ECO: not everyone has enough life to pay

What are the consequences for women’s health of IVF and why in Russia there are no statistics on its effects, says the obstetrician-gynecologist.

Clinics practicing IVF in the “fight against infertility” are ready to talk only good things about it, the forums of women who have come across the problem are not so clear. The consequences of in vitro fertilization are examined by an obstetrician-gynecologist, candidate of medical sciences Tatyana Strokova 

Hyperstimulation can lead to early menopause and fibroids

– What are the main risks of the IVF method for women’s health?

– I do not do IVF, but in my practice I often encounter women who have gone through IVF and am familiar with many negative consequences.  

The IVF method involves powerful hormone therapy with the goal of producing as many eggs as possible. 

This is fraught with ovarian hyperstimulation. It is sometimes difficult to calculate a dose adequate for this particular patient, since each woman has her own health index, hormonal features, and, most importantly, her final supply of follicles.

We cannot reliably know what this stock is, therefore the doctor is sometimes forced to move blindly, experimenting in each specific case. Up to the fact that the same dose of the hormone in someone will allow five eggs to mature, and in someone – 20.

Sometimes a lot of hormones come in, and as a result, no eggs suitable for fertilization can be obtained. Repeated stimulation begins, and the entire reproductive system is already disrupted.

A frequent result of hyperstimulation is ovarian cysts, fibroids. Usually they dissolve themselves as soon as the hormonal background is established. But for this it is necessary to give the body to rest at least a few months. Not all patients are ready for this: IVF – work on the result at any cost. 

As a rule, myomatous nodes begin to form if there is a history of more than three IVF attempts. Sometimes such neoplasms interfere with the onset or maintenance of pregnancy, since they do not allow the fetus to gain a foothold.

I had a patient: she made 4 IVF attempts, before the fifth she had a submucous node in the uterine cavity (benign tumor – approx. Ed.). And then she decided for herself that she would not try anymore, because her health was already in short supply.

With IVF , a woman takes several (with natural IVF – one or two) eggs, and “in vitro” fertilize with sperm. When the embryos reach a certain size (usually it takes from three to five days) – they are planted in the uterine cavity.  

– What happens to the reproductive system when it is actively “fed” with hormones?

– The worst thing that can happen is an early menopause, and a woman will no longer be able to be a mother if she does not already have children and also does not work with IVF. It becomes a real blow.

It is not uncommon when, after several IVF attempts, in the presence of superovulation, it turns out that the woman has simply exhausted the entire supply of follicles, her ovaries are depleted. And this is not at 40 or 50 years old, when menopause occurs naturally – but at 30 and a little, when, it would seem, everything is still ahead.

It also happens that after hyperstimulation, the body continues to produce not one but several eggs in the natural cycle, spending its reserves three, five times faster.

I have seen such girls in my practice. She is 32, and the follicular apparatus is like that of a woman at 45. If oral contraceptives were taken uncontrollably before IVF attempts, the risk of such an outcome increases many times.

“Can a woman herself understand that she has such serious violations?”

– To see the “squandering” of the eggs and to make the diagnosis of “ovarian hypofunction” can only a doctor on ultrasound. It is already impossible to make up for losses. There are drugs that can slow down the process, as a rule, these are herbs, homeopathy. But in case the early menopause has come, the patient is shown only hormone replacement therapy, which will alleviate unpleasant symptoms, but fertility, alas, will not return.

– In addition to gynecology, are there any other risk areas in women after IVF? 

– First of all, the thyroid gland. With infertility – because without this diagnosis, IVF is not resorted to, it is, as a rule, usually at risk. The work of the thyroid gland is closely connected with the work of the reproductive system, and if there are disorders, then they are often there and there.

In case of receiving a shock dose of hormones in the IVF protocol, malfunctioning of the thyroid gland is inevitable. Nodes may appear, a severe form of diffuse goiter may develop. 

Another risk zone is the liver. When more and more doses of drugs enter the body, it inevitably suffers.

In my practice, there was a woman who, after five IVF attempts, was diagnosed with biliary cirrhosis. Fortunately, thanks to a competent hepatologist, he was eventually removed, but that patient was forced to abandon the desire to become a mother: “I’m afraid for my health.”

Hyperstimulation makes the whole body work at higher speeds. And what happens to us when we are very tense for some very important jerk? Right, sooner or later comes exhaustion and fatigue. So with health. 

Two types of IVF protocol are mainly used: long and short . With a long IVF protocol, a woman receives hormones stimulating ovulation in larger quantities and for a longer period, and it is this type of IVF that is considered more “reliable”, but also more difficult for the body.     

The most frequent complaints of women after IVF

– What do women themselves who have undergone IVF complain about? 

– Many complain about weight gain, nausea, mood swings. All this is the result of hormone therapy.

Although many of the consequences of IVF are unpredictable. The human body is not a computer, and even an experienced doctor cannot always predict how it will behave.

