Fertlity treatments.

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What are your thoughts? Should people be having babies at age 60 and beyond? What about other types of fertility treatments, including the types that can lead to multiple births? Is this a bad way to spend our money and energy when there are so many hungry people in the world?

Um, I guess I revealed my biases there. Go ahead and reveal yours.

-- Anonymous, July 06, 2000

Answers

I think neither men nor women need to be creating babies much past the age of about 45.

And fertility drugs are scary as hell.

-- Anonymous, July 06, 2000


That "so many hungry people in the world" argument could be used against practically everything we do, including the time and money we all spend posting in this forum: if you sold your computer and gave up that DSL line, think how many Ethiopian children you could feed!

The bottom line is that people will spend money for things that are important to them, and raising a child is definitely something that most people hold dear.

I do think that there are a few legitimate ethical issues associated with fertility treatments: one is that women giving birth at 60 are more likely to become ill or enfeebled early in their child's lifetime. However, old men have been having kids for years with little public outcry! And who among us really knows what our health situation will be five or ten years from now?

Another argument I've heard advanced is that it's immoral to go through fertility treatments when there are so many children who are looking for adoptive homes. This, I concede, is a compelling argument, but I also think that having a child which melds the biological makeup of you and your partner is a profound act of love. I think that people should have the moral right to at least try to do this if they so choose.

-- Anonymous, July 06, 2000


Although I realise my attitudes would probably change if I was infertile, at the moment I kind of thing if something isn't meant to be, it should be accepted.

And as somebody who isn't comfortable with abortion etc, I have some real problems with the fetuses they destroy because they aren't needed.

-- Anonymous, July 06, 2000


I don't kind of thing, I kind of think. But I'm going to go home now, because my fingers and brain have become tragically disengaged.

-- Anonymous, July 06, 2000

if something isn't meant to be, it should be accepted

Even though I have serious reservation about some fertility treatments, I think the above makes no sense. If so, how can you justify any sort of medical intervention?

-- Anonymous, July 06, 2000



Well, I think there are degrees of intervention. For example, if I was told I was suffering from incurable cancer, I wouldn't undergo chemo. However, if I was told they had caught the cancer early, I would. Similarly, if I needed my tubes blown, I'd probably do it, but if I needed full artifical insemination I would accept I wasn't meant to have kids. I have a fatalistic view on life as a whole, and think that, if something is really difficult, it can be seen as a sign of a wrong option. Just my view on it.

-- Anonymous, July 06, 2000

The only people who really bug me in this arena are the ones like the McCaughey's [the Iowa septuplet people] who are viruently anti-abortion but go on about "God's will" in giving them 7 kids--that and the millions of dollars of fertility treatments and medical care for their brats.

-- Anonymous, July 06, 2000

I can understand the urge to have a child who's related to you, rather than adopting. I admire people who adopt but it just doesn't have the same feeling for me, and a lot of other people. So, I don't have a problem with people having fertility treatments to have a child. Some people go too far with it, though.

I think it's weird that people age 60 and beyond want to go through treatments to have babies, but it seems like something so unusual that it's not going to be a big problem. As someone else pointed out, it's not seen as weird for 60 year old men to father children.

Personally I find twins and triplets and beyond, the result of fertility drugs, repugnant. There's probably no way to keep people from doing it, though. Ethical doctors won't try to get lots of fetuses in one pregnancy - it's not healthy. It may be repellent if you're uneasy with abortion, but the technique where they kill a couple of the fetuses so that one can survive is actually seen as best practice by a lot of doctors. If you can't contenance that, maybe fertility treatment isn't for you.

I agree with the idea that the McCaugheys are repellent with their talk of a "miracle", after all the intervention. Yeah, it's miraculous that she was able to carry the babies to term. It's also a miracle that people built them a house, bought them a mini van, etc. If all this energy were directed toward other children in that same town who don't have a place to live, imagine what it could do.

I'm still a Zero Population Growth believer who thinks nobody should have more than two children, basically.

I don't think insurance should pay for fertility treatments.

-- Anonymous, July 06, 2000


I think it's a personal decision, just like any other. If, at 60, you felt capable of having and caring for a child, then fine, spend the money on it, and go for it. But how many 60 year old women can you think of that want a baby? Pregnancy wreaks havoc on most young women's, I can't imagine what it'd do to an elderly woman.

If a couple is willing to go through the mental and financial anguish of several years of fertility treatments, and end up with sextuplets or whatnot, then more power to them. Remember - not everyone is infertile. These stories we're hearing about multiple babies and other results of fertility treatments are still representing a very small portion of the population. A lot of the reactions here are stated as though suddenly everybody's going to be taking pills, popping out ten or twelve kids, and then doing it again when they're 75, and that's just unrealistic. Most women who've already had kids, will probably not want more after age forty. Most couples are not infertile.

