By Elana Frank
I have three rambunctious and adorable boys whom I love more than life itself. All were born via the miracle of in vitro fertilization (IVF), or, as my husband calls it, “test tube babies.” Technically, my husband is right because, like it or not, that little glass tube or dish is where the magic happens. Regardless of how you refer to it, the whole thing truly is a mix of medical marvel and Divine inspiration. And though I try not to imagine my babies spending their first moments of life in a glass tube, I just remind myself that, they would not have been born any other way.
Yet even with three beautiful, perfect children to be grateful for, I still get sad because I’ll never not be infertile. We can never just say, “Hey, let’s have another.” It’ll always be a process and a risk. I’ll never know the feeling of getting pregnant while on a romantic vacation or after a night of passion gone wild. And when I think about my sadness, it’s made even worse by the guilt I feel knowing that although it worked for me, for others even this process doesn’t work.
I remember those frustrating moments in our early months of “trying,” hoping that this month we would finally succeed. I remember a husband who found sex a chore, a baby always on my mind—probably not unlike many women whose biological clocks are ticking. At first, we bought the expensive pregnancy tests, waiting for two lines to pop up. Then, when month after month there was just one line, we began buying a pack of 20 tests from Canada and importing them to our home in Israel. I felt sure that this would be the month. But after taking way too many tests and always seeing only one line, we came to understand that nothing was working.
Israeli Factors in the Equation
Living in Israel, with its socialized medical system and strong cultural message about the desirability of creating Jewish babies, afforded me the opportunity to visit my doctor after only four months of trying. My husband says that it was my type A personality that made me expect something to work the first time, but I feel that I was fortunate to have had the foresight to get the process started early.
It didn’t help that women (and men) at the religious nonprofit where I worked did not understand why I’d been married for more than a year and did not have kids. “It’s time you started trying,” they prodded. “You don’t want your kids to have old parents.” Note that at the time I was 31 years old! Several of my colleagues started saying Tehillim (Psalms) for me. Keep in mind that they did not know that I was trying, but how could I tell them? On the secular front, my (blunt) Israeli family began to question our status as well. I’d say things like “Don’t worry, we are trying” or “All in due time”—and then go home crying with frustration and embarrassment.
In Israel, infertility procedures are based not on how long you’ve been trying, but rather on how long you have been married. We had already been hitched for more than a year, so the Clomid pills came rather quickly. Now, with popping the pills and getting my husband back into bed, I was sure I was going to conceive.
Our first few rounds of Clomid failed. As new olim (immigrants to Israel), we were still trying to navigate the health care system, and I started really having doubts that I’d ever get pregnant. I was getting desperate. I opened up to an Israeli family member who was connected to a well-known fertility specialist. Although he was not in my insurance plan, we were able to secure a private visit. In Israel, “private” might mean in someone’s own home. In this case, it was in his personal home at 9:30 p.m. For several months, we’d visit his “office” in the basement of his home, write him a check (we were Americans, after all, and were used to paying for medical care), and try to get pregnant. There was little testing and it did not feel right, but I was so desperate to see those two lines on a pregnancy test that I didn’t care if my husband was forced to do his business in this doctor’s personal bathroom in preparation for an IUI (intrauterine insemination) in his back room.
Tears in the Mikveh
Going to the mikveh was a constant source of pain for me. I was reminded monthly that my body wasn’t working the way that it should. I surely wasn’t going to open up to the mikveh attendant when she saw the tears in my eyes as I dunked. I know that mikveh should be a time to put my faith in Hashem, but truthfully, at the time, I just felt scared, anxious, and alone.
My best friend called to tell me that she was pregnant. It happened sooner than they had intended. She was more afraid to tell me than her single friends with no kids because she knew we had been trying so vigorously. I was so happy for her, but so sad for myself. It was almost a year of trying. Sex was no longer fun. I felt like my body was betraying me. Was Hashem punishing me?
Then something clicked, and my husband and I decided to move on from our sketchy basement doctor. We found another doctor through another Israeli relative. He didn’t come without a bit of “Oh, just relax, I’m sure that nothing is wrong” or “Go on vacation, just enjoy this time, and it will happen.” After another three months (the time it took to switch insurance plans), we finally met our miracle worker, Dr. Meir Nitzri. Within one month and after several painful tests, he found the problem. It was mine, but I was happy because this meant that we could finally pursue an action plan. The doctor did a little typing on his computer and told us that we qualified for IVF next month. I started treatment the next month. Yes, the injections hurt and the medications made me gain weight, not to mention that I was a hormonal mess—but IVF worked, and we welcomed our first son. And 18 months later, our second arrived. Both began as twins, and we suffered a loss during each pregnancy. I knew there were risks in implanting more than one embryo, but they were risks I was willing to take.
Returning to America
After five years of living in Israel, we made our way back to America with two young kids. I felt in my heart that I had more to offer my family. I felt guilty for wanting more children. Why couldn’t I be satisfied? I loved my beautiful kids and felt beyond grateful for my little miracles, but it was a visceral urge. My husband was not on the same page. He grew more and more frustrated that I was willing to do anything to grow our family. We had six embryos left in Israel, and I flew back and forth to transfer them (which was significantly less expensive than starting again in America). I was stressed. I put so much pressure on myself, but none of the remaining embryos “took.” No one could answer why. It took us another five years of angst, stress on our marriage, judgment (mostly from myself), more failed IVF cycles, and unsuccessful attempts at adoption to go on to have our blessing of a third child through embryo donation. Embryo donation is a form of third-party reproduction. We received another family’s remaining embryos after their IVF.
Over time, I learned that I wasn’t the only one in the world who had a hard time conceiving. For others it takes years, miscarriages, unbearable debt, oceans of tears, and heartache before finally giving birth, if at all. With the cost of IVF ranging from $14,000 to $25,000 in America, on average, many don’t even have a chance for a chance. Knowing that there is a grave need for funding, support, and enhanced awareness of this sometimes unspoken issue in the Jewish community, I founded the Jewish Fertility Foundation (JFF), which provides financial assistance, emotional support, and educational guidance to help others who are facing the challenges that I went through. People often ask if I can allow myself to feel satisfaction in what I’ve created. I admit that is something I’m working on, because living in the moment is hard for me. I’m already thinking of JFF’s goal of opening fifteen more community-based offices over the next five years. But daily reminders of the work that we’re doing offer me moments of pure joy. Just this week I was brought to tears twice. We gave out our forty-second grant to an Israeli couple living in Atlanta who came to us after four years of losses. The happiness we felt in offering them our largest JFF grant to date brought us all to tears. In addition, this week our forty-first baby was born. Baby Remy is particularly special to me because her mom is a single mother by choice—not an easy feat in the Jewish community today! Baby Remy is lucky to have a mom who fought so hard to bring her into the world.  
This week, after I light one extra Shabbat candle for all the infertile men and women seeking to have a child, I will share my high, low, and unexpected events of the week with my family. I will look around my Shabbat table at each of our young kids and take a moment to appreciate just how truly fortunate I am to be able to build my family.  

Elana Frank is the founder and CEO of the Jewish Fertility Foundation. A native of Atlanta, Georgia, she has twenty years of experience working with nonprofit organizations in America and Israel, doing fundraising, marketing, community outreach, and program development.

[Callouts]
I still get sad because I’ll never not be infertile. We can never just say, “Hey, let’s have another.”
Going to the mikveh was a constant source of pain for me.
Over time, I learned that I wasn’t the only one in the world who had a hard time conceiving.