Monday, February 16, 2009

President's day Rumination, Birth, Life, Fertility, IVF, the Nadya Sule

Happy Presidents' Day.

Nadya Suleman, the woman (in case you've been living in even more of a cave that I do) is the woman who recently gave birth to octuplets when she already had 6 kids at home, all conceived via IVF, and is also a single mom on welfare. Oh, and I think one of the kids is autistic and two have some kind of other disabilities.

Besides becoming a new pop culture figure who's on network TV, has an agent, etc., it's also opened vitrioltic debates about responsibility, etc. I've written a few times in print on the issue of choice, how the pro- lifers can be hypocritcal but also how pro-choicers need to face squarely exactly what happens during an abortion. And in my writing about fertility and why in many ways I think IVF not only needs to be regulated more, but also women themselves need to think long and hard about what this process does to your body and what it might entail. Anyway, for a change, here's not a link to something else but a whole essay by yours truly.

Pro-lifers, pro-choicers, egg donors, IVF users--comments?

Here's my essay on choice that I wrote for the Washington Post: "Facing the Reality of Choice."
Here's a post on what happens to the unwanted embryos: click here.

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Still leaning against the incubators he gave them, while the pencils scurried illegibly across the pages, a brief description of the modern fertilizing process; spoke first, of course, of its surgical introduction–"the operation undergone voluntarily for the good of Society, not to mention the fact that it carries a bonus amounting to six months' salary"; continued with some account of the technique for preserving the excised ovary alive and actively developing; passed on to a consideration of optimum temperature, salinity, viscosity; referred to the liquor in which the detached and ripened eggs were kept; and, leading his charges to the work tables, actually showed them how this liquor was drawn off from the test-tubes; how it was let out drop by drop onto the specially warmed slides of the microscopes; how the eggs which it contained were inspected for abnormalities, counted and transferred to a porous receptacle... One egg, one embryo, one adult-normality. But a bokanovskified egg will bud, will proliferate, will divide. From eight to ninety-six buds, and every bud will grow into a perfectly formed embryo, and every embryo into a full-sized adult. Making ninety-six human beings grow where only one grew before. Progress.

--from Brave New World by Aldous Huxley


Eight Is Too Much?

In the recent furor surrounding the birth of octuplets, one of the recurring questions seems to be, Why didn’t the mother use selective reduction when they found out that all eight of the embryos had implanted? The technology that brought us test-tube babies also brought us multifetal reduction, a technology that is routine today but was once considered to be impossible: reducing the number of viable embryos in utero without harming the others.

In 1984, Dr. Mark Evans reduced a quadruplet pregnancy to twins by literally stabbing two of the fetuses with a needle. It worked. Today, the more common method is to inject a feticide. These are the facts behind the nice-and-responsible-sounding term, “reduction.”

Any pregnancy beyond a singleton immediately becomes termed high-risk. Twins heighten a risk of preterm birth, preemclampsia (a lifethreatening disease of pregnancy that may result in abortion to save the mother’s life), low birthweight, neurological issues, and a host of other problems that require massive amounts of medical resources; thus, multiple pregnancies are routinely reduced.

Live births involving more than five babies used to be freak-show rare. But with the increased use of fertility technologies, times are certainly changing. In 2007, two couples using fertility drugs had sextuplets within weeks of each other. Both couples cited their Christian faith as reason for not opting for selective reduction. The babies of one couple, Ryan and Brianna Morrison, all expired after birth except for one. "Because it's life and God gives life and it's not up to us to decide to take it away," stated Brianna Morrison, who met her husband in Bible college. Similar reasons were cited by Nadya Suleman, the octuplet mom. While it seems naïve or illogical to become pregnant in the most artificial way and then claim it’s “God’s will” to give birth to eight babies, it does uncover a thorny contradiction within the abortion debate. Pro-life activists generally believe life begins at conception, and activists have campaigned not only against abortion, but against contraceptives, such as the birth control pill and the IUD, which prevent a fertilized egg from implanting.