It'll all balance out in the end. Nature adapts well to the little speed bumps people try and toss in its way.

-- Anonymous, July 06, 2000


"if something isn't meant to be, it should be accepted"

As someone who wouldn't be here if it weren't for fertility drugs, all I can say is thanks a lot.

I don't have a problem with fertility drugs, which can't have been all that expensive if my parents could afford them back in their young-and-poor days. I don't think this has anything to do with the hungry people of the world. I'm much more disgusted by people wasting money on excessive luxury items than on trying to have a baby.

On the other hand, after about age 45 I think it's time to give up the idea of having a baby. Enough is enough, for both men and women. Just because one gender can get away with it doesn't mean it's right. I don't think you should adopt then, either.

But then I also don't think you should have seven babies at once -- or one baby -- if you can't afford what it's going to cost in terms of basic care.

As for adoption instead of fertility drugs, it sure is a nice idea in theory. In reality, the paperwork is incredible, the waiting lists are awfully long ... no one does this kind of checking up on people who are fertile and popping out kids like a PEZ dispenser, but you have to meet all kinds of societal standards in order to adopt. I can certainly see why fertility treatments would seem more appealing.

Don't look at me, I'm not having any kids anyway. :)

-- Anonymous, July 06, 2000



I don't have a problem with fertility drugs in general. I can appreciate how strong the desire to have children who are genetically related to you, and while I certainly wouldn't want a child at 60 I'm not willing to tell someone else not to.

HOWEVER:

If medical researchers spent even a fraction of the time and energy researching better, safer, easier methods of birth control that they currently spend on infertility treatments...we could probably all stop bitching about the pill and the lack of options available. No offense to those who are infertile, but society as a whole would be in much better shape if those who don't want kids could avoid doing so - if birth control methods were cheaper and came with fewer side effects.

I know the answer is simple: there's a lot more money to be made marketing infertility treatments than birth control. It still pisses me off, though - just seems like such a juxtaposition of priorities.

-- Anonymous, July 06, 2000


Sarah, in response to your post:

Allocation of resources for medical research is a complicated process. It's true that people studying things which can result in profitable treatments have easier access to certain types of funding, especially funding from drug companies. But, a lot of medical research is also funded by the government, which evaluates research proposals mostly on the basis of their value to public health and their scientific merit.

There are a couple of reasons why there's not a lot of birth control research being done today. One is that the field is kind of "tapped out," and nobody has been able to come up with any really exciting ideas for future research. Barrier methods have been done, hormonal methods have been done, and there are no really great targets for therapy left. Another is that there is a sense that existing methods are reasonably good and inexpensive.

So, it's not quite as simple as saying that researchers are robbing Peter to pay Paul. If you had to choose between training your dog to roll over and training him to, say, set the table, which would you choose? The latter task might be more valuable, but it would be a hell of a lot harder, too.

-- Anonymous, July 06, 2000


Adopt.

Let me say that again - adopt. If you can't have kids, there are so many that need good homes. I've always said this, and it is silly, but it is true.... Going for fertility treatments when you can adopt a child who really needs a good home is, well, wasteful.



-- Anonymous, July 06, 2000

And even if you can have kids, you should consider adopting. All you fertile people don't get off the hook that easily.

-- Anonymous, July 06, 2000

"As someone who wouldn't be here if it weren't for fertility drus, all I can say is thanks a lot."

Gee Jette - melodramatic much? I never said fertitility drugs should be outlawed, I said I personally wouldn't use them.

-- Anonymous, July 07, 2000



"Adopt.

Let me say that again - adopt. If you can't have kids, there are so many that need good homes. I've always said this, and it is silly, but it is true.... Going for fertility treatments when you can adopt a child who really needs a good home is, well, wasteful."

It's not that easy. Adoption is horrendously expensive and takes a long time.

We would love to adopt, but don't have the 15,000 to 20,000 dollars to adopt internationally. I can't adopt domestically due to being disabled.

So in a few years, fertility treatments it is. Although if my doctor tells me to refrain from sex because there are too many mature eggs I will. I do not want to be another Bobby Mccaughey.

-- Anonymous, July 07, 2000


My wife and I put off having kids for a few years after our marriage so that we could afford them, but after a year of trying we still hadn't conceived. We wanted two children, and I didn't (still don't) want a child in college after I turn sixty, so we had sort of a narrow window.

