Everyone has heard of
Octomom, the woman who in January 2009 gave birth to octuplets after an in
vitro fertilization treatment. Nadya Suleman became instantly famous and raised
concerns about the consequences of implanting multiple embryos into a woman’s
uterus – in the United States, there is no limit to the number of embryos that
can be implanted. The reason for this is that women seeking IVF are already
having trouble getting pregnant, and the probability of success of assisted
reproduction is still low (approximately 25-30%). The more we implant, the
higher the chances of success, right? But is this actually true? And if so,
what are the consequences?
In Portugal, the limit of
embryos that can be implanted at a time is two. It was common practice to
implant four in the late 1990s, then three in the early 2000s but the legal
limit has now decreased to two. The UK is moving in the same direction, since
studies have shown that transferring more embryos at once does not in fact
increase the probability of pregnancy, what it does increase is the probability
of multiples – twins, triplets… Even octuplets as we now know. These cases are
extremely rare – what usually happens when multiple embryos take is the risk of
a miscarriage later on or defects in the fetuses’ development. Implanting more
than two embryos puts a woman at risk, especially when she is over the age of
35 (which is often the case in women seeking IVF). The US should follow
Europe’s trend of limiting the number of embryos implanted at once in order to
put the future mother’s health above all else, even her desire to carry a
child.
1 comment:
The policies many European countries have implemented that limit the number of embryos that can be implanted into a woman’s womb through in vitro fertilization (IVF) were based on research that has been conducted since the 1990s. These studies primarily focused on investigating how the number of embryos correlates to the likelihood of pregnancy and the increasing risks involved with multiple pregnancies. However, these studies did not sufficiently consider the effect of age on the rate of successful pregnancy. While two may be the optimal number of embryos for women under 35, as a woman gets older, the chance of a successful IVF pregnancy decreases. National data shows that in 2011, 46.2% of IVF cycles for women under 35 resulted in pregnancies. This statistic was reduced to 38.5% in the age range of 35-37, 29.3% for 38-40, 19.5% for 41-42, and a mere 9.1% for women over 42. Furthermore, even though U.S. law does not have a limit of two embryos, the average number of embryos transferred for women under 35 was 1.9. Though this number increased with age, even women over 42 only had an average of 3.1 embryos implanted. Thus it seems that women are generally well informed of the risks associated with multiple pregnancies and elect for a limited number of embryos. Octomom, who was in her early thirties when she gave birth to octuplets, is an exception. She had 12 embryos implanted, presumably because she was intent on having multiple pregnancies. However, her physician was soon after accused of providing substandard treatment and subsequently lost his medical license.
While creating legislation to limit the number of embryos that can be implanted is certainly not a bad idea, I don’t think it is imperative. Data from recent years has shown that the vast majority of women are capable of making informed decisions for themselves. Physicians are required to provide women with information regarding the benefits and risks of IVF and help women make a decision about how many embryos should be transferred in their wombs. No reasonable physician would recommend having 12 or even 5 embryos implanted. Though perhaps a law should be enacted to restrain those women who insist on having an exorbitant number of embryos inserted, for now it seems that age is too big of a variable to come to a definitive conclusion that two is the optimal number.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3455090/
http://www.nytimes.com/2011/06/02/us/02brfs-California.html?ref=nadyasuleman
https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=0
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