Progeny At What Price?

Allow me to begin here by thanking my favorite blogger, Jane, for tipping me off to the recent births of two sets of sextuplets in Arizona and Minnesota.  I read her post It’s a Uterus, Mrs. Masche, Not a Clown Car last Friday and preached over the canning jars all weekend.  I strongly recommend you read it, too. 

Some may view these births as a miracle, but like Jane, I do not.  I happen to personally know well the opposite is true.  If you happen to view technological advances in infertility as progress, I’m here to tell you it comes at a huge price.  At the very least, the incredible escalation we are witnessing in large multiple births is medically unethical;  at the top of the spectrum is its undeniable virtual effect of child abuse.

On the surface, the stories of the Morrisons and Masches sextuplets born in the last few days sounds wonderful and glorious.  You can’t help but be elated at what appears to be nothing less than a miracle that finally allowed both women to have their own children. 

Brianna Morrison, 24, tried to conceive naturally for a whole year, then sought a fertility clinic recommended to them by members of their church.  She went through two cycles of Clomid injections that failed (Chlomiphene citrate, the most commonly used drug — typically administered as a pill — to increase the production of eggs and stimulate their release) and then was given Follistim (Follitropin beta, a relatively new synthetic hormone (injected in concert with hCG hormones) to stimulate egg production and used when Clomid fails). 

Within a matter of a few weeks, the Morrisons learned Brianna’s ovaries had released ten eggs, four of which were not viable, and six that had fertilized.  Without fertility drugs, human ovaries release one egg, or in exceptionally, unbelievably rare instances two.

Mrs. Morrison was dealt Follistim’s greatest side-effect of all:  Ovarian Hyperstimulation Syndrome (OHSS).  Google that one.

During Brianna’s pregnancy, she took a myriad of medications to prevent miscarriage as well as to help (basically force) her body to handle the enormous nutritional and physiological strains during gestation of an unnatural number of fetuses.  In the last three months or so of her five-and-a-half-month pregnancy, she was confined to bed rest and had 24-hour nursing care to monitor the health of Brianna and her fetuses and dispense medication.

As is the norm in large multiple births, Brianna’s infants were extremely premature as she was only able to carry them for 22 weeks — the EARLIEST gestational age in which infants are considered to have any chance for survival, although that chance at most generous is considered to be a mere 10%. 

Most hospitals have a policy against resuscitation of 22-week infants, since survival without profound disabilities is so rare.  In fact, nationwide, almost all 22-week infants are recommended hospice care.  Did you know that?  It’s true.  The average human gestation — without obstetric complication — is 40 weeks (calculated from the first day of one’s last menses).  With thanks to huge technological leaps made in medical care of premature infants in the last decade, babies are generally considered “full term” at 37 weeks and have every likelihood of survival without having any developmental defects.

Just before midnight on Sunday, June 10, Brianna gave birth to four sons and two daughters.  All six remain in critical condition in Minneapolis’ Childrens Hospital Neonatal Intensive Care (NICU).  The largest infant weighed merely 19 ounces (appx. 539 grams) and the smallest a terrifying 11 ounces (appx. 312 grams). 

Ten hours later down in Phoenix, Jenny Masche, 32, gave birth by Caesarian section to three boys and three girls also premature, but which she was miraculously able to carry to 30 weeks gestation. That eight weeks’ difference in the two gestations was profound and resulted in much stronger, much better developed infants to the Masches.  The largest weighed three pounds (appx. 1361 grams), but the five smaller babies required ventilation.  All  are now breathing on their own two days post delivery.

Jenny and her husband tried for years to conceive and she did, although she suffered two miscarriages.  Last year, the couple sought fertility therapy through the nation’s leading fertility clinic, Nevada Fertility CARES Wellness Center in Las Vegas.  Jenny was given ovulation stimulation drugs, presumably Clomid, and likely hCG injections.  Then, when the timing was just right, she was artificially inseminated.

Jenny’s ovulation stimulation drugs caused many eggs to be released at once.  Six eggs were fertilized. And the rest, as they say, is history.  Jenny’s babies will hopefully be released from the hospital to head home in six to eight weeks, but no one is dare speculating on when Brianna’s sextuplets will go home…the bare minimum of time likely months.

It all seems wonderful, “miraculous.”  I’m a mother and I know these two families are elated!  Of course they are!  And I wish them every joy and blessing God gives to parents.  But when the cameras quickly fade away from these sensational, spectacular births of twelve infants, these families will face nearly insurmountable challenges ahead.

The very least of problems ahead are the medical costs.  In 1994, the American Academy of Pediatrics released a comprehensive report on NICU care costs averaged across the U.S.  Back then, NICU-only costs per day to care for an infant with a gestational age of less than 24 weeks was $2,346.  Per day.  For an infant born between 30 and 32 weeks, the cost was less than half at $945.  Per day.

