How to Make a Family: The Blog

One Big Happy Circle. Don't Ignore Infertility. But Remember Other Stuff More.

This is National Infertility Awareness Week®. It's an annual thing, and this year's theme by RESOLVE (the folks who trademarked the name), is "Don't Ignore Infertility." Some of my friends and other folks don't know that writing about fertility & reproductive medicine has been 90% of my livelihood for 15 years. Now you know.

Here's my requisite nod to NIAW. It features a woman whom I admire and respect a lot. And it alludes to my perspective that people experiencing infertility have a lot more to ponder than just how to get pregnant. 

And the awesome photo, featuring Jason Songhurst (aka The Roomie) and a big thunderboomer cloud, was taken a year ago off a highway that runs down the middle of a west Texas oil field. Proof that you just never know how things from yesterday and today and "tomorrow" will connect in this thing we call life.

And THAT is my NIAW message. 

 

Teaching Ethics to & Instilling Morals in Scientists. After the Fact.

I'm reading Challenges for modern scientific writing and editorship: have we lost our moral compass? on Reproductive BioMedicine Online.

My random thoughts as I read this apparently necessary finger-wagging by the editorial staff of RBM Online: 

They're using Wikipedia to start their definition of scientific misconduct. Hm. Huh. (No opinion here, just stating the facts...) That is certainly reflective of a shift.

I'm often asked how I can write on the same topic (fertility and reproductive medicine) for 15 years without copy-pasting my own stuff over and over. Seriously? I can manage to do that (not plagiarize myself) for things like consumer blogs and magazine articles by the hundreds, but researchers can't do it for high-brow study articles? Maybe it's yet another benefit of my sieve-like brain... I can't remember from one day to the next if this is the first thing I've written about oocyte cryopreservation or the 20th, let alone know on which hard-drive any previous files exist. But ask me what's in my pantry and fridge, any time, any day. 

I will admit this: my own kid, who is precociously bright with an advanced wit of his very own, sometimes posts things on his Facebook page that make me wonder... So I ask. Maybe too often. "Did you make that up?" It's clear that there's a little generation gap on this topic.

Glad to see they're offering "workshops on scientific writing at international conferences that focus not only on how to write a scientific report but how to do so in an ethical and responsible manner." It would be even better, though, to start that educational process a little earlier, like, maybe in elementary school.

Should You Borrow Money From Your Doctor For Fertility Treatment?

Does it matter to you how your fertility treatment is funded? I'm trying to remember if it mattered to me, 14 years ago. Sure, it's one thing for me to comment now, almost 13 years after finally, finally having that baby that I'd tried to have for 5 years and through 4 miscarriages. 

Hopefully without embarassing my son's dad (we're long divorced now, but still friends and co-parents of The Wonder Boy), I'll let you know that we were not in a financial position to even consider IVF after that last miscarriage. And PGD was in the pipeline, only available within clinical trial, and man, oh, man, was I willing to donate my body to science by that point. Of course, as soon as I started to explore that path (which would've been a long road to nowhere from Houston, I know in hindsight), I wound up pregnant again (our last ditch on Clomid with heparin shots) and he stuck. 

So the question of how I could afford to get pregnant became moot to me. But it's been impossible to stay in this line of work and not think about it every time another related story comes up.

Is the drive to get pregnant so visceral that we really don't care HOW the process is paid for? 

The question came to mind again when I read this Wall Street Journal article by Jessica Silver-Greenberg. She talks about the booming business of fertility treatment financing. Nothing new, and after all, I was employed for several years as the newsletter editor of IntegraMed America, one of the oldest and biggest vehicles for people who aren't flush enough to shell out tens of thousands of dollars for multiple IVF cycles. To clarify, IntegraMed America isn't a bank or even a lending company. Rather, as the article explains: 

"IntegraMed sets up couples with loans through a partnership with Springstone [Financial LLC] and NBT Bancorp of Norwich, N.Y. The partnership's number of loans jumped 41% in 2011 from a year earlier, and totaled $15.4 million."