Sometimes incredible things come out. For example, one of my patients after six IVF attempts began to go blind. Dyshormonal retinopathy was diagnosed and she was forced to stop experimenting with health. It took two years to restore vision, and we put women’s health in order for five years. 

– It seems that these are trifles, and nevertheless, among the “eco-girls” I met a lot of complaints about symptoms such as dry skin, hair loss and other “cosmetic” problems that greatly reduce the quality of women’s lives. Why it happens?

– All that you mention is just the symptoms of menopause. These are the consequences of superovulation, spending follicular stores in the ovaries and actually moving a woman to old age. In some cases, it is possible to regain its former attractiveness, and in some cases the consequences are irreversible, since the metabolism has already been disrupted.

– Does IVF harm men?

– If only psychologically, because stress, worries, expectations and unfulfilled hopes are experienced not only by the woman, but also her husband. But all the physical “charms” of IVF go to women.

The relationship between IVF and oncology is not proven

– There is an opinion that in about 10 years after IVF, the risk of cancer, mainly female, increases. 

– This relationship is not proven. I came across the opinion that is voiced in some forums on IVF, that, you say, you give birth, but you are unlikely to have time to raise it – you simply will not live up to the age of majority of the child. In my opinion, these are more likely horror stories of incompetent people than a medical fact.

Yes, there are such cases, but we cannot say with certainty that it was IVF that caused cancer, especially if these two events are very separated in time.

Why there are no statistics on IVF in Russia

– Is there a summary of statistics on the negative effects of IVF? They study it in our country?

– It is impossible to collect a detailed follow-up on this issue, and here’s why. Now there are many clinics that do IVF, both public and private. For the most part, this is a business, not counting IVF quotas, which can be done only once.

The number of IVF children in Russia is about 1.5% . Rosstat does not have accurate data on IVF issues.  

As soon as the fact of pregnancy is confirmed by the analysis, it is recognized as completed and the risk of premature termination (about 12 weeks) disappears, the patient, as a rule, leaves the clinic and goes to observe the pregnancy either at the place of residence or to some doctor on the recommendation. Therefore, doctors do not have the opportunity to find out what happens to women after the coveted test, and they do not strive for this.

There is a chance to observe these pregnancies for me and my colleagues – simple obstetrician-gynecologists “on the spot”, so we are more aware of the consequences.

We see those women who failed to conceive with the help of IVF.

– Does the likelihood of problems somehow correlate with the age of a potential pregnant? After all, most often they resort to IVF after 30 years.

– Of course, we do not become healthier with age. But if there are initially serious diseases, it is obvious that with age, both IVF and subsequent pregnancy will be difficult to tolerate, because the body accumulates problems. It is one thing to give birth at 40, and another to 30.

And I would add: you can not achieve pregnancy “at any cost.” After all, it may turn out that you simply have nothing to “pay”. But often women are not stopped by either the health problems that they already observe at home, or the nebulous predictions. Sometimes they change clinics uncontrollably, make more and more attempts.

One of my patients had a history of 15 (!) IVF protocols. As a result, she nevertheless gave birth to a child – with the most severe form of cerebral palsy.

Another woman made attempts, from 42 to 50 years old, and only age could stop her. As a rule, such patients do not hear anyone, and an extraordinary thing must happen so that they recognize the real danger to their life and decide on their own to refuse IVF.

Where do the “spare” embryos go?

During the short and long IVF protocols, the eggs are taken “with a margin” to obtain “spare” embryos. Later, replanted spares are reduced (destroyed), unsplated – they are frozen.

It is impossible to control the exact number of eggs that mature after stimulation; to “order” them as in a store. You can ask the doctor not to take out, for example, all 20 cells. But no one will guarantee that out of the 10 received, all are fertilized. Or, on the contrary, 10 eggs are fertilized at once, but giving birth to ten is impossible. Thus, IVF is a human experiment. The price of an experiment is human life.

In the case when it comes to the collection and subsequent fertilization of only one egg (with natural IVF), the probability of success is extremely small. If, under the standard IVF protocol, when several eggs are fertilized, the chances of pregnancy are on average 30% , but with manipulations with one, they are reduced to 20% or less.   

Therefore, the approach of most IVF clinics is to work on the result by fertilizing as many eggs as possible. So the problem of “extra embryos” appears. Two or three “plant” in the uterine cavity. Then, even those who have taken root and wholesome are reduced, so that it is easier for mother to wear not just twins or triplets, but only one baby. Doctors are afraid of multiple pregnancies – they are difficult to observe, childbirth comes faster, children are often born small and require special care.

The reduction – in fact, the killing of embryos – occurs with the help of a thin needle that is inserted into the heart of the unborn baby, and it stops beating.

Then the embryo dissolves in the uterus, but it happens that the reduction provokes a miscarriage, and other children who the patient wanted to leave die.

That is why the Church does not recognize the IVF method as permissible: according to the conciliar opinion of the Church on this issue expressed in the Social Concept, all fertilized embryos must be born, because all of them are already people with souls.