Then, the average cost nationwide of NICU care alone for a very low birth weight baby under 750 grams was $89,946.  Today, the hospital costs alone of treating very low birth weight infants (under 1500 grams) is over $1,000,000 per child, per hospital stay from its birth until the child is finally developed enough to be released.  That does not factor in costs of doctors, medicines, lost wages, prenatal care (which has been staggering for these families) or the huge sums reaped by the fertility clinics and their staffs.

All US health insurance carriers have lifetime maximums in benefits they will pay and typically cap benefits at $1,000,000.  You’ve got a cap — check the fine print in your explanation of benefits, or just call the number on the back of your card and ask.  At the most conservative speculation, these babies (especially the Morrison’s) will exhaust their allowed medical benefits long before they reach their first birthday.

The March of Dimes has been beating the drum about prematurity for more than 20 years.  I strongly encourage you to poke all around their site and learn why it is the Number 1 killer of infants and the Number 1 problem in Obstetrics.  The information they offer freely is amazing and 100% dead-on accurate.  Learn, people.  Thanks to fertility endeavors, this problem of large multiple births is growing by leaps and bounds.

Also very least of problems ahead are the costs of diapers (both families are soliciting donations), food (both families are soliciting donations), and once comfortable homes now found to be overwhelmingly small (both families are soliciting donations).

Way, way down on the list is the sheer number of PEOPLE who will be required to care for these children once home.  Fortunately, both families have church families who are volunteering.  That is a sincere blessing that cannot be understated.  But even with all the help in the world, the physical and mental exhaustion of merely taking basic care of six infants will be profound to both sets of parents for many years ahead.

The money necessary to support these families over the two decades ahead, regardless of instant presentations of free college tuitions and corporate sponsorships of free food and diapers, is meaningless.

The real cost — an actual crime in my mind — is to be found in the physiological and mental tragedies that have likely been inflicted upon these children, all because their parents were determined to force nature to provide them with their own genetic progeny and, once done, refused the immediate medical advice to terminate some of the fetuses (called “selective reduction) to allow others to achieve a survivable, healthy gestational age.

Unfortunately, the actual level and number of defects and, at very least, learning disabilities will not be revealed before these children reach about eight years in age.

I’m very biased on the subjects of fertility clinics, their inherent prematurities produced in births in quadruplets and greater and, therefore, their inherent and often exceptional birth defects.  For nearly a decade of my life, I was a pediatric nurse and manager of a pediatric firm with three providers.  I know billings, I know codings, I know health insurance and I know intimately the problems in medical care of low birth weight babies and their common birth defects.

For the Morrison sextuplets, so exceptionally small and young at birth, the risks are tremendous.  Those afflictions EXPECTED include:

Intracranial hemorrhaging.  Grade 1 or 2 bleeds are exceptionally common in extremely premature infants and Grade 3 or 4 bleeds provide profound learning disabilities and hydrocephalus.  Grade 1 or 2 bleeds occur in about 1/3 of babies born before 26 weeks, although there are medications that can be administered to the mother prior to birth to help lessen the chance and severity.  Coming through this is Cerebral Palsy and Hydrocephalus.

Feeding problems requiring nasogastric tube feedings for more than 8 weeks (most babies require nasogastric feeding if born sooner than 35 gestational weeks).  Since preemie newborns have underdeveloped gastrointestinal systems too immature to absorb nutrients, the most premature cannot even digest breast milk at first.

Necrotising enterocolitis (gut problems needing medical/surgical treatment).  See above.

Patent Ductus Arteriosis.  This cardiac disorder causes profound breathing difficulties.  In the womb during development, an artery called the ductus arteriosis is kept wide open by a hormone called prostaglandin E that allows blood to be diverted from the developing lungs directly into the baby’s aorta, since babies do not breath until birth.  At full term, prostaglandin E levels have fallen dramatically and have caused this duct to close, helping the fetus’ lungs to receive blood to finalize their development and function properly in preparation for breathing on their own.

Anemia.  Preemies usually have significantly reduced levels of hemoglobin and require transfusions.

Retinopathy (an abnormal growth of blood vessels in the retina caused because the infant’s vascular system in the eye hasn’t fully developed.)  Retinopathy causes serious vision impairments.

Chronic lung disease requiring ventilation (extra oxygen) for more than 8 weeks.  And the longer an infant is on a respirator, the greater the risk it will develop Bronchopulmonary Dysplasia.  (Because immature lungs sometimes cannot withstand the constant pressure of the respirator.)

A very, very high risk of developing Pneumonia and sepsis.

A very, very high risk of developing a myriad of infections.  This is one major reason why preemies are placed in incubators and thereby isolated.

Another major reason for placing preemies into incubators is because preemies are born with almost no body fat and immature skin and are incapable of maintaining body heat until they reach the age of near-term.

Presence of recurrent Apnea/Bradychardia for the first seven weeks of life.

A very high likelihood of an IQ below 85

A 99% likelihood of being small in growth throughout life.

