No Sex, No Baby

With many American women (and men) choosing to start families later in life, some are forced to turn to infertility treatment for help. Though there have been huge advances in the field over the past decade (which is why you’re seeing so many twins these days), in many ways infertility treatment is still the Wild West of medicine. To provide some common-sense advice, Maureen Regan and Julie Vargo have written a guide for the perplexed, A Few Good Eggs: Two Chicks Dish on Overcoming the Insanity of Infertility (ReganBooks/HarperCollins). Despite its occasionally cloying style, it’s surprisingly gutsy and no-nonsense—an Our Bodies, Ourselves for the Sex and the City generation. And among the more surprising revelations is the authors’ belief that many infertile couples simply aren’t having sex frequently enough to conceive.

Over dinner at Ruby Foo’s, Vargo, 45, a slender brunette journalist from Texas, and Regan, 44, a hoarse Long Island literary agent (who also happens to be publisher Judith’s sister), tell me their own infertility tales. Both endured years of bad advice from OB/GYNs before switching to reproductive endocrinologists and going on to have successful pregnancies—Vargo with the help of hormones and Regan naturally, who conceived while on vacation with her husband.

Part of the problem with infertility, they say, is that the causes and factors are unique to each couple, but many doctors don’t do enough detective work, like asking about the couple’s sex life. The textbook definition of infertility is inability to conceive after one year of regular, unprotected intercourse, but a year of sex at the wrong times can add up to nothing. One OB/GYN told Vargo that it’s hard to persuade couples to pencil in sex on their calendars. “He said, ‘They come in and complain that they’re not getting pregnant,’ ” Vargo recalls. “And when he asks how often they’ve been doing it, they say, ‘Twice last month.’ You only have twelve chances a year to get pregnant, and if you don’t know the right time to have sex, you can’t just do it twice a month.”

“I know couples that are more comfortable laying on that cold table in the doctor’s office,” says Regan, “than cozying up to each other. After you’ve been going through infertility for a while, sex becomes so technical. It’s not sex anymore.” When sex becomes clinical, goal-oriented, and obsessive, many couples would rather not have it.

But there are other reasons couples aren’t getting pregnant. For example, Vargo and Regan speculate that long-term use of the Pill can lead to fertility problems for some women. Vargo took it for sixteen years and thinks it may have contributed to her problems. “Our generation is the first generation to have been on the Pill so long,” says Regan. “If you’ve been taking hormones that are fooling your body for twenty years, and you stop and tell it to be normal right now, it might not happen, especially if you’re of advanced maternal age.”

Other women have problems, they suggest, because they’ve been pursuing a narcissistic lifestyle for so many years: smoking, drinking, having unprotected sex, dieting, and exercising excessively. Certain STDs can lead to pelvic inflammatory disease, which can affect fertility. As for chronic dieting, “estrogen, which is essential for conception, hangs out in your fat cells,” says Vargo, and trying to be ultraskinny is counterproductive.

The same culture of self-worship can trick older women into thinking they have more time than they do. Many fortysomething women, they say, look at their well-maintained, twentysomething-looking bodies and believe they have eggs to match. “Women need to know that you may look great, but your eggs don’t,” says Regan. “They age.”

When I point out that an equal percentage of fertility problems is the result of male factors, they insist they are not pointing fingers at women. “Most men are not going to pick up a book on infertility,” says Vargo. “The book is written from a woman’s perspective to other girlfriends, because they are the ones who are going to take the lead dealing with this.”

They are buoyed by the fact that celebrities like Courteney Cox and Brooke Shields have begun talking about infertility. But they say many celebrities stay quiet about their struggles, which ends up being misleading. Geena Davis, 45, recently gave birth to twins, but statistically, says Vargo, with IVF, “if you’re 45, you have a 3 percent chance of getting pregnant with your own eggs. You have a 51 percent chance if you use a donor egg” with IVF.

Women who aren’t in the know, they say, look at these celebs and think late-in-life pregnancy is easy. “I would hate for someone who’s 33 to look at Jane Seymour, Madonna, and Davis and say, ‘They were over 40. I don’t need to think about it now,’ ” says Vargo. “They need to think about it, because it’s not so easy when you’re older. I feel lucky that I got through the door before it closed.”

No Sex, No Baby