You may have heard the recent news about IVF experts speaking out against the common practice of transferring multiple embryos to the uterus, published in the New York Times. The multiple-birth method has been normalized by clinics—hoping to enhance pregnancy rates to attract patients—but now experts are voicing concerns about a link between this practice and high health risks to the mother and child, often not made clear to infertile couples prior to the procedure. In particular, the practice frequently results in the birth of multiple infants; these babies are often born prematurely and spend significant time in intensive care. The risks stretch further, with an increased chance of physical and mental abnormalities, such as cerebral palsy.
These are real problems that I’m glad are getting more attention. But I can tell you this is just the tip of the iceberg in terms of how IVF fails women. I say this as someone who has used IVF to have children.
More and more today, we hear stories of women who are infertile and heartbroken at the thought of not conceiving children. IVF is now the go-to answer for fertility issues. With relative frequency we hear and see ads for fertility clinics, read articles featuring happy IVF-created families, and probably even know a woman or two who has gone through the treament. It can seem like the compassionate thing to recommend—a solution to your infertility!—but the reality of IVF, and the relative casualness which which the risks are brushed aside, should give us far more pause than it currently does. Frankly, IVF is not a good answer for us.
One big problem with IVF is how it markets a questionable practice to desperate women. As a young girl, if someone had asked me what I wanted to be when I grew up, my answer would have been “a mother." As I matured and eventually got married, it never crossed my mind that I might not be able to have children. After marriage, my husband and I knew we wanted children but we decided to wait until we felt ready. It wasn’t until four years later, when I was off the Pill and trying to desperately to conceive that I began to think about the possibility of infertility for the first time.
My monthly period transformed into my monthly dread. We always hear about the fear a woman has when she has no period. Much less talked about is the fear and anxiety countless women have when their period comes, signifying one more month without conception, one more month that makes them wonder if they’ll ever have a family. With every month that passed, that fear and anxiety grew. I could not imagine a life without children.
Desperate to find an answer to this problem, I sought out an expert in fertility. A dear friend of mine happened to work at the local fertility clinic and suggested that I meet with a doctor there to discuss our options. Thus began our journey on a path that would change our lives forever.
Fear and Hope Don't Go Together
From the moment I met Dr. Smith (his name has been changed), it was clear that his goal was to help us get pregnant. He was very passionate about his work and seemed to truly care about us. He was very clear about what our options were and he impressed us with many statistics about our chances to conceive with each treatment option. Success rates vary widely from clinic to clinic, so many women will travel long distances to go to a more “successful” clinic for treatment (the CDC even provides a website for couples to look up success rates for their local clinics). Intrauterine insemination starts with a low success rate around 10 percent but increases the number of months you try it. One fertility site says with 3 to 6 cycles of IUI, pregnancy rates can be as high as 80 percent. Further down the list is IVF which many fertility clinic websites quote at a 20 to 30 percent success rate, and decreases the older a woman gets.
Speaking with Dr. Smith gave us hope that we would become parents. As the treatments began—blood tests, ultrasounds, surgery to treat endometriosis, at least two cycles of intrauterine insemination—my desire for a baby only grew. Unfortunately, so did my stubbornness and my impatience; I was determined to be a mom at what felt like any cost. I was unwilling to accept the possibility of adoption or of living in a family that consisted of only my husband and myself.
Looking back, I realize that I was in a dangerous place emotionally. I was making decisions out of fear and other unruly feelings rather than out of a clear mind that was capable of weighing the risks and benefits to all persons involved, including any new human life that may be created in the process.
At the same time, my husband and I were growing apart. He didn’t understand the way I was acting or why I felt so strongly about having a child. He didn’t experience desperation the way I did, and his attitude of acceptance of our infertility made me angry and allowed more distance to grow between us.
After surgery to treat endometriosis and a few unsuccessful attempts at natural conception and intrauterine insemination, I became increasingly more fearful of the possibility of a future without children. So when Dr. Smith gave us the option of IVF, I did not hesitate and said yes without further consideration. I was told about the medical risks of treatment, like premature birth or multiple births (and the challenges that come with both), ovarian hyper stimulation and about the relatively low 30 percent rate of live birth following the procedure, but honestly, I would have consented to almost anything at this point as long as it gave us a chance at pregnancy. My husband went along with the plan, knowing that there was nothing he could do or say that would make me change my mind.
The Chance Of Children
What happened next reflects the second major problem of IVF—the health risks to the mother. As it turns out, some of the severe complications I experienced as a result of IVF are very common for women undergoing the treatment.
When I met with an IVF coordinator nurse to learn about the timing of the steps in the process, I was surprised to learn that I would need to take birth control pills in the cycle preceding the treatment. This didn’t seem to make sense, but I was not questioning anything at this point. Next, I would inject very powerful hormones into my body over about 10 days in order to force my ovaries to super ovulate. The natural process of ovulation produces only one mature egg per cycle. With IVF, sometimes more than 20 mature eggs are produced. It is an understatement to say this is an extreme stress on the body.
