|  Selective Multifetal Reduction Tragic Irony After Infertility You pray, and hope. You dream of a child, and undergo whatever treatment it takes to get one. When you finally get that positive pregnancy test, you think you have won. Then you go in for your ultrasound, and find you have been blessed all too greatly. You are carrying higher order multiples, and now you are all at risk. Will you ever make it through this? Sadly, it is a known fact. Fertility treatments can result in higher order multiples. Of all babies born conceievd on Fertinex, Metrodin, and Pergonal close to 20% were twins, and 5% were triplets or more. IVF and the other ARTs have a 24% chance of twins, and 6% chance of triplets or higher. Even on Clomid you have a 10% chance of twin and a 1% chance of higher order multiples, and these statistics do not include pregnancies in which a selective reduction was performed, or the entire pregnancy was lost to complications. Now with the high competition between reproductive endocrinologists, with a lot of stress on their success rates some are compounding the problem by overstimulating women and not canceling cycles in which too many follicles have matured ignoring the fact that quads have a 50% chance of miscarriage and a 90% chance of low birth weight. So once you have conceived triplets, quads and more what do you do? Selective reduction is something everyone in the infertility community expects us to be quiet about, but that is not helping the problem go away. Too many ladies who cherish every baby inside them has to decide to sacrifise one or more to save the others. I was one of those ladies. 
Emily's Story, Two for the Price of Three. I had been trying for 3 years to get pregnant after the loss of my first son to incompetent cervix. In the process of trying I had six misscarriages, and all had had very low beta numbers, so I was thrilled to get a high beta the day before Halloween. My happiness turned to nervousness when instead of doubling in 48 hours, they quadrupled. The doctor warned me twins were a high probability, and my husband and I rejoiced. When we had our first ultrasound we saw 3 sacs, and I went home praying for three healthy heartbeats. It was stupid, I know, knowing my history of incompetent cervix, irritable uterus, and premature birth, but deep in my heart I wanted all three of my miracle babies. I loved them all, cherished them all, and never once imagined I would be asked to sacrifice any of them. When we went in for our first ultrasound, my heart stayed in my throat. The tech wouldn't say a word to us, but had a very tense look on his face. When we asked if something was wrong, he simply said, "Let's wait for your doctor to get in here". My heart jumped, and I worried about blighted ovems, no heartbeat, and ectopic. The truth never even crossed my mind. When my doctor got in, he got the ultrasound screen centered on three black blobs. He traced one black blob on the screen and said, "See this...this is a gestational sac...a baby.". My jaw dropped. My doctor mentioned on our way out the door, "you know, with your obstetrical history, triplets are not a good thing, Emily", but I never heard him. I was picturing three cribs, three babies in matching clothes and a long triplet stroller. He gave us the numbers of 6 different high risk OBs and told us to start calling that afternoon to find a doctor. It wasn't until the first doctor did I realize whet we were in for. We went to all six doctors on the list, and the first five wanted us to reduce to a single baby, and go on immediate bedrest. They said with my problems even carrying ONE, even twins would be impossible. The last doctor told me, if i stayed in bed, we could try twins, but warned me it would be a long, bedridden pregnancy, with lots of medications and procedures to keep me pregnant. The day of my reduction came, and I was already having second thoughts. I wondered if God was trying to give me a miracle, and I was turning my back, and taking away his chance. I had taken a Valium, but had to have another before they took me back to calm me. I went home defeated and deflated. I had several months of bedrest to wallow, and mope. The babies came at 32 weeks, after everything medically possible had been done. They were small, but now healthy, and I am grateful for their two sweet faces everyday, but in the back of my mind, I often wonder about tiny little baby C. I wonder if the baby wasa boy or a girl. A fraturnal, or an identical? Brown hair or blonde? I adore my sweet twin boys, and after eveything I went through know they would not have hung on as long as they did inside me, if the other baby had remained, but there is a piece of my heart that will always remain with that other tiny little blip on the ultrasound machine. My other baby. No one talks about selective reduction as if its the 'dirty little secret' of infertility.We all had the talk with our doctor, but never really think about it until it happens. I was not reffered to a support group because there is no such group. I looked and looked but could not find anyone who understood how I felt. I went to multiples groups, loss groups and never found a place to talk. I felt like the only woman to ever suffer this pain, and like no one understood me. Only when one of my close friends had to suffer through a reduction also did I realise how commonplace they are in the world of pregnancy after infertility. I was lucky. I had good friends, and supportive people around me to help me through. I also was blessed with healthy twin boys. I still mourn for my lost triplet, and sometimes I wonder if I did the right thing. I still get misty eyed when I see the triplet stroller at the baby store, and envious when I hear of another large, multiple birth. But when I look into the eyes of my children I know…they were MEANT to be here with me, and they are here, healthy and happy. That is what matters. If you are ever put in this difficult position, feel free to email me with questions, or just to talk about your feelings. ~Emily~
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Created and copyright by -Emily Robertson © Jan.2002 emily@selectivereduction.com |
