NPR segment on multiples and infertility

For all those mothers of multiples (with extra help!) out there, or those that didn’t have help, but are interested anyway, this NPR segment aired Monday. It is on multiples and how they are changing our lives—and I’m pretty sure she’s not talking about the specifics of MY life but the bigger EVERYONE’s. I found it disturbing on a number of levels, but perhaps that’s simply because I’m one of “those moms”, as she discusses, who would rather have had two babies at once than tried to do IVF again? My own personal feelings aside, I’m curious as to what others think of this? There are certainly some interesting ethical dilemmas which are highlighted, but I do think she misses out the positives of twins or more.

http://www.npr.org/templates/rundowns/rundown.php?prgId=13&prgDate=2-23-2009

11 thoughts on “NPR segment on multiples and infertility

  1. I’ll be checking this out and coming back with comments. You can get the podcast for free via iTunes if you don’t want to live stream it over your computer. VERY handy for listening to on your mp3 player while folding laundry or doing dishes :)

  2. I don’t know. My reaction is mixed having listened all the way through. My initial reaction was pretty negative. I was just bristling. So much negativity on multiples. So much dwelling on the risks. And I think there was very little consideration given, at least in the first part of the interview, to the emotional toll that people pay when going through all of these treatments.

    But I did think she made some good points. I suspect there really is an issue around “what is informed consent?” How can you really convey the risks and hardships of having multiples? It really is hard, and I think there are people out there who still have romantic ideas about having twins that don’t do justice to how hard it is, and I think it’s hard to really adequately “warn” people about that.

    So, I don’t know. I liked the later part better, and thought it was interesting about the new moral questions raised by the available technologies. But the initial treatment of twins as an epidemic… that, obviously, I was not a fan of.

  3. I listened to this piece and found it refreshing to listen to someone who had clearly educated herself on this topic and presented the tough but real ethical dilemmas that arise. As a mother of twins and a physician, I was skeptical. The physician in me felt like she did a good job presenting the data. The mother in me of course wanted her to talk about how totally awesome it is to have multiple babies. I took a slightly different view on this piece because I saw it much more as a piece about assisted technologies rather than having/raising multiples.

  4. As someone who had twins after IVF and a VERY complicated and risky pregnancy (and almost lost both of them), I’m still amazed at how little I knew about the risks. I was told “twins are a little riskier”, that’s it. That’s not informed consent, especially not when you’re a highly subjective and desperate infertile. I love my twins to pieces, and it turned out OK in the end, but for many, it doesn’t. I think couples should be better informed about the risks, and that one at a time is a better way to go whenever possible. Now that you have your babies, would you knowingly do something that dramatically raised the chances of death or seriously complications? Because, no matter how much we’d rather not hear it, that’s the reality when it comes to multiple pregnancies. I was also defensive when I heard the beginning of this peice, but by the end, I thought it was a great piece. We all love our babies, but the end doesn’t justify the often unnecessary risk inherent in the means, and the industry is clearly in need of reform and regulation.

  5. It has been a long week for me of listening to videos, podcasts and strangers on the street all wanting to talk about multiples. The risks, the downside, the questions…..

    Yes, having 2 is hard but it is also a blessing. A blessing I would have never known without IVF, without taking some risks to bring our precious babies into the world.

    Then again we had a GREAT experience and very healthy babies, maybe I would think differently if this wasn’t the case.

  6. I just listened to this while folding laundry. I have tons of opinions, comments, questions, etc… but in the interest of time I’ll just leave three things -

    1. It frustrated me the entire time that the host kept using the word “implant” when referring to transferring an embryo. I don’t know a lot about fertility treatments, but I know that they don’t yet have the technology to IMPLANT embryos but that the doctor TRANSFERS them. There is a misconception in our society that the doctor implants embryos and thus has an almost 100% success rate with each embryo. All of the articles I read about the octuplets used the word “implant” and I think this is misleading. I’m surprised that professional journalists use the word implant instead of transfer. (though Liza, the author of the book, and not the host, did use the word “transfer”.) But I thought she should have corrected the host and explained the misconception.

    2. Can someone who knows more about fertility treatments explain to me why there are leftover embryos? I’m so confused why the doctor even fertilized 11 embryos for the mom in California that had octuplets (supposedly 5 embryos for her current six children and 6 were transferred – two split- for her octuplets) because she didn’t want 11 children. It’s my understanding that she (and others) feel like they have to transfer all of their embryos, which can result in multiple births or just more children overall. Why do they fertilize so many?

    3. I always wonder when I listen to stuff like this if the author got pregnant on her first try every time and just takes her fertility for granted. She seemed to have little compassion and understanding for the serious heartbreak women (and men) with fertility issues feel.