We did use two of the less intense fertility drugs. The one that worked was Chlomid, which I understand can lead to multiple births if the dosage is too high. I didn't consider adoption because, it's difficult to admit, I just wasn't sure if I could love someone else's biological child enough to be a good father to him or her. Now that I have a child, I think it's irrelevant. I can't imagine that my feelings for my son would be diminished in any significant way if we had adopted him (I do get a lot of pleasure out of seeing family traits in him -- in some light he looks like a young version of his great-grandfather, whom I worshiped as a child). Still, I'm glad we could get medical help and have our own baby at the time we wanted. It was worth the minor risk that my wife's body would overreact to the Chlomid and give us octuplets.

As for babies late in life, I do think parents have some obligation to take their reasonable life expectancy and financial position into account (as we did in delaying the birth, then trying to time it so that our financial responsibilities would be over several years before my retirement). But if a penniless 65-year old couple wanted to have their own child, I wouldn't feel any more entitled to interfere than with any other risky pregnancy. I think it has to be about freedom of choice. Childbearing and -rearing are the most intimate societal decisions we make.

-- Anonymous, July 07, 2000


I think it's scary that doctors would allow people to conceive 7 or 8 children at once. If you must have fertility treatments, please accept that selective reduction might come into play. I think it should be part of the agreement. If you go on fertility drugs, and there is a risk of high multiples, you must allow the doctor to make a decision that benifits both mother and child(ren). If selective reduction is the decision presented to you, then take it. It's better than squeezing out 7 kids and having 3 come out with disabilities, like the McCaughys had. Not every town is willing to pick up the slack for your stupidity. One or more of her babies could have died, SHE could have died, but dammit, she needed those babies. When she told the world "It's God's will!" I nearly puked. She used science to concieve those kids, and she should have used science to reduce the number of babies she was carrying. Her faith in God is fine, but if you use science to concieve babies, be prepared to put God away for a while. And if you're not, then be prepared to not use fertility drugs.

-- Anonymous, July 07, 2000

"I think it's scary that doctors would allow people to conceive 7 or 8 children at once"

The Mccaughey's were told to not have sex due to the large number of mature eggs and went ahead with it anyhow. Unfortunately doctors can't control when their patients act like complete morons.

If I remember correctly 2 of the children have problems where they can't walk. 1 can not eat, she is feed through a tube in her stomach, and I believe 1 more has problems.

-- Anonymous, July 07, 2000


Jennifer,

You're right about the differences in funding styles between government and private sources - I was oversimplifying. And while you may well be right about having 'tapped out' ideas for birth control methods, I have to say that I'm not entirely thrilled with the options available. I realize how far we've come, but I still dream of a pill without side-effects, of an implant that would be easy to put in and take out as desired, etc. I think it would make a tremendous difference in teen pregnancy and abortion rates if there was a birth control device that you could just have put in and forget about it - no daily pills, no condoms - without having to worry about months of unwanted side effects before you can change your mind.

The other aspect of this I realize is more of a policy issue than a technical issue, but I think calling birth control pills "inexpensive" is not entirely accurate. I realize they're cheaper than many prescription drugs, but even with insurance it adds up. I know it's a controversial religious issue, but it frustrates me that the sectors of society that often most need access really don't have it.

Boy, I'm way off topic here, aren't I? Ok, end of rant.

-- Anonymous, July 08, 2000


to continue the tangent for a moment. I'm not sure that birth control is "tapped out," either. especially birth control for men. I seem to recall some articles on this a few years ago, about various options (synthetic 'plugs' later dissolvable by injection, to block sperm; hot -not scalding- water or other heat, other 'internal' barrier methods, etc etc). There is lots of research on lots of things that have not been done. it may be that the immediate market is tapped out, but i'm not even sure that's the case, as if men knew of a painless and reasonably easwy/cheap birth control that could last for a few weeks or a month they might well.. not sure how much research has been done on THAT subject either...

-- Anonymous, July 08, 2000

Is this a bad way to spend our money and energy when there are so many hungry people in the world?

You could say the same thing about anything. Look at the amount of money people waste on their pets, for example. Our pets get better food and health care than many people in other countries do. Is this right? I'd rather see people spending money on fertility treatments than an operation for their old dog.

-- Anonymous, July 08, 2000


I think it would make a tremendous difference in teen pregnancy and abortion rates if there was a birth control device that you could just have put in and forget about it - no daily pills

God, I have to laugh when people complain about the awful rigor of taking one fucking pill in the morning. Put it next to your toothbrush or hang the package by the front door.

It's not exactly dialysis. If someone's too forgetful and irresponsible to remember something so simple, perhaps they should abstain from sex until their memory matures.

