Embryo Adoption

I heard about the idea of Embryo Adoption as a potential path to pregnancy the same day I heard that embryo storage was akin to abortion.  I was listening to a speech by Dr. John Kilner, a noted bio-ethicist from Trinity International University.  I was lucky enough to spend some time with Dr. Kilner while he was in town giving the keynote speech for a conference my company was putting on.  Dr. Kilner made it abundantly clear that IVF was not unethical; it is simply a way to connect an egg and a sperm.  To him, infertility is just a disability that medical technology could cure.  Dr. Kilner's problem with IVF was that some clinics, in an attempt to raise their success rates, would attempt to create a surplus of embryos (I'm looking at you Nadya Suleman's doctor!), and dispose of or store any extra.  It doesn't take a rocket scientist to realize that destroying an embryo at any stage is a problem to many Americans; it is, for some, the same thing as an abortion of a viable embryo.

Dr. Kilner said that the use for surplus embryos would be for a future implantation.  You can put them in frozen storage, he said, but at a cost.  1/3 of embryos do not survive cold storage.  Imagine you have three children, and you hand them off to a babysitter.  When you come home only two of the children had survived.   Needless to say, you wouldn't use that babysitter again.

Is freezing an embryo the same thing as an abortion?  It's not for me to say.  What I can say is that this is a difficult thing for infertile couples to hear.  Not only do you have to worry about the cost of funding IVFs as well as the stress inherent in the process, but now, if you have extra embryos, someone can call you a baby-killer if you don't use them all.  This is quite the dilemma for someone who has already experienced the tragedy of infertility. 

As I drove Dr. Kilner to the airport, I told him about my wife's and my journey through infertility.  After hearing a bit about our story, he suggested that embryo adoption would be a less expensive and 'easier' path to pregnancy.   It would be an adoption, but wouldn't require travel, and my wife would be able to experience pregnancy.  There was the ethical side to him too:  We would be saving embryos that had been put in cold storage by other couples.  Embryos would not be destroyed nor used for research.

So now I'm in an ethical dilemma:  Cold storage=bad, but using embryos from cold storage=good?  It's a double standard that could be self-defeating.  If you keep everyone from using cold storage, then there would be no embryos for people to adopt who desperately need to get pregnant.

The change that occurs in a endometriosis patient is miraculous.  Women can receive a new lease on life.  She can get a few years endo-free.  I don't want to envision a McEmbryo world, and there should be some sanctity involved with embryos.  But it seems to me that mothers should be able to help other potential mothers if they want.

When I checked with the best embryo adoption center, they said we needed to be married 3 years in order to adopt.  At that time, we hadn't been married 2.  We are getting close to our third anniversary, and it is starting to look like one of the best options.

Health care stinks.

While I can be political amongst my friends, I try not to do so on the internets. I have my personal views on a lot of issues, but they require process to explain and some nuance. American politics are not fond of nuance. So I'll skip them over. If you are ever interested in having a beer with me, I'll go into detail of where I think our two main parties fail. I'm wrong most of the time, and know it, so I look forward to hearing your views as well, provided they aren't screechy. My main rule of thumb is you will not find salvation in your political party, so don't even try.

But since this blog is about our experiences with infertility, it's difficult to not talk about the problems we've had with our insurance coverage. It's easy to throw out a phrase like 'Death Panel', but when you've actually waited for your insurance company to decide if they will pay for something, you get the notion that all may not be right with our insurance system.

I'd like to talk about one personal experience with our health care system. My brother was diagnosed with cancer 7 years ago in October, and he died the following February. He was a seminary student, about halfway through with his studies. He went through a large surgery to remove a good portion of his cancer, had a lengthy hospital stay, followed by several rounds of expensive chemotherapy. When it was determined that the cancer would ultimately take his life, he was given wonderful hospice care and was able to die under his terms.

He actually passed away a half an hour after I arrived at my parents house on his final day on Earth. I am humbled.

I mention this story for several reasons. One, he was severely underinsured. Many young folk think they can swing staying healthy and skip insurance payments. If you're in school, you can't afford insurance, and you're 30 years old, it seems like a great idea until something catastrophic happens.

My brother racked up $200-300,000 dollars in medical debt during the four months he spent fighting his disease. What young person could payback that much money? He wouldn't have been able to. He died, and none of his bill was paid back to the hospital. The hospital makes up that payment by charging extra to people who can pay, or who have insurance that will pay. The next time you get treatment at a hospital, and are charged in exorbitant amount for a cheap-o medication, know that you are paying for someone else's treatment.

If my brother had survived, he would have been bankrupt. He would end up like many in our country: one catastrophic illness, and kiss-your-American-dream-goodbye. The hospital still wouldn't have received the entire payment, and you would still be paying out the nose for aspirin. Moral of the story - you get sick; you never make it out of debt. And everyone in America pays your debt through higher hospital bills.

