Misconception: Infertility Awareness and the Myth of Multiples

26 Apr

We are inundated with awareness. Pink Kitchenaid mixers, races of all sorts, yellow bracelets. It’s great to see something that affects so many people get so much awareness and the attention is deserved but sadly there are a great number of disorders and diseases for which awareness is lacking. 

Are you aware that infertility has an awareness week? It’s this week –  April 22nd-29th. Have you seen anything on Facebook about it or been asked to post your toenail polish color in a way to get people talking? Probably not. Sadly due to the nature of infertility most people are either ashamed to talk about it or reticent to share their journey for fear of judgement from others. Since infertility deals with sex and reproduction, both considered “inappropriate” topics for conversation in our culture, many who are infertile find it hard to open up to others about their issues. In order to spread some awareness in my own way this week I wanted to blog about an issue that has been weighing on me lately.

When it comes to infertility, especially when dealing with infertility treatment, there are a lot of myths and misunderstandings. One of the biggest misconceptions is that undergoing infertility treatment will always end up with the birth of multiples. While it can not be denied that the use of ovulation stimulating drugs does increase the chance of multiples for many couples, according to studies done by the American Society for Reproductive Medicine approximately 30% of pregnancies resulting from the use of reproductive medicines are multiples. This number includes all multiple pregnancies from twins higher. Spontaneous multiples (those without the use of fertility medications) occur in 1.11% of pregnancies.

Society loves to sensationalize the birth of high order multiples. In North America, this curiosity predates the use or even invention of infertility treatment, so it is nothing new. In 1934, the birth of the Canadian Dionne quintuplets (the spontaneous occurance of five identical embryos) was so shocking the quints were taken from their parents by the government of Ontario and put on display for the public to see. They were visited by approximately 6000 people per day until 1943 when their parents won custody back.  

Fastforward to the 21st century and we are surrounded by stories of women having six babies, eight babies, etc. While much of the rise in the number of high order multiples born can be attributed to the use of fertility medications; it’s important to recoginize that many of these cases are due to mismanagement of care, something that seems to be left out of the stories. Two cases that are great examples of this have recently been on my radar. The first is the extremely well known “Octomom” Nadya Suleman and the second is a woman in Houston who recently gave birth to sextuplets. Both women were profiled by the media simply for giving birth to a large number of children at once…but how did they get to that point?

In the case of the Suleman, an extreme mismanagement of care by her doctor. Since the birth of her octuplets, it has been discovered by the California medical board that Suleman’s doctor transferred tweleve embyos into her uterus during her IVF procedure. The standard protocal for a woman of Suleman’s age is two. The CA medical board revoked her doctor’s medical license but this information was not deemed nearly as sensational or newsworthy; a Google search for the phrase “Suleman Octuplets” garners 1,010,000 results. A search for the name of her doctor nets 139,000 results and the first hit is a link to his still active website, promoting free consultations for IVF.  

In the case of the woman from Houston, it’s the same story just on a much less famous plane. Sextuplets are obviously old news. The woman underwent inter-uterine insemination with six follicles, four more than allowed by most doctors and was seeing a standard OB who had no special training in infertility instead of a specialist. She ended up with six children because all six of the egg follicles she had fertilized. This, like the IVF involving twelve embryos should not have been and under good medical supervision IS not allowed.

Okay, okay so I’ve lectured you on why this stuff happens and why I feel like the view that infertility treatment = instant multiples isn’t a sound theory…but is this still really an issue? Why do we need awareness? The reason I brought up the woman in Houston is two-fold, I wanted to point out why her situation is not a standard infertility protocol but I also wanted to share some of the comments on the article, the thing that really drove me to write this blog in the first place.

“Too many babies at one time. It is time to put these fertility doctors outta business.”

“I’m so disgusted with all these multiple births being glamourized. there is nothing “miraculous” about it. A miracle would be if it NATURALLY happened. I cannot believe a “doctor” would allow 6 eggs while doing an IUI. Can’t wait for their website to turn into a donations site to help support this litter of kids.”

“Fucking fertility drugs should be banned. Too many fucking humans already. Stupid story.”

“Plenty of babies that need adopting.”

These are just a few examples of the comments on the story but it brings home the point that there is still a need for awareness of how infertility treatment works, a need for increased understanding. If you take nothing else away from this, just take a second to pause and think about what you are about to say the next time you hear of someone undergoing infertility treatment or having trouble conceiving. Think about if what you are about to say might be a misconception, think about how much you really know about the issue. The infertility community at large will really appreciate it.

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