-- Anonymous, July 09, 2000


Again Joy ... cue the heavenly choir ... you're right on the money.

-- Anonymous, July 09, 2000

I don't particularily like the idea of people purposely having children beyond the age of 60. Children shouldn't have to worry too much about their parents dying, if it can be helped. That's really my sole objection. Healthcare has come a long way, but we generally still age and die pretty predictably. It's difficult enough to deal with your parents' failing health when you're an adult.

I also don't really like the fertility drug induced litters of babies. Bad use of resources, definitely.

Why are these people not deterred by the possibility of having five or six thirteen-year olds at the same time? Just think about the horror! Just think of the cost of Clearasil alone! Braces! No hot water ever! The mental stress of having 5 or 6 kids simultaneously decide you are the biggest fucking idiot on the face of the earth! 5 or 6 sets of eyes rolling emphatically at your every utterance! These people are not thinking ahead, or they're delusional or something...

And that's a best case scenario. That's if they're all healthy and develop normally. What if two are ADHD and one is autistic?

If I thought I had that kind of energy, I would be a teacher or a social worker and try to help an existing problem rather than risk creating a new problem.

Then again, I don't feel an urge to procreate so I'm not in a position to understand the issue from both sides.

-- Anonymous, July 09, 2000


if men knew of a painless and reasonably easwy/cheap birth control that could last for a few weeks or a month they might well.. not sure how much research has been done on THAT subject either...

It's true that a male pill is in the works. When I said that the field was "tapped out" I didn't mean that there were NO new projects in the works, I just meant that most of the obvious things have been tried, and that the remaining prospects haven't generated much excitement.

The problem with the male pill is that it affects hormone levels, just like the female pill, and it seems inevitable that some men will have adverse reactions to it. Also, it's just not fair, but it's an unfortunate fact of biology that pregancy is easier to prevent from the female side of things. Pregancy in women can be prevented by blocking maturation of the egg, inhibiting fertilization, or interfering with implantation. In men, all you can really do is inhibit sperm production. Another problem with male birth control is that men make millions of sperm every day, whereas women usually only produce one mature egg per month.

-- Anonymous, July 09, 2000


"It's not exactly dialysis. If someone's too forgetful and irresponsible to remember something so simple, perhaps they should abstain from sex until their memory matures."

Joy,

That's exactly my point. Mature, responsible adults tend to have access to the pill, are able to afford it, and can be counted on to take it appropriately. For the same reasons, these are usually the people who are most ready to be parents. We all know, though, that there are plenty of people out there who for whatever reason (youth, immaturity, poverty) aren't or can't take the pill responsibly, and wind up with unwanted pregnancies. Abstaining may or may not be a good solution in theory, but it seems pretty unrealistic to me. In a sense, I think the pill works best for those who need it the least. That's a big part of why I'd like to see a better long-term birth control method that could be made accessible for everyone.

-- Anonymous, July 09, 2000


That's exactly my point. We all know, though, that there are plenty of people out there who for whatever reason (youth, immaturity, poverty) aren't or can't take the pill responsibly, and wind up with unwanted pregnancies.

No I think you missed my point.

My 8-year-old niece remembers every morning to take her Flintstones vitamin responsibly. She's no genius nor is she any more responsible then the average kids.

Where is accessibility to birth control a "problem"? There's Planned Parenthood, student health centers for college students, county medical clinics, private physicians for those with insurance.

Condoms are available virtually everywhere; so are spermicides. You can get them for cost or even free at most clinics.

Have you heard about the program started by a So Cal woman who gives $200 to female crack addicts who agree to get the 5-year birth control [name of the eludes me at the moment]. She's gotten a lot of takers--despite the screams of some accusing her of everything from racism to "genocide". I think it's a good idea.

-- Anonymous, July 09, 2000


Joy,

That sounds like a pretty good idea to me, too. And by "accessibility" I didn't mean that I think the pill is particularly difficult to get for those who are willing to go look for it. I meant that the people who perhaps need it the most often don't bother. I'd like to see birth control made so simple that it's as easy to be protected as to not be - so that you could go around simply offering it to people (crack addicts, teenagers, whoever) and it would require a one time 15 minute time investment and nothing else.

