About.com Health and Fertility Advocate on the Egg Freezing Debate
About the Author | Rachel Gurevich
Rachel Gurevich is the fertility expert for About.com and author of three books. She is a 2014 recipient of a Hope Award for Achievement from Resolve: The National Association for Infertility. She invites you to check out her site at http://infertility.about.com and to connect with her onTwitter () or on Facebook at About Fertility.
The egg-freezing debate has the media up in arms over whether these perks, soon to be offered by Apple and already available to Facebook employees, are good or bad for women.
It's 2014, people: let women decide what they want to do.
Now, I'm not saying that egg-freezing is a great solution to work-family balance. I'm not saying I think most women should go for it.
I really think it should be used only in very special cases or in case of medical need.
However, that should not be my decision. It belongs to the woman making the decision about what to do with her body.
Just like I don't want corporations, governments, or insurance plans to decide what birth control I can use, I don't think they should have a say in how I plan my family or handle my fertility.
More Options or Corporate Pressure?
The biggest fire in the debate is whether Apple and Facebook are somehow trying to hint that women should freeze their eggs so they can advance their careers.
But can't the same be argued for covering birth control? Or fertility-ending procedures like vasectomies or tube tying?
Medically speaking, birth control is way more likely to help a woman push off having kids than egg-freezing. Egg-freezing doesn't keep you from getting pregnant...
Remember, too, that some insurance plans don't cover egg-freezing even in the case of medical need.
I’d be willing to bet that even those that do cover egg-freezing before cancer treatment may not cover cryopreservation for women with a family history of early menopause or primary ovarian insufficiency.
These women have just as much of a medical need to consider egg-freezing as a cancer patient, but they probably wouldn’t be covered. But Apple and Facebook’s plans would cover them.
Coverage, in whatever way, should be celebrated, not demonized.
But Isn't Offering Egg-Freezing So Freely Dangerous to Women?
There's definitely some disagreement in the medical community on whether egg-freezing should be used to put off childbearing. The American Society of Reproductive Medicine and the American College of Obstetricians and Gynecologists don't recommend it.
I agree with them. However... no one is currently saying it shouldn't be an option. Only that women who choose that path should be well-informed of all the risks.
As an aside, egg-freezing is not the only optional medical procedure being covered by insurance providers that may have more risks than benefits.
For example, there's lap band surgery.
This elective surgery is marketed to obese individuals who have not been able to lose weight through traditional means.
The surgery is highly controversial. Many physicians are against it as a solution to obesity, and for a good percentage of people, it’s not a good long-term solution. It also has some seriously long term side effects. It’s way more risky that egg-freezing.
But it's still covered.
Bottom Line on the Egg-Freezing Debate
It’s not a big shock that there’s debate over this issue. It follows along with the general pattern that tends to occur with all women’s health issues in this country, especially reproductive issues.
There’s this theme that women can’t be trusted to make informed choices.
It also follows the pattern of fear and stigma that surround assisted reproductive technologies.
But that’s okay. We know you can make choices for yourself. We also know that sigma only lessens when things are talked about.
We, as a nation, need to talk about all these issues.
Let them talk... maybe it’ll lead to even more coverage for fertility.
For more on this debate, including some things to consider before you freeze your eggs, please read my article here at About Fertility.
Fertility Treatment and the Supreme Court Decision On Birth Control
The birth control debate rages on. Despite a ruling from the Supreme Court, the conversation has been turned onto high, not turned off.
It matters, whether you are trying to prevent a pregnancy or whether you are in fertility treatment. Any of us who have been or are currently trying to conceive know this. How many of you out there reading this has been on a course of birth control while at a board certified reproductive endocrinologists' (fertility specialist) program?
Here’s what Fertility Within Reach had to say on their Facebook page, “The U.S. Supreme Court rules some employers don't have to cover birth control. This is a HUGE blow to those needing treatment for endometriosis and other reproductive health issues. If this court decision hurts you or someone you know, please communicate how. They have a contact us section on their website. It's meant for us to use."