A 99% likelihood of having future need for full or part-time special education.

A 99% likelihood for special therapy with physiotherapists, occupational therapists and speech therapists.

A 95% chance of Jaundice needing phototherapy to protect an immature liver.

Last on the short list, but not least:  Sudden Infant Death Syndrome.  Preemies have a much higher risk.

Yes, survival today is possible for babies born at 22 weeks, but these preemies may face a lifetime of health problems.  I’ve already mentioned Cerebral Palsy and hydrocephalus, but must also add seizures, lasting neurological problems and, at very least, developmental delays.  The lucky, miraculous children suffer only with vision problems or mild developmental delays.

Not all preemies (by definition at younger than 37 gestational weeks) have medical or developmental problems.  By 28 weeks, the risk of serious complications is much, much lower.  And for babies born after 32 weeks, most medical problems are very short-term.

So, while the media reports the fantasticness of these two large multiple births, my focus is on the children themselves and the medical and mental challenges ahead of them that won’t be fully know for years.  Strides in overcoming infertility have been amazing, but don’t think for a second that they come without a staggering price sometimes.  And let me assure you the fertility clinics, doctors and medicine giants bear no liability whatsoever in any defects or disabilities these children may develop as the result of their interventions in nature.  You should see the disclaimers patients must sign prior to treatment or even consultation!

The miracle in these families did not come at conception.  Not God, but Man engineered these large litters that a human was never designed by God to birth.   The real miracle, I pray, will come from God in exempting all of these twelve children from a likelihood of lifetime disabilities that Man cannot prevent and is quite limited in an ability to effectively treat.

May God richly bless those who have long understood the intangible costs of forcing your own genetic progeny is potentially too high and turned, instead, to adopting a growing population of parentless children.

UPDATE:  6/13/07, 10:00 AM: “There’s a small amount of room for hope that at least one of the babies might survive,” says an Iowa pediatrician, professor at the UofI, and one of the most knowledgeable regarding low birth weight births in this country. What a tragedy.

UPDATE: 6/14/07 5:00 PM: “Another set of sextuplets are on the way near Tampa. The family hopes to take the fetuses to 28 weeks for delivery in mid-August.On the opposite coast, meet Brian and Gracie Soldani, who are also expecting sextuplets this Summer. Presently at 16-17 weeks gestation, Gracie is under hospital care and hopes to gestate to 32 weeks — the LONGEST time a woman has ever been able to carry six fetuses.

UPDATE: 6/17/07 7:00 AM: Three of the Morrison infants have died in the last week.

UPDATE:  7/30/07 8:36 AM:  Only one Morrison infant has survived to date and remains in critical condition.   The Masche infants, born at 30 weeks’ gestation, are doing much, much better with four infants now home.

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18 responses to “Progeny At What Price?

  1. You put me to SHAME. SUCH DETAIL. I just scream well. You actually DETAIL the whole mess. GREAT. Will link and ATTEMPT a trackback. THANKS!
    <em>EHeavenlyGads:</em> How very kind of you to offer such an amazing compliment, Jane…especially when I know better! 😉
    My bias is very clear: I strongly believe everyone taking Clomid and the like should first visit a neonatal center and see first-hand a struggling low birth weight child before ever being allowed to consent to this type of fertility treatment. I say this because Clomid always creates a moral dilema: doctors found a “solution” in Clomid to hypersensitize ovulation. But since it causes the ovaries to “explode” multiple eggs, several tend to be fertilized and the parents are almost always unable to follow their doctor’s stident advice of selective reduction so that two or three fetuses have a strong chance of not only surviving, but thriving. Isn’t that the dream of parenting to begin with? To have healthy children?
    Large multiple births are a familiar occurrence these days and increasing. To me, one who has held and fed and checked the nasogastric tubes of these preemies many times, moreover watched them struggle (both parents and children) in their adolescence, the incredibly selfish need to procreate at any cost — and refuse medical counsel — is so desperately overshadowed by the suffering typically inflicted upon the child itself. What sounds so wonderful on the surface will, indeed, break your heart in the reality.
    PS: You da bomb. I was pricing those toilets today you mentioned…. 🙂

  2. While I appreciate where you are coming from, fertility treatments do have their place. MOST women who undergo treatment involving injectable hormones or Clomid, end up with only one embryo that sticks. That said, I think doctors and patients are morally obligated to make the decision when faced with multiple mature eggs to cancel the cycle. It is irresponsible to go on and do an IUI when there is a great possibility of having multiples. These stories give fertility clinics on the whole a bad wrap — they don’t tell the whole story. They only speak to the negligent clinics that don’t urge their patients to convert the cycle to IVF or cancel it altogether. Please don’t “poo-poo” fertility treatments globally. There are many cases that merit these treatments.

