By now you’ve probably heard that another set of sextuplets have been born. The three boys and three girls were born in Pennsylvania on June 1 10 weeks premature. Births are supposed to make you feel happy, but this one left me feeling intensely sad. Oh don’t get me wrong, all new life is a precious gift, and these fragile babies are no exception, but their birth was most likely a failure of modern medicine.
The babies, weighing from 1 pound, 1 ounce to 2 pounds, 5 ounces, are in the Neonatal Intensive Care Unit (NICU) in critical condition with an uncertain prognosis. At least at this time , all six are still alive, and I pray they will escape the typical disabilities associated with multiple births and premature births.
It has not been reported yet, but I can almost guarantee that the sextuplets were most likely conceived through an intrauterine insemination cycle (IUI, also known as “artificial insemination”) using injectable ovulatory stimulating drugs. Before Octomom, I would have said it was almost impossible for a mega multiple birth to result from IVF, but she and her doctor (and I use that term loosely) proved me wrong. However, chances are really good that these sextuplets came from an IUI gone wrong.
Great care must be taken with artificial insemination using injectable ovulatory stimulating drugs. This procedure is more art than science since it is impossible to know ahead of time how many eggs will be stimulated. If sonograms reveal too many mature egg follicles, then both doctor and patient have to be willing to either cancel the cycle (and avoid intercourse) or change it to an IVF cycle to reduce the risk of higher order multiples. Unfortunately, not all doctors and patients are willing to cancel. Although the actual number of higher order multiple birth is not large (about 46 quintuplets or greater are born each year), I believe that the actual number of quint and greater pregnancies is much larger. From my experience, most patients when faced with triplets, quadruplets, quintuplets, sextuplets, septuplets, and heaven help them, octuplets opt to selectively reduce the pregnancy to twins in order to give at least two babies a fighting chance at normal development. Without getting into a moral discussion of fetal reduction, I strongly believe that all reasonable steps should be taken prior to conception to avoid the need for selective reduction.
Like it or not, money dictates a lot of decisions in infertility. IUI with injectable infertility drugs is more risky than IVF, but a whole lot less expensive. Although I think the only responsible approach is to abandon an artificial insemination cycle if too many eggs mature, I understand how hard this is after the patient has spent so much money on the medication. And remember, most people are paying for these treatments out of pocket. Doctors absolutely must explain this risk to their patients before they agree to the IUI and then should insist that the cycle be canceled or converted to an IVF. Easy to say, hard to do when this may be their only chance to conceive.
I pray that these six babies escape the typical health complication of multiple gestation and premature birth. They are already beginning their life in the NICU in critical condition. They are at an much much greater risk for cerebral palsy, developmental delays, and lung , eye, and heart conditions. We should want better for our children. I recently saw a video of the McCaughey septuplets. These seven children have had a host of health complication throughout their lives, and two of the children, Alexis and Nathan, have developmental delays and cerebral palsy. In the video when asked what she wanted for her 13th birthday, Alexis said, “I just want more friends at school and I just want people to know that I’m just a regular girl.” Oh course that’s what she wants. It’s also what she deserves.
Human beings are not meant to be born in multiples. The uterus is designed to carry one, or at the most, two babies to term. After birth, babies needs one on one (or one on two) adult attention to thrive. I once interviewed a mom of triplets who said you could always tell a house with triplets because there was always someone crying. If it wasn’t one of the babies, it was her because she knew she wasn’t able to fully meet the needs of all three.
I want infertility treatment to be available to all who need it, and I want to avoid too-restrictive governmental regulation. In order for this to happen, the infertility medical community needs to do a better job of regulating itself to avoid another sextuplet birth.
Image credit: wonderwebby