Monday, November 24, 2008

Thoughts on Number of Babies - Updated

Updated to make correction: I said I was pro-life, but hate abortion. I meant that I am pro-choice, but hate abortion. Thanks Nancy for helping me clear this up.

Nancy and Jewels had posts last week about implanting embryos and abortion that were very thought provoking. I can't help but share my thoughts.

For those unfamiliar with terms and situations for selective reduction, let me explain. Selective reduction is basically ending the life of a fetus, usually using a chemical solution, usually done in the first trimester. This can be done for a variety of reasons, including a terminal pregnancy where the infant how little or no chance for survival, and high order multiples.
For more information, see http://en.wikipedia.org/wiki/Selective_reduction

High order multiples (I'm defining as more than two fetuses) can occur for many reasons: naturally, after transferring embryos, after insemination, or with the use of fertility drugs and intercourse.

In transferring embryos, there are statistics that predict how many transferred embryos will implant and grow. For instance, a woman could transfer three and be told her chances for no pregnancy is 60%, singleton is 20%, twins is 17%, and triplets is 2.9%, and the chances of an embryo splitting to have quadruplets is .1% (made that up). She would have to make the best decision she could. Her decision would probably changed based on her age, financial situation, quality of embryos, and her thoughts on how many children she could handle. Hard decisions.

For an insemination or timed intercouse with the use of fertility drugs to stimulate the ovaries, things are different. A woman may be told, you have 3 follicles that could produce eggs. She has to decide if she is ok with possibly having 3 embryos form. Or she could be told she has 4 follicles. She has to decide where to draw the line and say no. That would be hard to say after she has invested time and money into a cycle.

It's hard to say what I think is right and wrong. I think there is a line to draw. To me, a small chance of quadruplets would be a good place to draw the line. More than 4 embryos to transfer or more than 4 follicles for IUI or intercouse seems like too much for sure. I don't think I would transfer more than 2 embryos because of our history of transferring two and getting two to implant.

But, who am I to judge people for their decisions? Selective reduction sounds so much more acceptable than abortion to some people, but really, it's the same, a life lost. But then again... what about our frozen embryos? What if we are not able to transfer all 9 of our embryos? I like to think life begins when the embryo attaches to the uterus. But some people may define life starting at conception. It won't be an easy thing to do for us to let them go if we have to, but where does that rank on the terrible people meter?

I'm pro-life, but I hate abortion. I hope we can concentrate on how to help women avoid having to do selective reduction and abortion by having adoption programs and having REs counsel women on the dangers of high order multiples. I've actually seen women post on message boards about using some of their leftover medications on their own, not supervised by their dr!! That is horrible! That could result in high order multiples or OHSS (ovarian hyperstimulation syndrome) which can result in severe pain and even death for a woman.

Bottom line, this is a very sensitive topic, and decisions of this nature should be given much thought and should be guided by a competent doctor.

2 comments:

  1. You said you are "pro life, but hate abortions". Do you mean you are pro-choice?

    For me - the risk of multiples was way lower, and that's why we went with more, plus, it was by the doctor's pushing of us. My problem is when a doctor says NO and the woman just plows ahead. That is when it gets my panties in a wad.

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  2. Definetly something to think about. I liked reading your thoughts on this :)

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