    EHeavenlyGads: First of all, I thank you for your comments that to large extent I agree with. Yes, you are dead-on point that the majority of women who undergo successful infertility therapy, even inclusive of Clomid, Pergonal and/or Follistim and the like, have singletons. And I could not possibly agree more that fertility clinics should refuse IUIs when ultrasounds reveal the production of multiple mature eggs. But they don’t. Not even in the most highly regarded infertility clinics in America. Even in IVFs, multiple fertilized eggs are reinserted in the hopes that one will stick. It’s obstetrics version of Russion Roulette. You hope that bullet isn’t chambered and most times it is not. Then…

    I have nothing against fertility clinics and my post certainly did not “poo-poo” fertility treatments globally. My point made, the same shared by the entire obstetrical and neonatal communities, is that large multiple births are a medical disaster and the rates for births of quadrupets, quints and higher order births have QUADRUPLED in the last decade and as the direct result of infertility treatments such as Clomid, Pergonal and Follistim. Since medical and legal ethics PREVENT physicians from making decisions on behalf of their patients, the BEST and ONLY action fertility doctors can undertake is to inform their patients of the complications of ovulation-stimulating methods, et al, and clearly define the exact risks of large multiple births. And they should especially do so when high order fertilizations are confirmed! All doctors must, by law, present information to their patients (how much is subjective and widely variable) and follow their patients’ INFORMED CONSENT. Because, by law, doctors can’t play God following high order fertilizations and so many parents find selective reduction abhorrent, we now have a growing medical crisis on our hands. And who suffers the most? The infants and profoundly.

    Moral obligations in our personal perspectives are one thing. Law and reality are another.

  3. I agree with your very well-written, very well thought out comments.
    I am appalled at the egotism, selfishness and narcissism of these “parents at any cost.” They have no concern for the possible poor quality of life their children may have to suffer through.
    I work at a center for people with disabilities, and we’re never going to run out of clients due to these selfish parents, who put their own wants (not needs) before anything else.
    They should be ashamed.
    <em>EHeavenlyGads:</em> Thank you for your comment and compliments, Annie, and bless you for the amazingly difficult work you do.
    But I must take issue with one of your statements that these parents “have no concern for the possible poor quality of life their children may have to suffer through.” I don’t believe that to be the case. No parent, especially one trying so desperately to conceive, wants their child to have a disability. But I do believe they and their doctors are willing to take a risk of triplets or quads that are much easier to carry to term and have a tremendously lower rate of complications. I doubt any of these parents wanted to have six children at once, but that was the result of the Russian Roulette game they were playing.
    I believe the decision parents made in these situations to keep all six embryos was ultimately based on one or more of two primary reasons: (1) an undeniable hope and belief that they will somehow break the odds, and an even stronger hope and belief that modern medicine will help them to do so; and (2) a personal inability to view selective reduction not as abortion and murder, but as the only viable means of ensuring (as best as possible) the ability for the remaining fetuses to reach a gestational age safer from expected complications.
    Until infertility technology finds a way to limit the sizes of these multiple births, this is a problem that is only going to get worse.

  4. I will add that this explanation you wrote is awesome and heartbreaking and I’ve posted it on a discussion board on salon.com. Thanks for setting the record straight.

    EHeavenlyGads: How very kind of you, Nancy. Thank you for stopping by.

  5. I have one last comment–the Morrisons had a lot of comments on their website and one was from a well-wisher (this was posted earlier on in the pregnancy) who was gushing about the great care she’d received with the same medical team, including Dr. So-and-So, who (she said in encouragement and affirmation) was also a “Pro-Life” doctor. Now, this bothered me a lot. I don’t know how it would have played out in reality, but is it possible that a physician in that position, due to his own religious beliefs, could have downplayed or even negated the risks of carrying all six fetuses to term? If this were the case, to call it unethical would be a huge understatement. Who knows if this really is the case, but you have to wonder what kind of advice they were getting.

    EheavenlyGads: Wow.

  6. I am the mom of a preemie ( 26 weeks) who is now doing fine at 9 months, but she had a 3 month NICU stay that was the definition of tortuous. I saw a few fertility induced multiple preemies and thier parents and much preemie literature was directed at them. I cannot imagine risking your child’s life by willingly creating a family of preemies. I am very sorry that these parents will have thier parenting experience constantly overshadowed by the fear that haunts all preemie parents. I am not sure that they were informed of all that goes into not just having multiples, but very medically fragile kids. For goodness sake, adopt some hardy Russian kid who you can nurture and love!

    EHeavenlyGads:I am so thrilled to learn of your own miracle, Bludab, and may your lives ahead be filled with blessings and happiness and no more shadows. Thank you for stopping by. God bless you and yours.

