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The American Fertility Association Blog

Infertility: where religion and science meet

August 3, 2009 - Monday
Posted by Ken

In a recent article titled Reconciling Religion and Infertility, the author thoughtfully outlines the beliefs and teachings of Judaism, Islam, and Christianity and how those beliefs affect each tradition’s teachings about infertility treatment. The article was written from the perspective of helping the 10 percent of the 10 million people worldwide that will be diagnosed with cancer this year and who may require fertility treatment. The term “oncofertility” has been coined for the field that assists patients in looking at fertility preservation options.

From my perspective, there are three key points raised in the article. First, those diagnosed with cancer have not been routinely offered fertility preservation options. Second, there is a real desire for dialogue with religious leaders on this issue, so that health care teams can better deal with people of faith who are faced with cancer and who desire to preserve their fertility. And third, that there are great variations between and within faith traditions on how to approach this issue, and those approaches may change or be nuanced over time as our understanding of technology continues to advance.

But the broader issue that the article points to is the importance of those undergoing or contemplating treatment to have a conversation about it. Have the conversation with your religious leaders. Have it with trusted family and friends. Share what you are going through so that assisted reproductive technology becomes human for others. Finally, share what you are going through so that the conversation becomes normalized in the population at large.

We often talk about the gains The AFA has made in terms of web traffic and media coverage. It’s not because I want The AFA or any member of the staff or board to have attention drawn to them. It’s because I want the conversation about this issue to become part of the mainstream so that the fear and shame, which still surrounds it, can be diminished.

So join the conversation. Health care professionals, patients, those faced with cancer, patient advocates, religious leaders, children born as a result of IVF – everyone’s voices are needed – and so are everyone’s ears; because talking is only half of it.

Ken Mosesian

 

Categories
Cancer & Fertility • Fertility • Fertility Preservation • Infertility • IVF • Reproductive Technologies

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Have We Pushed the Envelope Too Far?

March 5, 2009 - Thursday
Posted by admin

At a conference at Barnard College in New York City on February 28th entitled, The Politics of Reproduction: New Technologies of Life, a group of feminist scholars asked the same question regarding reproductive technologies and, perhaps surprisingly, suggested that personal reproductive choices may now need to be limited.  If you read the many recent news articles about Nadya Suleman (the “Octomom”), 60+ year olds conceiving and conceiving multiples, at that, and doctors offering preimplantation genetic diagnosis for parents wanting to select for sex, eye color, and hair color of their offspring, it is no wonder that the world is reacting with incredulity to the lengths to which both patients and doctors in reproductive medicine have gone and potentially will go. The infertile are being labeled selfish, self-centered, unfair to their progeny, crazy, psycho, and worse. The doctors are being labeled greedy and unconcerned with the potential damage they may inflict on patients or offspring they help to create.

But, for those of us who were around before 1973 (Roe v. Wade), we remember a time when women’s reproductive choices were significantly restricted by laws. Do we really want limits placed upon reproductive autonomy? What limits would we all, or even the majority of Americans, agree upon? Who will we call upon to set these limits? Do we want the government, doctors, lawyers, ethicists, mental health professionals, religious leaders… to determine available reproductive options for women? Religious extremists lurk, just waiting for the opportunity to prohibit first abortion, then perhaps birth control and possibly IVF.  On the other hand, should patients be allowed to dictate what their doctors will do even if they, the patients, are willing to accept inordinate risk to themselves or the children they hope to create?
There is a difference between conceiving on one’s own and requiring medical intervention with the use of limited medical resources in order to conceive. Yet, do we want the government to tell us what we can do in these very private reproductive matters? Other countries have done just that, with restrictions placed on the number of embryos that can be transferred, i.e., 1-2, health care coverage for IVF but with age restrictions, and no payment beyond expenses allowed to egg, sperm, or embryo donors to reduce charges of commodification of the reproductive process or product. 

In the United States, these decisions would be determined on a state by state basis, at least initially. Here’s a sample of decisions already made or in the making: Louisiana requires implantation of all embryos created by IVF. Embryos are not considered the property of the gamete providers, IVF physicians or the clinic. If a safe number of embryos are planned for transfer and more remain, the couple can relinquish parental rights prior to implantation and the embryo(s) must be made available for embryo “adoption”. Net result: physicians may be afraid to offer basic IVF to couples because of the possibility of future prosecution for not implanting all created embryos because of potential risk(s) to the woman who does not wish to relinquish her embryos for adoption. As I write this, the Georgia State Senate is planning a hearing on two proposed bills, SB 169 which would allow: only two or three eggs to be fertilized per IVF cycle with additional eggs not being allowed to be used,; only two embryos transferred per cycle unless a woman is age 40 or over; no cryopreservation of extra embryos (thus all embryos would have to be transferred, so keeping them within the limit of two means not fertilizing additional embryos and possibly not obtaining high quality embryos); no financial compensation for egg, sperm, or embryo donors; and SB 204 which is an embryo adoption bill, requiring the same provisions for embryo donation as for the adoption of a child, including judicial hearings, home visits, etc. Do others hear the footsteps of organized religion creeping in??

