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  #1  
September 25th, 2011, 05:08 PM
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Three articles about the option of selectively reducing only one fetus in a twin pregnancy:

http://www.nytimes.com/2011/08/14/ma...pagewanted=all

Twin reduction abortions: Why do they trouble pro-choicers? - By William Saletan - Slate Magazine

IVF and abortion: Is it morally wrong to abort an implanted embryo when you're expecting twins?

This excerpt in particular jumped out at me:

Quote:
This bifurcated mindset permeates pro-choice thinking. Embryos fertilized for procreation are embryos; embryos cloned for research are "activated eggs." A fetus you want is a baby; a fetus you don't want is a pregnancy. Under federal law, anyone who injures or kills a "child in utero" during a violent crime gets the same punishment as if he had injured or killed "the unborn child's mother," but no such penalty applies to "an abortion for which the consent of the pregnant woman … has been obtained."

Reduction destroys this distinction. It combines, in a single pregnancy, a wanted and an unwanted fetus. In the case of identical twins, even their genomes are indistinguishable. You can't pretend that one is precious and the other is just tissue. You're killing the same creature to which you're dedicating your life.
1. Do you think that it's ever ethically justifiable to abort one of two twins?
2. Should it be legal?
3. Does it make a difference whether these twins were conceived naturally or through IVF (or some other medical procedure)?
4. Is this any different from selectively reduction of higher-order multiples? Why or why not?
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  #2  
September 25th, 2011, 06:31 PM
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Part of my IVF counseling was to discuss selective reduction should the need arise. More than one baby is NEVER the goal of reproductive treatments and most who transfer two embryos will only have one implant if they are lucky. I don't think there are a slew of people having this done electivly.


1. Do you think that it's ever ethically justifiable to abort one of two twins? Yes, there are many reasons why selective reductions are performed.

2. Should it be legal? Of course it should be legal.

3. Does it make a difference whether these twins were conceived naturally or through IVF (or some other medical procedure)? Not at all. I didn't realize that being infertile somehow held my up to tighter moral guidelines.


4. Is this any different from selectively reduction of higher-order multiples? Why or why not? I don't see any difference between the two.

A few (or what seems to be ONE repeated in each article) anecdotal stories are just being used as fuel for the pro life movements continued vilifying of those who use reproductive assistance.
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  #3  
September 25th, 2011, 07:20 PM
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Quote:
Originally Posted by Poncho06 View Post

3. Does it make a difference whether these twins were conceived naturally or through IVF (or some other medical procedure)? Not at all. I didn't realize that being infertile somehow held my up to tighter moral guidelines.
In the article it's the other way around. The woman says that she only felt justified in having a selective reduction performed BECAUSE she had used IVF. She says that she wouldn't have done it if her twins had been conceived naturally.
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  #4  
September 25th, 2011, 07:29 PM
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Quote:
Originally Posted by Poncho06 View Post

4. Is this any different from selectively reduction of higher-order multiples? Why or why not? I don't see any difference between the two.
The original justification for the development of selective reduction procedures is that pregnancies involving higher-order multiples often involve significant risks to both the mother and the babies. Twin pregnancies, in contrast, are generally safe pregnancies. The reasons for performing one would be purely 'social,' as it's termed in the article, rather than medical.

I'll add another question to my original post: should doctors be under obligation to offer these types of procedures, if it offends their sensibilities to do so?
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  #5  
September 25th, 2011, 07:42 PM
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And if she conceived them naturally she would have found another justification for her decision. Those who conceive via IVF do not view our children any different than those who conceive them naturally. We don't love them any less or view their lives as less. Frankly to even suggest it is insulting.

Using one crappy person to build a platform of anti-fertility treatment rhetoric is flawed. This woman is not representative of those of us who have infertility as a whole nor do I believe her thought pattern is anywhere within the realm of "norm" and liken her to an "Octomom"



Quote:
Originally Posted by Quantum_Leap View Post
In the article it's the other way around. The woman says that she only felt justified in having a selective reduction performed BECAUSE she had used IVF. She says that she wouldn't have done it if her twins had been conceived naturally.
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  #6  
September 25th, 2011, 11:25 PM
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Quote:
Originally Posted by Poncho06 View Post
And if she conceived them naturally she would have found another justification for her decision. Those who conceive via IVF do not view our children any different than those who conceive them naturally. We don't love them any less or view their lives as less. Frankly to even suggest it is insulting.

