The American Society of Reproductive Medicine had their huge annual conference last week in Atlanta. Harkening back to my elementary school days, this blog will be my report on “What I Learned at the Conference”.
Sperm are cute, eggs are not, and the corollary axiom ~ sperm sell, eggs don’t. I have never been in a room with so many adorable sperm chotskies before. OK, truth be told, I had never seen a sperm chotsky before, much less been in a room with one, but still… I made it my mission to get one of everything sperm related and came home with a stuffed sperm plush toy, a sperm lapel pin, a sperm pen, and best of all, a sperm baseball hat. The possibilities for use and enjoyment of such treasures are simply endless. The first of such enjoyments came from the look on my children’s faces when they gathered around to see what I had brought them from the conference. Son #2 panics any time I mention the word sperm for fear that I’ll launch into another one of my “knowledge is power” talks (a.k.a. sex education), so you can imagine his discomfort when every other word out of my mouth was “sperm”. His little sister was enjoying his agony, until I handed her the lapel pin as her gift.
The gray areas of life draw me like a moth to a flame. I distrust easy answers to complex questions, and feel uneasy in the company of the black and whites of the world. When faced with someone who knows exactly what is right on an issue where right is not crystal clear, I feel compelled to formulate the other side in my head and play the “but what if” game. Not surprisingly, the sessions at the ASRM conference that I enjoyed most were the ones where very learned people discussed both sides of ethically confusing areas, and heaven only knows, infertility treatment is rife with these areas.
One such gray ethical area that deeply divides the infertility medicine community is gender selection. I attended a fascinating session on pre-implantation diagnosis/screening where several doctors and ethicists discussed the advisability of allowing couples to choose the gender of the embryos to be transferred during IVF. I so appreciated the depth of the discussion on this complex subject. Some doctors are opposed to gender selection in all situations other than to avoid gender specific diseases, others allow it to balance the gender of children in families, and some allow it for any reason at the sole discretion of the parents. Interestingly, it is not uncommon for there to be disagreement amongst doctors at the same clinic. What impressed me was how interested the profession as a whole is on “doing the right thing”, and they are just as confused as the rest of us on exactly what is right.
Another highly controversial session was on the advisability of a national registry for children conceived through donor egg or sperm. A registry would allow the flow of medical information between the donor and donor conceived person, and could prevent questions of consanguinity (accidentally marrying your half sibling). I don’t think anyone on the panel was seriously suggesting a government mandate requiring registration, but there was a good discussion about the advantages and disadvantages of a volunteer registry. Who would benefit, who should have access and under what circumstances, who would run it, and who would pay for it. I wonder if the whole idea of a volunteer registry is moot since the majority of parents using donor gametes aren’t telling their children. Although disclosure to children and registering them on a donor gamete registry are two separate issues, they are inexplicably connected since parents who do not tell their children that they were conceived by donor egg or sperm are not likely to voluntarily sign them up. Also, a registry is not necessary for those who use an identified donor. An interesting point I had never thought about was made by Dr. David Adamson, who will be our guest on the show this week on the totally different topic of how to pick a fertility specialist. He pointed out that a surprising number of people don’t know their paternity even when donor sperm are not used, so why should we suggest that those who used donor egg or sperm be the only ones to register.
And last, the session on whether clinics should be marketing egg freezing to woman wanting to postpone child bearing was thought provoking. The techniques for cryopreserving human eggs have advanced rapidly, but the ASRM still considers this procedure experimental. At what point should they end that classification and on what evidence? How do you do long term research on children conceived from frozen eggs without some form of registry. Actually, the same question could be asked about IVF kids in general. Should woman be encouraged to postpone conception at all? There are no easy answers, but I thoroughly enjoyed listening to smart people disagree on possible answers.
One of the best things about this conference for me was the chance to meet in person people I’ve worked with only over the phone or the internet or the radio show. Many of the speakers and attendees have been guests on the Creating a Family radio show, and I met others who will be on the show over the coming year to bring their expertise to you. I also met with non-doctor types that I’ve worked with through the years who have done so much for infertility patients. Here are a few I want to make sure you know.
- Mikki Morrisette is a single mom by choice and started Choice Moms to support others who have or are considering parenthood without a partner. Her site and book (Choosing Single Motherhood: The Thinking Woman’s Guide) are excellent resources, and Mikki is as nice and helpful in person as you would expect from her book and her appearance on our show. She continues to expand her services and support for woman choosing single parenthood, including a new radio show.
- Renee Whitley and Lee Collins are the force behind the National Advocacy Committee at Resolve, the infertility support organization. I would bet that few realize the debt we owe to the tireless work of these two women to make sure that infertility treatment remains available and legal. Throughout the year, legislation is introduced on the national and state level that affects the availability and affordability of infertility treatment. Some of these laws would result -either intentionally or unintentionally- in the severe restriction or prohibition of many types of infertility treatment. Lee and Renee stay on top of what is happening and provide information to the lawmakers on the consequences of the legislation to the infertile and support for advocates in each state. What impresses me most is that both of these women have finished building their families, so they won’t personally benefit from their efforts. They volunteer their time and talents just to make sure that the next generation of infertility patients has the option of building their family through infertility treatment. Check out some of their work at Resolve Take Action page. Hats off to you ladies and thank you!!
P.S. As to the fate of the pictured sperm hat: Daughter #1 wrested ownership of the hat from her dad. I must admit that he didn’t put up much of a fight. My daughter wearing a hat adorned with sperm wasn’t exactly the outcome I had imagined.