IVF Regulation Coming To Your State Soon!

You know it's sad, perplexing, and frustrating having to justify the way in which you as an individual decides to create your family.

Back in 1995 the CDC (Center for Disease Control) did a study on infertility and found the following:

- Number of women ages 15-44 with impaired ability to have children: 6.1 million
- Number of women who've ever used infertility services: 9.2 million
- Number of married couples that are infertile: 2.1 million
- Number of women using infertility services: 9.3 million

About 7.1 percent of married couples, or 2.1 million, were infertile in 1995 compared
with 2.3 million in 1988 and 2.4 million in 1982. In each of these years, about 1.0 million were childless and infertile. To be honest I am not sure what the statistics are for 2008 -- my guess is that the number is significantly higher.

For many of us who struggle with the pain of infertility it's almost overwhelming. We don't always get help with expenses - many of us don't have infertility insurance that covers IVF cycles, shots, pills, etc...

Personally I was an active infertility patient since 19985 -- and when I read stuff like this it makes my blood boil:

http://www.onlineathens.com/stories/022709/new_399028027.shtml

"Hudgens' bill, which is backed by Georgia Right to Life and other Christian groups, also declares an in vitro - or "outside the womb" - embryo to be a person and clamps down on the practice of storing frozen embryos for possible future pregnancies. Only two embryos for women under 40 or three for women over 40 could be fertilized at one time. And living in vitro embryos could not be destroyed if the bill becomes law."

Hello? Since when do I want the government being my doctor? I do not. Not at all. In fact, I want the government to stay out of my uterus.

Sadly, Nadya Suleman is an anomaly, she is clearly mentally unbalanced, has deep seated emotional issues, and selected a physician who clearly acted irresponsibly. There are so many things that went wrong regarding Suleman situation that's it's difficult where to begin. Why she wasn't flagged for psych is beyond me.

And now there are eight more lives that have entered the world, all premature-- along with the six others she already brought into the world, and now she's scrambling to care for them all. And yes, what's done is done -- and the knee jerk reaction by politicians is to ban it, regulate it, control it.

But I don't think that's the answer.

I am not sure what the answer is -- but I think a great start would be for physicians and ASRM to take a harder stance on those doctors who break those rules. In fact, it would be great if ASRM could take a stance period -- and not be so worried about being sued. It's a no-brainer to see that this doctor did the wrong thing.

And now, guess who is paying the price aside from supporting all 14 of these kids with tax payer money?

Me and you. Now my reproductive rights may be taken away because of one selfish woman, and one irresponsible doctor.

Not fair if you ask me.

But then again -- My mom always told me life's not fair.

What Does This Mean For Us?

Cynthia Davis, of the Missouri State Legislature is looking to ban anonymous donations in the state of Missouri and give all donor-conceived offspring the right to access the donor's identity at age 21. She is hoping to have a hearing about her bill (HB355) within the next three months. She is looking for donor-conceived adults and families from Missouri to speak there.

The Summary of the Introduced Bill:

HB 355 -- Sperm and Egg Donations

Sponsor: Davis

This bill allows an adult child born as a result of a sperm or egg donation to obtain identifying information regarding the donor by requiring the name of the biological parent and the donor parent to be shown on the child's birth certificate.

The State Registrar will file the original birth certificate in the event the non-donor parent requests a new birth certificate. Unless contracted in writing, no legal relationship will exist between the child born as a result of a sperm or egg donation or the child's parent and the child's donor.

In the event of a birth as a result of a sperm or egg donor, any person or entity required to file a birth certificate must send the Department of Health and Senior Services documentation of the birth including the child's name, sex, and date and place of birth; the biological parent's name or other parent's name; and the donor parent's name. An adult child of a sperm or egg donation made prior to January 1, 2010, can make a written request to the circuit court in the county in which he or she resides to secure and disclose identifying information of his or her donor parent.

Donor parents can register with the Children's Division within the Department of Social Services if they choose to allow a child to obtain his or her identifying information. Any adult child born as a result of a sperm or egg donation will be subject to the same requirements as an adopted child when seeking identifying or non-identifying information regarding his or her donor parent.

Children born as a result of a sperm or egg donation made after January 1, 2010, can receive a copy of his or her original birth certificate indicating his or her donor's identifying and medical history information from the State Registrar and the donation facility.

As a parent of a child via egg donation, I have a problem with some of the language in this bill. An egg donor is not a parent. Period. A parent is a a father or mother; one who begets or one who gives birth to or nurtures and raises a child; a relative who plays the role of guardian.

How is an egg donor or a sperm donor for that matter a parent? This whole donor mother or donor father, or genetic mother or father terminology is concerning on a whole.

While I am grateful to my egg donor -- the fact of the matter is she gave me one cell. It is tissue -- that has 23 chromosomes, a strand of DNA, and that cell mixed with my husbands sperm cell created an embryo that *I* carried, nurtured, birthed, and am raising. Not the egg donor.

If The State of Missouri passed this bill does this mean every other state in the Union is going to follow suit?

I want the government to stay out of my uterus, thank you very much.

Where Is The Accountability?

I never like to use the word "blame" -- it has such a bad connotation in association with that word. I much prefer the word "Accountability" I have been reading other great blogs that have weighed in on the topic, and there are many of us who are wondering as well what to think. And rightly so because this situation is just so tragic and complicated.

