Chrissy Teigen is one brave supermodel. She publicly announced that her current pregnancy was a result of IVF treatment. She even talked about undergoing treatment during her most recent Sports Illustrated shoot and how she covered up her injection bruises with makeup.
She also went one step further and announced that she selected the gender of her child. She told People magazine, “Not only am I having a girl, but I picked the girl from her little embryo. I picked her and was like, ‘Let’s put in the girl.” Not surprisingly, there are a wide range of strong opinions on this topic. She defends her choice here.
I am not here to say what she did was right or wrong. But it does highlight some of the choices and moral dilemmas we face when undergoing IVF. Selecting embryo gender before transfer via preimplantation genetic diagnosis or PGD is in fact a choice.
That choice however is the tip of the iceberg when it comes to the range of controversial choices I encountered all up and down IVF road, choices my fertile friends never had to think about.
Before treatment started, one of the things my husband and I had to do was sign a stack of consents at the clinic. This appointment took more time than most of the medical procedures so we always had to take half a day off work to do it. We usually made a breakfast date out of it once we were done.
The appointment took so long because there was some serious stuff in those legally-binding documents. Our choices had to be briefly deliberated, decided upon, and signed, sealed, and delivered, after being witnessed and notarized of course. Choices we never thought we would encounter when we decided to have children.
If you think about it, when you decide to have children, what do you think mostly about? Maybe it’s how many children you want, how far apart in age they should be, maybe the boy/girl mix, or what names they will have. For me as a fertility patient, those happy thoughts quickly ventured over to the dark side and looked more like a chapter out of my college Ethics textbook. These weren’t just my decisions either. My husband also had to sign the forms which meant we had to agree on what to do. Good times.
Yes, one form was about PGD. That procedure allows for gender selection but it also tests the embryos for a variety of genetic disorders. When I say genetic disorders, I mean some really horrible diseases, ones that will seriously threaten the health of your baby and compromise your quality of life. What do you do with that information? Do you go ahead and deal with the cards you were given or simply not go ahead with the embryo transfer and lose the IVF cycle?
That brings me to the topic of embryo disposal. There were a few forms devoted to this topic. If all works out in IVF you will have many more embryos leftover for lack of a better term. So, what do you do? You can freeze them to use later in case the cycle doesn’t work. That’s what we did. Or you can dispose them. If you dispose them, there are choices here too. You can simply have them discarded or you can donate them to science research. You can even opt to donate them to another couple going through treatment.
Each of those options has serious consequences. Sure, you can gift your embryos for the good of science, in theory but do you really know what happens to them once they leave the clinic? An even greater gift is the one you could potentially give to another couple but you have to be 100% okay with the idea that you will never have a connection to a child that is biologically yours.
Then there is perhaps the darkest choice of all.
Let me give you a couple of scenarios. Let’s say this this is your first IVF and your doctor recommends to transfer back 2 or even 3 embryos. It is so successful that they all take. Maybe, and this is rare, but one or more of them divides further and before you know it, you go to your first ultrasound and see that you have 2,3, 4 or even more embryos going strong. Or, maybe you already have one or two children already but encounter secondary fertility when trying to complete your family and you want just one more child. Again, IVF works so well that you are pregnant with twins, triplets or an even higher order of multiples. You find yourself asking, “What have we done?”
Now, in the post-Octomom era, I do think clinics are very cognizant of this and try to avoid this situation in the science that is IVF. Still, behind every science there is an art and art is always unpredictable.
There is a procedure called selective reduction that reduces the number of fetuses in your pregnancy. No one talks about it much and it is so controversial because, well, it sounds too much like that other procedure that starts with the letter “A”. But just like the “A” word, it is in fact a choice.
Again, I repeat, I am not saying choosing your baby’s gender, giving your extra embryos up or even undergoing selective reduction is right or wrong. But what I am saying is because these choices exist you and your partner have to give some serious thought and discussion to these very real possibilities.
And if you are fortunate enough to be fertile, please have some understanding for those of us who may be in the process of making not only children, but some difficult choices.
Isn’t infertility grand?
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