Supreme Court of the United States of America | General Contact Information:
U.S. Mail: Supreme Court of the United States 1 First Street, NE Washington, DC 20543
Telephone: 202-479-3000 TTY: 202-479-3472 (Available M-F 9 a.m. to 5 p.m. eastern)
Other professionals in the field have spoken privately on their personal FB pages. I have no doubt that public comments are on their way. I’m still waiting to see what our patient organizations have to say about this ruling.
We are already seeing what I view as the typical reactions; Viagra is covered but not birth control.
Women's Reproductive Rights
And while it might seem like a clichéd reaction about women's reproductive rights, is it really?
Companies are ok about covering a medication for a man who wants to have an erection, presumably to have sex, at least occasionally in a situation where he may impregnate a woman. That our medical insurance is ok to cover.
The desire to have sex apparently is ok. Even giving someone medication to be able to act on that desire is ok.
Having medical insurance cover a medication that will enable a woman to ensure there is no unwanted pregnancy, that is a problem?
And why is it a problem? Is it as simple as, “if a man was the one to become pregnant, it would be covered”?
Is it even as simple as, “the morning after pill is being used as birth control but actually amounts to abortion”?
Is it possibility as simple as, “pregnancy and unwanted pregnancies, in particular, are a woman’s problem”?
I don’t even pretend to know society's definitive answers to any of those questions. I’m quite certain it would depend on which part of our society was responding. I’m equally as sure that there are polarizing opinions out there, creating massive divides between us.
Interestingly enough, while I understand and appreciate the intellectual, cognitive conversation about this and can sympathize with more than one side -- emotionally? That’s a different story.
Burwell v. Hobby Lobby - Ruth Bader Ginsburg and Dissent
Here’s my emotional response to Burwell v. Hobby Lobby. Ready for a rant?
You don’t want us getting pregnant and having abortions? So you shut down clinics that give reliable, understandable and affordable reproductive information. We allow men to have medications that give them erections but these medications do nothing to prevent an unwanted pregnancy. We don’t allow women to protect themselves from having babies? What does that say about women having sex? We can have sex but only if we are afraid? Are you kidding me? Are we really going to add fuel to the maelstrom conversation about abortion? Now, not only is it more and more difficult to end an unwanted pregnancy, we will make it harder and harder to avoid getting pregnant? Are you kidding me?
What century are we living in? Are men only going to be allowed to have Viagra if there is proof of a marriage to a heterosexual woman? Will they be followed up to make sure that they are only having sex with their wife? After all, otherwise it’s adulterous and of course men shouldn’t be having sex out of wedlock either.
How far do we go about allowing someone else’s religious or moral beliefs impinge on our rights? Companies offer health insurance. Period. End of story. They do not and should not get to decide how, what, or any of the other details.
My opinion. They should not be able to do that.
I disagree, emotionally, with the Supreme Court decision. Most emphatically.
I’m not the only one. Read more in this Huffington Post article for Ruth Bader Ginsberg’s 35 page dissent. She is far more eloquent than I am.
End of rant. Thank you for listening.
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Infertility Does Not Define Us
Maya Angelou was a writer and poet and more.
She was a woman.
Not a goddess. She didn't need that elevated status. She knew that being a woman was encompassing of much more.
She was content to be just that.
A phenomenal woman.
As you all are. As we all are.
We are phenomenal women.
And an infertility diagnosis does not define us. Nor does having babies or carrying a pregnancy. We are not weak because we cry from sadness and disappointment. We are strong. Beautiful. Brave. Healthy.
We are phenomenal women.
Every single one of us.
Thank you Maya Angelou~ Lisa Rosenthal
Pretty women wonder where my secret lies.
I'm not cute or built to suit a fashion model's size
But when I start to tell them,
They think I'm telling lies.
It's in the reach of my arms
The span of my hips,
The stride of my step,
The curl of my lips.
I'm a woman
I walk into a room
Just as cool as you please,
And to a man,
The fellows stand or
Fall down on their knees.
Then they swarm around me,
A hive of honey bees.
It's the fire in my eyes,
And the flash of my teeth,
The swing in my waist,
And the joy in my feet.
I'm a woman
Men themselves have wondered
What they see in me.