Using one crappy person to build a platform of anti-fertility treatment rhetoric is flawed. This woman is not representative of those of us who have infertility as a whole nor do I believe her thought pattern is anywhere within the realm of "norm" and liken her to an "Octomom"
I was going for anti-abortion rhetoric rather than anti-fertility treatment rhetoric, but I guess I must not have explained well. Of course I don't think that mothers of IVF children love their children any less than mothers who conceived naturally do. However, a mother who chooses to selectively abort one twin -- whether that mother conceived naturally or used medical assistance -- must not have much love for that particular twin, correct? As in, she would have rather if he/she had never existed? She prefers not to have to care for him/her? What am I missing here? I don't see how you could love something and at the same time want it to disappear.

Would you see it as ethical for a mother to give up one of her two twins for adoption? If not, how is this any different?
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  #7  
September 26th, 2011, 12:16 AM
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To complicate matters even further, I'll refer back to this thread from a million years ago: http://www.justmommies.com/forums/f1...-rights-4.html (Men's Reproductive Rights) Here, when it was asked why men shouldn't have the legal right to participate on an equal footing with women with regards to abortion decisions, the repeated response was that since women have the unique physical burden of carrying a pregnancy, this decision should remain solely in their hands (this response was made in post #46, #57, #76, and others). In other words, a woman can choose to have an abortion even if the child's father would prefer to keep the child, because a woman has the right to reject the physical burden of being pregnancy (which she uniquely would have to bear).

However, in the case of selective reduction, after the procedure the woman continues to be pregnant. She is still bearing that physical burden (willingly). She still has to go to prenatal appointments. She still has to gain the weight, and undergo the physical changes, and go through labor and childbirth, the whole dog and pony show. She consents to all that. The only part she doesn't consent to is having a child. (Well, she consents to having one child, but not two).

So....what should happen if a mother conceives twins, and the father wants to keep both babies, but the mother wants to abort one of the two? If the mother has already consented to the pregnancy, then why shouldn't she and the father have equal jurisdiction over this type of decision at that point?

This issue is really too complicated and makes me squeamish.
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  #8  
September 26th, 2011, 09:27 PM
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Quote:
Originally Posted by Quantum_Leap View Post
I was going for anti-abortion rhetoric rather than anti-fertility treatment rhetoric, but I guess I must not have explained well. Of course I don't think that mothers of IVF children love their children any less than mothers who conceived naturally do. However, a mother who chooses to selectively abort one twin -- whether that mother conceived naturally or used medical assistance -- must not have much love for that particular twin, correct? As in, she would have rather if he/she had never existed? She prefers not to have to care for him/her? What am I missing here? I don't see how you could love something and at the same time want it to disappear.

Would you see it as ethical for a mother to give up one of her two twins for adoption? If not, how is this any different?
You didn't especially when putting a fertility treatment specific spin on your questioning.


I would see it as ethical for a mother to place one child up for adoption while keeping another. Much in the same way I would find it ethical for a mother to place a child for adoption if she had children already or to go onto having additional children after placing one for adoption.

The woman in the story used for all the articles you posted was 45. In no way is a 45 year old woman pregnant with twins considered a typical pregnancy, regardless of how she conceived. Most if not all multiple pregnancies are placed into an atypical category,though she may stay with an OBGYN and not transferred to a Peri she will be monitored more closely, have a much higher chance for gestational diabetes, TTTS (if there is a shared placenta), pre term labor etc.


I can't explain her rational for her choices. Perhaps her apparently callous statements are to deflect judgement, perhaps she's an @$$hole, or perhaps she is a made up person being used to push an agenda. My best guess would be the latter scenario.
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  #9  
September 26th, 2011, 11:04 PM
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Quote:
Originally Posted by Poncho06 View Post
You didn't especially when putting a fertility treatment specific spin on your questioning.
I brought it up as a question because it was discussed extensively in the original articles and I thought it was interesting. I never indicated my own stance about it one way or the other.
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  #10  
September 27th, 2011, 01:05 PM
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I am pro choice, so reduction is just another choice. What someone does, no matter how I may personally feel about it, is just their choice.

I'm one of those annoying people who are "pro-choice but...". I don't agree with abortions except for medical reasons beyond viability. I do not believe with gender selective abortions. So... that being said, if the reduction is before viability and not gender related I really have no opinion other than I think reductions should be reserved for high order multiples and used for the health and well being of the mother and remaining babies. If there is a medical need to reduce a twin, then that would be fine.

but my opinions are just my own, and are based off personal feelings. I'm not going to openly condemn someone who's done what I don't believe in.
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  #11  
October 8th, 2011, 11:25 AM
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I'm missing something. IVF isn't something you take lightly. You transfer embryos only based on # you are willing to carry and/or raise. I would NEVER reduce twins to ONE without some serious risk to myself and/or the other twin. How would *I* get to choose which one lives and which one dies? I am not about to play God.