-- Anonymous, July 09, 2000


About male birth control- I did a paper on this awhile back and will quote from it:

One example of going against the norm being generally rejected by the scientific community, despite its worthwhile benefits, are studies done on male contraceptive devices. The popular opinion is that there is little demand for male birth control in our society, and therefore research into other, more effective and desirable methods that men can use is not needed. There are a surprising amount of male contraceptive techniques, based on injection, heat, or semi-surgical techniques that do exist and have been researched, mostly in China. However, cultural biases of the people who provide funding for the research into these methods has pretty much prevented any of these methods from being studied more or becoming available to the public. Very little work has been done on other methods due to lack of funds and technical difficulties in study. An example given of the difficulties of going against the norm scientifically in this area is the study of ultrasound contraception, a simple, convenient method of providing a man with six months of sterility. Only one man, Dr. Mostafa S. Fahim, has researched this in the United States, but he quit doing so in 1980, and ultrasound is considered by most researchers to be a dead subject. This was due to limited funding, and also Fahim's university's requirement that he could only experiment on men with prostate cancer who would probably have their testes removed anyway in his trials, instead of men who were planning vasectomies that would have been better subjects. Many researchers have doubted Fahim's results because they were so different from the normal studies of science. Male science seems to choose that women be the ones solely responsible for birth control.

Unfortunately, the excellent source I got this section from is no longer on the web.

-- Anonymous, July 10, 2000


Jennifer wrote:

However, cultural biases of the people who provide funding for the research into these methods has pretty much prevented any of these methods from being studied more or becoming available to the public.

I suspect that this is partially true, but probably not the whole story. And, I don't think those "cultural biases" are so unreasonable...if I have sex with someone, I'm the one who risks getting pregnant, and frankly, I'd rather be on the pill myself than depend on my male partner to do so.

Only one man, Dr. Mostafa S. Fahim, has researched this in the United States, but he quit doing so in 1980, and ultrasound is considered by most researchers to be a dead subject. This was due to limited funding, and also Fahim's university's requirement that he could only experiment on men with prostate cancer who would probably have their testes removed anyway in his trials, instead of men who were planning vasectomies that would have been better subjects.

Couldn't Dr. Fahim's lack of support result from a lack of scientific merit in his claims? And the university's requirement that he test his treatment on men with prostate cancer is absolutely standard! It is very hard to get permission to do human studies, and in this case, cancer patients were probably used because the ultrasound has a potential to damage sperm without killing them. The men awaiting vasectomy would clearly have a higher chance of fathering a child during the treatment which could result in birth defects or stillbirth. Using this fact to claim that this man has been unfairly discriminated against due to his unorthodox ideas seems to be a serious misrepresentation.

It's very easy for people with unorthodox scientific ideas to claim that the powers that be are biased against them.

-- Anonymous, July 10, 2000


Regarding 'Doctors' letting a woman or a couple conceive 7 or 8 children through fertility treatments - don't ever kid yourself - most doctors [not all] have 'the GOD complex' and what is more powerful and God-like than the creation of life or in this case lives. Coupled with the "it's God's will" screaming patients - well, we've seen that outcome.

The thought of having a child at 60 with the high potential of not being alive to see them graduate college is insane - but that's just me.

Multiple births? Oh yes, it makes perfect sense to bring 7 or 8 sickly children into the world so they can all live an overly medicated, constantly hospitalized life. *Sarcasm* Yep, perfect sense. Perfect example of self absorbed, self-parenting to bring these sickly children into the world - unnaturally in the first place to prove that they could.

While I am supportive fertility treatments as well as the right to have the choice of abortion I strongly believe that both the patient and the doctor vastly abuse both options. In addition there's an irony to the ease of the unwanted pregnancy and the difficulty of the so desired pregnancy. That I'm tell you folks, if you believe in a "God's way" is God's way.

-- Anonymous, July 10, 2000


Jennifer Wade wrote: "I suspect that this is partially true, but probably not the whole story."

This is true. My paper was on biases in science related to the sexes, so it was obviously slanted in that direction.

"And, I don't think those "cultural biases" are so unreasonable...if I have sex with someone, I'm the one who risks getting pregnant, and frankly, I'd rather be on the pill myself than depend on my male partner to do so."

Well, I'd agree with you there, but there's other biases involved too. I wouldn't trust a man to take a pill every day (I'd forget, why not him?). If there was a version of Depo for men, sure (or some of the other methods in the paper).

It strikes me that male pills would probably work well for (a) men very much against having children, enough to take the pill all the time on their own or (b) long-term coupled men. Everyone else, I doubt it.

"Couldn't Dr. Fahim's lack of support result from a lack of scientific merit in his claims?"

Possible. There was a -lot- more information on it in the original source than in my paper. My boyfriend at the time is a scientist and I passed it on to him, and he seemed to think it was valid. (He went down to Planned Parenthood and asked them why they didn't have things like this available, actually).

"And the university's requirement that he test his treatment on men with prostate cancer is absolutely standard!"

Ok, that I didn't know, since I'm a non-science major.

-- Anonymous, July 10, 2000


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