IVF is the acronym for In Vitro Fertilisation. IVF is an alternative fertility option for those couples who are unable to conceive a baby through natural intercourse or are considered infertile. There are many reasons that a couple may be deemed infertile, there may be problems with the sperm, the egg, or other problems. IVF is a procedure that involves fertilising an embryo with male sperm in a controlled clinical laboratory environment. This is done outside the body and when fertilised and developed, the egg is implanted into the female uterus to develop/grow. IVF is a highly regarded option for many people and provides couples with an improved prospect of being able to have a baby.
Like any medical procedure, IVF has a range of advantages and disadvantages.
The advantages of IVF are;
– The possibility of conceiving a child which would normally not be possible.
– There are no known long term problems of being conceived by IVF.
– There is a chance, in the case where more than one embryo is implanted, that multiple embryo are successful, you could have more than one baby.
On the opposite side however, there are some disadvantages;
– IVF costs vary depending on the treatment but estimated costs can be around $10,000. Some of this cost may be claimable back on Medicare. Some couples may need to have multiple IVF treatments to get a successful result and this can make it unaffordable for some families. In addition to this, medications for the treatment are an extra expense, as well as specialist hospital admission, scientific techniques as well as embryo and sperm donor expenses if this is required. If you have private health cover, these costs may be reduced.
– Whilst this can also been seen as an advantage, there is a chance, in the case where more than one embryo is implanted, that multiple embryo are successful and you could have more than one baby. For families only seeking one child or have financial constraints, this could be see as a negative.
– It is possible that babies born via IVF may have a slightly higher risk of having a birth defect, like eye, heart or reproductive organs for example.
– With any pharmaceutical drugs, there are generally side effects and this is no different with IVF medication, this can include headaches, nausea etc.
The IVF process takes around six weeks and consists of a number of steps;
1. The first step is to select and meet with a suitable IVF provider to discuss treatment options, costs etc and look at any medical information you have regarding your infertility. An ultrasound scan is also performed in order to assess ovaries, the uterus etc.
2. You will be required to inject yourself with a Follicle stimulating hormone which increases the amount of eggs made by your ovaries. The more eggs the better chance of fertilisation.
3. Various ultrasounds and blood tests are conducted to monitor progress in order to identify the correct time to stimulate ovulation in order to retrieve eggs.
4. Egg collection is performed whilst the female is under mild sedation. The procedure involves using a needle to collect the eggs.
5. The eggs are then combined with the male sperm and monitored to check if fertilisation has been successful. You would normally know by the next day if this has been successful. The embryo is then maintained in a controlled environment for between 2-5 days to develop.
6. The embryo is then implanted into the female uterus and a pregnancy test done at about ten days to check if it is positive.
7. If the female is pregnant, a scan is then normally conducted around 2 weeks later to check for a heartbeat.
Preimplantation genetic diagnosis (PGD) is the process of removing cells from an embryo for testing and diagnosis of genetic disease or chromosome abnormality, before embryos are implanted in the female body. This maximises the chance of a healthy baby.
PGD may be appropriate when the male and female carry a gene or chromosome that may negatively impact the embryo/baby. PGD is also often used if cases where there have been ongoing unsuccessful IVF attempts, recurring miscarriages (embryo quality is checked before implantation) or risk of other down syndrome etc. in more mature parents.
There are some disadvantages of PGD such as cost (approx. $1000), potential loss of embryo due to the cell biopsy, possible misdiagnosis of the embryo including possible incorrect identification of the sex of the baby. This last point crosses an ethical boundary in the case where people are terminating due to the sex not being what they want i.e. girl or boy.
PGD allows parents to make an early decision on a range of genetic disease and chromosome abnormality and avoid the heartache and cost in termination of the pregnancy at a later stage, it effectively improves the odds of producing a healthy baby.
3-M syndrome is a disorder that causes short stature (dwarfism), unusual facial features, and skeletal abnormalities. The name of this condition comes from the initials of three researchers who first identified it: Miller, McKusick, and Malvaux. Individuals with 3-M syndrome grow extremely slowly before birth, and this slow growth continues throughout childhood and adolescence.
The characteristics and symptoms of dwarfism include:
• a trunk of relatively normal length
• disproportionately short arms and legs
• bowed legs
• reduced joint mobility in the elbow
• other joints that seem overly flexible, or ‘double jointed’, because of loose ligaments
• shortened hands and feet
• a large head
• a flat mid-face
• crowded teeth, because of small upper jaw
• a prominent forehead
• a flattened bridge of the nose.
Personally, I would accept the offer from the doctor to have them test for 3-M syndrome with a view to not using an embryo if it was shown to be homozygous for 3-M dwarfism. This is because I would not want to place my own child through certain life risks neither take the pain of my child passing. Difficulties during childhood can include breathing difficulties due to narrowed nasal passages, ear infections caused by narrowed Eustachian tubes, bowed legs meaning the legs are initially straight, but become bow-legged once the child starts walking, increased lumbar lordosis which is a backward curve in the lower spine, reduced muscle strength due to the child’s softer muscle tone, an increased risk of hydrocephalus (one in 100), which is an accumulation of cerebrospinal fluid inside the skull that can lead to head enlargement, narrow foramen magnum where the child has a smaller than normal opening at the base of the skull causing it to sometimes press against the brain stem and cause symptoms including apnoea (cessation of breathing) and neurological signs.
There are also many challenges that have to be faced during adolescence as well. These difficulties can include nerve compression causing numbing or tingling in his/her legs,
I don’t know that I could live with myself knowing my child is unhappy to be alive because of the way they look (such as obesity) and have great difficulty fitting in. Also if I produced a daughter it is common those with dwarfism have high risk pregnancies and I would not like to see my own daughter go through pain or suffer because she wants a beautiful family of her own. For these particular reasons I personally would not choose to implant the embryo.