1. Do you think that it's ever ethically justifiable to abort one of two twins?
Medical Extremes ONLY, not just because I transferred 2 embryos (and SIGNED A FORM agreeing to this and KNOWING I could possibly have twins. I could have SIGNED A FORM agreeing ONLY to an SET (single embryo transfer) instead! It's proven that SET is JUST AS SUCCESSFUL as transferring 2 embryos HOWEVER transferring 2 embryos doesn't create "more" chance of success; just a higher chance of conceiving twins (or more if any split). Any GOOD RE will explain this to their patient. If the patient chooses to go forth with a multiple embryo transfer in spite of the warnings, then I cannot see justifying the reduction of twins to one.
2. Should it be legal?
If it's illegal, the extreme medical cases in which it might be necessary would be a problem so no it can't be illegal. Therefore selective reduction should STAY legal. I do think that MULTIPLE EMBRYO transfers should be looked at again. If a person says to their RE that they are AGAINST twins (or more) then it should be illegal for an RE to suggest transferring more than one embryo to said patient.
3. Does it make a difference whether these twins were conceived naturally or through IVF (or some other medical procedure)?
No. If you conceive twins naturally, it is just part of getting pregnant. If you had IVF and the twins are not ID twins, then you KNEW the risks and still chose to proceed. Desperation, fear of a cycle not working, money issues are NOT excuses to proceed with a risky procedure and then just decide to reduce one of the babies you didn't want.
4. Is this any different from selectively reduction of higher-order multiples? Why or why not?
YES. Because HOM pregnancies automatically fall under the medical extreme category. Obviously HOM's are much riskier to carry, usually do not go to term, and almost always require surgery among many other reasons.
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  #12  
October 8th, 2011, 08:43 PM
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Quote:
Originally Posted by GSLynn View Post
I'm missing something. IVF isn't something you take lightly. You transfer embryos only based on # you are willing to carry and/or raise. I would NEVER reduce twins to ONE without some serious risk to myself and/or the other twin. How would *I* get to choose which one lives and which one dies? I am not about to play God.

1. Do you think that it's ever ethically justifiable to abort one of two twins?
Medical Extremes ONLY, not just because I transferred 2 embryos (and SIGNED A FORM agreeing to this and KNOWING I could possibly have twins. I could have SIGNED A FORM agreeing ONLY to an SET (single embryo transfer) instead! It's proven that SET is JUST AS SUCCESSFUL as transferring 2 embryos HOWEVER transferring 2 embryos doesn't create "more" chance of success; just a higher chance of conceiving twins (or more if any split). Any GOOD RE will explain this to their patient. If the patient chooses to go forth with a multiple embryo transfer in spite of the warnings, then I cannot see justifying the reduction of twins to one.
2. Should it be legal?
If it's illegal, the extreme medical cases in which it might be necessary would be a problem so no it can't be illegal. Therefore selective reduction should STAY legal. I do think that MULTIPLE EMBRYO transfers should be looked at again. If a person says to their RE that they are AGAINST twins (or more) then it should be illegal for an RE to suggest transferring more than one embryo to said patient.
3. Does it make a difference whether these twins were conceived naturally or through IVF (or some other medical procedure)?
No. If you conceive twins naturally, it is just part of getting pregnant. If you had IVF and the twins are not ID twins, then you KNEW the risks and still chose to proceed. Desperation, fear of a cycle not working, money issues are NOT excuses to proceed with a risky procedure and then just decide to reduce one of the babies you didn't want.
4. Is this any different from selectively reduction of higher-order multiples? Why or why not?
YES. Because HOM pregnancies automatically fall under the medical extreme category. Obviously HOM's are much riskier to carry, usually do not go to term, and almost always require surgery among many other reasons.
I think (not positive), but I think that in the case of the woman featured in the article the twins were identical and had split following a single-embryo transfer.
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  #13  
October 8th, 2011, 10:00 PM
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Quote:
Originally Posted by Quantum_Leap View Post
I think (not positive), but I think that in the case of the woman featured in the article the twins were identical and had split following a single-embryo transfer.
that just makes me squeamish.... just how do you explain that to your child? (just a general question, not really looking for an answer lol)

But I think Lynn worded things very well.
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  #14  
October 10th, 2011, 10:27 AM
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It doesn't say how many "Jenny" transferred. The standard these days is 2 embryos and the other girls transferred multiple embryos according to the articles (although one didn't do any reduction at all).

