About 50,000 babies are born each year in Utah, which has the highest average family size in the United States.
It's no wonder many couples struggling with infertility also struggle with something else — the sense they are not complete.
"The societal expectation is, you've got kids," said Eric Jergensen, a Salt Lake City resident and City Council member. He and wife Diane talk about friends of theirs who, like them, have struggled with infertility.
"All the neighbors kept coming over: Why don't you have kids? Are you being selfish? not understanding that this couple was agonized," Eric Jergensen said.
Rachelle Hasenohrl of Sandy tells a similar story. "People ask you, they always ask you. If you're married, after six months they ask you."
Hasenohrl always knew she and husband George would have a difficult time getting pregnant. But she didn't know it would be so hard to go through fertility treatments.
"That was the hardest part. Every month you got that negative pregnancy test," she said.
Dr. Matthew Peterson works with infertile couples as the chairman of the Utah Center for Reproductive Medicine. "Infertility is a huge issue," he said. "It's considered a medical condition."
Peterson's infertility practices grows about 8 percent a year. "It is your neighbors. If you line up 10 couples in a room, one of them is facing that at least. Maybe two."
Working with the Utah Center for Reproductive Medicine, the Hasenohrls, after several tries, were able to conceive through artificial insemination.
"It's still a little miracle no matter how it happened," Rachelle Hasenohrl said.
"A miracle" is how the Jergensens describe their 18-month-old girl, Anastine, whom they were able to have after in-vitro fertilization.
"It's a tremendous miracle and also a real risk. There are real high highs and real low lows," Eric Jergensen said.
Those lows affect many people who are infertile in this fertile state. But Peterson said he has seen those emotions everywhere. "I don't know any human being who doesn't have an innate desire to have children."
In vitro is not easy — there are months of therapy and shots for some women, and very invasive procedures for others. It can also be expensive. But, it's a baby.
"Would I do it again?" Diane Jergensen questions. "I would ... because the chance and the hope that it gives us is absolutely amazing."
The Jergensens decided to try in-vitro fertilization after being told they were too old to adopt. The in-vitro method has its critics.
"You can't play God," said Gayle Ruzicka, director of the Utah Eagle Forum, a pro-life, pro-family organization. She's not against fertility treatments to get pregnant, but she has ethical concerns.
"As far as families making this choice, as far as they aren't killing, that's fine," Ruzicka said. She also is concerned embryos could end up being used for scientific research. "I don't believe we should discard leftover babies. That's horrible."
"(Columnist) Bonnie Erbe said in an article that it was selfish for people who didn't have children to use IVF," Eric Jergensen said.
"Things have changed dramatically, and it's a way for people who otherwise would not have the opportunity to have their own biological children. From my biased standpoint, we think it's a good thing," Peterson said.
Couples who create more embryos than they implant at one time can choose to freeze some, Peterson said. "For our program there's not a lot of embryos left over. We have stored embryos but for the most part patients are planning to use those embryos."
"About 60 percent of embryos that are frozen and thawed have a chance to become a transferred embryo," Peterson said.
The Jergensens had no viable embryos left to freeze. But they say they signed papers detailing every possible scenario and question. "I have absolutely no qualms about the morality and ethical nature of in-vitro fertilization."
Peterson said his ethical concerns are with insurance companies who refuse to cover infertility treatments as a necessary medical procedure. Because it's not covered, he says couples feel forced to create then implant more embryos in the hopes of getting pregnant in one shot. That leads to high-risk pregnancies.
"We would hope that in this state where families and children are valued so highly, and it's a managed-care issue, that managed care would get on top of managing it," Peterson said.
Ruzicka believes government should not step in to force insurance companies. If a couple feels like implanting several embryos at once, that's their choice. "If only one baby takes and the other two don't, God's in charge there."
And as for the question of playing God and creating life: "There's no question to me that this is about creating life, and isn't it wonderful?" Eric Jergensen said.
The Jergensens are expecting another baby, through in vitro, this spring.
On the air
KSL Newsradio is airing this news story in two parts, with its concluding report airing twice today at 7:40 a.m. and 5:40 p.m.
E-mail: mrichards@ksl.com