Sunday, April 19, 2009

Fallout

Since the birth, and subsequent media storm of the California octuplets, I often get asked my opinion on the matter. As someone who suffered infertility and then was blessed with multiples myself, I definitely have some pretty strong feelings. I'm going out of my comfort zone in posting this but I feel that it is important that we understand some of the fallout that is already beginning. Feel free to disagree but please be respectful if you comment.

The question that seems to have come to the forefront in chatrooms, blogs, and news articles is "Why would a doctor treat a woman, who already had 6 kids, for infertility?" Folks, I think the wrong question is being asked here and the potential ramifications could be devastating. The issue should not be in how many children she had but in the recklessness shown by her, and especially by her doctor. You can get pretty desperate as a infertile woman who wants nothing more than to have a baby. You get to the point where you are willing to do anything, no matter how dangerous, if you could only have your little bundle of joy. It is the ultimate responsibility of your doctor to show restraint and good judgement to lower the chances that you could end up with a high risk, potentially deadly, pregnancy . Something her doctor did not do when he transfered 6 live embryos at one time knowing that she had already achieved 5 pregnancies including one set of twins from IVF procedures. (Isn't there something in a doctor's creed about "first doing no harm"?) This scenario could have turned out far worse in that it could have left 6 kids without a mother. Since the firestorm surrounding this woman is likely to have quite a bit of backlash that could have a profound effect on anyone seeking infertility treatments, including married couples, I'd like to just remove her marital status from the discussion for now.



How many children a person has should not exclude them from any kind of assisted reproduction services. Many people aren't aware that I returned to my IVF clinic when the babies were 3 to try and add to our family. A few people thought I was nuts but I had to know beyond a doubt that I had brought the children into this world that I was supposed to bring. (Sort of my own version of "No Child Left Behind.") It turned out that it was not in God's plan for us to have more but I was grateful for the opportunity to at least give it a shot and close that chapter of my life. It certainly was not the responsibility of a doctor or, (heaven forbid) a government regulation, to determine my family size for me. We are traveling down a very slippery slope when we, as humans, make it our business to try and decide who already has "enough" children and therefore wouldn't "qualify" for treatment to have more. The last time I checked, I still lived in the United States of America where I believe that building a family falls under "life, liberty, and the pursuit of happiness." And for those of you worried about families being dependent on government assistance and thinking limits would be OK for families needing welfare, think of this. President Obama is in the process of removing every restriction on abortion in every state and has already lifted some bans on federal funding. Eventually, this may mean that as taxpayers we won't have any say as to the number of abortions a woman has at taxpayer expense...should we really be able to limit the number of children one has? If you are one who believes in a woman's right to terminate a pregnancy, surely you have to give that same right to women who choose life. And for those of us who are Pro-Life, well, we're just going to have to realize that there will always be babies born under less than ideal circumstances and these children will likely need our assistance. There will always be those who abuse the system. More regulation will not fix that. More government interference into assisted reproduction is not the answer.


While doctors should not be turning away fertility patients because they have some randomly set number of children already, they do have a duty to those they treat to make sure they don't put them in harms way by transferring high number of embryos. Now, the government is beginning to look into putting arbitrary limits on doctors. Take a look at some pending legislation in Missouri and Georgia. These two states are already trying to put laws into place that limit the number of embryos transferred in one IVF attempt to two (three if you are over 40). While many clinics already follow this as a guideline, they need to have the ability to customize a woman's treatment to her own particular case. Ultimately, these restrictions would only make a very small difference in multiple birth rates since IVF cycles actually account for very few of the higher order multiples. Most are conceived through Clomid or some sort of injectible drug and either intercourse or insemination. Of the 18 families I personally know, 66% of them have multiples from Clomid, injectibles or naturally, 33% of us were IVF patients (two of whom transferred less than 4 and got quads anyway). As IVF techniques improve, the higher order multiple rate with IVF treatment continues to go down. All by itself, all without assistance from a bunch of politicians, all because science is improving.

Putting strict, government imposed limits could in effect end the chances of some infertile people. Not every embryo results in a baby and not every couple has unlimited funds to pay for multiple attempts of a very expensive treatment that is rarely covered by insurance. I transferred 3 embryos on four different attempts and didn't get a thing for it. Not even a faint line on a pregnancy test. At my age and with my history, our fifth attempt gave us 4 embryos that we ultimately made the decision to transfer. This was in no way a reckless decision, especially since two of the four looked like they had arrested. Yes, we ended up with our beautiful quadruplets and do not regret one thing about them. (BTW, one of my embryos had indeed arrested and another split into identical twins so we got 4 anyway.) Sometimes things like this are going to happen despite every one's best efforts. Believe me, I'm all for showing restraint when determining the right course of action but involving the government is not the answer. Granted, there are irresponsible doctors out there who put their patients at risk by transferring high numbers of embryos but I believe they are few and far between. Most of these doctors are truly caring people who just want to help others experience the joy of parenthood. It seems to me that the better alternative would be to allow the American Medical Association and the Society for Assisted Reproductive Technologies deal with unscrupulous doctors on an individual basis and allow the others to do their jobs free of potentially stifling limitations.

My hope is that the story will fade, tempers will cool, and people will look at the big picture, not just the one that seems to have gone horribly wrong. My prayer is that people will soften their hearts and provide assistance to these innocent children regardless of how they may feel about their mother.

1 comment:

COME ON BABY said...

Amen sister!! Well said!!