  7. That broadcast was intense. I’m struggling with how I feel about it. There was a negative tone to the discussion I didn’t like, an implication multiples are a problem to be solved. That certainly isn’t how I see my children. At the same time, I do think that most people do not know the risks of a multiple pregnancy. My twin pregnancy was a train wreck. I had to be medevaced off my island, spent 5wks in the hospital prior to the birth, had the girls at 33wks, and they had to spend time in the NICU. Still, we were very lucky. NPR and other news agencies would have you believe that NICUs and intermediate nurseries are teeming with twins. That was not our experience. Our twins were the only multiples there. There is a sad flip side to that fact though. We met parents for 2 others sets of twins. In both cases, one baby had died, and the survival of the remaining siblings looked uncertain. I think about those parents all the time. I feel guilty.

    There’s just no telling. That’s what drives me crazy. My cousin had a perfect, full-term twin pregnancy then almost died in childbirth. My best friend is a “surprise baby” twin. Her mother and mother’s doctor had no idea there were two in there until they spied another head after the first had been delivered. It all went off without a hitch. I just don’t know. Medical professionals should better inform mothers of the risk. At the same time, I wouldn’t want to terrify them.

  8. I, like other previous posts, was a little defensive during the first half of the broadcast. It started with a very negative tone and much of the content did focus on “prevention” — prevention of multiple pregnancies and of the risks associated with them. But to be quite honest, I was very naive to the negative outcomes experienced by some parents of multiples until very recently when I came across a blog of a mother who lost her twin sons in utero at 23 weeks. Unfortunately, I have now come across other similar blogs in my travels. I do agree that those families’ stories receive far less, if any, attention in the mainstream media. However, Jon and Kate Gosselin are household names.

    Having been through IVF, I distinctly remember signing paperwork concerning what we wanted to do with our leftover embryos at the very onset of the process. Therein lies at least part of the problem. At the onset of the process, all I wanted to hear about were success rates and positive outcomes. Once I had a child, I would worry about the rest. I quickly gazed over the legalese and opted to freeze any remaining embryos, thinking I could always change my mind later. As it turns out, we never had the chance to make that decision because our embryos were of “too poor a quality” to freeze — tell that to both embryos, now A&E, who are 17 months old! Thinking about it now, and not seeing things through the painful lense of infertility, I realize that making the decision about how many embryos to transfer and what to do with the remaining ones, is not so easy. I admit that I am relieved that we didn’t have to make a difficult decision regarding the fate of our remaining 11 embryos.

    I believe that no doctor can adequately explain options and consequences when such emotional and moral decisions are involved, or more accurately, that many couples are really listening beyond success rates. I would have liked to hear the author touch a little more on the emotions behind infertility treatments, as I feel it’s a major factor that is inextricably tied to the decision-making process.

  9. I will listen to the podcast later, but I have read Ms. Mundy’s book and thought it was very good, particularly the chapter on multiples. At the time my husband and I were taking a yearlong break from infertility treatment, and I had some ethical questions that were well discussed in the book. And I credit this book with helping bolster my decision to stick with the RE who had the most ethical reputation and lowest embryo transfer number in the area, even though we were paying out of pocket and the financial stakes were high.

    I had an “easy” twin pregnancy but it all went to hell in the delivery room. I do think that often patients and doctors are lulled into complacency. Certainly my RE was more worried for me than my basic obgyn.

  10. As I read these comments, I realized that much of my experience is colored by the fact that we went to a very conservative center, which is well-know for doing single embryo transfers. In fact, we had one the first time we did IVF. I think they went nuts around highlighting the issues and risks with twins—and were quite upset when I got pregnant with twins after a FET. I think they had informed consent covered, to the point where they wouldn’t let me transfer two the first time. Obviously, this might be a rather unique kind of place.

    Luckygirl—when you do a “fresh” cycle, which includes stimming drugs and surgery to retrieve the eggs, they get as many mature eggs as they can, often 8-12 or so. Some won’t be mature, some won’t fertilize and some won’t grow out to 3 or 5 days, when the transfer will occur. So, say that they retrieve 10 eggs, 8 fertilize and 3 grow out to 5 days. They might put one back, and then the other two are frozen so that if the IVF cycle doesn’t work, the mom doesn’t have to do all the stim drugs and the surgery to retrieve the eggs again—a cycle using frozen embryos is much less risky and invasive for mom. And, more like $3,000 versus $12,000. At my clinic, you use frozen embryos before doing a fresh cycle—both to decrease risk to mom but also, I think, to prevent the problem you highlight, of having 5 or 10 frozen embryos “left over” once you have your babies.

  11. I finally got a chance to listen to this and my take on it was very different. I had “natural” multiples and didn’t find out there were 2 until 18 weeks. My OB practice was associated with a fertility clinic and they treated twins like a normal pregnancy bc they were so used to higher-order multiples. I had to do all my own research and reading and constantly push for answers on things. I don’t feel my practice did a good job at all explaining the risks of multiples to me… even when I went into serious PTL at 32 weeks and was hospitalized. They told me the babies would be fine, even though the statistics are very different. Twins have become so mainstream it’s not treated like a big deal, even by OBs.

    Anyway, I thought the author did a great job explaining this very complicated concept of fertility treatments, and the moral dilemmas that are faced at each step of the way.

    Thanks for sharing. It really made me think a lot about a topic that is “normal” for us but very un-normal for the general public.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>