And what topic is that you might ask? The birth of the Octuplet's of course.

I admit when I first heard about this -- I thought for sure it was a story out of the World News, or some other rag. I thought this couldn't possibly happen in the United States in the year 2009. Haven't we learned our lesson from the births of Chukwu septuplets or the McCaughey septuplets. But it did. Right in our own backyard.

There were so many unanswered questions -- and then we saw the interview with the mother, Nadya Suleman, and listened to her justification and we shook and we shook and we shook our heads. For some it was in disbelief, for others in sadness, and for yet others disgust.

The question now is -- Did this woman feel entitled? Or was she just lacking in judgment.

Not being a Psychologist nor a Psychiatrist I can't pretend to be in the mind of Nadya Suleman or know what her mental health background is about. I do muse out loud if Nadya had a psychological evaluation before she underwent this procedure. And I do also wonder what in the world her doctor was thinking.

The actions of her doctor and herself will possibly cause many issues for those of us who will be undergoing future 3rd Party Reproductive treatments in regards to regulation.

Do we really want the government in our uterus? Do we really want to be dictated to in regards to how many children we are aloud to have?

Of course we don't -- and so far our doctors have been self regulated. We have associations, and organizations, committee's and peer pressure, but in this case this doctor seems to not only be lacking in common sense but ethics. I can't imagine that he couldn't think that transferring that many embryos could possible not do any harm. And so that leaves me with thinking that his motivation was purely greed.

So - this brings me back to the title of today's blog. Who's accountable? Where does the accountability begin?

With Nadya? After all she could have just said "No" 0r does that accountability begin with her doctor? Who is the trained professional -- and while he's not a Psychiatrist or a Psychologist he did know this woman already had six children -- maybe that should have been a red flag? Maybe he should have referred her on to a mental health specialist to talk about her need for more children, and what her mental status was regarding her state of mind?

At the end of the day -- what's done is done, her children are all here, and you, me, and everyone else is going to be paying for them, and their care.

So what can we do to prevent something like this from happening again?

Fertility Drugs 101

I have received feedback from my post about the Octuplets, and how dare I be so judgmental because after all, the woman who had the eight babies most likely used Clomid.

Because I am all about being fair I think it’s important to understand the drugs that are used in ART.

Clomid is the brand name for the fertility drug clomiphene citrate. Clomiphene citrate may also be sold under the brand name Serophene. Whether you’re taking the brand name Clomid, Serophene, or a generic version of clomiphene citrate, it’s all the same drug. (Think of Clomid in the same way that we use Kleenex® to refer to facial tissues.)

Clomid is the most well-known fertility drug, probably because it is the most commonly used. And with good reason. About 25% of female factor infertility involves a problem with ovulation, and clomiphene citrate, as a fertility drug, is easy to use (taken as a pill, not an injection), with not too many side effects, is pretty inexpensive compared to other fertility drugs, and is effective in stimulating ovulation 80% of the time.

Clomid is used when there are problems with ovulation, but no problems with blocked fallopian tubes. (We know the woman with the octuplets had blocked tubes so she wouldn't have been a candidate for Clomid - In that case, stimulating ovulation would be pointless –- the egg and sperm can’t meet if the tubes are blocked. And furthermore reports are this woman had embryos transferred back into her uterus.) If a woman has irregular cycles, or anovulatory cycles (menstruation without ovulation), Clomid may be tried first.

Clomid is often used in the treatment of polycystic ovarian syndrome (PCOS) related infertility. It may also be used in cases of unexplained infertility, or when a couple prefers not to use the more expensive and invasive fertility treatments, like IVF.

The side effect you’re probably most familiar with is the risk of multiples. You have a 10% chance of having twins when taking Clomid, but triplets or multiples of more are rare, happening less than 1% of the time.

If Clomid on its own isn't successful, your doctor may recommend injectable hormones to stimulate ovulation. Some of the types are referred to as the big guns:

* Human Chorionic Gonadotropin (hCG), such as Pregnyl, Novarel, Ovidrel, and Profasi. This drug is usually used along with other fertility drugs to trigger the ovaries to release the mature egg or eggs.
* Follicle Stimulating Hormone (FSH), such as Follistim, Fertinex, Bravelle, and Gonal-F – These are the drugs that create many many follicles, not just two or three depending on ovarian response.
* Human Menopausal Gonadotropin (hMG), such as Pergonal, Repronex, and Metrodin. This drug combines both FSH and LH. – Another powerful drug which is commonly referred to as a “stim drug” for mass ovulation.
* Gonadotropin Releasing Hormone (Gn-RH), such as Factrel and Lutrepulse. This hormone stimulates the release of FSH and LH from the pituitary gland. These hormones are rarely prescribed in the U.S.
* Gonadotropin Releasing Hormone Agonist (GnRH agonist), such as Lupron, Zoladex, and Synarel
* Gonadotropin Releasing Hormone Antagonist (GnRH antagonist), such as Antagon and Cetrotide.

The scary part about all of this is that someone screwed up, and I think the screw-ups were on many levels.

If this was an IVF transfer, shame on the doctor for even suggesting or allowing that many embryos to be transferred into this woman. Shame on the mother for allowing it to happen in the first place.

If this was an injectable cycle, IUI cycle that went wrong, I am still shaking my head in disbelief at the irresponsibility that has taken place.