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How Far Should Selective Reduction Go?


a blog by Alec, August 25, 2011

To read more Alec, The Infertility Guy blogs, CLICK HERE.

I read a New York Times article a couple of days ago, and I find myself angry. “Jenny” reduced from twins to a singleton after six years of fertility treatments. At 45 years old and already with school age children, Jenny offered the following rationale:

“If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it. But we created this child in such an artificial manner — in a test tube, choosing an egg donor, having the embryo placed in me — and somehow, making a decision about how many to carry seemed to be just another choice. The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.”

I vehemently disagree with her on so many levels. I wonder if she recognizes the many ways she hurts other infertile people.

But her story also opens the floodgates on a discussion about medical ethics in this new world. If abortion is permissible, then would not reduction logically follow?

I confess that I have more sympathy for childless infertiles than for those with children. And more sympathy for infertiles with one child than those with two or more. I cannot claim this belief is based upon anything logical or fair. I only feel that for those with children, the need is not as great.

Couples are warned that multiples often result from fertility treatments. I know we were. The idea of triplets scared us both, but if that was our fate, we were ready. In the world of assisted reproduction, nothing — NOTHING — is certain. Did Jenny believe that at the end of her fertility journey, she would have exactly the right size family?

The article cites her advanced age and energy levels, and worries that she would not have enough love left to split two ways. This is where Jenny begins to be laughable, if tragically so. If you are worried about age, why start anew? Clearly, your parenting time has passed. And if you are worried about the love you have to give your children, then clearly your heart was never all that large.

But the quote above illustrates the most disturbing piece. Jenny describes this pregnancy as “consumerish." She bought the pregnancy. She bought the embryos. The twin was expendable, because it was not her own.

And anyone who holds to that belief is too despicable to receive the gift of an embryo when there are countless Wannabe parents that would never once think of that same child as anything but their own.

Many of you are aware that JK and I have twins now, and that we nearly lost one of them at birth. They are brother and sister, fraternal, but it hardly matters. They are already one another’s best friend and likely will be for life. There is a psychic connection there, perhaps even a shared soul.

When Jenny decided to reduce, she took that connection away. I wonder if that child will forever sense a missing piece, without knowing its cause.

As for the ethics of reduction, I might begin to chime in on the discussion this way: Doctors should not be so quick to assent when the Wannabe parents knew of the eccentricities of assisted reproduction and still signed up.

“You got what you wished for,” I might say, “and now you want to throw it back?”

I’m interested in delving deeper into selective reduction and the ethics involved. Please comment, or if you wish, send confidential messages to

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