Sticky Situations

There has been a whole lotta talk out there about the ethics of IVF, about limitations on the number of embryos that can, and should, be transferred, the overwhelming increase in multiple births as a result, etc, etc.

I feel like I want to chime in, not because I'm suddenly thinking about this issue just now, but because it is foremost on my mind each and every time someone comments that I now have a "ready-made" family, or asks if I want to have more children. I think about it each time I hear or a friend, acquaintance, or perfect stranger, who is planning to do IVF.

I think about it because I want to shout, at the top of my lungs, THINK ABOUT WHAT YOU'RE DOING! ASK FOR MORE INFORMATION ABOUT MULTIPLE BIRTHS! CONSIDER YOUR OWN HEALTH AND SANITY IN ADDITION TO YOUR DESIRE FOR A CHILD!

I know, I know, hindsight is 20/20, and each individual is guided by his or her own very strong desires. And at the risk of being completely redundant to Emmie's post (as my thoughts practically mirror hers), I just want to share my feelings on the matter.

We planned to transfer two embryos, knowing that twins were a possibility, but not a certainty. I know full well that I didn't care. I am young, healthy, and we believed the root of our problems to be male-factor. We fully expected to retrieve lots of eggs, do ICSI, have plenty of embryos to "save for later" to try again if it didn't work. We only retrieved nine eggs, and only six (I think. I'd have to check to be sure) were fertilized.

I think the top three were graded A, B, and B-. Our RE didn't feel that transferring two would bring success, and presented us with his opinion as I was laying half-naked on the table, ready for the transfer, having popped my Valium an hour before. Not the optimal time to be making a decision like this. Of course, I said to go for it. I wanted a baby, damnit.

It probably wasn't necessary. Probably two embryos would've sufficed and at least one would have implanted. I wish we'd been able to track which embryo didn't make it.

None of our leftover embryos survived to be frozen, and this only strengthened my resolve in our decision to transfer three.

Just as Emmie has said, I would not trade my precious children for anything. I would not take any of this back. I could not choose one over the other, and I am full aware of how lucky I am to have them both. But I would have preferred to have them one at a time.

I went into labor at 29 weeks, and again at 31, when they were born. They spent five weeks in the NICU. As I am aware, the cost of their stay was well into the six-digits. And they were pretty healthy, as far as preemies go. And I can't imagine how much my two weeks (one at 29 weeks, one after delivery) of hospitalization cost. I'm lucky I have decent insurance. Now add the bi-weekly doctors visits that happened for the first weeks home. Even more.

It's not just about the money. It's about having to make a decision of monumental importance, with minimal information, at one of the highest emotional levels possible. With hormones in flux. With desires raging.

I'm a researcher by nature. I read everything I could about infertility, IUIs, IVF, ICSI. In all that information, I never found much about the serious issues surrounding multiple births. Everyone I knew with twins seemed just fine! My RE, in our initial consultation, said "You know, the risk of multiple births does go up with IVF" (gestures to stack of photos of twins on his desk.) I smile enormously ... that doesn't seem so bad. That was it. Period.

I don't neglect the fact that there is some personal responsibility tied up in all this. It was my choice. And I chose to go for it. But I didn't really know all that much. And if I, who did a lot of information-seeking, didn't really know about the risks of multiple birth, what about the couple who does no research or real thinking about it, and just wants a child?

I vacillate back and forth when thinking about trying for another child. Which will not be happening soon, mind you. Could I really go through another IVF cycle, and transfer only one embryo? Knowing full well that it might not work? I'm lucky, I only had failed IUIs; my first IVF worked. And worked well.

And while I may want to try for another child, I can tell you point-blank, I do not want twins again. I don't want to compromise the health of more children, I don't want to compromise my own health. And I look forward to regular sleep. Sometime in my future.