March 18, 2009
Today’s topic is a controversial one; a topic that is extremely relevant to many people dealing with infertility, yet which I’ve barely heard even mentioned in the blogosphere. As you may have noticed, I’m no shrinking violet. I’m not afraid to tackle the topic head-on — even if the thought of actually dealing with it scares me shitless.
Let’s talk about selective reduction.
It’s a topic that I thought a lot about during IUI #5 (my first FSH cycle), then forgot about once I moved on to IVF. Now, after my preposterously high 2nd beta, it’s back on my mind.
I truly don’t know how many gummy bears I’ll see on the ultrasound next Tuesday — hopefully not zero, of course. Maybe it will only be one — that would be fantastic. Two would be fine. More than that and I start to get very worried. Lots more and I freak-the-hell-out. Mostly because of the incredible risks of carrying higher order multiples — prematurity, low birth weight, disabilities, death. With triplets, the odds are almost 50/50 that the pregnancy will be lost entirely or that one or more of the babies will die after birth. With more than triplets, the risk increases even more.
I’ve written before about the reasons why I would choose selective reduction, although I have always desperately hoped that I’d never be faced with that decision and although I know that it would break my heart and haunt me forever.
Of course, prevention is preferable. I would never transfer a large number of embryos in an IVF. Many patients or doctors choose to cancel FSH cycles when there are too many follicles. But, the option of canceling an IUI cycle due to a high number of follicles has never come up for me, because the odds of even one baby sticking have been so low. Cancellation never even occurred to me with this most recent IUI, because it was the cycle that I gave a 0% chance of working and was doing just to meet an insurance requirement.
So, let’s say that without irresponsible actions (for example, transferring 6 embryos after having multiple successful IVFs in the past), you ended up pregnant with higher-order multiples. How many would be enough to make you consider reduction? 2? 3? 4? 5? 6? More? Or would you never consider reduction no matter what, even if the lives of the babies were in jeopardy? What if your life were in jeopardy?
I won’t know my true answer unless/until I’m faced with it. But, I’m pretty sure that 4 would be too many. Maybe 3. DH’s number is definitely 3. He says they’re only “theoretical children” at this point anyway. This decision is much easier for him.
I am hoping so desperately that I won’t actually have to deal with this decision, but I think it’s good to think through preliminary plans while I’m relatively calm. And, since I’ve seen so little on this topic among ALI bloggers, I’m very curious to see what people think.
What would your number be?