Pre­cious prog­eny of a Petri dish

This is the true story of IVF, writes An­tonella Gam­botto- Burke

The Weekend Australian - Review - - Books - IVF & Ever Af­ter: The Emo­tional Needs of Fam­i­lies By Ni­chola Be­dos Rock­pool, 213pp, $ 32.95

EURO­PEAN So­ci­ety of Hu­man Re­pro­duc­tion and Em­bry­ol­ogy data re­veals that more than three mil­lion in- vitro fer­til­i­sa­tion ba­bies have been born across the world since the first in 1978. Last year, about 4 per cent of Aus­tralian births ( 10,000 ba­bies) were con­ceived in Petri dishes. And it is pre­dicted that within 25 years — and partly be­cause of the es­tab­lished global trend for de­layed moth­er­hood — one in three Aus­tralian births will in­volve IVF.

Ni­chola Be­dos, the widely pub­lished psy­chother­a­pist and in­fant men­tal health spe­cial­ist, has writ­ten IVF & Ever Af­ter: The Emo­tional Needs of Fam­i­lies , a su­perb ex­am­i­na­tion of, and guide through, the in­tense emo­tional im­pact of IVF on par­ents and their mir­a­cle chil­dren.

We learn that one in six Aus­tralian cou­ples is in­fer­tile. More than 41,000 IVF cy­cles be­gin in Aus­tralia each year and the over­all 21 per cent suc­cess rate vaults to 35 per cent of all pro­cesses be­gun by those un­der 40.

For those con­sid­er­ing treat­ment, skilled psy­cho­log­i­cal sup­port is crit­i­cal: emo­tional com­plex­i­ties must be ex­plored be­fore IVF is at­tempted. Be­dos ob­serves: ‘‘ Ar­riv­ing at the door of an in­fer­til­ity clinic with­out hav­ing re­flected on the feel­ings evoked by a di­ag­no­sis of in­fer­til­ity can be dis­as­trous.’’

The af­ter­math of suc­cess­ful and un­suc­cess­ful IVF cy­cles not only af­fects the im­me­di­ate fam­ily but a wider cir­cle of rel­a­tives and, ul­ti­mately, the com­mu­nity at large. Be­cause of the in­creas­ingly ef­fec­tive tech­nol­ogy, in­fer­tile and older cou­ples, car­ri­ers of ge­netic ab­nor­mal­i­ties and same- sex cou­ples can be­come bi­o­log­i­cal fam­i­lies. The prob­lem? Fun­nelled through prej­u­dice, IVF has the po­ten­tial to hurt hu­man­ity.

‘‘ If IVF could pro­duce the gen­der re­quested by par­ents for cul­tural rea­sons, it could also lead to se­ri­ous shifts in the make- up of a so­ci­ety,’’ Be­dos writes. ‘‘ In this in­stance, we ( would be) able to achieve sci­en­tific change that may not nec­es­sar­ily ben­e­fit us as a species.’’

IVF, she re­minds us, presents chal­lenges on many lev­els — medico- le­gal, eth­i­cal, re­li­gious, emo­tional and phys­i­cal — for par­ents and their chil­dren, who may later con­tend with is­sues about their ge­netic her­itage and sense of iden­tity. The is­sues are any­thing but mi­nor. Last year, the Aus­tralian In­sti­tute for Health and Wel­fare found the IVF baby death rate is twice that of the nat­u­rally con­ceived: one in 50 is still­born or dies within a month. And there are greater risks of early la­bor, pre­ma­ture birth, lower birth weight and chronic con­di­tions such as cere­bral palsy.

Women who pur­sue the process are sad­dled with such un­nerv­ing pos­si­bil­i­ties. Be­dos notes that par­ents un­der­go­ing IVF are nine times like­lier than non- IVF par­ents to pro­duce twins. More than 50 per cent of women us­ing IVF strug­gle to care for their new­borns af­ter Cae­sare­ans. More than half of all IVF moth­ers switch to bot­tle feed­ing in the first three months, cit­ing fail­ure to es­tab­lish a good milk sup­ply. IVF par­ents ex­pe­ri­ence what Be­dos calls ‘‘ a per­va­sive fear of loss’’, kin­dled be­fore the IVF process.

She writes that IVF par­ents of­ten suf­fer a lack of con­fi­dence in their par­ent­ing skills and are three times like­lier to seek help from par­ent­ing cen­tres. In­va­sive IVF pro­ce­dures can cre­ate a sense of loss of own­er­ship of the body, and sex­ual in­ti­macy can be cor­roded or dis­tress­ingly de­fused. Be­cause of the high level of sci­en­tific in­ter­fer­ence, IVF moth­ers can also feel un­re­lated to their ba­bies, which is a se­ri­ous threat to the self- es­teem of par­ents and chil­dren.

The stress hor­mone lev­els of women un­der­go­ing IVF treat­ment have been shown to be sim­i­lar to those with a life- threat­en­ing ill­ness and this be­comes an ob­sta­cle to ef­fec­tive liv­ing. Ma­ter­nal stress hor­mones cross the pla­centa, in­fil­trat­ing the fe­tal blood­stream. Stud­ies have shown that this af­fects the baby and leads to a more sen­si­tive, or dif­fi­cult, new­born. There is also ev­i­dence that anx­i­ety causes pre­ma­ture birth. Be­dos deals in­tel­li­gently with all th­ese is­sues and her coun­sel is never pa­tro­n­is­ing.

Be­dos knows from ex­pe­ri­ence that what­ever con­cerns sur­round in­fer­til­ity, cou­ples face ten­sions that can de­rail the strong­est re­la­tion­ships. Griev­ing cou­ples are ir­ri­ta­ble and likely to re­act strongly to even the slight­est neg­a­tive com­ment, and anger, too, may quickly com­pound so that evenings be­come wars be­tween part­ners need­ing to vent. The so­lu­tion? Coun­selling be­fore, dur­ing and af­ter IVF treat­ment. In some cases, psy­chother­a­peu­tic help is seen as a crit­i­cal com­po­nent of the IVF process.

Ar­guably a world first, IVF & Ever Af­ter is des­tined to be­come a par­ent­ing clas­sic. Be­dos’s lu­cid­ity and tal­ent for sim­pli­fy­ing com­plex philo­soph­i­cal is­sues all con­trib­ute to her psy­chother­a­peu­tic im­pact, but ul­ti­mately it is her gen­eros­ity that reels in read­ers.

Her re­cep­tiv­ity to emo­tional re­ac­tions so sub­tle that they es­caped the at­ten­tion of in­ter­na­tional ex­perts for more than 20 years qual­i­fies her as an author­ity in the field. Im­por­tantly, she be­lieves in the wider sig­nif­i­cance of the fam­ily unit and in pre­serv­ing it as a lo­cus of com­fort and nur­tur­ing for all its mem­bers. An­tonella Gam­botto- Burke’s web­site is www. an­tonel­lagam­botto. com.

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