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Wednesday, February 11, 2009

An Open Note to the People Googling about the Octuplet Woman

Dear People Who Have Been Googling About the Octuplet Woman:

I'm glad the news story has made you curious and you're seeking information about fertility treatments. Since you have ended up here, I thought I'd compile all of your general questions that have been bringing you to my blog into one post and address them all at once.

We're with you--octuplets are just not a great idea. And no, the community in general is not happy about all of the news coverage concerning the octuplet mum. We'd love to see news stories about the other 99.9% of us--the ones that had success with fertility treatments (since not everyone does--you can go through IVF and still not have a child in the end) and have one or two kids and live happily ever after. But since the general public tends to like their news with a side order of extreme, those aren't the stories that end up on the Today Show. But we agree, we also are watching the story unfold with our mouths open.

Is it normal to transfer 6 embryos (by the way--the correct term is "transfer" with IVF. A doctor can transfer embryos and there are even additional techniques that they think help embryos implant, but a doctor cannot manipulate the embryo to dig into the uterine wall and stick around for 9 months. So let's use the term "transfer" which is placing the embryos inside the uterus and hoping for the best)? Well, no.

The goal of IVF (and all fertility treatments) is to produce one healthy baby. Multiples are a side effect of treatments but not the goal. Because IVF is so expense and most people are paying out of pocket, doctors will transfer two embryos in order to increase the chances for implantation. Even with transferring two embryos, more often than not, if the cycle is successful, the person ends up with a singleton. There are also cases usually based on age or past experience where a doctor will transfer more than two embryos.

But six? Well, that's pushing it. Especially since one news story reported that IVF has worked for her on the first try every time. If that were the case, it would make more sense to engage in eSET which stands for elective single embryo transfer. Of course, the news could have it wrong. Her medical records should be a private matter and perhaps there was good reason to transfer six embryos all at once.

Is IVF selfish? Well, I already answered that question back here.

Yes, there are more options with fertility treatments than just IVF. IVF is just one of many things a person can try including surgery, oral medications, injectable medications, IUI, PGD, ICSI, and assisted hatching. In fact, IVF itself is not a static procedure--there are dozens of protocols used as a starting point and then each cycle is tailored for each individual with daily sonograms and hormone monitoring to ensure the best possible outcome.

Do people have IVF because they're lazy? Well, I just told you that there are daily sonograms and hormone monitoring. Beyond that, there are daily injections of different medications, a surgical procedure, and an uncomfortable transfer. I think it's safe to say that just as people don't have g-tubes inserted because they just don't have time to eat, people don't engage in IVF just for the hell of it.

Listen, we're on your side with this. In general, this is a highly educated and rational community. We want exactly what you want--a healthy child--it's just that we need assistance to make that possible whereas you can reproduce privately at home. I think a good rule that most of us believe in the community is that just because something is possible doesn't mean it should be done.

Most of us think that medicine works best when it mimics what should happen if all body parts were functioning properly. For instance, I think the guideline of using a woman's gametes until 45 and donor eggs until 55 is fair because it is based on the reality that 5% of women can conceive without assistance using their own gametes at 45 (so it's possible) and 55 is the general age (again, we have to speak generally because every body is different) where menopause is complete. A body couldn't have a child without assistance simply due to the course of nature, therefore, we shouldn't override that just because we can. But I also believe that each case is different and I can also see where a 56 year old should not be denied donor gametes simply based on a cut-off point.

IVF is meant to mimic a naturally-conceived pregnancy. It's aim is not to produce multiples, though it is a reality of the procedure. Still, bodies naturally produce twins and even triplets. The chance of a body naturally conceiving higher order multiples such as octuplets is so far out of the realm of possibility in nature that I don't think it should be done just because it can be done regardless of where the person is in life.

