Making Infertility a Health Care Issue : Insurance: Groups want the Clinton Administration’s reform package to include coverage for procedures to aid infertile couples.

Among infertile Americans, the Clinton Administration’s massive proposal for national health care roused a sense of concern.

Nowhere in the more than 1,300-page document is their problem addressed.

“We were on the drop-off list, completely,” said Diane Aronson, executive director of RESOLVE, a national support organization for infertile people based in this Boston-area community.

But a campaign of lobbying and letter writing appears to have brought a turnaround. Aronson said she is confident that the phrase “including infertility” will be added to the section of the proposal that discusses “family planning and services for pregnant women.”

White House spokeswoman Marla Romash said “technical changes are being made right now” to the health care bill submitted to Congress recently. Although she was uncertain how such changes might affect infertility issues, Romash said that “my understanding is that the plan covers all (infertility) services that are not experimental.”

An exception is in vitro fertilization, which is specifically excluded from the Clinton proposal.

Lynne Lawrence, director of government relations for the American Fertility Society in Washington, said she was hopeful that a clear reference to Americans who have difficulty conceiving children would be among the revisions.

“I don’t feel comfortable if it’s not specifically mentioned,” said Lawrence, whose 11,000-member international organization is composed primarily of physicians.

Appendix removal is not explicitly referred to, either, but that procedure lacks the stigma often associated with infertility, she said.

The National Center for Health Statistics estimates that one in 12 couples are unable to conceive children on their own. That population--which translates to about 5 million people at any one time--forms a kind of “hidden constituency,” Aronson said.

“Most people are hesitant to identify themselves as ‘infertile,’ ” she said. “There’s a resistance to what they see as a not-very-attractive label.”

With its overtones of sexual dysfunction or inadequacy, infertility also encounters a bias not associated with less intimate conditions, Aronson said.

“There’s almost a prejudice about this disease,” she said.

Frequently, in lobbying efforts on Capitol Hill, for example, Aronson said, “People would say, ‘Well of course, infertility is a lifestyle choice, not a disease.’ ”

She said this perception stems from a belief that many infertile couples have postponed childbearing to further careers or for other personal reasons and have therefore brought the condition on themselves.

Washington political consultant JoAnn Howes said that in lobbying on behalf of RESOLVE, she had come across “some people who argue that (infertility) is not a health issue. They feel that it’s too bad if you can’t have a child--but that if you can’t, you can’t.”

Howes credited a “minor groundswell” on the part of infertile people with helping to “win the conceptual agreement in health care--that infertility is in fact a medical condition. I think that is very significant.”

Support from the Women’s Legal Defense Fund and the Campaign for Women’s Health also helped to overturn certain misapprehensions about infertility, Lawrence said. But she said a misunderstanding persists that most infertile couples resort to in vitro fertilization.

This high-tech procedure remains expensive, between $5,000 and $8,000 per attempt. But Aronson said only 2% of couples who are treated for infertility move on to such “assisted reproductive technology.”