ON A SUMMER DAY IN A MINNEAPOLIS SUBURB, Karmin and Steve Eisma watch fondly as their nephew pushes a toy duck down the driveway and their niece peddles a miniature bike with training wheels. The children belong to Karmin's brother, and the childless couple dotes on them. The Eismas are professionals in their early thirties. They long for children of their own. "It just seems like it's so ingrained in me to want a family," Karmin says wistfully.

Karmin describes her yearnings for a baby.
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Steve nods thoughtfully. "Having a family I think is, or will be, a way to help shape a life," he says. "I'd want the child to be just a very strong person, a good person that has integrity and is a shining light in the world."

The Eismas are infertile because Karmin lost her uterus to cancer in 1991, a few years before they met. They recently tried to adopt a baby, but the birth mother changed her mind a few weeks before the baby was born.

With a remarkable offer from their sister-in-law, Becky, the Eismas are trying high-tech medical treatments that offer a chance to create a child genetically-related to a woman with no uterus. In summer 1997, doctors took eggs from Karmin's ovaries, fertilized them with Steve's sperm, and transferred them into Becky's uterus. Becky offered to be the baby's "gestational carrier," essentially loaning her body--her womb--to Karmin. Just before the transfer, the doctor showed Karmin and Steve their laboratory-made embryos under a microscope. "We saw them," Karmin says with awe. "I actually did it after all this. I made ... " She trails off and then says softly, "Those were my babies." Three of the embryos were transferred to Becky's uterus, but did not survive. The odds were always gathered against them. Only one in three IVF procedures results in pregnancy. Karmin's case was especially difficult because internal scarring from her cancer surgery meant she needed a general anesthetic to have her eggs extracted. When she came to, dizzy and in pain, she said, "I'm never doing this again." She later changed her mind. Having already spent more than $20,000 on legal and clinical services, the Eismas are saving up for another IVF as soon as they can get the money together.

"I remember watching shows where people said they spent a hundred thousand dollars trying to do the IVF and I just said, 'Why would they keep trying?'" Karmin says. "And I know, now. It's very hard to let it go when you actually saw them. And it's a good chance." She pauses a moment and says, "An okay chance."

Donna Shen, president of the Infertility Network in Houston, says infertile people who use assisted reproduction are simply doing what they have to do to have babies.
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Psychologists say the cycle of hope and despair infertility patients go through can be addictive. It's like playing the slot machines: an occasional small win keeps people dropping quarters in, hoping for a jackpot, even though the odds are with the house and they know it.

Shen says once people start treatment, they may end up spending more than they expected.
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Dr. Cecelia Valdes, an infertility specialist in Houston, saw a 44-year-old patient recently who asked about the chances of getting pregnant with her own eggs. A female is born with her entire lifetime supply of eggs. Researchers say a woman's fecundity drops precipitously after age 40, largely because of declining egg "quality." Valdes told the patient her chances of success were five percent, at best. The patient answered, "So there's hope."

Valdes will tell her patients the odds, but not when they should give up on treatment. That's the patient's decision, she says. A few decades ago, it was easier for a doctor to tell an infertile couple when to stop. If surgery failed, that was the end of it.

Today, a patient's hopes are rekindled by the steady stream of new developments in reproductive medicine. "What was an experiment last year is a treatment that we're offering a lot of people this year," Valdes says. Just when it seems to a couple that all the medical possibilities have been exhausted, researchers come up with a new solution. That means another expensive chance for people who dream of bearing children.

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