Tuesday, January 22, 2013

My Story on Choice: Reproductive Choice is About Infertility

Today is Blog for Choice Day, and the charge for bloggers is to share our stories on choice:

It’s our personal stories that change hearts and minds about the importance of always protecting a woman’s right to choose. That’s why this year we’re asking you to share your story about why you’re pro-choice.

My story on choice revolves not around abortion, but rather, infertility, as you may have guessed, if you are one of my regular readers, or you've noticed my blog description.  I have a hormonal imbalance called polycystic ovarian syndrome, or PCOS.  For me, this means I don't ovulate, and I just about never get my period without medicine to induce it. This may seem pretty obvious, but if you don't ovulate, you can't get pregnant. 

When it came time for my husband, J, and our to begin building our family, we already knew we'd need medical assistance because I already had my diagnosis and knew I didn't ovulate.  I started seeing a reproductive endocrinologist (RE), and I began fertility treatments.

I like to explain fertility treatments in three tiers.  Depending on your diagnosis, you'll start somewhere in one of these tiers.

Tier 1 is oral medication--Clomid or Femara-- and varying level of observation, perhaps a few vaginal ultrasounds and some bloodwork, maybe a trigger shot of hormones to induce ovulation once a follicle (hopefully containing an egg) or two has matured, and either timed intercourse (TI) or intrauterine insemination (IUI, a fairly simple procedure where a catheter is used to insert sperm into the uterus).  You get to try this a few times, maybe up to 6 cycles.

Tier 2 is injections to stimulate follicles--Gonal-H, Follistim, or any number of other follicle stimulating hormones (FSH)--and much more intense observation including vaginal ultrasounds and bloodwork just about every other day until a trigger shot induces ovulation, followed again by either TI or IUI.  Monitoring is stepped up on this tier because FSH can be pretty powerful, and there's the risk of high order multiples if you develop too many follicles, containing too many eggs.

Tier 3 is in vitro fertilization, or IVF.  This is the mack daddy of fertility treatments, and while there are varying degrees of IVF, depending on if you use your own eggs and sperm, or if you use donor gametes, or if you go the route of gestational carriers, or surrogacy.  With IVF, you again use FSH to stimulate follicles, and you again go through intense monitoring, every other day, and sometimes daily.  Again, there's a trigger shot, but this time, the timing is critical because next comes a surgical procedure--egg retrieval or ER--where a needle is inserted through the vaginal wall to retrieve the eggs, before they ovulate.  Then you wait while sperm are either mixed with or injected (Intracytoplasmic sperm injection, ICSI) into the eggs in a lab, and then they are cultivated to grow for 3 to 5 days.  Ideally, they develop into beautiful blastocycsts, and then comes the embryo transfer (ET), where a catheter is used in a relatively simple procedure to inject the embryo(s) or blast(s) into the uterus.

This may all sound pretty complex to the uninitiated, or the Fertiles.  But to me, this has been my life.  I went through all three tiers, over the course of 13 months, in order to conceive my first son.  I got lucky and got to go straight to IVF the second time, and I was again lucky to conceive my second son on my second round of IVF.

And I had choice each step of the way.  I got to choose the level of medical intervention.  I consulted with my RE, and she made the recommendations best suited for my medical condition and how my body was (or wasn't) responding to treatment.  Sometimes, I also had to deal with insurance because I couldn't get approval for the legitimate medical procedures needed for my valid diagnosis, but that's a whole other story...

My point is, I made the choices.  My husband and I together discussed our options, taking in the information from our doctor, and we were able to build our family using the best medical technology available to us.  We didn't have to worry about laws restricting us regarding the creation or disposal of our embryos.  We didn't have to consult legislation regarding how many blastocysts it would be appropriate to transfer.  We followed the sound medical advice of our doctor and made the choices that were best for us, our family, and my body.

I'm always astounded when infertiles aren't pro-choice.  I don't get it.  Being pro-choice is about supporting reproductive rights, reproductive freedom.  I've never had to face the decision of an abortion, but I have had to face the decision of fertility treatment, and I will forever and always be pro-choice because I personally know how important it is to have choice.

Some infertiles say being infertile has made them anti-choice.  Once they want a baby that badly, and they struggle through fertility treatments or pursuing adoption, they say they can't understand abortion because they want a baby, and they'd adopt that baby....and so on...Yea, okay, but if you understand the magnitude of your or your partner's medical diagnosis, or the biological reality for lesbian and gay couples, and your need to either pursue fertility treatments or adoption, then the matter of choice should be so incredibly important to you, I believe.  You may not have gotten to choose your medical diagnosis, but you get to choose how you build your family...and you wouldn't have wanted that to be legislated for you, I would imagine.

And then the personhood laws or the arguments about emergency contraception just kill me.  Any infertile knows you aren't pregnant until an egg is fertilized AND implants in the uterine lining.  Implantation is oh-so-important to infertiles.  We joke about being PUPO, or pregnant until proven otherwise, but really, that's just being hopeful and thinking positively.  After IVF, when I lay on bed rest, desperately hoping for the blast transferred into my uterus to implant, yes I did have a fertilized egg--even more than that, I had a blastocyst-inside of me.  But I certainly wasn't pregnant.  

And I have 3 embryos cryopreserved.  But we're done building our family.  And so we've signed the paperwork to dispose of those embryos.  We've made that choice...again, choice.  Those embryos aren't people.  They have the potential to become people, but they aren't people.  And my husband I alone get to make the choice about what to do with those embryos.

Today, on Blog for Choice day, I celebrate reproductive choice.  It goes so far beyond abortion, to decisions regarding family--family building and family planning.  And those are choices only individuals and couples can make.  I will fight for those choices to be forever within the individual control.  

Being pro-choice means being supportive of making your own choices about your body, your future, your life, your family, and no government should be able to legislate that.  It's far too personal, far too powerful, far too important to be legislated, other than to have legislation to protect that freedom.  

I will forever be pro-child, pro-family, pro-choice.


  1. Thanks for sharing your vision on pro-choice. This was different than all of the others i have read so far. The way you explained why you are pro-choice even if you are infertile was brilliant. Maybe it will change the views of other infertile women to be pro-choice too. I always hated that "pro-choice" automatically meant "pro-abortion" or "anti-family." At least we know it doesn't meant those things!

  2. Thanks for furthering the conversation on this important women's issue. Please visit Venus Blogs as they also promote stories and issues that enlighten the masses about women's topics.



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