I was closely monitored with ultrasounds and blood tests during this time. I was warned about a rare side effect of this treatment called “ovarian hyper stimulation syndrome” that occurs when the ovaries become very swollen and secrete fluid from the developing follicles (cysts that contain the eggs) into the abdominal cavity. While I knew this had a less than 5 percent chance of occurring, I never expected how I would become very familiar with this unfortunate outcome and just how painful it would be.
Once the ultrasound showed that the eggs had reached the appropriate size, I was ordered to take an injection at home that would trigger the process of ovulation in preparation for the egg retrieval procedure about 36 hours later. On the morning of the retrieval, my husband was told to give a sample of his semen that would be processed and later added to my eggs in the lab. My eggs were retrieved using ultrasound-guided needle aspiration while I was awake, with my husband at my side. As we looked at each other, we had the palpable sense that this whole process felt completely unlike the warm, united, and loving way children are usually conceived. This? This felt unnatural, sterile, and strange—but there was no turning back now.
Things got a bit stranger when we got a phone call the next day telling us about the eggs that were fertilized—how many and the quality of the embryos. We learned that over 20 eggs were initially fertilized; only 8 survived over the following 3 days until the scheduled embryo transfer, when the embryos are put into the uterus. After being counseled by Dr. Smith, we decided to transfer 3 of the highest quality embryos and to freeze the remaining ones. The embryo transfer procedure was very simple. We left the hospital and waited with much anticipation to hear whether the procedure was successful.
About one week later, after eating food at a barbecue, I began to have some unusual upper abdominal pain and wondered if it was my gallbladder. By the next day, the pain had increased to include my entire abdomen and I felt very nauseated and lightheaded. Soon, it became difficult to walk because I felt so weak and dizzy. My family brought me to the emergency room where Dr. Smith met me and told me both good news and bad news. The good news was that I was pregnant based on blood tests. The bad news was that I had a case of severe ovarian hyper stimulation, and I needed to be admitted to the hospital for close observation and intravenous fluids. I remember feeling a different sort of fear while lying in the hospital room that night. For once, I was not concerned about being pregnant; I just wanted to be alive. I have never felt so sick and helpless.
I was able to go home two days later but soon there would be new reasons to worry. Three weeks later, an ultrasound confirmed a triplet pregnancy! The doctor was very surprised about this outcome based on my pre-pregnancy hormone levels and the quality of the embryos that were transferred. Serial ultrasounds were done every week thereafter that showed abnormal bleeding surrounding each baby’s sac called sub chorionic hemorrhage. I was told that this could result in miscarriage of one or more of the babies. I was told to go home and rest and return each week for ultrasounds. Four weeks later, we received the news that one of the babies no longer had a heartbeat, presumably due to the growing hemorrhage that separated the baby from its blood supply. Further, we were told that the other two lives were also in jeopardy due to increasing amounts of bleeding near their sacs.
I cannot convey how emotionally painful it is to process the loss of a child in your body, when you’ve been longing for this child for so long. I was so happy to be pregnant but at the same time, I felt that I couldn’t enjoy the pregnancy because of the looming risk of further miscarriage that was a very real possibility. I was ordered to remain on bed rest for the remainder of the pregnancy. Once the immediate threat of miscarriage had passed, I was transferred into the care of a high-risk obstetrician to guide us through the remainder of the pregnancy. I went into labor one month before the due date. We were thrilled to welcome two beautiful, healthy boys into our family.
Calculating the Costs
I am forever grateful for my boys, but with the gift of hindsight, I can now see more clearly how problematic the procedure of IVF can be. Our IVF journey took a significant toll on my body, our marriage, and on the lives of the embryos that were created in order to be destroyed in the process. While we are so grateful to have our children, I cannot recommend IVF to anyone. I now realize that this is another example of the fact that the end, even if it is healthy babies, does not justify the means of how they’re produced.
In the years that have passed since this procedure, I have learned about alternative technologies that I wish I had known more about before deciding to try IVF. In particular, NaProTechnology is a restorative approach to infertility that first seeks to find the underlying cause of infertility and then works to restore health to the couple so that they can naturally achieve a healthy pregnancy. Of course, that doesn't mean every couple is able to conceive, but given that only roughly a third of IVF treatments are successful, I wish I had known that there was another option.
My hope is that by sharing our story, other couples may avoid the pitfalls that often come with IVF and find hope and success with the better technologies that are available today. I believe every life is precious, no matter how small, and I know that, for women who want to get pregnant, this belief is vivid. To best serve these women, we should push for technologies that don’t lead infertile women to more fears, increase risks to their health, or force them to experience the all-too-common and very tragic loss of a child.
Pregnancy is a most sensitive time in a woman’s life, and my hope is that with better options than IVF, women can experience theirs not with dread, but with great expectation.
Photo Credit: Horace and Mae Photography