I have no problem with people financing their medical treatments. In fact, I'm one of the too many in this country without a speck of health insurance. I know very well why the medical loan and medical tourism industries have blossomed. But there's one part of this WSJ article that prompted this conversation with my faithful listener, The Roommate:

Me: "I just read in the WSJ that loans made to patients by companies who are backed by private investors aren't monitored by the same Federal or state agencies that oversee banks."

The Roomie: "Yeah?"

Me: "And what's even crazier is that some of those lending companies are funded by the doctors whose clinics offer the loans."

The Roomie: "Yeah?!"

Me: "Isn't that a conflict of interests?"

The Roomie: "No. That's a coordination of interest."

Me: "And the docs aren't required to disclose this information to their patients!"

The Roomie: "Wow! Those doctors are pretty smart! Win-win-win!"

Is it me?
Signing off, From the Pollyanna Department

Never Mind The Menopause. There's A Tsunami of Children.

I ran across this synopsis of fun facts about reproductive stuff via the headline "6,000 Women A Day Hit Menopause" -- and believe me, that's definitely not the most entertaining tidbit in the piece by Leslie Mann on the Baltimore Sun. In fact, I'm not sure why they chose to pull that one data point from the American Congress of Obstetricians and Gynecologists' "2011Women's Health Stats and Facts" to highlight, except that the editors might think it's alarming. 

Why do we think menopause is alarming?? Tons of reasons. Don't get me started. But for the record, I don't think the absolutely natural and normal cessation of menstruation and fertility warrants headlines. If it were up to me, I'd have pulled this fact to head up the article:

"Assisted-reproductive therapy, or ART, an infertility treatment, is on the increase, catering to women with an average age of 36, and resulting in more than 600,000 babies a year."

600,000 babies a year. From ART. 

Y'all know me. An earlier sentence in the piece ("Only 12 percent of women suffer from infertility.") had me grumbling and mumbling about how 12% isn't nearly as high as the industry likes you to think and how it all depends on your definition of the terms. I'm up to here with other headlines that shriek about infertility being "on the rise", while The Roommate (a much real-er scientist than I) says 12% is indeed pretty impressive.

When I got to the paragraph about offspring and read that aloud to The Roommate, he exclaimed, "600,000?!"

Me: "Yep. Crazy, huh?"

Roomie: "Yeah! That's like, like, like a..."

Me: "A tsunami?"

Roomie: "Yeah! A tsunami of wanted children!"

And I smiled. 

And that, my friends, is how perspective adds up to everything. And, fortunately, how quickly mine can change on a good day.

 

Quick Hit: Pioneers Have More Babies

While you're wondering and worrying about why you and yours are having trouble disseminating your DNA, here's a short blogpost about an interesting population study, kindly passed on by my scientific Roomie.

It's not so helpful in terms of your own fertility struggles to know things like "Pioneers tend to have more babies" -- but data about unassisted fertility in populations might give you pause to think.

I wonder all the time about long-term consequences of reproductive medicine success in terms of the species. Part of that's the influence of my roommate, the mathematical biologist, but related notions have been bumping around in my head since way back when I was trying to force my own DNA to descend. 

Do you ever wonder what the Big Picture will look like for humans once we've truly nailed this whole "I want a baby, therefore, I will have one" thing? I ponder it constantly. Beyond the concept of "rights" -- the umbrella question is how will we wind up once we're decades past adherence to "laws of nature"?

If you're not up to reading the blogpost or study, here are a couple of snippets:

The study analyzed marriage and birth records in Canada’s Charlevoix Saguenay Lac-Saint-Jean region (northeast of Quebec City) and found that “families living on the edges of the expansions had 20 percent more children than families living at the settlement’s core. They also married one year earlier, on average, and contributed up to four times more genes to the region’s current population.”

and

Pioneering ancestors with high fertility had children who also eventually had high fertility...