They try so much
But they can't touch
My inner mystery.
When I try to show them
They say they still can't see.
It's in the arch of my back,
The sun of my smile,
The ride of my breasts,
The grace of my style.
I'm a woman
Now you understand
Just why my head's not bowed.
I don't shout or jump about
Or have to talk real loud.
When you see me passing
It ought to make you proud.
It's in the click of my heels,
The bend of my hair,
the palm of my hand,
The need of my care,
'Cause I'm a woman
Photo Credit: Maya Angelou, The Carolina Theater, Greensboro, North Carolina, September, 2008, Flickr Creative Commons, Talbot Troy
Poem Source: Maya Angelou, “Phenomenal Woman” from And Still I Rise. Copyright © 1978 by Maya Angelou.
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Miscarriage and Loss Remembrance
Strange where those words burrow themselves in. Miscarriage and loss.
I had two miscarriages. Many years ago. Many experiences ago.
My grieving went on long after it made much sense to me. After all, the losses were so early they were barely losses. Right?
They were losses after IUI's (intrauterine inseminations). I knew exactly what day I had been impregnated, exactly how far along I was. I could practically have told you how many cells each embryo had and how they were developing.
I hesitate to write on this sensitive, emotional subject. There is a political aspect to this conversation that is undeniable, given that we have a presidential election a scant 3 weeks from today.
The emotional, spiritual side is unmuddied by the political controversy. For me, I can separate these issues as easily as I open my eyes after a full, restful night's sleep.
I believe in a women's right to choose to have a baby or not to have a baby. That is my belief. I vote with that belief. That is not only my political belief; that is my feminist belief.
And yet. Those pregnancies held my future as I hoped it would be. Those two pregnancies were filled with soft, green grass and blue skies and picnics, holding a baby. Dreams of lighting candles and seeing the lights reflected on my baby's face. Gently holding my baby as I read my favorite books. I breathed into those places of sleeping and waking, knowing that my baby was alive and real and part of my waking life, not just a dream.
Yes, all those dreams and thoughts about an embryo so small that there was never any possibility of survival past living in my uterus.
Positive Pregnancy Test Dreams
While in fertility treatment, after a positive pregnancy test, I dreamt a whole life with my baby, toddler, pre-schooler. I dreamt of life with my child, all the way through college. All in the first several weeks, all while that baby was only a possibility of a baby. And I mourned the loss of that baby, child, and adult when the pregnancy failed. My heart broke with each realization that not every conception or embryo or pregnancy resulted in a baby in my arms.
I mourned the loss of those embryos that did not survive to babyhood.
I still do.
I still know exactly how old those children would have been. When their birthdays were.
I know that the moment I got those positive pregnancy tests that those embryos became babies to me.
Prayers to Those Mourning Recurrent Pregnancy Loss and Miscarriage
My prayers go to all of us who are mourning those losses today. Infant loss, spontaneous miscarriage, recurrent pregnancy loss--this pain has many different names. I am sending you loving thoughts, hoping that comfort finds it's way into your lives, moment by moment.
I hope that you can separate your loss from the political side of pregnancy. In three weeks we elect a president that is being very clear on his position. The issue is not abortion. It's about freedom to choose and reproductive health.
Vice presidential candidate Paul Ryan said in the debate with Vice President Joe Biden that he and Mitt Romney, if elected, would place supreme court justices on the court who would vote against Roe v. Wade.
Please understand that this is not only about abortion. It's also about fertility treatment and the ability to create embryos that create our families. It's about being able to have fertility treatment as a choice at all. If you think I'm exaggerating, please refer back to previous blogs about embyos being granted personhood.
I support a woman choosing. Choosing to have a family. And choosing not to have a family. Her choice. Not mine.
My choice is to take a few minutes today, two decades later, to sit quietly and remember the pregnancies that I lost. The embryos that didn't mature into the young men or women that I dreamed of. I will say a prayer of love and gratitude.
For all of us.
Big Fertility News
Fertility news is big the last few days. I read some of the conversation online. As you need to be a subscriber to Time Magazine to read the full cover story, I have not done so. I do not want to subscribe to the magazine; I prefer the way that the news has been coming into my consciousness, deliberately.