In “natural IVF” the risk of embryo death is less, but not excluded

It was IVF of the natural cycle that was the first in the world implemented IVF that occurred in the UK in 1978. It is the “natural IVF” that is considered the most humane and sparing women’s health.

The essence of the method is that against the background of the usual cycle, without stimulation or with minimal hormonal support, take only one egg (in rare cases – two, if they have matured independently) , fertilize the egg in vitro and then, again with the support of hormones, transfer the embryo into the uterus.   

There are medical risks. Pregnancy may not occur on the first attempt, because the quality of the egg does not always meet medical requirements, or conception in vitro for one reason or another does not occur. It is more difficult for doctors to track ovulation – it comes on its own, and not under the control of drugs, and it must be constantly monitored by ultrasound. If ovulation occurs too early, the cycle will be a “failure”, conception will fail. There is a risk of maturation of an empty follicle, in which there will be no egg.

In the protocol of “natural IVF” there is no need to reduce and store the “extra” embryos. But this does not make the method ethically justified from a Christian point of view. Its effectiveness is generally lower than that of IVF with stimulation, and sometimes it takes several attempts to succeed.

So, it is impossible to exclude the death of the embryo – both before and after planting in the uterus.

In this case, the death of the embryo cannot be considered “natural”, since the procedure that led to death had its own customer.

The fate of the “snowflakes” and “cryoshka”

Fertilized but not prompted embryos are sent for cryopreservation. They can be used if the pregnancy breaks in the early stages. Or plant it later, if parents want it, planning to still have children. For the storage of frozen embryos, you need to pay about 500-1000 rubles per month.

When the financial proceeds from the parents cease, the clinic is in an ambiguous position:

Doctors have no right to destroy unborn children, and parents often “forget” their “snowflakes” (the term is accepted in the West) or “cryoshes”, as they affectionately call them in Russia, without supervision.

According to unofficial statistics, only 50% of couples return for their unborn children.

What happens behind closed doors of the pressure chambers, few people know. Theoretically, there is the possibility of free donation of such embryos for couples who do not have the opportunity to conceive, but in practice and from the point of view of legislation, this issue has not been resolved.

The clinic cannot realize such a donation without the consent of the parents, in addition, you need to do a lot of genetic tests so that someone else’s child takes root in the body of the adoptive mother. Another option offered by the clinics is to transfer the embryos “for scientific experiments”.

Most women, especially those who nevertheless became mothers, can no longer decide to kill, but, thinking about a second attempt, they doubt that the frozen embryos will be “fresher” than those received from new stimulation and later fertilization.

“The child is almost 3 years old. 2 times went to the clinic to dispose, but could not even pronounce these words. I can’t do that. I pay 6,000 per year for storage and do not regret it.

Nobody knows what will happen tomorrow. These are my children and it’s calm for my soul, so let it be so, ”writes one of the participants in such discussions at the forum about IVF. It is interesting that she, without hesitation, calls him a “child”, and her frozen embryos – “children”.

The advice that sounds most often there: to constantly postpone the decision to destroy their own children, maybe the situation will be solved by itself.

Rights of embryos of different countries

In different countries, the law differently regulates the protection of the rights of an unborn child.

In the United States, talking about the embryo’s right to life is possible only after it has fixed itself in the uterus and shows signs of vitality. Therefore, in local court practice, there are cases when one of the parents insisted after the divorce on the destruction of embryos that were already formed and cryoprotected in order to avoid their subsequent birth and, as a consequence, the need to pay alimony. In Germany , the principle applies: a person’s life begins from the moment of fertilization. Therefore, the law protects the rights of unborn children from the moment of conception. It is strictly forbidden to carry out preimplantation preparation (“selection”) of IVF embryos, reduction without parental consent and experiments on embryos. Prohibited and surrogate motherhood. In Italy donation of embryos for scientific research is prohibited, even if parents themselves take such an initiative, prolonged cryopreservation is not welcome. In connection with the reform of the Code of Health Laws in France in January 2000, it was proclaimed that the life of a human being should be protected from the moment of its first signs of manifestation – that is, primary cell division after fertilization. The UK is gradually moving towards giving embryos more rights and guaranteeing the right to life for unborn children. In Ireland, the legislation is stricter in this regard, it says that “any fertilized egg should be used for normal implantation and should not be intentionally destroyed.” In Australia, there is a principle that the embryo has the right to file a claim for damages caused to it by negligence during its intrauterine development. And finally, Russia. In Russia, not only the rights of embryos, but also the rights of children born prematurely are not regulated. Children born before 22 weeks of gestation with a weight of less than 500 grams are officially called “late miscarriages” in documents . It is impossible to obtain documents on them until their viability is established, they cannot be buried in case of death – the bodies are disposed of as biowaste. Recently, an attempt was made to amend part 2 of Article 17 of Chapter 2 of the Constitution in the wording: “Fundamental human rights and freedoms are inalienable and belong to everyone from the moment of the first heartbeat” (currently “from birth”). The amendment was not approved. 

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