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Old 08-18-2008, 03:05 PM   #91
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Re: Selective reduction

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1) You don't "implant" embryos. You transfer them. They either implant into the lining of the uterus or they don't. Going about talking about "implanting" embryos just makes it sound like the speaker doesn't know much about IVF.

2) The McCaugheys were born at 30-31 wks (hardly near-term imho) and were conceived using ovulation-induction medication (metrodin). Not ivf. Just for the record.

3) As for the question about why they wait to do SR until 11-12 wks - they want to avoid reducing an embryo that's going to spontaneously miscarry, and they want to be able to have the sacs/embryos big enough to see what they're doing well so that they avoid affecting the remaining embryos. And often they want to wait on CVS results.

For the OP, I'm just sorry that your sister's having to decide this (with her DH) - I agree that they're the only two who can really decide, and it's a hard decision. She may well have regrets either way, unfortunately. Neither is the quick/easy/obvious thing to do (despite many comments from PPs.)

I have two friends who've chosen to do SR, and both feel that it was the right decision for them, but neither had an easy time making the decision. (Both were advanced maternal age, and reduced from triplets to twins, and all four twins are doing well.) Both chose to have CVS prior to deciding, in case of chromosomal problems, and thought that was helpful information to have. I'd guess it might be helpful for your sister, too.

FWIW, I'm pregnant with twins after IVF, and have been on bedrest since 22w, and have had a moderately complicated pregnancy. I can't imagine how things would have gone with three more in there, but I can't imagine it would be good.
You are right, I don't know that much about IVF. I am going through this through my sister. I have never done IVF personally.

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Old 08-18-2008, 03:31 PM   #92
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Re: Selective reduction

I don't have any advice for you, but I wanted to send some to your family. This is a tough decision and you need all the support you can get, no matter what path you take.
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Old 08-18-2008, 03:37 PM   #93
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Re: Selective reduction

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I would also like to add something else. I see SO many of you who are saying don't put in any more than you are willing to carry. I totally and 100% agree with this. HOWEVER I do personally know more than one person who has had one implanted, and ended up with twins. (The embryo split.) Then, another who was more than fine carrying twins, so they put in two. One stuck, the other stuck and split THREE times. So, she was then carrying a singleton and set of identical triplets.

It happens.

It makes me sad to read posts that call selective reduction *killing*. It's not that simple and it puts parents who are faced with this awful predicament in an unfair category. They are not killers like someone who deliberately takes someone else's life without thought. No parents should have to go through this...it's a loss like any other.
To put it more bluntly and to try and look at it in an analogy - what if someone came here and posted on that other thread about formula feeding that regardless of the situation, formula is detrimental to a baby's health and is sub par to breastmilk. Sure, we know breastmilk is best, but we also know that for whatever reason not everyone can do it.
To imply that parents make these tough decisions without mindful contemplation is disrespectful.

I can post an anecdote. A good friend of mine who was also my doula has a coworker who went through IF and got pregnant with either 3 or 4. She might have done IVF or she might have done something less invasive, I'm not really sure. Anyhow, she chose to keep them all despite knowing the eggs were not high quality AND her doctor's explanation of all the risks. She and her husband made up their minds and decided to go ahead with the pregnancy intact. She went on to suffer a massive infection in her uterus when one of the babies died and wound up losing them all anyway.

My point is that things can happen, both blissful and devastating, no matter if you go forward with trying to keep the high number multiples or selectively reducing.

And someone said awhile back that infertility is infertility is infertility (not a direct quote but that was the gist) and I wholeheartedly agree. But I will say this. Once you walk through the doors of an infertility clinic you have entered a whole 'nother world. You are now probably not only digesting the fact that you have failed at conceiving on your own but the fact that you will most likely go into debt trying to have a child. Infertility treatments/IVF is an art and there are loads of moronic doctors out there who are purely in it for the money. Some couples live in such a small town that they have to travel hours away to see their specialist - and don't forget we're talking every day as ovulation approaches.
I can only assume that the OPs sister did know what she was getting into but felt that her options were so limited all she could do was take her chances. She wanted a child, it's that simple.

Fwiw, I went through IF and this time had about 20 mature follicles at the time of ovulation. There was a chance I could've had multiples and I'm so grateful it turned out the way it did. I knew the risks and was ok with choosing selective reduction if it came to that. I know that dh and I did not want any more than two and also knew that my doctor is an expert and did all he could to avoid multiples.

Gosh, didn't mean to write a book. I really feel for the OP. I'll be holding your family in the light, mama...
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Old 08-18-2008, 03:57 PM   #94
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Re: Selective reduction

I remember in an interview with Bobbi McCaughey, she was asked about being faced with this decision. She teared up, and pointed out that had they chosen to do that, she knew exactly which children would not be in her life today, because of where they had been in her womb, and the easiest to reach for a reduction. She had a hard time even verbalizing the grief at the mere thought of not having those kids.

I would not judge someone for doing this, but I would find it heartbreaking. I agree with needing to heavily weigh the risks on both sides of the fence, and whether a person could live with themselves for a less than optimal outcome with their choice.

Also, with regards to not putting in more embryos than you can handle, I agree, but that's really irrelevant, as what's done is done.

To the OP, my heart is breaking for you right now. I cannot imagine what you must be going through. I sincerely hope that no matter what choice is made, everybody can be at peace. I will be praying for you and your family to find guidance through this.
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Old 08-18-2008, 05:59 PM   #95
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Re: Selective reduction

SR is a tough issue, try to be there for her as much as possible, either decision (to reduce or not to) is very emotionally draining and intensive.

Best of luck to her!
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Old 08-18-2008, 07:21 PM   #96
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Re: Selective reduction

poor things! I can't imagine what a day they have had! Do you know if they are doing the CVS testing? I've read of that being done first also. I wonder about those that were fragmenting...


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Old 08-18-2008, 07:32 PM   #97
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Re: Selective reduction

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eta- my bil also explained that there is very little data and statistics on quintuplets because almost every pregnancy ends before 20 weeks. The basic choice is this: continue with 5 and lose them all or reduce to two and have healthy babies.
Yup. I'm sorry -- I don't have the scientific links and personal experience you're asking for, but I wanted to lend some support. I can not even imagine how difficult it must be to be in her situation -- in the UK they consider it a severe form of psychological trauma and provide long term counseling, regardless of the decision made.

I would reduce in her situation. No doubt about it. Would there be guilt? Yes, but the odds are simply better -- I could not handle the overwhelming odds of losing ALL of those babies rather than a precious few -- that would provide even MORE guilt. I know she's in a horrid place emotionally.

For those who are saying she'd be taking the lives of her children, is it really better to take MORE of them through inaction? That's what the odds are on the side of, unfortunately -- and while many of you obviously still think it wrong, that's just the way it is odds-wise, unfortunately. We're not talking twins or triplets here -- those stories are not comparable.
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Old 08-18-2008, 08:29 PM   #98
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Re: Selective reduction

you and your family are in my prayers. just give her a hug, support, and love those babies that are born 5 times harder *hugs*
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Old 08-18-2008, 09:04 PM   #99
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Re: Selective reduction

Hugs to your family. May whatever happens be the right thing for your sister and BIL.
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Old 08-18-2008, 09:25 PM   #100
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Re: Selective reduction

Even if you look into Jon and Kate plus eight, their sextuplets were originally a set of seven babies. They obviously didn't selectily reduce. Sometimes "nature" reduces on its own. Multiples is a risk I would have thought she was aware of. I couldn't reduce. I'm sorry shes faced with this terrible dillema! It must be the only thing she can think about.
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