Tag Archives: Secrets & Lies

In vitro fertilization: Lots of things can happen, and most of them are bad

My twins
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I came across Fertility treatments: Would you get selective reduction? – CNN.com via Paging Mother Nature (read it as well).

The whole CNN piece was a glimpse into the mindset of those who don’t think carefully about matters of life and death, or even insurance, for that matter. Note how many times this worldview is in direct contradiction to reality.

Some segments and my thoughts . . .

Are they one of your success stories?” I asked, pointing behind Dr. H. to a large silver-framed photo of two fat-cheeked babies, identical twins. Dr. H. was my fertility doctor, and this was our first appointment.

“They’re my grandkids,” he explained, then laughed. “But everyone always says the same thing” — he held up his hands, like someone appealing to a higher power, and shook them dramatically — ” ‘We don’t want twins!’ ”

Hilarious, I thought. Dr. H.’s reaction suggested that anyone desperate enough to visit him would take a kid any way she could get one.

“But I really don’t want twins,” I said. “I already have a 3-year-old, and money is tight. One more is all we can handle.”

“Welllll,” Dr. H. replied, “given your age, we need to be aggressive. So I’d recommend going right to IVF. But if you want, we can transfer only one embryo.”

For that privilege, I had my insurer to thank, surprisingly enough: Since my policy covered three rounds of IVF, Dr. H. said, we could be conservative with the number of embryos we implanted each time.

For starters, why should insurance cover IVF at all?  Think about it.  I would gladly pay less for a plan that doesn’t cover wildly expensive and largely unsuccessful and unnecessary treatments.  This is the costly fallacy of many health care discussions.  Just because a procedure exists doesn’t mean you have a “right” to it and that others are obliged to provide it.  If you can’t have kids and don’t want to adopt, then pay for IVF yourself.  We had fertility issues before we were blessed with kids and we would not have used IVF.

“Great,” I replied, with a sigh of relief. “Then let’s get started.”

I left the consultation feeling excited and optimistic. Here was a science so precise that Dr. H. could choose among outcomes — you don’t want twins? Fine. I’ll just implant one embryo.

I was in control, finally. I’d spent months taking my temperature, monitoring my cervical mucus, and visiting an acupuncturist, wondering all the while if these efforts were any more effective than chanting a spell: Bibbity, bobbity, boo!

What if we did just one embryo?

One thing I’d somehow forgotten to ask Dr. H. about was my chance of becoming pregnant using a single embryo. According to research I’d done before seeing him, I knew that the live birth rate for in vitro fertilization for a 43-year-old like me was less than one in 20, and that was when the average number of embryos implanted was three. So going with only one had to worsen the already poor odds, didn’t it? But I kept silent.

Short version: She comes to realize that if she doesn’t implant multiple embryos that her odds of conceiving go down.  No kidding.

And we seemed to have luck on our side: The crappy health plan supplied by my husband’s nonprofit employer paid for three IVF cycles. As I said to him after meeting with Dr. H., what did we have to lose?

Again, note how a system that provides three IVF cycles is “crappy.”  I’d say providing more than zero is a waste.

. . .  “You’re pregnant. In fact, your levels are quite high.” He paused. “And I’m afraid it might be twins.” He sounded apologetic; maybe he’d registered my objections after all.

I reminded him that when we did the insemination, he’d said that although I’d produced four follicles — as opposed to the one generated naturally — it was “highly unlikely” that more than one of the eggs would be fertilized.

“We won’t know anything for sure until we do a sonogram,” Dr. H. tried to reassure me. “And a third of the time, one of the twins vanishes anyway. So it’s too early to tell. But you’re pregnant — that’s the important thing…. Congratulations.” It came out sounding like an admonition.

Or perhaps he was opposed to abortion and trying to steer me away from the procedure known as “selective reduction,” in which one or more fetuses in a multiple pregnancy is terminated. I had no way of knowing.

I hope he was opposed to abortion.

It happened to be my husband’s and my anniversary. We’d been together long enough that we didn’t feel obliged to mark the occasion with flowers or candlelit dinners, but as he walked in the door that night, the timing suddenly seemed serendipitous. “Happy anniversary!” I said, pressing my lips to his. “I’m sorry I didn’t get you anything. Oh, there is this one little thing….” I stared coyly up into his face.

He lifted his eyebrows. “You’re pregnant?”

I nodded, but already my choice of words, “one little thing,” rang ominously in my ears. I trapped my bottom lip between my teeth. “Apparently my levels are high. He thinks it might be twins.”

My husband pulled back from me with the abruptness of someone who’s just learned he’s been betrayed. “Bettina, we can’t handle twins,” he said firmly.

“Well, we could if we had to. People have a toddler and twins all the time.”

“I told you when you started all this that I didn’t want twins.”

What about adoption instead of selective reduction (i.e., abortion)?  This option was not even mentioned in the article.  It reminds me of the deadly pride and selfishness of a boyfriend of a Care Net client I spoke to.  He was pushing for abortion.  When I raised the possibility of adoption, this “macho” guy got serious and said, “There’s no way I’m going to let someone else raise my kid.”  Uh, yeah, but you’ll pay someone to kill her?

