Thursday, December 4, 2008

The fate of the frozen embryo


Today's New York Times yields yet another infertility article, this one on the difficulty former IVF patients face in deciding what to do with leftover frozen embryos.

According to the article, more and more couples are struggling to decide what to do with remaining frozen embryos when they want no more children. They are choosing to do everything from freezing the embryos indefinitely (at a not insignificant cost) to donating them to other couples (rarely) to donating them to research to saying prayers over the petri dish when the embryos are thawed and destroyed.

It's difficult to know what one would do in this situation. Given our struggle to produce a single offspring, I find it almost impossible to imagine that our problem could some day become the potential for too many children. And we have learned very well, through hard won and bitter experience, that an embryo (even several embryos) does NOT equal a baby. Not even when you actually get pregnant with said embryo.

At the same time, we do not see these embryos as just a piece of cultured tissue. They represent the potential for human life. And in that way, they are (the words are loaded but I don't know better ones) somewhat sacred.

Will and I personally entered the frozen embryo debate when we met with the RE to tell him we wanted to do another fresh cycle this time (while having six embryos frozen at the 2PN stage from our last attempt).

I believe the RE's exact words were: "What do you want, a library of embryos?"

Ouch.

I suddenly felt like the RE thought we were aiming to collect vast quantities of our genetic material to keep in jars in various rooms in our apartment. Just to gaze at.

His words surprised us, and definitely gave us pause. After reflecting, we explained our reasoning (to ourselves and to him) thusly: that we want multiple children if possible - gosh, a whole family of them if we could. That we worry I am headed into premature menopause because of my chemotherapy treatment almost a decade ago for lymphoma. That we can actually afford another IVF cycle right now because I have - just for this year - a very generous insurance policy that has a special arrangement with my IVF center. We reminded him that we are Irish Catholics (lapsed and mortally sinning Irish Catholics because we're doing IVF, but still.) That for us, a family with several children would not be a bad thing. We'll be grateful for one, mind you, but a whole passel of kids would be fine too.

But reading the Times story today made me realize for the first time another major factor underlying our decision to do a 3rd fresh IVF cycle: keeping six embryos on ice gives us a sense of continued hope. These embryos dull the full keening urgency we feel about starting a family. Their existence gives us a sense (falsely perhaps) that as long as we have them, we still have the potential to be biological parents.

This article also made it clear that it will be much more complicated than we ever imagined should we someday encounter circumstances that compel us to not use these embryos and instead have to decide their fate. What would we do then?

It's a decision I hope we never have to make.

Mo

13 comments:

I Believe in Miracles said...

Thanks for stopping by and the sweet comment. It is greatly appreciated.

I love this post. I've had this dilemma in my head too. But I don't have embryos on ice (after a transfer yet) so I have no idea. Sort of going - not counting my chickens before they hatch policy.

Good luck with your decision.

April said...

I struggle with this as well. I had nothing to freeze from my first IVF attempt, so all of my musings are just that--not based on any type of fact or personal experience.

I agree that they give continued hope. When we first started IVF prep, my RE said, "You will have a bunch of 32 year old embryos to use when you are 38 and we are all worried about genetic anomolies." That got me thinking that having some stuff on ice would be nice...it would give me some options for later, since this early part has taken much longer than we could have anticipated.

Then, this summer/fall, I diagnosed my mom with Parkinsons. That makes me want to help by donating to embryonic stem cell research....which just became legal in MI.

I have no idea what we will do if we are ever in the situation. Even though the first IVF baby just turned 30 this year, the science is still relatively young and riddled with moral, ethical, and social issues.

Take home message: It's a toughie :)

Michelle said...

This is a great post. I have often thought about what I would do in the situation and I have determined that I just don't know. I know what I THINK I would do but until I get there I really can't say. IF does a lot of crazy things to your mind and I just never know when I might change it. Good Luck with whatever decision you make. Im sure it will be right NO MATTER WHAT.

Lisa said...

Great post - it would be a crazy hard decision -one that I have not been faced with yet since we either never had extras or they did not make it to freeze. The only thing that matters is that you and your dh are comfortable with the decisions that are made.

Kischa said...

This is truly a great subject to post. Even though I have stage IV endo and my re strongly suggested that I go straight to ivf- my dh and I opted to try and beat the odds with iui for precisely this reason. We only want 1 more child and did not want to have to dispose of any of our embryos. We are very pro-life. We are currently in our 1st cycle praying for a miracle.

Virginia said...

Do you read the Times entirely and daily or do you have a news alerts there You are my numero uno NYT fert source. ;-) Love it! Come to think it, maybe I should get a google IVF news alert. That would feed my monster quite well.

Betty Rubble said...

My head seriously snapped at your RE's comment. I know this is a grey area for anyone--right up there with selective reduction. I understand that for him/her that its just "business" but as you said, those 6 budding babies represent hope.

We have a friend who had to undergo 3 IVF's before having their son, and who had 3 embryo's left. They only wanted 1 child EVER, but they decided that they couldn't destroy them, adopt them or donate them. So they tried one more time w/all 3. Guess, what they are still only the parents of one.

So I say keep stocking the library for as long as you want. It is not up to the RE to make any decisions regarding your family for you!

sprogblogger said...

That is a hard question to answer, and I hope you both find peace with whatever you decide. Personally, knowing from hard experience that an embryo does not equal a baby, I think your doctor's comment was out of line. If my eggs were of a good enough quality to freeze, I'd think that having some embryos on ice would be a huge relief from the ticking-clock-of-doom stress that we're all dealing with.

Whatever you decide, it'll be well thought through, and it'll be the right decision. Sorry your doc is making it harder than it needs to be.

musicmakermomma said...

I think we all wonder about this, but since I had only 1 viable embryo (from a donor cycle!) last time, we didn't have to think about it. I can see why you would want to get your eggs while the getting is good (or at least better) so I totally support your plan to have another fresh cycle before you use the frosties. Good luck, and I hope you end up with a whole passel!

Rachie Pachie said...

Hmm, I can completely understand what you mean. There's still hope with those embies there.

And how rude that your doctor would say that!? I think I'd be pretty inclined to use someone else. I agree with your path... with the insurance & the months that could go by...

Thanks for the post!!

Clio said...

your reasons sound good enough to me. But definitely, it's one thing signing about what fate to give to hypothetical embryos, quite another to be faced with a real life decision.
so, Mo,. are you triggering tonight?
you are in my thoughts and my nondenominational prayers. :)

PJ said...

YAY!!! Egg Retrieval is an exciting thing! The FSH makes me tired, so I am looking forward to having the retrieval and having that stuff leave my system. That said... then I'm ready to be tired again from getting pregnant! Maybe?

Anyway, I hope you get oodles of grade A eggs, and of course a BFP that sticks for the long haul.

Echloe said...

This is something that I (also a Catholic IVF sinner) am struggling with. I don't want to destroy any embryos we freeze. but we don't have an endless cash supply to freeze them forever. I figured we would just cross that bridge when we came to it. But my RE had us sign papers saying what we would do with any frozen embryos. We said we would keep them frozen. But maybe adoption of the way to go. I don't think I could have them destroyed. I know I couldn't. In a perfect world we could just end up with a big family. But I don't really see that happening either seeing that my body is so uncooperative. I'll pray for both of us that this all somehow works out.

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