An article in the NYT's today: http://www.nytimes.com/2009/10/11/health/11fertility.html?ref=health
And later, Project 2.0 hits a brick wall.
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Still infertile, but now with adventures in long distance parenting
2 comments:
Grr. That article kind of pissed me off. While money is definitely a factor, the truth is that success rates with single embryo transfers are so tiny when compared to transferring more that it almost becomes irresponsible to transfer just one. IVF is such an incredible physical task to undertake. The drugs cost a lot, they make you feel like crap, the cycle takes up so much of your time, the procedures are painful and sometimes embarrassing, the whole thing is so fucking awful that when your doctor says that pregnancy rates with a single embryo transfer are around 30%, but jump to almost 80% with two, you kind of have to look at the last two months of your life and think, "What is the responsible thing to do?" I mean, should I look at the last couple of months as just this fun little trip I've been on to have a 30% chance at pregnancy, or should I look at the 35% risk of twins as just another cost of bringing home a live baby because it increases our odds to over 80% for just getting pregnant period?
Yes, twins are risky, and yes, when they are born early, they are expensive and can endure lots of medical hardships, but this article seems to ignore the fundamental issue, which is not that people undergoing IVF are happy-skippy-yay about twins and don't get the true risks (though I suppose some are), but rather that in the face of a procedure that is time consuming and horribly emotional and depressing and exhausting and expensive and just shitty, shitty, shitty, the thought of doing it all over again for another 30% chance just doesn't fly.
So, until medicine can provide better odds, I don't see single embryo transfers becoming the norm, no matter how threatening the possibility of early term delivery becomes. Money is a factor, but realistically, the stress is a far, far bigger thing for me. I'll take the gamble to never have to do this procedure again.
My clinic asked me specifically whether or not I would want to transfer one or two. My embryos look good, and so for my under-35 age bracket, the recommendation is to transfer only one day 5 blast. But because I am on the upper end of that bracket, I'm in a grey area where one more year would push me to a recommended two day 5 blast transfer. And if this one doesn't work, I will be even closer to that edge where they would recommend transferring two anyhow. So I'll be transferring two, and will have questionable feelings about whether or not I actually desire twins. Truthfully, I don't want to do this ever again. We will hopefully be lucky enough to have some totsicles left over so that we can get one more "easy" try in the case that this one doesn't work, but honestly, the thought of continuing with intramuscular injections ever again in my life is horrifying, and since those are one of the things required for FET, I'm scared shitless for this thing not to work.
I just wish that the article had focused a bit more on the fact that IVF isn't just financially painful-- it hits so many aspects of your life that there is a major incentive to chance a more risky pregnancy.
And of course (before this becomes the longest article ever), the also completely ignore the fact that issues resulting in preterm labor with twins are often issues when pregnant with singletons. An incompetent cervix is incompetent whether or not there's one or two (or eight), and often, those who have preterm twins will have had preterm singletons as well (maybe not as early as twins, but complications will arise nonetheless). And, of course, the article also ignores that infertility generally is also an indication for complications with pregnancy. There may be no clear causal tie, but even with singleton pregnancies, there's a higher rate of complications with women who pursue IVF to become pregnant. There just is.
So. That's my .02 on the NYT article. I admit that it can strike fear into our hearts, but there's just so many issues that they ignored that give a very unbalanced view of the (potential) mother who chooses IVF.
Um, started to comment, but clearly Kate said it all!
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