I've fallen upon your essay by chance, looking for statistics in IVF and as I've just failed my first IVF attempt I'd like to react to some points.
First the one for which my reaction is the less rational, but the most heartfelt I think.
Parenthood is not defined by genes, despite what fertility doctors would like us to believe. See, I'm so lucky in living in a country (France) where the state insurance covers 4 ivf attempts, where adopting takes years and years just to get an agreement. So. I had an IVF, I'll have a thawed embryo transfer next and then if it doesn't work another attempt at ivf and up to four. It has nothing to do with genes. I have a 50% probability that any son of mine would be colour-blind, and I'm becoming progressively deaf as my father and his mother were before me. As for my husband's genes, I think he doesn't care either, and while it's true that I would enjoy finding some resemblance between him and a child (because I love him) I really don't care about his genes either.
So what? Well, I want to bring this hypothetical child to life from the beginning. I want to feel it grow in my body, I want to know it from birth. I think I could give love to an adopted child, but I'm not completely sure I could free myself from being jealous of the woman who felt it grow and saw it first and I know I'll miss strongly all I don't know of those first moments.
So I know what I want to try first and that if it doesn't work I'll have some work to do to be able to welcome an adopted child.
As for the rest...
I don't think doctors are necessarily the ones to insist on a large number of embryo. At least in France, where fertility clinics are not subjected to so much pressure about statistics, patients are the ones to require multiple embryo transfers and doctors the ones to aim for healthy pregnancies. There are even some clinics that have a strict one-blastocycst transfer policy. What I see is a lot of women on forums dreaming of twins because after so long without a child having two feels like a miracle and some who don't understand how dangerous a triplet pregnancy is.
But... Statistics do show that on average, pregnancy rates rise with the number of transferred embryo up to three. Pregnancy statistics also show that the risk of late miscarriage and birth problems is slightly higher with twins, but rises tremendously in triplet pregnancies. Honestly, knowing that, and knowing that my husband and I would do better with one than with two, I was willing to chance the twin pregnancy. For me the higher pregnancy rate and the 20% of twin pregnancies balance the slightly elevated risk.
Transferring ONE embryo does lower the pregnancy rates, unless you are lucky enough to have got several embryos that weren't immediately transferred and went on dividing for 5 days until the blastocyst stage. Then you have nearly a 50% chance of becoming pregnant whatever the embryo number, which is great. A friend of mine had this tried, got embryos but her embryos stopped dividing. Those might have survived in the uterus which is after all a better environment.
If you were beginning an IVF after years of infertility, many other failures with lighter treatments, knowing that the number of attempts is only four (or worse, that each costs so much), would you be strong enough to opt for a single embryo transfer? There's (from memory) an average 15% implantation rate and a 25% pregnancy rate. How would you feel knowing that? And if you were the doctor, would you be strong enough to go for the one embryo option knowing of all your patients' hopes?
And a last thing
however, caring for premature infants is incredibly costly. Yes, it is. As are caring for cancer patients, or for old people and for fertility treatment as a whole. I might be a feminist, but I'm not differentiating between men and women when I say that having a public health system that allows us all to access expensive treatments is one of the basic requirement of a developped country. Whatever the responsibility of the patients in their condition.
Well, I hope I didn't anoy you to much with my outburst! I'm sorry it fell on you... Also, I sincerely wish that you'll never have to make these kind of choices.
no subject
I've fallen upon your essay by chance, looking for statistics in IVF and as I've just failed my first IVF attempt I'd like to react to some points.
First the one for which my reaction is the less rational, but the most heartfelt I think.
Parenthood is not defined by genes, despite what fertility doctors would like us to believe.
See, I'm so lucky in living in a country (France) where the state insurance covers 4 ivf attempts, where adopting takes years and years just to get an agreement. So. I had an IVF, I'll have a thawed embryo transfer next and then if it doesn't work another attempt at ivf and up to four. It has nothing to do with genes. I have a 50% probability that any son of mine would be colour-blind, and I'm becoming progressively deaf as my father and his mother were before me. As for my husband's genes, I think he doesn't care either, and while it's true that I would enjoy finding some resemblance between him and a child (because I love him) I really don't care about his genes either.
So what?
Well, I want to bring this hypothetical child to life from the beginning. I want to feel it grow in my body, I want to know it from birth. I think I could give love to an adopted child, but I'm not completely sure I could free myself from being jealous of the woman who felt it grow and saw it first and I know I'll miss strongly all I don't know of those first moments.
So I know what I want to try first and that if it doesn't work I'll have some work to do to be able to welcome an adopted child.
As for the rest...
I don't think doctors are necessarily the ones to insist on a large number of embryo. At least in France, where fertility clinics are not subjected to so much pressure about statistics, patients are the ones to require multiple embryo transfers and doctors the ones to aim for healthy pregnancies. There are even some clinics that have a strict one-blastocycst transfer policy. What I see is a lot of women on forums dreaming of twins because after so long without a child having two feels like a miracle and some who don't understand how dangerous a triplet pregnancy is.
But... Statistics do show that on average, pregnancy rates rise with the number of transferred embryo up to three. Pregnancy statistics also show that the risk of late miscarriage and birth problems is slightly higher with twins, but rises tremendously in triplet pregnancies. Honestly, knowing that, and knowing that my husband and I would do better with one than with two, I was willing to chance the twin pregnancy. For me the higher pregnancy rate and the 20% of twin pregnancies balance the slightly elevated risk.
Transferring ONE embryo does lower the pregnancy rates, unless you are lucky enough to have got several embryos that weren't immediately transferred and went on dividing for 5 days until the blastocyst stage. Then you have nearly a 50% chance of becoming pregnant whatever the embryo number, which is great. A friend of mine had this tried, got embryos but her embryos stopped dividing. Those might have survived in the uterus which is after all a better environment.
If you were beginning an IVF after years of infertility, many other failures with lighter treatments, knowing that the number of attempts is only four (or worse, that each costs so much), would you be strong enough to opt for a single embryo transfer? There's (from memory) an average 15% implantation rate and a 25% pregnancy rate. How would you feel knowing that? And if you were the doctor, would you be strong enough to go for the one embryo option knowing of all your patients' hopes?
And a last thing
however, caring for premature infants is incredibly costly.
Yes, it is. As are caring for cancer patients, or for old people and for fertility treatment as a whole.
I might be a feminist, but I'm not differentiating between men and women when I say that having a public health system that allows us all to access expensive treatments is one of the basic requirement of a developped country. Whatever the responsibility of the patients in their condition.
Well, I hope I didn't anoy you to much with my outburst! I'm sorry it fell on you... Also, I sincerely wish that you'll never have to make these kind of choices.