Monday, March 03, 2008

Book Tour - Embryo Culture: Making Babies in the Twenty-First Century by Beth Kohl

Embryo Culture is an interesting book about infertility and the process of IVF through a woman who went through it. It is the first book I have read that has not only the scientific and clinical perspectives outlined into the story, but also the emotional roller-coaster that one feels while dealing with the whole process. While her experience was far different from mine, I enjoyed reading about her journey.

The author describes her journey through infertility both in terms of a faith journey and a process of scientific discovery. How has infertility impacted your faith journey and your views of science/technology?

Being an athiest, I found the religious discussion in the book to be an interesting perspective on the subject. For me personally, I never had a question on the moral or spiritual issues involved in infertility treatments. One of my issues with religion as a whole is that the institutions are often more than willing to tell their flocks what things are forbidden to them but yet, will not offer up some help with the alternatives. I still feel that there are many ways that the religious community could help support people going through infertility, and in my time in the blogsphere have noticed that faith is something strong for many women (and men) going through this tough journey. I hope that each person that seeks solace in their religion have been able to find support and guidance through the journey--but I worry that, like in the rest of the society, infertility is just not addressed like it should be.

As for my views of science/technology: Going in I had every confidence in the scientific basis of ART. It was overwhelming, and I was not totally "into" all the science involved (before going through this myself, I had a vague sense of the fact shots were involved, that it used to be called "test tube babies", etc.). Going through my first IVF/ICSI cycle, I put what "faith" I could into the clinic--"Look, the doctors had found the problem, they know the solution, we are doing all we can--IT WILL WORK!" When the first cycle failed, I had to go back and realize how many times the doctors were qualifying their statements and often pointed out to me that this cycle was "promising" (re: not the "miracle of science" that I was hoping for). It struck me how often the doctors (even in my "world class" clinic) were having to "guess" as to what protocols would work. The science foundations are there, the success rates are amazing--but, it is still often a matter of "luck"!

Going through the next cycle, I was much more my typical cynical/scientific self and going through the two week wait was far more clinical to me. I read through statistics I had not bothered to go through before--I was more experienced at the loss side of the coin. And when I got that BFP, I was actually surprised because I had come to the conclusion that while science has come a long way in the ART process--it still has a long way to go. The good news is that they are coming up with new processes and techniques all the time--one process I read about was a better way to distinguish viability in embryos, making the transfer of better and more mature embryos more likely in the future.

The author talks about how many embryos should be transferred at any given cycle. Should there be a limit?

I do think there should be a limit on how many embryos are transfered. I think new techniques in establishing what embryos are most viable will make this something that will not be an issue in later ART techniques. As is the adage around the IF block--it only takes one--its the quality not the quantity of embryos. It is better for the mother and better for the embryos themselves.

Beth makes certain that she tracks how she and her husband respond to infertility in different ways - through diagnosis, debates about treatment, and how infertility is perceived in the "normal" world. Do you find such differences between yourself and your significant other(s)? Was it difficult to determine upon a course of treatment due to those differences?

My husband and I have a lot in common and often agree on things. But, as with any of the big decisions in our lives, we usually have different perspectives that do play a role and often we compromise (sometimes internally) to come to a common ground. (Meaning, we arrive at the same conclusions but in different ways).

When we started having problems having our second child, we both thought it was more of a time and effort issue—we needed to make more time in our schedules for intimacy, we needed to track ovulation, etc. During the first part of trying for the second one, we had a lot of other issues coming up in our lives that needed more of our focus—and part of the lack of effort on our parts was denial of there being a problem.

Finally, after many discussions, both of us decided we needed to go to a fertility clinic. Then the testing began. For me, I felt that I got a lot of the testing and had to be more “in the zone” of infertility, while my husband was able to be in the background of it.

After a year’s worth of testing, etc. It was finally determined that it was male infertility. I think that in many ways that made my husband and I stop discussing what was going wrong and to go for the “solution” of IVF/ICSI. Before this diagnosis, I think I blamed myself more for the lack of progress in the baby-making and I was far more emotional about the lack of another child. I was the one that needed the emotional support and comfort, which my husband provided. But when it became an issue of his infertility, I think I took on more of the role of comforter and one of the ways I try to comfort people is in finding solutions. I think my husband was all for IVF/ICSI because to his mind, the statistics (40% success to our 2% success if via “normal” reproduction) and the science were there. For me, I think my first thought was how I could help my husband not feel worse than he already did.

Going through the process, as usual, my husband and I read and reread about IVF/ICSI and we poured over statistics, etc. Going through the process, as usual, my husband, while not being able to understand all the emotions I was going through, was there for me to comfort me. As usual, he buried his emotions and worries when he thought it was best for me not to see them …and I lightly tip-toed around his vulnerable issues and comforted him when he was not seeking comfort, but needed it. We really did have a team effort and I totally feel like this baby was an effort by the both of us.

Hop along to another stop on this blog tour by visiting the main list at You can also sign up for the next book on this online book club: The Mistress's Daughter by A.M. Homes (with author participation!)


Jendeis said...

I really enjoyed reading your answers. I too feel like the initial focus at the fertility clinic is on the woman and not really on the man at all. We're in the beginnings of the process and I'm having to undergo tons of bloodwork and ultrasounds and an HSG, etc., but JD doesn't have to do anything, and we know (well, JD and I know, the doctors say they don't "officially" know) that we're dealing with male factor. I think that it just reinforces the false belief that infertility is a woman's problem.

loribeth said...

You've brought up some interesting points. I especially liked what you had to say about religion needing to provide more support and alternatives for people like us. I could also relate to your answers on science, because I was the same way!

Helen said...

I agree with your statements that at first you have faith in the clinic - which, after failures, soon leads to just believing in luck! Well said!

The Town Criers said...

I liked the description of the back-and-forth that went on in navigating IF with your husband--especially the idea of one person having to be more in the zone and then finding the balance again.

The Dunn Family said...

I liked reading your answers. I agree that religion in general doesn't offer a lot of resources to help with issues that they believe are "God's will". Sad, really.

The Dunn Family said...
This comment has been removed by the author.
Anonymous said...

"I do think there should be a limit on how many embryos are transfered. I think new techniques in establishing what embryos are most viable will make this something that will not be an issue in later ART techniques."

One new technique being developed to identify viable embryos, safely is through metabolomics. A company called Molecular Biometrics is working on a solution to this problem. Enabling single embryo transfer is one of the biggestest challenges for ART.