  7. I just came across your comments, and with your permission, would like to forward your original obserbvations on to a couple of young women I know, who are contemplating this very situation. (I took Clomid decades ago, to have my birth daughter, who was born healthy.)
    I agree your observations, and my conclusions also carry the same concerns for the – multiple preemies – children’s quality of life in their future. (Financial and emotional costs not withstanding.)
    I find it interesting, that just because we are in an era of “being able to do something,” it automatically seems to become that which we, “should do.” Then for some people, it almost appears to be a challenge to meet; since, “others have done it before me.”
    On another note: a doctor I read (referring to the recent multiple births) was quoted as suggesting “families just go out and adopt since there so many children needing homes.” (And if I may, I’d also like to make a response to your viewer’s comments about just going to Russia to adopt a child. Stereotypes about adoption continue to abound.)
    Apparently the doctor who was publicly quoted, has not adopted a child lately. I have personally been involved in adoption for almost 30 years. Let me share the heartbreak and joy, of adoption. Is it worth it? Many of us think it is, but it is not for the light hearted or think skinned.
    While there are hundreds of thousands of children needing permanent homes in America (I am an adopted mother of an American biracial daughter (young adult) who had (and has) ongoing medical and emotional needs; a partly blind son from the Far East; two birth children; and soon to adopt again from another part of the world…let me share the real story….
    If one is in wants a healthy Caucasian baby, the wait through an American adoption agency is years. Let me repeat that – years.
    Private adoption is ify at best and scary at worst. Open adoption is an outside possibility. One contacts a birth mother through private attorneys depending on the state (there are no uniform adoption laws across America) or works through an agency, you eventually MAY, adopt a healthy baby; and you and the baby’s mother, will be in your child’s life from then on.
    There are many, many sibling groups across America who need homes. These children come in all colors of the rainbow, with the majority being children of color. Approximately 800,000 children are in foster care in the USA, right now. A percentage of these children with disabilities, and or physically healthy sibling groups (2-4/5 kids) need homes. All need on-going care…all have dealt with some sort of abuse…all need some sort of support system (medical or emotional) outside of what your loving family can provide.
    And adoption is not free.
    I adopted locally (a 2 year old – in the States) years ago. It was expensive even then.
    One needs to have a support system; you go through a very extensive home study to help you and the agency know, 1. Why you want to adopt? 2. What kind of potential parent you (and or your spouse and partner) will be? 3. Can you financially afford to take care of a child on-going…that means decent (albeit expensive) health insurance? 4. What kind of physical room do you have for a Childs optimum growth?
    Today adoption cost has soared even more.
    I know. We are in the midst of it now. We are waiting for a son from another country. We have been in process for almost 2 years, waiting for the child we carry in our heart as ours, for over 9 months. We have no idea when he will be home.
    Our son it not in Russia. Have you looked into Russia? (We did, within the past 2 years.) Waits to get a referal are lengthy, cost is at least $30,000.00 to $40,000.00 and takes a long time (months to a couple of years depending on many factors including governments) after your referal to get your child home.
    Many Russian children are coming over with great mental, emotional and physical problems. How could they not?
    There are aprox 800,000 children being warehoused in orphanages due to sad economic conditions. Russians love their children; they just don’t have the means to do anything different for their orphans right now.
    Sidebar: Our intercountry adoption is also costing about $40,000.00 (plus travel and misc expenses); and loans are not available to pick up this cost. (We took loans from family members to afford our current adoption.)
    With any adoption, let alone a child from another country, there are no guarantees. Like birthing a preemie (who may or may not have a myriad of conditions life long), adoption is not a panacea for anyone simply wanting a child. (Not to mention your time in researching and finding legitimate adoption agencies in America.)
    Adoption takes commitment of time, money and emotions. Adoption takes heart. I understand the ache to have a child, and for some, that ache means a birth child. There are effective ways to have a family. Clomid is one, and adoption is another. Having had both, I am blessed to know that one is not better that the other. It is different.
    So folks, while I think we are in agreement that having birth children carries an inherent responsibility to give our children a quality of life; please note that quips of just go adopt a child from Russia, carries it’s own set of multiple challenges. Money being the least.
    Having children always carrys a responsibilility to give them their best life.
    If you want to know more about adoption, please check out Wednesday Child, an American organization for children who need parents. http://adopt.org/servlet/page?_pageid=289&_dad=portal30&_schema=PORTAL30
    Or check out a legitimate adoption agency, such as this one:
    http://www.claarfoundation.org/
    Thank you for your time.
    Blessings,
    Linda

    EHeavenlyGads: Thank you for this wealth of info and your opinions, Linda. Very much appreciated.

  8. Why not quantify the release of eggs, and adjust medication as to minimize the extreme release of eggs before fertilization, approach the conception more scientifically and cautiously. I think the medical cost shared collectively should concern us all or should. As far as the health issues we all share a fear and concern of having to raise a handicapped child and can only hope and pray that we can overcome them as I hope these new parents will.
    Chris
    <em>EHeavenlyGads:</em> Chris, there is no way yet to regulate how many eggs are ovulated in a hyperstimulated ovary. These drugs like Clomid and Follisim have been around since the late sixties, although modern techniques have yielded huge success when combined, with precise timing, with hormone therapy. And while they’ve been around a long time, medicine alone cannot control egg bursts and must rely upon diagnostics (ultrasound) to predict same. There are some women who never conceive on these therapies and a few, like those of recent note, who have large bursts and then choose to refuse selective reduction. Until fertility clinics put their professional feet down and mandate beforehand that women undergo selective reduction or not receive treatments, moreover judiciously monitor all of their patients electing ovary-stimulating meds, we’re going to see more and more of these high order births of exceptionally low birth weight infants. I could not agree more with your comments. Thank you for stopping by.

