Fertility Treatments

It’s a Brave New World

“What you have to know is that these aren’t the best embryos. The best embryos were taken by the first couple, and these are the leftovers.”

That, to the best of my recollection, is what the doctor told us at our consultation. She wasn’t being unkind, she was being honest, and I appreciate honesty in this journey. Still, it was hard to hear, and we wanted to know, how can we increase our chance of success?The only answer the doctor gave was Preimplantation Genetic Screening (PGS). If you’ve never heard of this, it’s a process by which a doctor will biopsy the part of an embryo that will become the placenta to determine whether or not the embryo has the right number of chromosomes.

When she, the doctor, said “PGS”, something in my stomach froze over. PGS testing is, at its core, eugenics. It’s dicey eugenics, too, but I wouldn’t know that until later. Do you want a boy, or a girl? PGS claims to guarantee one or the other. How about avoiding Down Syndrome? If that’s ideal, PGS testing is for you. I knew I would have this option presented to me, but I didn’t expect it to be in the context of increasing our chances of a pregnancy. I assumed it would be to avoid an “undesirable” child, which would have been an easy thing for me to reject. This idea of using PGS to bolster our chance of any successful pregnancy was new to me.

It turns out that when an embryo has too many, or too few, chromosomes, it often doesn’t implant. Even if it does implant, making it past that first and most precarious step, it often miscarries or doesn’t develop at all past the embryonic stage. This was news to me, and terrifying news at that.

We decided to get as much information as we could. We didn’t agree to PGS testing on the spot, but we weren’t opposed to being properly informed. Our first red flag was this: the coordinating nurse, upon hearing that the doctor recommended PGS, said it might not be the best option for us since our embryos were frozen. The doctor herself had told us that she had survival rates as high as 50% (whoopee!) and that not all the embryos would survive the testing. The nurse then asked how many embryos we had and, upon hearing we had 9, her face lit up. “Oh, you should definitely do PGS, that’s a lot of embryos!” she exclaimed. Why, I asked, did the number of embryos we had make a difference? Her response was chilling: not only would a few of our embryos not survive the thaw/test/refreeze process, but any declared “abnormal” would be shelved. Permanently. This, to us, felt like playing God. A line was being drawn in front of us. Would we cross it?

I’d like to say that, at this moment, I refused point-blank and walked out with head held high. Instead, I decided to reach out to the embryo donation agency to see how much it would cost. Money is a consideration. It’s $11,000 each time we try, after all. If we’re unsuccessful this time, we’re looking at more loans and more debt to try again, and again, until we succeed. It makes me sick just thinking about it. The embryo agency’s response was startling: we’d have to pay the PGS fee, plus the remaining adoption fee on all 9 embryos, which came close to another $20,000. I was floored. After I sent a scathing email to the agency for the injustice of this, our representative there very patiently invited me to call her and talk it over. It turns out they’re against PGS, and strongly. It puts the embryos at such a risk that the agency will not take them back once they’ve been tested (hence, the remaining adoption fee). Instead, the agency recommended (again) that we implant two embryos at a time. I’ll go into that, and why we’re not doing it, in another post.

Before we started this journey, I asked a few priests whether or not what we were doing went against Church teaching. Their answers were always consistent: this being in the spirit of adoption, no; HOWEVER (big caveat here), PGS is not permissible and neither is a double implantation. This is how God works in my life (or, rather, how I’ve allowed Him to work since I never seem to abandon myself to trust in Him completely from the start):

He says, “do this thing.”

I say, “well, okay, but I’ll do it with my own will and controlling nature exerted over it.”

He says, “I’ll let you do that, but here’s all of the horrible consequences you didn’t consider that would be the natural result of you doing this ‘your way’. I wish you’d just trust me the first time around.”

Then I say, “fine, I’ll trust you” and I go on trusting Him grudgingly and anxiously, never once considering how much happier my life would be if I really did abandon myself to His will.

Sorry for the long post, but this topic deserved a few more words than usual. Ultimately, we did decline PGS and are happy with our choice. Here are a couple of articles that I found useful on the subject and helped in my trusting, but fretful, choice:

https://www.fertilityiq.com/topics/pgs-and-ccs-genetic-testing/criticisms-of-pgs

https://www.winfertility.com/blog/six-facts-everyone-considering-ivf-know-pgs/

This link in particular gives some statistics on the likelihood of chromosomal abnormality by maternal age. Since the age of the donating mother for our embryos was 23, we have really good odds: https://www.advancedfertility.com/preimplantation-genetic-diagnosis.htm

Have you been through fertility treatments and offered PGS? What were your reasons for trying, or not trying, PGS?

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