Saturday, March 01, 2008

BBBT-Embryo Culture

The latest stop on the book tour is Embryo Culture by Beth Kohl. This book was a look into one woman's IVF experience and a broader look at the IVF world as a whole. The author is from the same area as I am so it was interesting to be able to recognize landmarks and places. She took us through her 1st IVF experience but really didn't discuss her second one that much except for the results. In the end, I enjoyed the book as it caused me to question my own perceptions of IVF and other ART technologies but at the same time reaffirmed our current decision. I did read parts of the book to DH but for him... his position on IVF currently isn't up for discussion so he wasn't very receptive or responsive. I have to speculate that even if he took the time to read the book in the end... he would still feel the same way. Please understand that we know that many people have had wonderful experiences and are blessed with happy and healthy children as a result but... any opinions expressed are solely mine and are not intended to offend in anyway.

Note: some of the answers have been edited from original posting as I wanted to clarify my answers.

The author also talks about how many embryos should be transferred at any given cycle. Should there be a limit?

Personally, I think there should be a limit. While there are many cases of extreme multiple pregnancies occurring without incident for the most part many of those babies start out at a disadvantage. They are younger gestational age when born then is ideal. Just because we can push the envelope doesn't always mean that we should. Perhaps my opinion is a bit tainted by someone I know who underwent IVF, implanted four embryos, gave birth to four fairly healthy babies but in the long run the stress of the infertility treatments and raising quadruplets proved too much for the marriage and they ended up divorced. Are all families this way? No.

At the same time, if I were in that situation where they had implanted over 3 embryos and they all were successful, I don't think that I could selectively reduce. Then what? While I understand fully that someone attempting an IVF cycle wants the best shot for a successful cycle... it seems to me, to much of a risk to implant more than 3 embryos. Risk for health issues for the babies and for the mother alike.

Beth Kohl discusses her fears about how IVF may lead to increased health problems for her children, and she thinks about this in the context of her daughter's surgeries for cysts on her bladder. Do you ever worry that IVF or other ART could compromise the health of your children created through the process? How has that affected your decision to pursue treatment?

Actually one of the concerns that DH and I have is about the health of the future child. Both about what if we pass down the "bad" parts of us and what if all of the medical intervention actually causes medical issues that would not have normally occurred. Until this book, I hadn't done much research about health issues that the IVF procedure might cause it was just a speculation on both of our parts. When you take control of something and override the natural steps it seems that there are bound to be repercussions in the long run. For everyone? probably not but it was interesting to read the statistics of the health issues thought to be caused by the IVF conception process. Currently, we are not pursuing treatment for many reasons but this factor is part of that decision.

Beth likens Dr. Frankfurth's office to one that "should have belonged to a family doctor in Anchorage, circa 1950, and not to a late twentieth century endocrinologist." How much do appearances matter? What were your first impressions of your RE's office? Did/does that color your interactions with the RE himself or herself?

I haven't actually been to the RE's office. My husband has but I have been dealing with a regular endocrinologist. Due to the nature of the relationship between my previous internist and the endocrinologist that she referred me to I had a good deal of confidence in his ability and his patient care philosophy. They share the same office and the same staff. Since all my previous dealings with her had been fine and not problematic, I had no reason to think that something would be awry. However, the first time that I met with him, he was running over an hour behind with no one notifying us previously. Also, he is very flamboyant and he talked over both of us several times. I continued to see him for a few years but now I am on the search for another endocrinologist because I have decided that I just don't want to deal with a doctor who stresses me out. He never runs on time, his office staff screws up messages and medicine refills every time, and during the appointment I am so frustrated and upset from having to wait forever that I just don't want to go over everything with him for the millionth time because he can't read my chart before he comes in the door. I had high hopes and he didn't live up to them so now I have given up on both of those doctors in exchange for a more organized clinic and a harder to get in schedule usually... but I am okay with that as long as the whole event of going to the doctor doesn't stress me out.

So my first impressions were wrong and in the end just made it harder for me to take care of my medical issues.

Beth makes certain that she tracks how she and her husband respond to infertility in different ways - through diagnosis, debates about treatment, and how infertility is perceived in the "normal" world. Do you find such differences between yourself and your significant other(s)? Was it difficult to determine upon a course of treatment due to those differences?

Until recently, we have been on the same page. We both felt that a medically assisted pregnancy was not in the cards for us and that there were other parenting options out there to explore. The more we look at those other options, the more frustrated I get because of the amount of inspection into our daily lives. I don't think right now I would be a candiate for a successful medically assisted pregnancy anyhow due to other medical issues and my weight. But... the more desperate I become to make us a family... the more options I am willing to explore. Does that mean that we will pursue IVF---most likely not. But maybe we are overlooking some of the smaller and less invasive treatments that are around. So until recently... no, there was no difficulty is working out a treatment plan because there wasn't one. In the future... maybe.

In terms of emotional response, there has been a difference. My husband tends to be more emotional then most men I know but for some reason within this journey, I think he feels he needs to be the strong one because I have been so raw and over emotional at times. I have felt at times that he has withdrawn from me because I am in the middle of an emotional crisis and he can't fix it nor can he understand it. But at the same time I think he has pulled away because he is afraid that his display of emotions would make things worse. All I know is that there have been several moments over the past several years that I have felt that he just didn't care enough about the "issue". Don't get me wrong... the majority of the time, he will just hold me when I cry and for the most part that is enough but ...

Hop along to another stop on this blog tour by visiting the main list at You can also sign up for the next book on this online book club: The Mistress's Daughter by A.M. Homes (with author participation!)


Jendeis said...

Just wanted to say that I enjoyed reading your responses to the questions. :)

loribeth said...

Thanks for some interesting reading. I especially appreciate your thoughts on multiples. You never know how you're going to deal with a situation until you're in the middle of it, and it doesn't always work out the way you think it will.

The Town Criers said...

It is an interesting idea about not gambling with more capital than you have. In other words, if you wouldn't carry 3, never transfer 3 because the possibility exists. It really is a big risk.

The Dunn Family said...

I have a hard time with the hard and fast limits on transfers. I know most high order multiples tend to be a result of IUI and not IVF. But I wasn't willing to transfer more than 2, because I didn't want to reduce, but I was willing to have twins. And being that it was my first IVF, and we didn't know how I would respond, my dr wouldn't have put in more than 2 even if I pushed.

I have thought about the medical issues that might be a result of going through IVF, but I guess for me, I really wanted to have a biological child, and this was my only way there. I trusted in the research and in the doctors. And it helped that I know many IVF babies/children that are healthy and thriving. We won't know what will happen until later down the line for sure, but I just nourish my kids every day and hope for the best.

Thanks for your responses.

seattlegal said...

Regarding limits, I do believe that there probably should be some kind of limit, but I guess the question is who gets to decide what those limits are?

I transferred two embryos and ended up with twins. I was scared of having twins - my husband excited. We decided to transfer two because I just didn't want to risk it not working. I didn't want to have to go through IVF again. I'm glad we did what we did - I love my two babies and couldn't imagine my life any other way. I wouldn't have transferred more than 2 though.

Thank you for your responses!