Tuesday, February 10, 2009

Implantation vs. Transfer

Yes, I'm still around, still reading quite a few blogs (I even comment sometimes). Many of the last posts I've read have been about how angry women are at the fact that the media (in general) can't get the term right - specifically, they're referring to the Nadia Suleman octoplet story, which is all over the news.

I think that everything that needs to be said has been, but I'll just give my personal take on a few things:

First, any doctor who agreed to transfer as many embryos as s/he did (the current claim is 6) was extremely irresponsible - because I believe that the goal of IVF should be a singleton pregnancy (this from a mother of twins... and has also read studies on eSET and its alternatives and the results of such decisions - and I am very pro eSET for the recommended group - I'm sure I had another post, but I can't find it...)

Second, Ms. Suleman is clearly a masochist because otherwise I can't understand her agreeing to transfer so many embryos. I can understand an "addiction" to being pregnant, giving birth and having a neborn or infant, but the toddler stage is... well... very draining, if you ask me. Especially when you've got a few strong-willed toddlers with a high tolerance for screaming and fighting (not to mention any names from my personal experience). For a long time I could not imagine reaching a point when I would not want another baby. Since Yirmi was born, I feel that our family is complete. I don't think it's a doctor's decision to make, though (when a family is complete, regardless of the circumstances). [To address comments I've read like, "How could anyone treat a woman who already had 6 kids?"]

Third, parents don't always think things through, but after 6 kids, you should know the implications of having more children. Counting on others to support you (if that was her plan) is reason enough not to have another (even "just" one). Again, if that was her plan.

I can't talk about selective reduction because I would have avoided the need to consider it to begin with in her case. (Though admittedly, personally I was just lucky because in 1993, it was common to transfer 4 embryos, which I did - and ended up with one baby. In 1995, I transferred 4, but only one was considered really good enough to transfer - explain fraternal twins? By 2001, I knew enough to transfer 'only' 2.)

And now to the part you've all been waiting for. Implanting or transferring embryos. Clearly the medical term is transfer. It would be nice if the media would use the correct term, but is implanting really wrong? Implant means "to insert in living tissue (as for growth...)" or "to fix or set securely or deeply". And what happens during embryo transfer? The doctor inserts the catheter into the uterine lining and places the embryos there. IN the uterine lining. S/he doesn't just randomly shoot them into the uterus and let them land wherever they please. If that were the case, probably most of them would just immediately fall out, when actuallythe effect is more like super glue. So... in fact, the embryos are literally being implanted into the uterus. Kind of like plants that you put in the ground. Sometimes they take root and sometimes they don't. Getting upset about the terminology seems silly. As if women who've had IVF form some exclusive club... I find the awkward pronunciation of nuclear (nook-you-ler) much more annoying.

You might also be interested in "How many embryos should I transfer?"


Sarah said...

i totally agree. and i can't stand when people say "nuk-u-lur!"

your historical perspective is so interesting (forgive me for making your earliest ART experiences sound like artifacts)!

Rachel Inbar said...

While I was looking for links showing how the embryo transfer is done (i.e., into the uterine lining), I found this one - http://www.advancedfertility.com/embryotransfer.htm - ironic that the last question on the page is "How many embryos can be implanted in IVF?" OOPS.

Artblog said...

I agree on most points but I have to say he is irresponsible to treat a woman with 6 kids already, he can have a say but the fact that this person agreed to transfer 6 at he already has his scruples all wrong so I'm not surprised he agreed in her case.

A woman can let her hormones and desire for more children rule her head, we need a professional doctor to keep woman like this on the straight and narrow, do you see what I'm saying.


Jenna said...

I have to say that it is morally irresponsible for a doctor to implant that many embryos in anyone let alone a mother with 6 children!
I hate that this has become such a topic lately, I wish that it would die down and she wasn't getting so much publicity because she doesn't deserve it, she was endangering her life and the like of all of her children.

JCK said...

Hi Rachel,

Been a while. ;)

What a great post. I truly didn't know that the embryos were implanted and I went through 3 IVFs and 2 FETs. Amazing! Somehow I imagined them just floating around. I really thought I remembered my doctor saying, we need to wait and see if they implant. But, it must have been to wait and see if the implant takes.

Hope you are well.

We've been celebrating over here that the most infamous of men who used NUKE ULAR is now out of office!

Sara said...

I couldn't agree more about nu-ku-lur. It makes me want to scream.

I agree completely with the rest of your post also. How many children she has is her own business. How many she has in the same pregnancy, with medical intervention, is very much the doctor's responsibility too.

I didn't know about embryo transfer going into the lining. That's really interesting.