Sunday, August 14, 2011

nyt magazine

This morning in the New York Times Magazine, there is an article called "Unnatural Selection."  The article is about the increasing demand for twin to singleton pregnancy reductions.  I am pro-choice.  I firmly believe that a woman has a legal right to make choices regarding her own body and her own reproductive health.  As a woman who has lost three children and is now anxiously awaiting the birth of my 32 week twins, this was quite a difficult read.

After our journey with recurrent loss, we were elated to find out we were having twins.  I literally felt like I had won the lottery, only this was better.  We were having two children.  Sure, two children at once brings up scary questions about time and money and energy, but after working so hard for a pregnancy, these fears paled in comparison to the joy we felt.  Reading that many women, after undergoing fertility treatments, choose to reduce to a singleton for social or financial reasons is baffling to me.

What is more difficult, though, is a quote near the beginning of the article.  One of the women interviewed stated: "If I had conceived these twins naturally, I wouldn't have reduced this pregnancy, because you feel like if there's a natural order, then you don't want to disturb it.  But we created this child in such an artificial manner--in a test tube, choosing an egg donor, having the embryo placed in me-- and somehow, making a decision about how many to carry seemed to be just another choice.  The pregnancy was all so consumerish to begin with, and this became yet another thing we could control."  Why would any woman say this, allowing such garbage to be published in an international publication?  These are the very beliefs that we, as members of the infertility community, are trying to fight against.  Whether conceived through IUI, IVF, with donor eggs or sperm, our children are not "unnatural" or "artificial."  Calling fertility treatments "consumerish" implies that you can somehow go pick out the kind of child you want and then be guaranteed to take that child home in 9 months.  But we know it doesn't work that way.  Despite ours and the doctors' best efforts, treatments often don't work.   

When members of our own community are making such ignorant statements, we have a long way to go in making people understand infertility and its treatments.  Here's hoping that not many people read this article.


  1. Wow. I have not read the article, and don't plan to after reading your post as I have no doubt it will just upset me. I can not believe someone who is from this community would say something so...harmful, it is down right insulting. Thanks for posting about this!

  2. Thank you also for posting about this. We conceived triplets (you know our story) from a two embryo IVF cycle. Every time higher order multiples happens the RE suggest 'selective reduction.' I was scared to death, it's risky, birth defects are statistically higher but I always thought:
    1) How can I ask them to help me get pregnant but then not want what I was given? How can I say, 'oh, I didn't sign up for three?'
    2) If someone had told me that I would have triplets before I started fertility treatments I would have taken it in a heartbeat.
    Two of our babies are identical which means they shared a placenta. If we would have reduced (which we never would have) we wouldn't have our Baby A. I couldn't imagine my life without this beautiful baby girl.
    Babies are miracles and we should treat them as such for however long God gives them to us.
    My triplets are healthy and happy. Sure, my life is crazy and it's expensive but isn't this what God intended for me? I wouldn't change it for anything.

  3. Okay this really upsets me on many levels. If you don't want twins, then DONT but two embryo's in!! Sorta common sense! It then irritates me bc they got TWO babies and chose to abort one, while others are still sitting here wishing, hoping, and praying for one (or two) still!! Also, after working that hard to get to where they are, they are going to take the risk of aborting one? Selective reduction is not fool proof and can very easily result in aborting all! irritated.

  4. Having read so many blogs on infertility, I have never come across a woman who wanted to "reduce" her twin pregnancy. So where oh where did the NYT find this woman? It's different if a woman becomes pregnant with more than 4 but twins??!! I don't understand that at all.

  5. This makes me sick. If you go into fertility treatments hoping for a baby and asking for HELP, why can't you accept that what eventually implanted on it's OWN, IS natural. This makes me sick, especially having my own twins on the way. Who are these women?

  6. I'm so angry I'm practically choking. IVF is, in a cynical light, very consumeristic. But it is still miraculous. How can you go through it and lose site of that? I pity this woman and her very natural child(ren).

  7. wow- that article is terrible. I can't belive someone who went through IVF would talk about it that way. Disgusting.

  8. I have read the article. Here's my take. I am currently undergoing IVF. My husband and I are planning to have two embryos transferred. We have chosen this because we believe it increases our chances of having at least one and because we believe we can handle it if two arrive. Thankfully, we have a doctor who has been very up front about all the risks of different fertility treatments, including IUI. We skipped IUI and went straight to IVF because I could not stomach the idea of selectively reducing the pregnancy if it were more than two and we don't believe we can handle more than two at a time, financially, emotionally, maritally.

    So, clearly, I have thought through the options. What bothers me about the reactions to the article is the lack of real information people have access to. People are saying that they shouldn't have chosen to implant two embryos but do we really know that was the case? Maybe they implanted one and it split. For the woman who sounds like went through IUI and ended up with triplets, maybe her doctor didn't inform her of the risks of IUI and multiples before she went in to it.

    I'm not saying that any of these women's' choices would be for me but what I am saying is that we should reserve judgement of others choices, period. What one person chooses doesn't have to agree with my morals, values, or lifestyle any more than they should have to ascribe to mine.

    I think this sort of highly negative response, rather than promoting a civil and open dialogue about the issue, is exactly why those that have gone through it have chosen to guard their identity so closely. We need to talk to each other, not condemn. After all, it wasn't that long ago that IVFers were in the same boat. Very little understanding on the part of the public mixed with insulting response meant that most of us kept quiet too.

    I know I will have the less popular take on this subject and I'm okay with that.

  9. FYI, Doctors almost always transplant multiple (usually over 5) embryos with the assumption that most will not take. This simply results in an increase chance of multiplets.

  10. That is simply not true. At least not for the doctors see. Ours is hesitant to transplant even two. And in our beginning paperwork, we were asked to sign a consent that selective reduction would be on the table if we happened to get pregnant with more than three. Our doctor considers a single pregnancy a success and in fact, multiples (even twins) is considered a negative in his statistics.

    The fertility community is quickly realizing the risks and dangers with high order births and more and more physicians are controlling for this by transplanting fewer embryos.

  11. you hit the nail on the head. we have a long long way to go to get people to understand infertility and articles like that set us back. it was a truly appalling article.

  12. I totally agree with you. I am 100% pro choice, and I believe that there are reasons for selective reduction. I can't, and won't, say it is wrong for somebody else... But this article, boy is it sensationalist and way out of line. From the moment I saw two heartbeats on the screen all I felt was relief. And when they told me that 1 out of 4 twin pregnancies naturally reduce to a singleton in the first trimester all I felt was fear that I would lose one. I know that that is definitely not true of everyone. But seriously, NYT, couldn't you find someone in our community who wanted to reduce who didn't put it quite so.....badly? I'm sure they did, maybe dozens of them, but this is the woman they went with? It's a shame. A shame that someone would feel this way about an ART pregnancy and a shame that they published it. Bad form, NYT, bad form.

  13. Alex, you are terribly wrong. It is considered malpractice to transfer 5 embryos in one go and an RE can lose his/her license for doing so.* REs are moving more and more to transferring only one blastocyst to prevent twins. Higher order of multiples are getting rarer all the time, and are usually from IUIs, not IVF.

    *the RE that transferred Octomom's embryos lost his license a few months ago.