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Who gets to choose?

The recent news of the milestone birthday of the Octuplets, and the story of a 59 year old British women electing to do IVF seems to have the online world all a-buzz  about fertility regulation.  And so many people are coming out with very strong opinions demanding regulation. 

What happened to the concepts of “my body, my choice”?  Why doesn’t that apply to fertility treatments too? 

Many voices seem to be calling for greater oversight and regulation of IVF – both in the US and abroad.  But really, is that what we want or need?  I’m not so sure. 

In many countries that have tightened their fertility regulations, they have literally forced patients to go abroad for services.  Either because certain procedures were no longer allowed or severely limited, or because the wait lists became so long that patients with ticking biological clocks simply can’t wait for years to have their treatments.  Do we want the US (or global) regulations to reduce access for everyone?  I don’t think so! 

Let’s tackle the concern about how many embryos should be transferred.  In my opinion, it should be however many embryos my doctor and I decide is best for my case at that time–not what Senator X or Government Organization Y decides (neither of whom generally have a clue about this technology).  Do I think it is prudent to only put back as many embryos as a mother can carry?  You bet!  But I want the right to make that decision with my doctor.

I also think that if IVF was less expensive (by insurance coverage or other methods to bring down the cost), more patients would take a more conservative approach and maybe even opt for E-SET (elective single embryo transfer).  But let’s be fair – if you only have enough money for one IVF cycle, the chances are you may be more aggressive and try to put back more embryos to increase your odds of success.  

I think cost has been one of the main reasons why so many patients are turning to countries in Europe & other areas for IVF services.  The costs are most certainly lower than in the US – but each country (and clinic) may have their own regulations about what is allowed, so it is always best to do your research in advance so you are well-informed about what is legal and available.  

Bottom line, I don’t want the rare exception (like Octomom) to create an outrage that generates legislation that effectively impacts the ability of the rest of us to make our own well-informed and well-reasoned choices.   Do you?

This has turned into a rather long post, so I’ll postpone sharing my thoughts on the “how old is too old” dilemma until my next post.

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2 Responses to Who gets to choose?

  1. Victoria says:

    Interestingly, I had this very discussion with my RE, regarding regulation of how many embryos could be transferred. Surprisingly, and some what ironically (given that in one cycle I transferred 7 embryos! (and with no success)), he said he’d (and he felt other REs) would welcome the regulation. He would be fine with a “will transfer no more than” rule based on the age of the woman and whether they were own egg or donor egg conceived embryos.

    I think that more than the media exploitation of the extreme ART stories, the rapidly improving success rates of SET will drive regulation. The need to improve success rates while decreasing multiples pregnancies (especially HOM) is going to get attention (if it goes that way).

    • Sue T says:

      Thanks for your note. That is interesting – but I still feel like it takes away some of my choices. After all, a doctor can certainly say “no” if he feels it is ethically or medically inappropriate. I just get concerned when someone else is going to impose arbitrary rules that leave no room for a doctor and patient to choose the best option for a specific situation.