Yet, most of this not-shy group have been strangely silent on the other end, the issue of fertility technologies, which create life with the side effect that sometimes you have too much life, routinely involving selective reduction as well as the mass disposal of viable embryos. Given the growing tide of negative opinion against the most recent crop of super-multiples (dare I even joking say, litter?), octuplet mom Suleman should at least be supported by the pro-life camps for “using up” all her embryos and not discarding them. But then if super-multiple births should become normalized, what are the potential risks to the children, the mother, the environmental impact of using artificial “fertilizer” to create such a large brood? The pro-life lobby, if they indeed are concerned with life after birth as well, might do well to consider either discouraging the use of artificial fertility technologies (as does the Catholic church), if anything for the sake of ongoing life on the planet.

Perhaps this issue has largely escaped the pro-choice/pro-life, liberal/conservative debates because people on both sides avail themselves of this medical service (fertility technologies are categorized as elective medical procedures, a less-regulated, consumer-oriented designation that includes cosmetic surgery) and manage to look away from its necessary moral/religious pitfalls and thus “reduction” has homey connotations of a wine sauce while the word “feticide” is rarely used. There is and will be similar divides in the brave new world of medical technologies. For instance, it is a little known fact that the MMR and other vaccines, which are generally regarded as lifesaving, are prepared from attenuated viruses is grown in human diploid culture that is derived from aborted fetal tissue. So is it pro-life to vaccinate or to refuse vaccination? As technology accelerates ever faster, we as a society need to examine exactly what we think of when we talk about “life.”

p.s. It’s easy to find references to the use of aborted fetal tissue in the production of the MMR (or the rubella monovalent vaccine) is easily verifiable via the CDC’s informational website: http://www.cdc.gov/mmwr/preview/mmwrhtml/00001893.htm

Or, from the Physicians’ Desk Reference, a compendium of information supplied directly from the manufacturers themselves.

9 comments:

Jen R said...

I'm pro-life, and I'm not necessarily against IVF, but I am against the way it's often practiced.

I think that IVF would be ethical if no embryos were deliberately destroyed (because they are "extras", or because they have been diagnosed with a disease), and if no more embryos are transferred to the mother than she can carry healthily.

Most of the time when a large number of embryos are created and transferred, it's because IVF attempts are so expensive and people want to maximize the chance of any given attempt working. They also don't want to have to go through the process of superovulating and harvesting eggs more often than necessary. If insurance covered IVF, that would cut down on the perceived need to transfer unsafe numbers of embryos. If technology for freezing oocytes continues to improve, that would mean there was no reason to create and freeze embryos for future attempts. I support both of these things.

Anonymous said...

For the record I am pro-choice but my thoughts on IVF come from a much more personal POV. After more than a year of trying to get pregnant the old fashioned way, we found out that is a near impossibility. It is pretty devastating to learn your body fails at a basic human function. We want desperately to have kids and looked into IVF and adoption. Truthfully, though expensive and unpleasant, IVF was a better choice for us. There is all this pressure to consider adoption before IVF from the religious folk, but adoption is no picnic. It's more pricy than IVF and the whole system is designed in such a way the price is set on the age and color of the child. The more I learn about our adoption system, the more it creeps me out.
I was not lucky enough to have "extra" eggs from my first IVF cycle, which did result in pregnancy but ended at 7 weeks in miscarriage. I am just starting a second and cross my fingers it will take this time. People who don't have issues with infertility are quick to judge and society and insurance companies treat infertility with some disdain as though we somehow chose to have defective reproduction systems. I am not getting a nosejob or a new rack. I have a medical issue which prevents my body from getting pregnant. The same way my doctor would assist with any other medical issue, he is helping overcome this.
This Octuplet mom is a lunatic, plain and simple, and her reproductive exploits are deplorable since it is questionable whether she can care for her kids,
but as someone who has done and will do IVF, it's nobody's business how my kids come to be.

GreenFertility said...

Thanks for the comments, and Jen R. for reminding me to post the link to the post on putting the wee embryos down the (sigh) drain...

--marie

Medela Metro Bag said...

I was really very much amazed to hear that she's unemployed and already have six children, I am really very angry on this woman, she must have kept all the consequences in her mind before delivering 78 more!

Debra

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