It's unusual for me to be attracted to the news, I'm embarassed to admit. I've been avoiding the television and the newspapers for quite a while.
Still, the news seeps in. Sometimes it's called to my attention, like it was yesterday about egg freezing.
Time Magazine Cover
What else is all over the news? The new Time Magazine cover. A 3-year-old nursing. Standing up, breastfeeding.
Think it's controversial?
You bet it is.
And, as usual, I'm not going to enter it. I'm a huge believer in live and let live these days.
How does it relate to infertility?
It has to do, once again, with judgement and inflicting one's point of view on someone else. Whether it's political, moral, psychological, or religious, when do we stop assuming that we know better for another human being what's best for them? Or even what's best for their families?
Here's the relationship to infertility: fertility treatment. How many times over the last twenty two years have I heard similar comments and conversations about the fertility treatments that men and women experience as a process to create their families?
Too many times to count.
I've heard the same comments. Identical comments, especially after major technological breakthroughs in fertility treatment. Here are a few:
- It's not natural;
- I would never do that;
- There will be something wrong with those children;
- If God intended . . . (a personal favorite, fill in the blank);
- It should be illegal.
The name of the article, the cover, is "Are You Mom Enough?".
For those of us going though infertility, we are already Mom and Dad enough.
That's how dedicated and determined we are to have our families. Despite what someone else might question, we are already enough.
And we don't have to let anyone else decide for us whether fertility treatment is moral or what God intended.
On a political side note, we should keep an eye out about the legal piece of it. There are many in political office that would make the decisions for us. Careful who you vote for.
Is An Embryo A Person? Virginia Says No . . . For Now
Virginia is a safe place for now. Why? And from what? From the "Personhood" bill that was presented in the Virginia Senate. Not sure what that is? Read on for details about the bill.
The Virginia "Personhood" bill stated that “unborn children at every stage of development enjoy all the rights, privileges, and immunities available to other persons, citizens, and residents of the commonwealth, subject only to the laws and constitutions of Virginia and the United States, precedents of the United States Supreme Court, and provisions to the contrary in the statutes of the commonwealth.”
While it's very nice that Delegate Bob Marshall would like to have us believe that this bill is primarily about a fetus that is killed in a car crash, it is overwhelmingly obvious that those would not be its only effects. Clearly, this bill would affect anyone undergoing fertility treatment and having embryos created.
Embryos and Fertility Treatment
Regardless of your stance on abortion or on how this bill would have affected women's reproductive rights, granting embryos personhood has many ramifications for fertility treatment. When embryos are created for an IVF cycle, often there are more eggs than are able to be transferred (used) in that particular cycle. The extra embryos are then frozen (cyropreserved) until they are needed for another cycle.
Virginia is not the only state that has been considering a bill that considers the rights of embryos. It's just the only state that has been this close to granting them. As it stands now, the couple or persons that have created the embryo, via DNA material (ovum and sperm), have the right to make the decision about how the embryos are used and/or disposed. Some persons or couples choose to allow their excess embryos to thaw, stopping the freezing process and having the embryos cease to divide. Others would like to call this killing or destroying the embryos, without giving consideration to the fact that the embryos cannot survive past a certain time outside a woman's uterus. They certainly cannot grow and become "people" outside of the uterus.
Women's Reproductive Rights
Granting "personhood" to an embryo decends a very slippery slope, where fertility treatment and the creation, freezing, donating, use and disposal of embryos are all at-risk. One could argue, fairly reasonably, that it would make it legally impossible to continue to create embryos for those who needed treatment for infertility. Assigning personhood to a mass of cells that only have the potential to become a person is, in fact, nonsensical. It does not make sense to assign personhood to cells that have only the possibility, not the inevitability, of becoming a human being.
Then again, it appears to make plenty of sense to many people, including state delegates and other legislators. In Virginia, as in every other state so far, more people agree that it is nonsensical. The way to ensure that women's reproductive rights remain in tact is to stay vigilant--keep informed, be involved. Read the bill in full for more background.