  9. You are dead on. I have been through these same fertility treatments. My doctors were VERY clear, before I started them, about the heath risks to the babies and to me. It was made clear to me that selective reduction was a decision that had to be made prior to any conception. I am a small statured person, and even a pregnancy of triplets would be threatening for me. Agreeing to cycles that limited the possiblity of conceiving to 3 or less was required for my fertility doctor to treat me.
    It scares me that obviously neither of these women were receiving daily ultrasounds prior to their IUIs. I did, and it’s the gold-medal standard to prevent hyperstimulation. If they did, the number of follicles developing would have been seen, and these crises averted. I had cycles canceled because I was developing more than 3 follicles, more than once. It was heartbreaking at the time, but my husband and I were also sure that it was for the best… my health as well as the health of any babies.
    I completely agree that you can’t say “It’s God’s will” how many babies survive when it wasn’t “God’s will” to get you pregnant. You can’t have it both ways. I may be biased because I ended up getting pregnant with my two children on natural cycles following failed IUI cycles. The doctors think I had a “boost effect” on my own hormones for a few cycles following several fertility drug cycles.
    I put the blame for this tragedy squarely on the shoulders of the parents, who should have known better and started their parenting life by making hard choices before they even conceived, and the doctors, who ignored the health risks to better increase their clinic’s success ratio.

    EHeavenlyGads: Stine, I appreciate your comments and allow me to say “Amen” to your every word. You hit the nail on the head regarding the necessity of daily ultrasounds and I’m glad to know your own experience was with highly professional fertility specialists. I’ve no doubt you were an exceptional patient, as well.

    Your experience is all about what is good in infertility therapy and how it should be practiced. Bless you and your precious family in happiness all the days ahead. Thank you for commenting.

  10. Just wanted to clarify that the fertility drug the Morrisons took was follisitim, not clomid. Clomid is pill, and follisitim is not. It must be injected and it’s stronger than clomid, so it typically produces more follicles (potential eggs). I have 3 boys from IVF (artificial insemination with clomid or follistim) 1 single and twin boys because artificial insemination didn’t work for us after several tries. IVF is at least controlled — my clinic is very conservative and will only transfer 3 embryos max up to age 40. And my doctor (like Stine’s above) will cancel an injectible artificial insemination cycle if too many follicles are produced. It happened to me. Unfortunately, I think he’s in the minority. But that’s why I went to him — I wanted healthy children, not a litter, and he was totally on board. I’d heard people complain he wasn’t “aggressive” enough, but I didn’t want to have to make the tough selective reduction decision. So I just wanted to reaffirm that there are good doctors out there, but you also have to be a good patient. Don’t call it God’s will when you resort to highly artificial means. It’s so hypocritical. And you must be monitored.
    And by the way — twins are hard enough! I totally agree that a trip to see premature low birth weight babies should be required. My guys were born at 33 weeks and spent 5 weeks in the NICU. And we are lucky that at 2 1/2 they are totally 100% fine.

    EHeavenlyGads: Ellen, I thank you for your underscoring the Follistim injections that I outlined in the fourth paragraph of my post. The drug, as you said, is second tier and used at failure of Clomid. More than anything, I am so pleased to hear your own outcome of healthy twins and also from having undergone care at another highly professional and responsible fertility clinic. Your story speaks loudly as to what good is being done in the realm of infertility measures.

    Twins a lot of work? EGADS! My hat is off to you — I’m well acquainted with several pairs! And I send you my very best wishes for a lifetime of joy ahead with your wonderful family.

  11. A couple points I want to make:

    First, follicle monitoring is hardly an exact science. It’s possible for even experienced sonographers to undercount follicles via ultrasound, especially in women with PCOS whose ovaries are cystic in appearance. It’s also impossible to know how fast supposedly-immature follicles will develop after taking the HCG trigger shot. In fact, one of the sextuplet mothers was told she had only two mature follicles, so she most likely triggered thinking she had no chance of high-order multiples.

    Any woman who does an IUI cycle is at *some* risk of high-order multiples, even with the closest ultrasound monitoring possible and cancellation for multiple follicles. Those of you who did IUI should think carefully about that before criticizing the sextuplet mothers and their doctors.

