Infertility and Selective Reduction

I want to talk about a very "touchy" subject today because it has been causing some drama on an infertility forum I visit every now and then. The subject is selective reduction (SR). For those of you that do not know what this is it is the practice of reducing the number of fetuses in a multifetal pregnancy (those involving more than one fetus). With selective reduction, one or more fetuses are "selected" for termination. This is usually suggested to women who are carrying three or more fetuses.

I feel it is important to bring this up because when you are struggling with infertility you do not really hear a lot about this. Most of us get blindsided by it. We are so stuck on focusing on getting pregnant that the thought of SR never exist.

So, what started the huge debate on the infertility forum? A woman who struggled for 5.5 years with infertility finally had a treatment work. She went to see her doctor last week and heard three heartbeats! Exciting news, right? It can be until your doctor pulls you aside and tells you that you should "reduce" one in order for the other two to have a better chance at life.

When you get pregnant with triplets or more, the doctors will tell you of the certain gloom ahead for your three babies and yourself. They will tell you your babies have a much greater risk at being born blind, deaf and having cerebral palsy. Oh yeah, and your own mortality rate increases because of the high risk pregnancy.

So now this woman who just heard three heartbeats is waiting to see if the three heartbeats grow stronger over the next week or two. If they do, then she will have to consider SR. Well, one friend of mine who is also a triplet Mom sent her some information explaining that a triplet pregnancy is achievable. There are many of us out here that had successful births. She wanted to be the glimmer of hope for this woman who will have to decide on such a terrible thing.

She sent her facts and told her she would support her in any decision. Then somehow the word "abort" came into play. This is when all hell broke loose. One woman went off on my friend and even called her selfish for carrying three babies and not reducing one! She was attacked from a lot of angles and I think it was all over the word "abort." It seems that you can talk about SR but if you bring up the word "abort" then you are banned from the site.

At least that is what happened here. My friend was banned from this forum. She had been on this forum for over a year giving her support and encouragement to a lot of women in need of it. I have been shocked by the events of this week. Banning someone from a site who has positive views and facts to share. Sure, maybe she should not have used the word "abort" but isn't it the same thing?

I guess for me it is. I did not see any harm in the use of that word. Selective reduction is preformed this way: The doctor gives a lethal injection of potassium chloride into the heart of the baby; which induces cardiac arrest and therefore “reduces” them. This procedure is also used to preform abortions.

"Abort" is not a pretty word but doesn't it mean the same? Either way you are killing the fetus. I know there are some extreme cases of women who have to reduce one baby in order to preserve their own life. I know many women and babies do die because of unsuccessful multiple pregnancies. I also understand women have to reduce because they simply can't carry six babies.

This is where the real question comes into play; how many embryos should you be allowed to transfer? If you have struggled for many, many years without one pregnancy then maybe you will want to put six in and see if one takes. On the other hand, if this is your first procedure and you have had kids before then maybe you should just put 2 in. And then, these embryos can still divide...

For me, I did not want to put more in then I was willing to carry. I struggled for five years without one pregnancy. My doctor was insistent that I put five embryos in. This is how our conversation flowed that day:

The doctor said, “Let’s put all five in and see what happens.” I said, “What happens if all five take?” He said, “Then we would ask you to reduce down to three.” I said, “Do you mean abort two of them?” He said, “Yes.” I said, “No way. Let’s just put three embryos in then.”

He didn’t like my decision because I am sure he was thinking that I need the extra “chances.” Five years of treatments and not one pregnancy. He tried to talk me into five but quickly picked up that I had already made my decision and that was that.

My point in today's blog is not get into a heated debate over pro-choice or pro-life. I don't even really want to debate if abortion and selective reduction are the same thing. My main goal is to inform women who are currently going through infertility treatments that they need to seriously think about selective reduction. It will hit you like a freight train if you do get pregnant with higher order multiples. Be prepared. Be wise on the number of embryos you put in. That is all.

And as for my friend who was banned from that site; shame on them. You are welcome to post anything you want on our blog.

Take care,
Alicia