I feel I can speak about this very very clearly and personally because I have been there in all types of ways.

1st it took us 4 years to have my dd, took another 13 months with medications to have my son who it was suspected that he had an ID vanishing twin brother. I always joke about it saying "I couldn't handle to of him", but it was scary either way. I thought for sure that meant I'd lose him, but I was grateful that he carried on to more than full-term. Then I decided to be an egg donor. One of the stipulations was there would be NO abortion without a clear medical reason, and the IP's had to sign something that stated this. I did this for two people, each who ended up pregnant. The first one got pregnant first try and had a baby girl in March 2005 and then the 2nd one had a baby girl in Dec 2005.

Then I wanted to have baby #3. I couldn't get pregnant. We tried everything from clomid to injectables and nothing worked. It was ironic how I had such healthy eggs that I could help two families, but I couldn't even have my own last child. We knew we didn't want to wait too long so we called the RE and asked what else we could do. IVF was discussed but we needed to get our insurances and what not in order before we could seriously consider it. Fast forward a month: I get a call from the clinic and the second IP who had the one baby girl wanted to do another cycle with me. It took me two weeks to make a decision. I couldn't just give her another baby when I was struggling...so I agreed to do a shared cycle. I donated 1/2 my eggs to her and kept the other 1/2.

The cycle was VERY aggressive and I got sicker than I could have imagined. She transferred and I didn't due to severe OHSS complications. She got pregnant. My embryos were frozen for 31 days and then transferred. The quality SUCKED bad so we transferred 4 frozen embryos. I decided that for me if I got pregnant with quads, I'd have them all. (this is me as a woman who was going through secondary infertility so I can't say it was the best decision in hindsight).

I got pregnant with triplets. It was a shock. We decided to continue the pregnancy because we didn't believe in abortion and we figured it was meant to be. We knew how risky carrying triplets would be to me and took things very slow. In the 11th week, however, I got very very ill (not pregnancy related) and by the 12th week, baby "C" was gone. No heartbeat. The pregnancy had naturally reduced to twins.

I was resentful toward the person who got me sick with these illnesses. I was hospitalized and medicated and we believe that baby "C" was already the weakest and felt that no matter what, he may not have made it. Then I thought what if we DID make it? Would the twins have died too? What if I only made it 28 weeks? (As it was, my twins were 5 weeks early). This is all in hindsight, though. Not during the pregnancy.

The two strongest survived and were born in 2007. i'm so glad I kept them both and looking at them, I can't honestly imagine having to choose which one of those faces I'd have to have reduced. We went through a lot ourselves, A LOT but made it through.

Life isn't about the perfect plan...it's about trying to make it each day. It's not about impressing my friends or being on some social list or being fearful. Life is precious and I don't go into these things just thinking "Oh, well if I get pregnant with twins, I'll just reduce one". It's a lot of thought and money and time and energy and love.

I went on to do one more egg donation in 2008 for the first IP that I donated to in 2004. I was supposed to do it two months earlier, but oops, I got pregnant and didn't know. It miscarried very early and was deemed chemical. She had her second baby girl in Jan 2009. In Aug 2008, I was pregnant with another baby of my own and lost her as well. It was very difficult knowing that I was an egg donor who every one of the pregnancies each of the ladies had ended healthy while I was losing one of my own babies. I decided I was done.

In Jan 2009, when my first IP's baby girl was born, I made the monumentous decision to become a surrogate. To help someone who wanted a baby and I knew I could understand because I'd been there.

Taylor died in 2010, April. I was devastated. I had worked so hard for this couple. The first transfer failed. We transferred TWO embryos even though I wasn't thrilled with the idea of twins. I knew that if I had gotten pregnant with twins, it'd be ok. I got pregnant with twins, and one passed before the 7th week. We thought by the 2nd trimester we were clear. But we weren't. Her parents had to live with this loss after all they'd been through. I went through it with them.

We were going to try again, but finances for them were not in order. So, we postponed our match and I decided to try again with another family while we were waiting.

That was the miracle of the whole thing. Arlet. She is why I did this and the happiness I could bring to someone else was indescribable. I KNEW what it was like and that's why I knew I was doing the right thing helping other families.

This is why I could NEVER ever reduce and I could never transfer more than I am willing to carry. This is why I would never match with someone who had different views than me. This is why the article pissed me off.
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