    However, the flip side of that is that the risk of conceiving high-order multiples are very very small, even with a lot of follicles present. I actually ran the numbers (details on my blog), and even with six mature follicles, the odds of conceiving quads or higher are less than 1%. The odds of sextuplets are about 1 in 100,000 — much, much lower than a singleton mother’s risk of dying in childbirth, or of the baby’s death. The sextuplet mothers took a risk, yes, but it was a very tiny one.

    As background, I have 36-week twins born after a Repronex/IUI cycle, in which I came down with OHSS. I had 4 to 6 mature follicles, and triggered after discussing the possibility of high-order multiples with my husband and my doctor. So it’s not just theoretical for me.

  12. Who are you to criticize anyone’s attempt at creating a family? How dare you link to the private pages of families who are seeking to create a POSITVE experience. “Procreate at any cost”? Isn’t there enough negativity in the world?

    EHeavenlyGads: “Private pages of families” addressing an unknown public with myriad details and seeking monetary donations? Are those the “private pages” to which you refer? Wake up, Katie, and smell reality. EXCEPT by a miracle from God, there is no such thing as a “positive experience” for a gestation so large that it is doomed to produce extremely low birthweight infants. (Hope you feel better now after the personal attack, notably not one against the facts involved…)

  13. I know this has been pointed out before, but since so many want to paint every patient receiving fertility treatment and every medication with the same brush, I think it bears repeating. Jane, especially, seems to feel that all patients are irresponsible and uneducated.

    Clomid 30 years ago resulted in twins and triplets fairly often. It was a new drug, with very little long term information known. Today, the twin rate for Clomid is 5%, anything else is virtually unheard of. As a woman 10 weeks pregnant with my first, a clomid baby, I know many women in the same boat as I who have used clomid and only ONE has had twins. All others were healthy singletons.

    Follistim is another demon altogether, and 30% of births are multiple births.

    And as someone who has received treatment, I can tell you that these women and their doctors are the exception, not the responsible ones. The majority of RE’s do very close monitoring and cancel cycles when it appears multiples are a risk, they talk to their patients beforehand about selective reduction. And as for the patients, most are not as naive and irresponsible as these families. Most are well educated about their treatments, look at all their options, and make the most mature and responsible decision. So, please, do all us infertiles/subfertiles a favor, and don’t assume we’re all clammering to have a little of children at any cost.

    And Linda? You’re probably gone by now, but what a great post. Too many people think the easy answer to infertility is adoption, when it comes with as much stress, emotion, and hard work as having a child biologically.

    EHeavenlyGads: Jen, I thank you for your comments. And I am certainly happy to learn of your own success. For the record, I do not assume ALL “infertiles/subfertiles” are “all clammering to have a litter of children at any cost.” Far from it. But you, yourself, hit the nail on its head in stating that most fertility patients “are not as naive and irresponsible as these families.” That is precisely my point. I agree with your statistics regarding Clomid and Follistim, but would add that Clomid frequently fails and Follistim is almost always the secondary medication employed in concert with changed therapy techniques. It is this which causes the dilema of high order births. Clomid and even Follistim can be true miracle drugs, as you have experienced. But the increasing number of large order conceptions are almost always guaranteed to be disasters in low birth weight babies. Some patients — not all, thank God — are incapable of making hard decisions to protect the viability of some of their fetuses and some doctors allow them to do so. I believe the Morrisons know this heartbreaking reality better than most today.

  14. Ahhh..The gift that keeps on giving. THE MASCHE THREAD. When are these agenda driven, desperate females going to stop doing google searches trying to find justification for their own selfishness, dropping in on us and being surprised when we don’t coddle their romantic delusions?

    Keep the heat on, girl. These women need a reality pill, not a fertility shot.

  15. OH…and “KATIE”, honey>>>the WEB does not contain a single, “PRIVATE” ANYthing. If it were so “private” they would password protect their sites. But then, they couldn’t guilt the “PUBLIC” into vast quatities of sympathetic, PROFITABLE DONATIONS, then COULD THEY?

    Bleeechh..get a life that does not include so much EMOTING, Katie. LOGIC and reason will carry you MUCH, MUCH farther.

  16. I thank you for being so kind and level-headed in your reply. I did not think you were assuming that all infertiles/subfertiles acted in this way, but others were. Some people do think that anyone receiving treatment for infertility is desperate and wanting to get pregnant at any cost, which is just not true, and far from it.

    When my husband and I started trying to conceive and then started treatment, we made the decision that anything above two would be selectively reduced down to two. We made decisions about congential abnormalities and diseases and which we could terminate for. We decided that if any child was born before 25 weeks, we wouldn’t want any life saving measures taken. We made all these decisions before or right as we were starting treatment, and most of the families I know did the same. Most families have decided before they have started where their end point is.

    I guess my problem is that whenever a horribly tragic event like this happens, people want to jump on the entire community and on every family (btw, why do so many posters only talk about the women receiving treatment and not their partners?). Families like these two, and the doctors that treatment them, are not common. The responsible ones are the rule. If people were to take a closer look at these cases, some things seem suspicious to me, and the fact that the Morrison’s were offered treatment as such an early age after only one year of trying and then bypassed much of the medical protocol is disheartening to me.