I nodded. He had said that. Unlike me, he’d been reluctant to have a second child. Our son was everything we could’ve wished for — funny, smart, a source of regular joy. As he got older, our lives got easier.

We took trips and found time for exercise and going to movies; we even had space in our two-bedroom apartment for guests. But at that moment, I didn’t want to hear any of that. I’d always wanted two children, and I countered with my best argument: Preserving our lifestyle seemed like a self-centered reason to deprive our son of a sibling.

Sadly and ironically, she will destroy one of his siblings to preserve their lifestyle.

Selective reduction had been my contingency plan, yet I’d never thought — or felt — through actually using it. I didn’t even know how the procedure was done. Now I was horrified at the idea of terminating one of the fetuses growing inside me by injecting potassium chloride into his or her heart.

Yes, that is horrifying.

With my son, I’d witnessed the step-by-step progress from blip to eight-pound, two-ounce boy, marveling at the increasingly recognizable sonogram images, poring over the weekly e-mail announcements from a pregnancy website: Your baby now has fingernails, your baby is now the size of a lemon, a banana, a melon. … And while I strongly believed in women’s right to have an abortion, the unlucky fetus destined for elimination wasn’t merely an abstract potential life, or an accident.

He or she was the product of my love for my husband, a life we’d made together on purpose. This fetus had an identity, not least as someone’s twin. “Selective reduction” was Orwellian; I knew I was ending what could be a life.

She comes close to honesty there.  She knew she was ending what is a life.  It is a scientific fact that the unborn are unique, living human beings from conception.

I also worried that the surviving child would be scarred by the loss. Perhaps the fetus would register the cessation of the heartbeat in the neighboring sac, the stilling of the fluttery movements.

Bizarre.  She doesn’t even know which one to kill yet, and is worried about the survivor’s reaction.  But if she isn’t a life yet, that makes no sense.

Could the proximity of decaying fetal tissue infuse my womb with the specter of death? If the chosen one ended up with mental illness or autism, would I always blame myself for having a reduction? All this may seem melodramatic, but I’ve heard about identical twins holding hands in utero; I’ve seen the secret language and private reality shared between even fraternal twins.

. . .

“But neither of us even likes our brothers and sisters that much,” my husband persisted. In fact, if it weren’t for the affection between our son and his cousins, he went on, we’d rarely see our siblings.

. . . .

During my weekly visits to Dr. H.’s office over the next month, I watched the two little sacs on the sonogram darken and grow, develop heartbeats and vaguely human outlines. “Can you turn the screen away, please?” I asked, tears pooling in the corners of my eyes. “I don’t want to get attached.”

. . .

My husband was convinced that twins would radically change our lives for the worse. We’d have to leave our beloved neighborhood for a place with cheaper rents and better public schools — there was no way we could afford private education for three kids.

Meditate on that, folks: They think it is better to kill one child than to have to send them all to public schools.  The pro-teacher union / pro-abortion folks must be tied up in knots over that one!

We’d kiss goodbye any hope of career advancement, at least for the foreseeable future. To his list, I added the loss of my income, necessary to meet our expenses. I couldn’t see how I’d be able to resume working after the birth since we could never afford full-time help, and — no matter how well they napped — two infants wouldn’t leave much time for anything else.

Trot out the toddler time: Could they kill any child outside the womb for those reasons?  Of course not.  So the only question is, “What is the unborn?”

My husband told me he’d support whatever choice I made, but for him, there really was no choice. Our twins weren’t part of God’s plan, he reasoned (or rationalized?). They were the product of artificial insemination.

Yeah, they are all about following God’s plan here.

If we’d become pregnant with twins naturally, would we be making the same decision? I didn’t know. All I knew was that ultimately, I didn’t think we could have twins and remain an intact, happy-enough family.

Boo-hoo.  Seriously.  Has this lady ever stepped out of her Liberal enclaves to see the rest of the world?  People endure far more than she could dream of, and many do it with much more joy.

After another stretch of silence, I asked, “Could you say a prayer when they’re doing it?”

He glanced at me, looking slightly surprised. “Sure. Of course.” Neither of us is very religious, but I wanted God to know that he or she, or whatever form God took, hadn’t been forgotten.

I hope they learn to think more carefully about God.  It is their only chance at true joy and forgiveness.  I doubt this marriage lasts very long after this.

Our doctor told us that she’d take into account any gender preference if the CVS determined that both babies were equally healthy. Now as she examined the ultrasound, she asked whether gender mattered to us. “Well, we have a boy at home, so I guess we’d prefer a girl,” I said, realizing with a start that since she gave us a choice, I must be carrying a boy and a girl, and I’d just chosen to terminate a boy.

One of the rare gender selection abortions that destroys a male.  Usually this “pro woman” practice results in dead females.

What a sad story.  I hope they find forgiveness and peace someday.  And I hope this cautionary tale makes people think more carefully about IVF and reproductive issues in general.  You do not want to put yourself in a position of having to make life and death choices like that.  And if you do, choose life.  Don’t buy into their bleak worldview.