Lehman and Shanelle Best listened to soothing classical music as they drove from North Raleigh to the infertility clinic in Cary. But nothing could keep their anxiety at bay.

They sat quietly in a love seat at the N.C. Center for Reproductive Medicine, waiting for a nurse to call their names.

Lehman attempted a few jokes and tapped his sneaker on the carpet. Shanelle put her hand on her forehead.

On this chilly fall day, they were counting on Dr. Sameh Toma to get them pregnant.

They had already been through one cycle of in-vitro fertilization in their former home of Indianapolis. It hadn't worked.

This time, the Bests, as well as their doctor, were confident they would be welcoming a baby into their lives in nine months.

After all, they are both young and healthy -- he's 27, she's 28.

It used to be that young couples would try for years to conceive naturally before seeking fertility treatments. IVF was typically a last resort for infertile couples.

But more young couples are turning to IVF as one of their first options in treating infertility. Toma, who runs the Cary center, sees 130 new patients a month, he said.

"It has gone up year after year" since he opened the center in 1992, he said.

Of the roughly 62 million American women of reproductive age in 2002, 10 percent had had an infertility-related medical visit at some point, according to the Centers for Disease Control and Prevention.

The CDC also reports that in 2005, 134,242 fertility treatments were performed across the county and resulted in 52,041 infants. Many of the treatments produced multiple births.

At UNC-Chapel Hill's Reproductive Endocrinology and Fertility Clinic, more couples under 35 are seeking fertility treatments. In 2002, 37 percent of the patients there were under 35. In 2006, 51.4 percent were under 35, said Marc Fritz, who runs the clinic.

Infertility among younger people is not necessarily on the rise, Toma said. But the stigma of seeking infertility treatments is less than it used to be. And IVF is more readily available to couples at private clinics, not just major medical centers, said Bill Meyer, a doctor with Carolina Conceptions in Raleigh.

Also, Fritz said, the procedure is getting better results.

"The success rates with the technology legitimately make [IVF] an appropriate first line of treatment," he said. IVF has replaced surgery on reproductive organs, he added, because it is more effective.

Toma charges $5,500 for the procedure, plus $3,000 to $5,000 for the drugs the woman must take before and after the procedure. Duke's fertility clinic charges about $10,000 for the procedure and $1,500 to $3,000 for drugs, said Susannah Copland, a doctor in the clinic. Copland, whose clinic has not seen an increase in younger couples, said younger women save money on the drugs because they don't need as many as older women.

Some, like the Bests, have medical insurance that pays for IVF treatments. Toma offers a shared risk plan: After three unsuccessful IVF cycles, the patient gets her money back.

Typical problems

Most infertility issues in younger women tend to be related to problems with the uterus or obstructions in the fallopian tubes, Toma said.

Among the younger couples Toma sees, many cases involve problems with the male partner. Typically, the men have a low sperm count, he said. That means they have sperm but not at the numbers needed to get pregnant naturally. And that makes them excellent candidates for IVF, in which doctors implant the man's sperm directly into the woman's egg in a petri dish. Then the embryo or embryos are implanted into the woman's uterus or fallopian tubes.

Next page >

Get $150+ in coupons in every Sunday N&O. Click here for convenient home delivery.