    I happen to think that these two families and the other two families expecting sextuplets this year are irresponsible and selfish. However, I also know the feeling of wanting a child (at the ripe old age of 27) and not being able to easily conceive one. I couldn’t afford adoption, I didn’t have tens of thousands of dollars at my disposal. It would have been my choice instead of fertility treatment, but my insurance covered my treatment, which amounted to 3 rounds of Clomid at the lowest dosage.

    The fertility field is laregly unregulated because in most cases, it’s a cash business. For families that have insurance that covers such treatment, you will find very restrained and carefully monitored treatment. People won’t agree that such treatment should be covered by insurance (mine was covered because of a specific medical diagnosis), but if it were, you can bet that the field would be regulated overnight.

    Anyway, again, thanks for being willing to have a conversation about this.

    EHeavenlyGads: Jen, it is comments like yours that have made this blog both enlightening and a pleasure for me. Your comments are well taken and very much appreciated. Thank you for sharing your thoughts on ALL points made. Kindest regards.

  17. While yes, I do agree with you about the problems with having multiple preemie babies, especially at the cost of the parents and their families having them, I do think that this is not entirely, no let me correct, not at all their fault. It is a hard decision for any parent to have to look at the ultrasound monitor and then have to tell the doctor, “Ok, I am fine with terminating the life of three of these children.” ESPECIALLY when that couple has gone though the harrowing experiance of fertility treatments. I have experienced this fertility treatment rounds second-hand through my brother and his wife. My sister-in-law was so devastated when she learned could not have children, it ripped my heart out just seeing how horrible she felt. It was gut-wrenching for me and I truly wished I could have a baby for her. Many of these people are like my brother and his wife when they walk though those clinic doors. They really want a child and they will take any risk to get one. When they sit in that waiting room and have to go through embarrassing treatments, many of the following questions go through their minds: “What happens if the doctor says we just can’t have children because of medical reasons.” or “What if it’s my fault or maybe, just maybe, your fault.” Or even the worst thing of all: “We don’t know why you aren’t getting pregnant, we just can’t help you, sorry.”

    If you REALLY need to place the blame, I feel should be at the feet of the fertility treatment clinics.

    I feel that when this happens as much as it has in the past year, then we need to take a harder look at what is happening inside these clinics. Instead of saying it is a miracle, (which undoubtedly this is for the families who had been trying to concieve for so long.) But maybe we’d better look at it as a form of medical malpractice. In my book, that is EXACTLY what it is.

    There is just no way that a doctor should even consider asking the family to terminate ANY of those fetuses. My sister-in-law went to the same clinic that the Masche’s did but….and here is the big but…..her IVF treatments they (the parents to be and the doctors) agreed to inseminate only three eggs at a time. It was an expensive few years for them, but a decision that my brother and his wife could live with. As I have read here and from other accounts, the Masche’s miracle was basically a freak accident, the doctors and staff not knowing that all the eggs were viable. Why are we getting upset at the families then, for not being able to choose which child to terminate and which one not to? This was something that the health clinic should have been more careful of. They should have procedures and guidelines in place that KEEP this from happening. Maybe they need to re-examine the way their treatments are done. I don’t know, the answer to that. I do know though, from personal experience, at the time of pregnancy, emotions are high, hormones are completely out of whack for both parents and the thought of asking a woman to terminate a child after all that hell that’s been placed on her body is not something that should be done. Instead, Why don’t we put this WHOLE thing back on the shoulders of science? They created this monster…..so they need to learn how to control it. If they can’t, then in the meantime, there needs to be some better guidelines put in place, nationwide, that will keep familes such as the Morrison’s and the Sodani’s from having to go through this heartache and will keep families like the Masche’s and the Byer’s at a minimum.

    No, I am not angry at all at the families, I think it is wonderful that science could help them. The only ones who should have to hang their heads in shame is their clinics and doctors who created this mess. They should have the means and resouces in place to help these families clean this mess up. I mean, they are the ones who let the monster loose after all.

  18. As far as I can tell as a non-medical type, your site is about the connections between fertility treatments, premature babies, and birth defects. It’s very informative, although a little scary as well. But I’m wondering if there are any demonstrated connections between 1) increasing use of fertility drugs and 2) increasing cases of autism over the last few decades? It seems that researchers have been scrambling lately to explain the autism epidemic, and I just wonder if they’ve researched this possibility.

    EHeavenlyGads: A fascinating question, Bob. I have no idea if a link between modern fertility methods have been studied in the Autism research. As far as my knowledge on the subject goes, the vast majority of opinions, whether based upon qualified large-pool research or not, is in a belief that certain carriers of vaccines may be a culprit. But you were spot-on about my correlations regarding prematurity.

    Please advise if you should run across such research and happen to remember my site, and I shall do the same and post here should I find same.

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