• We do need additional high quality long-term medical research on the safety for both women and offspring of the ARTs.
• The well-conceived (no pun intended) guidelines and policies developed by The American Society for Reproductive Medicine must hold weight with the reproductive endocrinologists and others working in the field of reproductive medicine and somehow need to be professionally enforced. If this doesn’t happen, legal regulation is sure to follow.
• Infertility patients need to be made aware of these guidelines and their rationale in advance of agreeing to undergo treatment. While these guidelines are developed by interdisciplinary committees of the American Society for Reproductive Medicine, with concerns for patient safety,  health of the potential babies that are created, and both patient and physician autonomy, input from representatives of the infertile community would be useful, as well.

From a psychological perspective, it is often quite difficult for prospective infertile parents to think about the potential short- and long-term ramifications of their reproductive choices since it feels too risky and is too scary for them to be optimistic enough to actually believe that they will become pregnant. However, fortunately, many do get pregnant through ART.  Thus, patients must carefully consider the risks that they are exposing themselves and their potential child(ren) to by their choices.

The science behind infertility treatment has been truly amazing and has been responsible for offering so many options that were not available to those experiencing infertility even 40 years ago. Physicians need to refuse to perform procedures that go against their professional guidelines because they are deemed too unsafe for their patients or the potential offspring they help to create. Yet, patients must be responsible, as well.

The recent media frenzy about assisted reproductive technologies has brought reproductive choices back into more general public discussion. Let’s bring those actually experiencing infertility into the discussion regarding policy and regulation, as well. So, what do you think? I’d love to hear your comments.

Best,

Joann Paley Galst, Ph.D.
Chair, AFA Mental Health Advisory Council and Co-Director of AFA Support Services
30 E. 60th Street, Suite 802
New York, NY 10022
212-759-2783
jgalst@aol.com

Categories
Family Building • Infertility • Reproductive Technologies

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Tyra Update - Part Deux

January 23, 2008 - Wednesday
Posted by admin

To our extraordinary members:

We wanted to share our experience of you in the wake of our response to the calls, emails and blog entries we received about the taping of the Tyra Banks Show segment on infertility. The whole episode obviously struck a chord deep within this community. The blizzard of cyber-notes sent to us about our stance regarding the show’s alleged mishandling of the issue has been overwhelming. Thank you!

Thank you for your letters, both affirming and critical of our actions. Because what’s most important in all this is that you’ve spoken up, engaged with us and your peers about topics as sensitive and critical as fertility, infertility, assisted reproductive technologies, family-building, individual choice and public perception.

What can we say? You are remarkable.

Just to update you: Like you, we’re awaiting the airing of the show. We do believe in their right to produce whatever they want. We also believe in our right to respond. Now, everything we know comes from people who’ve told us what they witnessed at the toping. The reports were infuriating. So in the interest of getting a clear picture, we phoned the producers, hoping to hear their perspective. We’re still waiting for a return call.

Now, perhaps, as two of you have written, we jumped the gun with our open letter of protest to the show’s senior producer. If we did—great! Nothing would make us happier than to be mistaken about the Tyra Banks Show. We’d gleefully offer an apology. All we’re after is fair and intelligent treatment by the media. There’s no question but that we’ll fight for that and fight hard. (We’ll keep you posted as the situation unfolds.)

By the sheer volume of your correspondence to The AFA, it’s clear that you want the same. Your activism and input are essential to keeping the media, politicians and regulators on the ball and honest. So we want to take this unique opportunity to urge you to continue this dialog with and through The AFA. It’s so important that we communicate among ourselves, a kind of de facto think tank. To that end we’ll be publishing as many of your notes as we can fit in the next issue of Connections and putting all of them up—pro and con—on our blog.

It’s your voices, your opinions, ideas, experiences and observations that help The AFA shape its perspectives, educational initiatives and policy agenda on everything from compromised fertility, access to health care, treatment affordability and insurance to sexual and reproductive health and the pursuit of family-building. It’s your insights that make the difference.

Yes we are an educational organization, full of top-notch information free to everyone. But The AFA is also an energetic advocate for enlightened policies to guarantee the basic human right to have family. That means that we not only work on infertility and its ripple effects, we also tackle social, legal and political issues through the lens of fertility preservation and prevention. That includes, but certainly isn’t limited to, access to scientifically based sex education, an environment free of fertility-damaging toxins and efforts to promote all forms of family-building. Our goal is to elevate our issues into the mainstream national discussion about reproductive health and rights. Our goal is to be in the room when policy is made, not merely to respond after the fact.

So tune in and jack in. Ask questions. Send your personal stories for The AFA blog or our publications. Share your take on the medical, social, political aspects of infertility, fertility, third-party reproduction, adoption, foster care. After all, it’s about creating a family. It’s what you’re about. It’s what we’re about. We’re in it together. Let’s keep the connections open.

With warm regards,
The AFA Staff

Categories
Fertility • Infertility • Reproductive Technologies

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