So, to sum up, we're with you on thinking the octuplets probably were not well-planned. We're sort of creeped out that she has a PR person and is doing television appearances. I sort of expected that she'd be at the NICU and not on the Today Show. But that's just me. I know when our twins were in the NICU, I didn't have time to eat a proper meal much less get hair and make-up done for a television appearance. IVF is not selfish or for lazy people or for crazy people. It is merely a tool that is used to circumvent a problem (infertility) and like all tools, it can be used irresponsibly.

Oh, and for the person who googled "how did ancient queen check up their genital...with photo," well, I can't answer that question and I'm sorry that you ended up somehow on a post about progesterone supplements. I would guess that they squatted over a mirror or had their ladies-in-waiting check out the goods...if they checked them out at all? I just haven't come across a lot of information about genital checking in ancient times. Especially with queens.

Love,
Mel

P.S. If you want to hear more of my thoughts, I actually wrote about this topic recently on BlogHer.

47 comments:

meandbaby said...

Well said! And LOL on the last paragraph.

anofferingoflove said...

Amen!

tragicoptimist said...

Fantastic and well said. I have a feeling I'll be pointing people this way a lot. Your last paragraph about the search for the ancient queen looking for her genital (with photo) had me cracking up.

Cassandra said...

Eloquent food for thought for a public hungry for information on Octomom (as I was amused to see her called on the cover of the NY Post).

Years after quitting teaching, you continue to be an amazing educator.

Somewhat Ordinary said...

I was wondering when this might pop over here! Thank you, thank you, thank you for speaking on behalf of the community. I agree 100%!

Danse said...

Well said. I literally just blogged about the same thing.

Kristin said...

Well said. And, that last little bit had me laughing.

noswimmers said...

Amen, sister! "Implanting" embryos---gahh! My biggest pet peeve!! Don't we WISH they could implant embryos?

Tara said...

Thank you so much, Mel. This needed to be said (badly) and you have done it in the most elequent (and entertaining) way (as usual).

Kathy V said...

I am really glad you decided to blog about this topic here and at blogher. You are very thoughtful in everything you said. Thank you for posting this so that people outside of this community won't think that everybody that is in this community and uses these tools will be like the woman who had octuplets. These cases are not the norm and should not be used to judge everyone who undergoes any procedures to help with the treatment of infertility.

Cathy said...

I know, totally not the topic of the post, but you cracked me up with the g-tube part.

Mostly because I was tube-feeding a squirming toddler who wanted to be DONE but had an oz to go. "Well, sweetie, if you had just taken it from the bottle, we'd BE done...". Necessary, but far from convenient or easy.

Rather like IVF.

bbrsbaby said...

Mel you ROCK!

I am dying over here, that post made my week!

I'm putting a link to this on my blog, let me know if thats not ok!!

Thanks!

Cara said...

HA! Just...Ha!

Ellen K. said...

Heh, good point about the NICU.

Wordgirl said...

Hear hear!

And I thought to myself today "great, now that Dr.Phil is going to have a bunch of nut-jobs yakking about their ideas about IVF am I going to have to write about octo-mom again -- but this time defending ivf, rather than questioning her doctors ethics?" -- thankfully, no -- because you've done it so beautifully and with your characteristic wit.

Pam

JamieD said...

You should have made this a petition rather than a post so we could all sign our names to it.

Well said, friend!

My Reality said...

Amen! Way to go Mel! I hope the news junkies all over this story find this and use the information to help educate the general public.

G & H said...

Your so funny! Great posts! Also did anyone else notice that she said she had a ectopic pregnancy with ivf?? If I am thinking correctly thats impossible. Ectopic is when the embryo implants in the tubes, IVF sets the emryos in the uterus so how could she had a ectopic!!! AND if she's lying about that what else is she lying about!

Chili said...

So well written!

'Murgdan' said...

Dear Lollipop,

BRAVO!!! I'm so sick of hearing about this woman. Well said. Well said. I want to go read it again!

Signed,

Lazy

loribeth said...

Bravo, Mel!!

one-hit_wonder said...

Great open letter! And loved the last paragraph.

