Can we all leave Nadya Suleman alone now? Every time we punish Nadya Suleman, we punish her babies.
Yes, she is crazy.
Yes, she should not have put in 6 embryos when she already had six kids.
Yes, she looks strange with her stick straight hair and her puffy lips.
Every time there is an issue boiling underneath the surface, it takes just one person and a grand situation to make the volcano explode. Nadya is our catalyst; She is not the problem. The problem involves ethics and raises real questions for real people making these decisions every day. So, let’s get down to business, shall we? Let’s stop talking about the octo-mom.
The written title of this blog was actually my second title. My first title was How many embryos should I put back during my IVF embryo transfer? I work a lot with patients undergoing IVF in my acupuncture practice and I hear this a lot: “What do you think, Liz? How many embryos should I put in? 1, 2 or 3?” Over the years I have hesitated when responding to these questions for many, many reasons. In fact, I hesitate when I write this blog. But, I know in my heart that this needs to be done.
I want to say right off the bat, that the “how many embryos” answer is not my decision to make. Patients are not asking me because they believe that I have some expertise in embryology (which I do not). They are not asking me because they believe I am a philosopher or an expert on ethics (which I am not). When people ask me how many embryos they should put in, they are mostly looking for validation for a decision they have already made, even if they don’t realize it. They trust me and want to know what I have seen.
The answer to this question is riddled with ethical and religious issues. Luckily, the fertility clinic I work with analyzes each and every embryo and helps the patient make the decision based on the quality of the embryo and their compiled statistics. These days I rarely see the insertion of three embryos. It is usually 1 or 2. If three (or more) embryos are put back, it is usually a special circumstance.
Right now, in the United States, this decision is completely voluntary. To make this important decision, I think a person needs to ask themselves (at least) these three questions:
1. Are you open to selective reduction? If you know your answer is black and white and you are not open to selective reduction (for religious reasons, for example), then you might want to consider not putting in more than two. If you know for you sure that you absolutely will reduce, than putting in more than two might be the best decision for you. If you are not sure, and feel that you don’t know what you would do if put in that situation, you might want to think about not putting yourself in that position in the first place. I personally cannot imagine a harder decision to make, especially after wanting to be pregnant for so long.
2. What is the quality of the embryos that you have by the day of your embryo transfer and what are the statistics for your age category with 1, 2 or 3 embryos? If your embryologists and doctors are not discussing this with you clearly, you might want to think about switching fertility clinics. I do not think you should ever have to make this decision based on quantity of embryos that you have. It should be based on the quality of the embryos and the clear statistics provided by your fertility clinic. Nor should the decision be made on emotions and how badly you want to be pregnant.
3. If you are pregnant with multiples, are you prepared to possibly have your babies in the NICU for 2 weeks-4 months. It is so hard for me to write this part because I feel in my heart that the love for these babies override any issue with money, but, alas, this definitely needs to be looked at. The cost of one baby in the NICU for one month is approximately $350,000. Plus, you need to add the cost of the risk to the mom, including potential hospital bed-rest, the inability to work, the cost of high risk medicine, and the c-section.
In Europe, there is a move towards only one embryo being implanted. For more information on that click here.
This is such a sticky topic and I would really love to hear what YOU have to say. What are your thoughts?
Liz Richards, L.Ac.