Has anyone heard of anyone doing this? I imagine through IVF, she could get implanted with her own embryo as well as the embryo she was carrying for someone else. Among the many concerns, one thing I wonder is, would there be any way to know right away which one was which when they came out? I suppose you could have amnio earlier, test the baby, and then keep track of the position of the babies?
Well, assuming the surrogate and her mate are white, you could implant a baby from two black parents.
twins is a higher risk pregnancy. I don’t know why anyone would actually want to deliberately have twins from a health perspective.
I am torn about posting more about this, because it seems like in many threads (and maybe this is more true in IMHO and MSPSIMS) no matter how much you try to frame the question to elicit relevant/helpful responses, there will always be someone who comes in with snark and/or irrelevant comments. But I value the information from true ignorance-fighters with a genuine desire to provide info. With a plea for empathy and kindness, and an acknowledgement that this situation includes many, many issues that are too numerous and too broad for this thread, here goes:
A person who has become a dear friend in recent years has lost, if I am right about the count, 8 babies. One was a stillbirth, the other 7 she miscarried at various stages. I didn’t know she had lost so many until about six months ago. After I found out she had lost, by then, 7 babies, my husband and I started talking. Parenthood has given us both so much joy and we felt – I don’t know, compelled – to offer that I would carry a baby for her. I know she probably couldn’t afford to pay a traditional surrogate. We have known so much joy through our child and it made us so sad to think about how she had gone through so much and still was without a child. So…we did offer. [This is the part that I am afraid people are going to post about – “Why did you do that?” “That was stupid. You’re an idiot. Why didn’t you think more before offering?” “Why doesn’t she adopt,” etc. OK. I get that, but this thread, I hope, is about something else. I’m hoping we can get ignore those issues and discuss what I’m asking about.]
Anyway, she and her husband responded positively and said they wanted to try one more time. They did and she lost the baby two weeks ago, so that makes 8. We have one child. I had a very healthy pregnancy and easy delivery - was in easy labor all day, hard labor for a few hours, no drugs. I am healthy, exercise, etc. However, I’m 36. We have one child - a 1-year-old - and we want two more. I don’t really have tons of time left on the biological clock to have the 2 kids that we want. So (if we actually do it), I am wondering:
1)I know twins are more risky, of course. Does anyone know how much riskier it would be? (I am thinking about weighing relative risks as one aspect of the decision-making process. For instance, it will also be riskier the older I am when we have a baby or babies after the one I carry for her…)
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Does it seem likely that a doctor would be willing to let me carry one of our babies and one of her babies at the same time?
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Has anyone heard of this being done?
Hmm… this is an interesting idea. I mean, if she’s getting free prenatal care (paid for by the to-be parents), she might as well get care for her own baby. And if she’s going through the work of carrying a baby, she might as well carry one of her own, right?
Wow, this sounds like a wrenching situation.
Here is a recent New York Times article about the risks associated with twins: The Gift of Life, and Its Price. (free registration req’d)
As you can read, the risks aren’t negligible. My question to you is what happens if you get two embryos implanted, and only one develops? (Can someone clarify if it’s possible to determine in utero the parentage of a baby?) Would your friend be able to deal with nine months of not knowing if she has baby or not?
What happens if both embryos take and her baby is fine and healthy and yours has life-long complications from the pregnancy, possibly due to having to share a womb and being born premature? Will you be okay with that? These are tough questions that you’ll really have to hash out beforehand.
Erdosain, thank you for that link. Ack, those are the kinds of things I’m concerned about. Just reading that one article makes me pretty much want to give up the two-at-once idea. Just one of the many risks it mentions- the risk of cerebral palsy is four to six times more likely in twins. I was primarily thinking about risks during the pregnancy and delivery, not lifelong problems. Seems like too much of a gamble. And Seranata, if it was just convenience and money, I wouldn’t have considered it, but I was just thinking about “time left in life to bear children.” Maybe if it really was a good option, more people would have done it by now…
The bigger issue is that embryos are rarely (if ever) implanted one at a time. Because only about 40% of them take, the tendency is to implant 2-5, in order to get good odds of one or two babies. The problem with rolling the dice that way is that you never know exactly how it will come out. Let’s say you do three of your own and three of the other woman - now you have a chance of 0-6 babies, with 0-3 for each family. If there are too many, risks of complications go up. Those risks might be moderated by selective abortion of some of the babies but it’s still high risk.
Even worse… imagine how she’ll feel if you wind up with three more kids and she still has none.
I don’t think determining the parentage would be a huge problem. Amnio can tell you while in the womb and paternity tests aren’t that hard after the birth.
Right. I wasn’t sure how they do the implantation. Ack, ack, ack. Yeah, not a good idea at all. In fact a terrible one. OK, thank you.
Amnio carries some risks, doesn’t it? Would a doctor actually perform it just to determine paternity before delivery?
This is actually not true. Most fertility doctors will gladly implant one embryo at a time, as long it is of sufficient quality. It’s true that most doctors usually do two to three at a time, but one is not unheard of and will probably become more and more popular as people discover the true risks of multiples. The problem is that IVF cycles are so expensive, that people want a return on their investment and are willing to gamble. The doctor would be glad to do one; it’s the potential parents that push for more.
