"In my opinion," said one of my partners, "A woman should have to agree to have selective termination if more than three embryos result before we agree to have that many fertilized eggs placed." One of the perinatologists agreed. Hmmm, I thought. So much for the non-judgmental approach.
The subject of selective termination came up, not surprisingly, in the comments section of my previous post about sextuplets. Selective termination means reducing the number of embryos in a multiple pregnancy, by terminating them, until there are two or three embryos remaining - a number that is much less likely to result in extremely preterm delivery. Since it involves abortion, it is not surprising that it can lead to heated, emotional discussions. Although in this post I don't really want to get into the whole abortion debate, I do want to say why I think that selective termination will never be the best answer for multiple pregnancies caused by infertility treatments.
For one thing, whether you are pro-abortion or anti-abortion (or pro-choice or anti-choice), we can all agree that there are many people who, because of their anti-abortion beliefs, will simply never consent to selective termination, and this is probably a sizable proportion of the population. Are we to deny some infertility treatments to that many people because they do not agree to selective termination?
The thing that bothers me the most, though, when people talk about selective termination as a solution for these pregnancies is that it's like closing the barn door after the horse got out. Selective termination after we've caused a pregnancy with, say, five embryos? Wouldn't it be much better to be more careful and do a better job of not making a woman pregnant with quints in the first place? If this requires changes in insurance reimbursement for infertility treatments, then so be it. If this requires better education of couples to assure that they don't have sex when the woman's ovaries are releasing six eggs due to infertility treatment, then lets do that.
But acting as if selective termination of a multiple pregnancy that we have iatrogenically caused is a fine way of dealing with the problem - regardless of your abortion beliefs -is just bass ackwards.