For Korean Americans, infertility is complicated by a heritage that emphasizes family names and bloodlines.
For that reason, some couples face not just the high financial price for a shot at biological parenthood – but also an emotional one.
by Rebecca U. Cho
Lisa Park was in no hurry to have a child.
She was 26 and working for the nonprofit Korean American Coalition in Los Angeles when she met David, a student test pilot at Edwards Air Force Base in California. Eight months later, they went to the altar.
About a year into the marriage, the couple began trying to have a baby. Some time went by.
Then, several months.
That’s when the worrying ensued.
“We’re not getting pregnant after months of trying,” says Lisa. “What’s going on?”
Because her husband was in the military, the couple made an appointment to see a specialist at Walter Reed Army Medical Center, not far from where the pair was living in Maryland.
Their doctor came back to them with a puzzling diagnosis: unexplained infertility.
“We were dumbfounded.”
Infertility, or the inability to get pregnant, is a condition that 6.1 million Americans, or 1 out of 6 couples, face each year, according to the American Pregnancy Association. It is a taxing, emotionally painful and isolating experience for any couple, but for Korean Americans, the condition is further complicated by a cultural heritage that places great importance on a couple’s ability to bear children in order to carry on the family line.
“Infertility can make or break marriages,” says Lisa, now 34 and living in Alexandria, Va., with her husband, 42. “And particularly with Korean or Asian families, there’s the added pressure to conceive not only a child, but a son.”
The desire for a biological child, particularly among many first-generation Korean Americans, stems from an Asian culture that emphasizes filial responsibility, family name and bloodline, say many of the couples interviewed for this article.
For Lisa, the pressure was so intense, that some days, she blamed herself entirely for the couple’s inability to conceive and pondered divorcing her husband so he could find someone with whom he could bear biological children.
After three rounds of failed intrauterine insemination, or IUI, a procedure in which sperm is placed within a woman’s uterus to increase the likelihood of pregnancy, Lisa went on to three rounds of in vitro fertilization. The procedure, also known as IVF, involves fertilizing a woman’s eggs outside of the body and then placing the embryos directly into the uterus. She started taking hormone drugs to stimulate egg production. Then the couple began to consider adoption, to which Lisa had always been open.
“I told my husband one day I don’t really care how I become a mother. I just want to be a mother,” Lisa says.
Her mother-in-law, who lives in South Korea, thought differently.
“For David’s mom, that was not something she wanted to consider,” Lisa says. “She urged us to try again.”
The Parks spent $18,000 on their fertility treatments, less than what many other couples spend on the same treatments because the Parks receive military benefits.
Lisa says many of her friends have spent $30,000 or more for just one or two rounds of fertility treatments. The average cost for one cycle of IVF in the United States is $12,400, according to the American Pregnancy Association. And many times, couples engage in several bouts of treatments in order to get pregnant.
The emotional price is also high. “Emotionally, physically and mentally, it was very draining,” says Lisa, who recently gave fertility treatments one last try at Walter Reed. “You have your breaking point,” she reflects. “I wasn’t quite there, but I was close.”
For many South Koreans and Korean Americans, the idea of someone who does not share the same blood carrying on their family name is difficult to swallow, says Ailee Moon, associate professor of social welfare at the University of California, Los Angeles.
As a result, many first-generation Koreans, like Lisa’s mother-in-law, have a hard time endorsing adoption for their adult children. Instead, they push fertility treatments. And for many second- and third- generation Korean Americans, their parents’ opinions and their own desire to respect their parents’ wishes remain a great influence on their family-building decisions. Couples often turn to fertility treatments first and have to fight this familial discouragement if they eventually want to adopt.
“There’s an emphasis on blood, pure blood,” says Moon, hose research focuses on gerontology and Asian American families. “Your last name is Moon, you carry Moon’s blood. Adoption means … you’re messing it up.”
Simon Hong, senior embryologist and laboratory manager at CHA Fertility Center in Los Angeles, says the establishment’s Korean patients are adamant about having a biological child.
“Koreans want their ‘own’ baby,” Hong asserts. CHA, or Comprehensive Health for All, is the largest fertility institution in South Korea, treating 5,000 IVF cycles each year, Hong says. It opened a Los Angeles outpost in 2001.
Korean egg donors are also a rarity, Hong says. The clinic takes up to 100 egg donations a year, of which five to 10 are from Korean donors. At the clinic, Hong, who specializes in IVF, meets with patients to explain fertilization procedures and updates patients on their progress during the treatment cycle until the embryo’s transfer to the uterus. He also specializes in the freezing of a patient’s surplus embryos for later use.
Although the Los Angeles clinic primarily served Korean patients upon its opening, only about 20 percent of its clients today are Korean, Hong says.
Studies show Asian Americans wait longer than their white counterparts before seeking treatment for infertility, said Dr. Victor Fujimoto, professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco. One of Fujimoto’s studies, published in 2009, showed Asian women were twice as likely as white women to delay treatment for infertility beyond two years of trying to conceive unsuccessfully.
He said cultural influences most likely are at work, such as the shame associated in Asian cultures with infertility, which may lead to many women postponing or not seeking care.
“In Asian cultures, infertility is considered taboo,” Fujimoto says.
Other racial disparities exist in the reproductive research literature. Asian women are less likely than white women to experience a successful pregnancy through IVF, according to a study released last year from researchers at Stanford. Of the women who received IVF treatments at a clinic, 48 percent of white women gave birth while 31 percent of Asian women experienced success.
The reason is unclear, says Fujimoto, whose own fertility research also shows lower success rates for Asian women. He says the difference may have to do with the way women respond to the fertility drugs they receive in the process.
Sue Ann Park, a 45-year-old pediatrician based in San Diego, is mother to both biological and adopted children. Her eldest son, now 17, was conceived naturally, but after failing to get pregnant again, she tried IUI and IVF.
“Koreans still have a hard time with adoption,” she says. “I have cousins and friends who go to Korea to do fertility treatments because it’s cheaper. They try acupuncture. They do everything to get that biological child.”
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Read the full story on Korean Americans and infertility in our January 2011 issue – order here to purchase a copy!