In my job, if a system is causing everyone to fail, you realize that the problem isn't all the people who can't handle the system, it's that the system is broken, and you fix the system. Right now, in America, if you or a loved one gets terribly sick, you will go bankrupt. There is no way to survive a catastrophic illness without becoming a debtor for the rest of your life. The health care system is and has been broken for quite some time, and needs to be fixed.

Angie can talk at length about how she knew something was wrong with her, and her doctors couldn't figure out that she had endometriosis. If she had been given the diagnosis sooner, she could have gotten it removed, and remediated and given therapy sooner. She could have chosen her own path to fertility. This is obviously not health insurance problem, but a lousy doctor problem, but if we did have a system of best practices, she may have gotten the information she needed sooner.

As I've mentioned in passing before, the best therapy for endo is pregnancy. An endo patient's body figures out what's up, and can give her anywhere from 5 years to indefinite balance of estrogen. Getting an endo patient pregnant is the hard part. It's difficult to say what the actual problem will be, since each patient is different, but it can affect quality of the eggs, the shape of the ovaries, it can create blockages of the fallopian tubes, and it can prevent embryo implantation. How can you solve all of these problems? IVF! Yes, evil IVF, which most insurances won't cover, which can cost $30,000 per cycle, and oh, yes, you might need to go through a few cycles before you get it right. I'll talk about our experiences in IVF another time.

It's considered evil by some for a few reasons. Some say it's playing God. It's actually only helping the process along by uniting a sperm and an egg, so I don't have time for people who use this argument. The other argument that is used is that it creates extra embryos which are frozen and stored. Since there is some risk to freezing embryos, this is considered on par to abortion.

Look, I can't solve your fears on this one, but speaking for an infertile couple, you need a back up plan. If you can create extra embryos, you can use them down the road for another try, or another child, or you can choose to put them up for adoption. Seriously. I'll talk about embryo adoption more another time.

Anyway, the point is, none of the costs of IVF, from treatment to the medications, are covered by my wife's insurer. Nor are they covered by many insurers. I don't expect to get it all covered, but since the very same drugs are covered in smaller doses if a person decides to pursue an artificial insemination, why can't part of it be covered? And since this pregnancy through IVF would also be a therapy for her endo, why not cover it if it could remediate my wife's disease for up to five years (or potentially longer)?

So, now what happens to my wife? She can't get therapy through her insurance, and she can't get different insurance since she has a 'pre-existing condition' - what options do we have? THIS.IS.THE.INSURANCE.COMPANY.COMING.BETWEEN.YOU.AND. YOUR.DOCTOR. You can't blame a government bureaucrat for this one.

I won't go into the idiocy of the surgery I had last summer, that my insurance did pay for, but there was no rationale for why it was done, and while it did improve things, they actually didn't need to be improved. I guess I did go into it, but I'll try to talk about it more another time.

Post #2 - 6 months later

Well, 6 months have brought many changes to our thoughts about our process to become parents. We got the news around the time of my last post that we would not be able to have biological children. I won't lie, it was hard to hear, but part of me knew that was going to be the answer after not being able to conceive for so long. While being very sad, I think it was the kick in the pants to start down another road.

As kicks in the pants go, it didn't take long to get another hiccup. My wife had been diagnosed with 4th stage endometriosis last summer. We had played around the endo for a long time, hoping Angie could conceive to 'reset' her system. This seems to be the proscribed method - if you can't conceive because you have Endo, you need to try to conceive. Huh? The cure actually is the impossibility. After going through the heartbreak (not strong enough of a word) of two failed IVFs, Angie heard of Dr. Charles Haislett. Dr. Haislett specialty was excising endo, and he recommended we get it done right away.

The surgery was set for 1 month following our pre-adoption classes at Children's Family Home Society. The way the doc had described it was that it would be a quick surgery, and she would go home that day. Both of us had had outpatient surgeries last summer to clear up infertility issues- Angie was supposed to be 'lasered' (one way of removing endo) and I had a varicocelectomy. Look it up. Obviously, none of this worked at the time.

The big day arrived - late April. Angie got sent to pre-op, and I was allowed to follow in about a half an hour later. As we sat and joked, the doctor finally arrived. He was hurried, because the anesthetist was late. He mentioned as we talked that Angie would be staying for three, maybe four days. Huh? Hadn't planned on that. It ended up that she needed it. She still has the 6 inch scar along her mid-section. Ouch. Sitting up was very hard for her for about a month after the surgery.

In the end, the doc removed almost all of the endo in Angie. To get it all, he would have most likely needed to remove her womb. He did take one ovary and fallopian tube, and about 30% of the other ovary. The hope is, that someday, with treatment, she still could conceive. The short-term solution is to get her pregnant through a donated embryo, which should 'reset' her system. For now, she is one hormone suppressants.

All of this put a damper on adoption for a few months as we reconnected and vacationed over the summer. We're getting into high gear again, getting paperwork ready for our homestudy. Fun. Lots of intrusive questions that biological parents don't have to answer about childhood, and how you were raised, and stressful situations you've gone through. The unexamined life is not worth living? Socrates was a jerk.