I think your upper estimate of six is way high, too. It is my understanding that responsible clinics won’t transfer more than three embryos at a time unless there are some serious mitigating factors. The American Society for Reproductive Medicine recommends transferring one to two embryos at a time, max. Octomom’s doctor transferred six embryos and was kicked out of his medical group because of it. He is the outlier.
Many people don’t realize that IVF is rarely responsible for high-order multiple births, precisely because no reputable doctor would transfer a large number of embryos. Most of the quints, sexs, and septs result from Inter-Uterine Insemination and taking Clomid, not IVF.
Different country, but my IVF specialist strongly recommended we only have one embryo implanted, and would probably at most have been comfortable with 2. Their primary concern was the risks of a multiple pregnancy, both to me (preeclampsia etc), and to the babies (developmental difficulties and premie birth). I was comfortable with this and didn’t inquire much further, but I think a little research would clarify these risks a little more.
From watching shows about IVF in the US though, it does seem common enough to have up to 4 embies implanted, so this could be an option. Enhanced risks I would think.
Practicalities which spring to mind - do you know what is causing the miscarriages? Is it something about her inability to carry to term (uterus issues, endocrinal factors), or is there an issue with the egg/embie quality? I would really recommend that this be clarified before you go any further with the idea - has she consulted a fertility specialist/other specialists to identify the cause of these miscarriages?
This may indicate whether you would really be a better bet than her to carry one of her embies to term - it may not make any difference. And how would you feel if there was an issue with her embie, which caused you to lose the embie you had implanted for your family?
Are you prepared for the time and cost involved in producing embies for yourself, to allow for the implantation as you propose? A fertility specialist would be able to give you more specifics, but you would more than likely need to undergo a costly full IVF stim cycle, which would involve the pill to co-ordinate your period with your friend, drugs to shut down your hormone production, drugs to stim egg growth and follicles, repeated dildo-cam ultrasound, a (rather painful) trigger shot, and a light general anaesthetic to collect eggs (with a 1+ day recovery). Plus there is the not to be underestimated risk of ovarian hyperstimulation syndrome, which in severe cases can require hospitalisation or even cause death.
You would then need to consider what you would do if one of you responded better to this treatment than the other - it’s not uncommon for a cycle to result in no viable embryos (or nothing the FS would recommend implanting, given they grade the embies) - would you still proceed if one of you had nothing to implant? Bearing in mind that you could always freeze the successful embies until you both had sufficient numbers - but they don’t always unfreeze successfully.
Then you have the issues that others have mentioned - identifying prenatally who’s embies have survived - which would come at some risk - and are you comfortable assuming this? How would you both feel about not knowing until birth?
Then there may be legal and ethical questions to consider which are specific to your location - for example, we were asked to consider what happened to additional embryos which we didn’t need - when would your offer of a uterus expire - when your family was complete, or hers?
I applaud your good will in wanting to help your friend, but it may have been a slightly premature gesture, given the complicated nature of the technology and ethics involved - it seems to be much simpler for those who already have completed their own family. But, if after reading the responses to this thread you are still interested, the next step might be to meet with a clinic and see what their reaction to the idea is - it may be more common than we think.
Depending on the reason for the miscarriages, maybe your friend may need to consider other options like an IVF cycle on her own, donor eggs, adoption, or even coming to terms with the idea that kids may not be in her future. It’s a really hard topic to discuss, so I wouldn’t suggest presenting these options to her, but encouraging her to seek professional advice and counselling while remaining open to her sharing her feelings could be the way to go.
Happy to answer any other questions about the IVF treatment if you have them.
While we’re discussing IVF and number of transferred embryos, I’d like to emphasize what Erdosain touched on - that the number which can be reasonably transferred, and the risks of multiples depends on many mitigating factors.
While more than one embryo transferred might be unreasonable in one situation, six might indeed be completely within reason in another couple’s situation - especially if we have historical data to validate our viability estimates.
Quality of embryos vary a lot (likelihood to continue to grow).
Chances of successful implantation vary.
If a couple shows a history of low viability for embryos then it is not unreasonable, or even all that risky to implant larger numbers in the hopes that “one sticks”.
It’s the reason that you have fertility specialists involved, and why they ultimately need to help the couple evaluate the risks and come to a decision.
Having a hard upper limit imposed because the public is outraged by the octomom and her doctor’s actions is not a reasonable response, and is in fact unfair to those with the worst fertility issues who need IVF the most.
Also, having had an easy pregnancy and delivery has no bearing on what future ones will be like.
I think the point still stands. If you implant one from each family, there’s a good chance, if you get any babies at all, that you’ll get just one. If you implant two from each family, you can get anywhere from one to four. If you do happen to get two, there’s a one in three chance that they’re from the same family. There is no number of embryos that you can implant to be near certain of having exactly one of each. If you want to go for at least one of each, you can increase your chances with lots of embryos, at significant risk of triplets or more.
I agree that the point still stands and that it’s a good point. There is just too much uncertainty with the whole procedure to be able to make a deal like this. It’s also worth pointing out that the doctor has to agree to implant the embryos, and he may not be willing to implant more than a certain number.