I would also like to inform the general fertile populace that IVF is NOT a surefire guarantee. Just because octo-mom gets pregnant every time on IVF does not mean that all infertile women are successful with IVF. Many women go home after IVF without babies.

Renovation Girl said...

Another AMEN! over here!!

MrsSpock said...

I'm totally avoiding blogging about this issue. I think you've said everything quite eloquently here.

Another Dreamer said...

LOL! Well put. Wonderfully said.

jungletwins said...

Frikin hilarious, and so true!

Sassy said...

This is a great post. But there was one bit that bothered me. 99.9% of infertiles don't end up with one or two children. Correct that bit, and then plaster on every street corner.

itsazooaroundhere said...

Thanks Mel. I hope many, many people take the time to educate themselves and use your post to do so.

And "harvest"...."implant"....UGH!!

sassy said...

Very well put. Oh, and here in rance my RE is scratching her head over the 'human marsupial'. I guess they do have laws about these things here, which is probably a good thing.

battynurse said...

Very well said and I love the last paragraph.

Brenna said...

I linked to your BlogHer column about this last week. The posts coming out of this community re: Octomom (love it) are the only ones I care to read. The whole thing is just so confounding...thanks for tackling the topic again here!

TeamWinks said...

Another "Well said!" from me!

Jen said...

Perfect, Mel! Now send a copy of this to all the news stations.

Heather said...

I'm confused on the whole implant thing...didn't they actual do a new procedure on her where they put them under the surface of the uterine wall - as in implanting them?

beagle said...

You tell 'em Lolli!

They ought to have YOU on the Today Show.

projectkjetil said...

Well put.

Wouldn't it be amazing if your words got picked up by a news organization, and were used to convey a more moderate viewpoint, one which isn't anti-IVF AND is pro-careful-decisionmaking?

Hmmmm... the only one that I can think of that hasn't been obsessed with "Octomom" has been NPR (and probably PBS). Oooh, maybe there could be a This American Life featuring Lollipop Goldstein.

Just an idea...

serenity said...

Well said. Much nicer than my post about her, anyway. :)

Barb said...

great post Mel.

Soralis said...

Great post again!

(ha ha the word verification for this comment is unwed)

Bea said...

Good answer. To both questions. The stuff some people google.

Bea

Molly said...

G&H asked if it was impossible to have an ectopic pregnancy with IVF, since they transfer the embryo(s) to the uterus, thus bypassing the tubes:

Unfortunately, no. Ectopic pregnancies are still possible with IVF and I've known a number of women who have gone through this. Though the embryos are transferred to the uterus, in the early days post-transfer, pre-implantation, they can still float off into the tubes. Women who already have tube issues and/or previous ectopics (and hence are doing IVF for this reason) may be at greater risk for this for various reasons. Even women whose tubes have been removed can have ectopics in some cases, with the embryo implanting at the little leftover bit of tube or in some other place entirely, though the odds are greatly reduced, I believe.

Heather said...

I've noticed as well that the media keeps using the term "implanted embryos". I grate my teeth every time I see that term. I think we all wish technology was that good.

I am finding this whole thing of her octuplets very upsetting and making it harder for people to understand those of us that go through ART to have our children. We don't want that many! Our doctors want quality not quantity. I really think that her doctor was having issues with his success statistics and was trying to improve them by transferring way too many embryos and putting both the mother and babies at risk. Careless, man.

Molly said...

What I'm amazed by is the number of doctors who've been interviewed and keep talking about implanting interviews. I guess in a colloquial sense it can be accurate.

Kim said...

Amen!

nonlineargirl said...

I am knocked out by how many people think "nora is having twins, I should forward her news about the octuplets". 'Cause you know, it is totally the same thing.

millie said...

Great post!

The whole "implant" thing was really getting under my skin as well but unfortunately that's the term that doctor uses as he claims that's what he does. To get those stellar stats of his. ;)

Phoebe said...

Thanks for posting what I would have, but have been to disgusted to talk about. Creeped out indeed!