There's much talk in women's health about reproductive choice. It has been a prominent issue in national elections, Supreme Court Justice nomination hearings, and the efforts to pass a healthcare reform bill. Women's reproductive choice has moved beyond the healthcare arena to become what many believe is the most divisive issue in our country today. Almost everyone has a firm position on the issue, and neither education nor reasoned arguments will change anyone's views. Reproductive choice has become a social and moral issue for our society.
Yet, there are a group of women in this country who, by virtue of biology, have no reproductive choice whatsoever: those who are experiencing infertility. Infertility affects rich and poor, gay and straight, and women and men of all races and ethnic backgrounds. The cost of infertility treatment can limit access to care for those of modest means. Only a handful of states mandate that healthcare insurance cover infertility treatment. Although improved technology has increased the "take home baby" success rates of infertility treatment, it is often at a monetary cost of many tens of thousands of dollars. The cost in terms of interpersonal relationships, mental well-being, and self-concept is also significant.
Is parenthood a right or a privilege? As a society we've debated the argument in relationship to those with unintended pregnancies, yet we have not had the same discussion in relationship to those with unwanted infertility. What rights and privileges do they deserve as they seek biological parenthood? What about those seeking nontraditional ways to achieving parenthood? These are interesting questions that have not received the same amount of informed debate. Moreover, what about those who navigate the maze of infertility treatment and become pregnant? Although pregnancy may provide a baby, does it "cure" infertility, or does the condition of infertility continue to be a part of the infertile person's self-concept?
Our authors in this issue have selected to share with our readers some special topics in infertility including parenting after infertility, egg donor rights, multifetal pregnancy, use of alternative or complementary treatments for infertility, and multifetal pregnancy reduction. My hope is that those who care for pregnant women and their newborns will have an increased sensitivity to the unique needs of their infertile patients, and that the articles in this issue will serve to stimulate dialogue and discussion.