Monday, August 22, 2005


Paying the price of indecision

Last week, I sent another cheque for $300 to our fertility clinic, and bought myself another year of indecision.

Tristan was conceived through in vitro fertilization (IVF) in the summer of 2001. At the time he was conceived, a total of three embryos were created. Because of my relative youth and reproductive health, the doctors advised us that they were only willing to put two of the three embryos back into my uterus, as twins was a more mitigable risk than triplets.

It was a hard decision for us to accept, at the time. We had gambled everything we had, financially and emotionally, on the success of IVF, and we had a hard time understanding how transferring three embryos wouldn’t improve our odds of success by 50% more than transferring two embryos. And it left us with the question of what to do with one lonely leftover embryo.

We followed the doctors’ advice, and transferred two embryos. The third was cryo-preserved – frozen in suspended animation at 3 days old. When I found out a little less than two weeks later that I was pregnant with twins (we lost one at 9 weeks), we were relieved that we hadn’t transferred all three.

Every year around the anniversary of our IVF treatment, we get another bill from the clinic for rent. Apparently freezer space is even more valuable real estate than downtown Manhattan, because we pay $300 a year for about a half a cubic centimetre of space. The embryo itself is nearly microscopic, and it is stored in a tiny glass pipette thinner than the ink stem in a bic pen. Friends of mine who have frozen embryos from more than one treatment cycle pay $300 for each tiny pipette of embryos. IVF is not for the financially faint of heart. (And despite the many praises of socialized medicine in Canada, we are on our own with the costs. Everything is out of pocket, and in five years of looking I have yet to come across a private health-care insurance company in Canada that covers any part of an IVF cycle, aside from the drugs.)

Our original plan was to go back to the clinic when Tristan was two or three and ask them to thaw and transfer our little “frosty”. The chances of the embryo surviving the thaw are somewhere around 30 per cent. The chances of the embryo successfully implanting and leading to a full-term pregnancy are about 30 to 40 per cent after that. But before we could put that plan in motion, out of the blue came my sure thing – Simon, the surprise baby.

So, each year I scratch out a cheque for $300 to keep our frosty on ice and buy another year to think about the future of our family. We had never really planned for three kids. Our finances are modest, as is our little townhouse. If we were blessed with a third child, we’d have to double kids up in a room and get a mini-van (this last being perhaps the most insurmountable hurdle. Me, driving a mini-van? Yikes.) I have serious concerns about the “middle child” dynamic, and about having the kids outnumbering the parents.

What really keeps me awake at night is the biggest “what if” of all – what if it’s a girl? A daughter. A mini-me. An XX ally in a house teeming with men. There is no way to find out the embryo’s gender, despite what many people seem to think about IVF. While it is possible to determine the embryo’s gender, that would only be done if you were already doing some heavy-duty genetic screening (at a wicked cost, by the way, and only at the prerogative of your clinic), but you can’t just order these tests à la carte for your family planning convenience. And if indeed we are blessed with another pregnancy, and it turns out to be a hat trick in my collection of boys, that would be okay, too.

There’s no real hurry. I read last month that a baby was born fully 13 years after she and her siblings were conceived. (It’s a fascinating story, although I almost didn’t want to add the link because of the bit about the clinic being shut down for taking people’s eggs. I expend a lot of effort fighting against those kinds of ideas when I talk to people about reproductive technology.)

So I scratch out my cheque each year, and think almost every day about our little totsicle, sleeping in a nitrogen bath. Although I am not in any way opposed to donating embryos to other families, or even to science, I don’t think that is the destiny of this little embryo. We can’t leave (him? her? it?) frozen forever, but each $300 buys us another year to think about it.


Labels: ,