NYTimes article: Grievous choice on risky path to parenthood

(5 posts)(4 voices)
  • Started by tianarahagalala ago.
  • Latest reply from gtuncer.
  1. This article doesn't give a lot of info about s/r, but brings up some of the issues that lead to people being faced with s/r in the first place. I was also glad to see that they mentioned the fact that s/r can also lead to loss.

    nytimes.com

  2. Thanks for posting this article Candace. I have a friend who judged me harshly about SR (she is actually no longer a friend) and I think she judged me because she, and many others who have never been put in our position, DO NOT comprehend or understand the risks involved with carrying multiples. It is impossible sometimes to get through to people that Jon and Kate plus 8 and the like are the exception not the rule and that carrying twins also involves many risks. I hope you are doing OK. I am coming up on the year anniversary (11/17/08) of the loss of my son at 17 weeks gestation (I had a reduction from 3 to 1 at 11 weeks) and I am still grieving and finally started counseling a few months ago. My grief has lessened in intensity, but still effects me daily. My thoughts are with you and all of us who experience so much pain going through this process. An article like this helps put the reality of it all in perspective.

  3. Thanks for posting this article. I think it is a difficult chioce for any couple to consider using selective reduction in order to provide a better chance for the remaining embryos and to have an easier safer pregnancy....but ultimately I believe that the information-however controversial-needs to be out there and needs to be avaliable for all couples to consider BEFORE they ever need to think about it seriously. I truly believe that nobody goes into this process wanting a HOM pregnancy-but that educaion and information go along way in hlping couples make more educated choices about fertility paths, possible risks and also options they have to reduce the risks of HOM and micro-preemies. I know that selective reduction is an extreemly difficult and emotionally charged topic-but I believe that it is definately something that needs to be left "on the table" for all couples so that choices regarding the number of embryos transfered and the level of hormones taken will be thought about more thoroughly and jopefully lead to a lowering of the necessity of reductions. As with all reproductive rights-I am a strong advocate for leaving the choices up to the parents-with the guidance of their doctors but I also beieve that with proper education from the begining and counseling regarding all risks/benefits etc. can help a couple be better prepared to make tought chioces that are sometimes hard to consider once the embryos are already developing.

    As an example-my dh, myself my surrogate and her husband all wanted to reduce the possibility of HOM-so we chose togethere that we would only transfer 2 embryos at a time. This helps to minimize the difficult situation the four of us would be in if we were faced with a HOM pregnancy....something that was important to all of us. I feel that it is very important-though diffiucult to have those kinds of discussions prior to taking the first medication....mainly because once you are in the thick of an issue that is not the time to begin to argue or disagree about how to move forward.

    That is my two cents anyway....

  4. DD mentioned. Good points. I think part of the problem too is that for us women having to do repeated IVF cycles, after you have failed so many IVF cycles and have put back countless embryos that did not implant, you begin to think it is impossible to get pregnant and that putting back 3 embryos or more doesn't seem like a risk but a better chance at succeeding. Also too, once you are over 35 and may need the assisted hatching procedure on the embryos, even if you do put back just 2 or even just 1, the chances of an embryo splitting in half and becoming identical twins is much higher. In our case, we did Clomid, IUI's, and 3 IVF's before conceiving our dd on the 4th IVF with PGD. On our 3rd IVF we put back 3 embryos against the Dr's recommendation of 2 and NONE of them took. On the 4th IVF with PGD we put back 2 blastocysts that were "perfect" and one implanted and is now my almost 4 year old dd. So from our frame of reference, starting treatment up again for a 2nd child, and me being 4 years older, putting back 3 embryos did not seem risky to us. We had no hope it would work at all. You sign all the paperwork with a notion that the risk of multiples literature somehow doesn't apply to you because of your past track record. On trying for our second child, we had our first cycle cancelled due to poor response, and on the 2nd IVF did a 3 day transfer of 3 8 cell embryos (cause at 36 that was all I had and at that I was lucky they all looked so good). We did assisted hatching and then 2 embryos implanted and one of those split causing triplets (identicals sharing a placenta and one fraternal (which ended up being my son I a gave birth to and lost in my 17th week of pregnancy). Having to do the reduction and then losing our son 6 weeks later has altered our lives. We will never be the people we were before. There is a hole in my heart that will never heal but will get smaller over time (at least that what my counselor tells me). But getting back to the point, the hard reality is, when I was 32 and trying for my first child, desperate, nothing any Dr. could have said would have stopped me from putting back 2 or 3. You can't have a concept of the anxiety and fear you feel finding out there is HOM until it actually happens to you. You can't know the awful feeling of being in the room actually having the reduction performed until you are there, and then in our case, you just cannot know the heartache and loss you feel from losing your child until it happens. That is all stuff that just happens to other people you think. We had such a hard time conceiving our dd, there is no way HOM would happen to us, and it did. Also, even if you have the foresight to take the Dr.'s warnings about multiples very seriously and act responsibly by putting back 2, HOM can still happen due to assisted hatching. These discussions are good to have. It puts our situations and all the possible outcomes out there. In our case, we tried one more IVF cycle 6 months after our loss, it failed miserably (only 2 5 cell embryos, I went to retrieval with only 3 follicles). I had an unexlpained bleeding episode 4 days after the transfer. My Dr. then started giving me the donor egg speech and after lookign at our whole situation (possible incompetent cervix, fear of multiples, no family in the area to help us with dd if I needed bedrest in a future pregnancy, burn out from treatment (this had been our lives for so many years), fear of something happening to me during pregnancy, fear of another loss, etc.. we made the decision to stop trying for a 2nd child. It was a hard decision but in our case, we had been devastated enough and it was time for us to fully focus on the blessing of our dd and for all 3 of us to have our lives be about something besides treatment. Dealing with the loss of my son and the loss of any more children at the same time was what made me decide to start counseling. It was too much for me to bear alone. As one woman in the article mentioned, the technology of fertility treatment is far ahead of their knowledge about the psychological devastation that happens to us when things go wrong. The long term effects of what it does to us to have to make these decisions about SR, or to deal with the stress of babies born prematurely, or the stress of loss. Sorry for babbling on. All in all I am just wishing everyone some peace. These boards have helped me so much over the years of my IVF journey and continue to help me here on this SR board and over on the loss board.

  5. I wonder how many HOM are result of IUI. I get what Raby's saying about reducing risk, but with IUI things are so much messier... less precise.

    I know two women IRL who got pg w/ quads via IUI, reduced, and had premie twins (one twin is battling quite a few health problems as a result). Another woman I know IRL conceived trips via IUI and lost them all to PTL. A couple in our area had sextuplets a few years ago via IUI. The children lived, but aren't well (truly profound disabilities in some cases). Of course J+K also conceived w/ IUI.

    IVF\'s cost is out of reach for many, and that's truly a shame. $$ must be a huge determining factor in why people choose to transfer more embryos as well. When it feels like you're weighing the risk of HOM and *ever* achieving success b/c you're out of financial resources, I can see how things get hard.

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