LEARN INSURANCE

A long-term study following 1,000 families with children born using IVF between 1994 and 2002 in the UK and US has shown the importance of parenting in the outcome of a child's behaviour.

In the study, which investigated the mental wellbeing of both the parents and children, some of the children were biologically related to their parents, while others were unrelated and conceived using either donor sperm or eggs, or both. This gave the researchers a unique opportunity to compare the role of nature (genes) and nurture (the environment) in the development of a child's behaviour.

This is why patients who use donor gametes for IVF after counselling and forethought are usually very happy with their kids !

When an infertile patient gets pregnant after IVF , they are on top of the world. All that hard work and effort has finally paid off - and you can now look forward to cradling your baby in your arms soon !

However, there are still 8 months to go before your baby is born - and the pregnancy can be packed with anxiety and suspense. Will everything go well ? Will the baby be normal ? Every ache and twinge causes worry because you are scared you may miscarry. This is a "precious pregnancy" - and you do your best to take things easy and be as careful as you can, so you can nurture your baby.

This is one of the reasons why many doctors advise bed rest during an IVF pregnancy. In fact, some patients will voluntarily place themselves under house arrest, because they do not want to take the slightest risk !

The truth is that there is no sensible biological basis for providing this advise. In fact, bed rest can be demoralising and is very unhelpful, because your mind starts playing games when you sleep in bed all day long !

However, it's often patients ( and their relatives) who force the doctor to provide this kind of advise.

When I tell my patients they do not need bed rest, many of them look at me in disbelief, as if I am an idiot and do not know what I am talking about !

Isn't it "common sense" that pregnant women need bed rest to prevent a miscarriage - after all, this is what doctors ( and midwives) have been advising for generations, so it must be true ! Won't walking around cause the baby to fall out ? Isn't this an "artificial" pregnancy which needs to be treated with much more caution and attention ?

If a doctor agrees with this advise , then patients are happy, and feel he is a good doctor because he is providing advise which is sensible by their preconceived notions

However, if he does not agree, then they start wondering if they can trust anything he says ! If he does not even understand the medical importance of bed rest, then his medical competence is suspect !

Most doctors are too busy to argue with patients. It's also good for them to advise bed rest. They can charge extra for home visits ! And if something goes wrong, then the doctor cannot be faulted, because he provided the right advise !

However, if he does not advise bed rest, and the patient miscarries, then no one will ever forgive this doctor. They will actually blame him for the miscarriage ! ( Didn't he know how precious this pregnancy was ? How could he be so callous and careless ? I wish we had gone to a better doctor !" ) His entire reputation will be tattered and torn to bits - and in a few years, he will be left with no patients !

For most doctors, it's much easier to toe the line and tell patients what they want to hear, rather than to spend time educating them and correcting these old wives' tales. This is why all these myths and misconceptions continue to flourish !

Right now the world record for the oldest mother has been set in India and the oldest woman who has given birth is 73 ! At an age when most women have become great-grandmothers, is it sensible for a woman to want to have a child ?

Let’s explore this in more detail. Let’s suppose we decide , like some countries have done, that the age cut-off should be 45 and that women who are more than 45 should not be allowed to have IVF treatment, because they are “too old”. Then what happens if a 46 year old woman who is otherwise very healthy wants to have a baby ? Is it fair to say no to her just because she is one year past the cut off age ? Why ?

It’s quite likely that older women are going to make very good mothers. They are mature – and have spent a lot of time and energy in making this decision, which means they are likely to be thoughtful and caring parents ! While they may not have as much physical energy, they are likely to have many more financial resources ! And they are much more likely to make better parents than 14 year old unmarried girls ( who society allows to have babies , just because they are capable of doing so biologically and do not need our permission to do so !).

I agree this does raise a number of ethical issues ! Are IVF doctors being irresponsible ( in order to earn more money ) by agreeing to such requests ? Is it fair for the child ( who is likely to become an orphan at a young age, because his mother is likely to die in a few years) ? Should society lay down guidelines ( like it does for adoption ) ? Or is it a decision which the woman should make for herself ? Are we being ageist by not allowing older women to use this technique, just because we think it is “unnatural” ? Isn’t it sexist as well ? When a 70 year old man gets a 20 year old woman pregnant, society applauds his virility and manhood ! Why shouldn’t we be happy to encourage older women who want to have kids as well ? After all, this is their personal decision, and we should be happy to honour their autonomy. They are not harming anyone and if they are well off enough to afford IVF treatment with their own funds, presumably they are well off to be able to provide for the child’s well-being, even after their death. Maybe in an Indian joint family, the child will be well-cared for, whether the birthing mother is infirm or not ? One option would be to make independent counseling mandatory for older women, before they go in for donor egg or donor embryo IVF , so we can help them to make the right decision.

Image via Wikipedia

Many infertile couples are happy to explore the option of adoption in order to build their family when IVF treatment fails.

They naively believe that after going through the ordeal of many failed IVF cycles, adopting a baby will be a piece of cake. However, many find to their dismay that there just aren't that many babies available for adoption anymore !

In one sense, this is hardly surprising ! With improving levels of education and the empowerment of women, unmarried girls use contraception and terminate unwanted pregnancies. Very few women will now carry an unwanted pregnancy all the way to term.

However, while the number of abandoned babies is gradually shrinking, the number of infertile couples is progressively rising. There are now long waiting lists - and many adoption agencies just do not have any babies available for adoption ! The ones they do have are often much older; or have a disability, which means many infertile couples are not happy about adoption them, because most would prefer a healthy newborn.

The good news is that there is now a newer option available, to help many couples satisfy their desire for a baby, if they are willing to consider adoption. This is the option of embryo adoption. Unfortunately, this is a choice which not many infertile couples are aware of. Sadly, even social workers in adoption agencies and gynecologists are not familiar with this new advance.

What does embryo adoption involve ? Rather than adopt a baby, couples adopt embryos ! The option has many advantages.

• There are no waiting lists
• The success rates are high
• Couples get to experience pregnancy and birth
• There is no social stigma, since the name on the baby's birth certificate is the infertile couple's
• There is no need for the couple to get permission for this decision from family members

Where do these embryos come from ?

These are supernumerary embryos which young infertile couples going through IVF freeze and store for themselves. If they get pregnant in their fresh IVF cycle, many are happy to donate their embryos to other infertile couples, to help them build their family. Embryo adoption is usually anonymous and confidential.

You can read more about our embryo adoption program here.