle."
"The insurance companies say it's voluntary, but I think it should be a right that everyone has an opportunity to have a child," said Dodson.
Blake and Julie Plumley saw numerous reproductive endocrinologists in their home state of Florida before they were told they would never get pregnant. But through friends they heard of a top doctor in Massachusetts and were able to conceive their daughter.
Blake, who works in the resort business, and Julie, a former golf professional, estimated they spent at least $100,000 out of pocket throughout the seven years they tried to get pregnant.
She said one Florida doctor told them to try again would "be a waste." Another "took advantage" financially.
Blake, 41, said the difference was Massachusetts had mandated coverage. "This legally required coverage allows the doctors in Massachusetts to have much more experience and by default they become much better," he said.
Julie, 39, agreed. "The difference was literally like going to a doctor who was practicing without modern x-rays and stepping into a hospital with everything you can imagine."
Within 90 days of traveling to Boston, the Plumleys were pregnant with Haley, who is now 5. Surprisingly, they conceived their 13-month-old daughter, Madison, without medical intervention.
"Infertility isn't a choice and that's where it sits in the medical field," said Julie. "No one chooses to have trouble getting pregnant. But you are left out there to figure it out and pay for it yourself."
For those who served in the military, no coverage for IVF is a bitter pill.
Ben Brown, a 31-year-old Navy veteran, was paralyzed in a car accident when he was on active duty in Europe in 2002. As a result, he has minimal sperm production, but was able to undergo sperm extraction for an IVF procedure with his wife.
"Like anybody else, I wanted to be able to start a family," said Brown. "We got lucky and the first go-round was successful."
Today, they have a 3-year-old named Lorelei. And just this week, the couple had another round of IVF, trying for another child. But four cycles have cost the Lexington, Ken., couple nearly $40,000.
Brown noted that procedures are performed at Walter Reed National Military Medical Center in Washington, D.C., at a price that is discounted.
But, he said, "We have to pay out of pocket for lodging and meals and all the procedures."
"My wife is a school teacher and I draw veterans' benefits," he said. "We pinch pennies where we can and sometimes we have to borrow a good amount of money."
Brown said that at the VA hospital he sees injured veterans in wheelchairs and with prosthetic limbs, almost all of them childbearing age who may eventually want to have children.
"The medical technology has proven to be a success," he said. "And it's the obligation of the VA to treat the disabilities of young men and women. The only thing standing in the way is passing legislation."
And just today, Louise Brown echoed the sentiments of Ben Brown and others, calling for IVF to be made more readily available to couples. "...if you're told you can't have children, you'll do anything," she told the British press today.
"It is difficult to say what it is like to be the first test-tube baby as I have been brought up with it. People ask what it feels like, but it's just always been there; it's my life."