By Beth Kohl
I am a person with too many items in storage. There are reminders of late relatives, like my grandmother’s chipped porcelain tea cups that call to mind her living, breathing, sipping mouth upon their rims, the wrinkled half moons of coral lipstick still barely perceptible. There are framed photos from my parents’ lost marriage, my dad in a white tuxedo jacket and my mom with a startlingly chic pixie cut, his arm draped comfortably around her tanned, rounded shoulders, all of these souvenirs from my past that I’ve stowed until I decide what to do with them.
I’ve meticulously packed and labeled things—the Chinese figurines from my deceased grandmother’s condo and the belongings I’d salted away when my mom decided on a near whim to sell the house—as if I knew it’d be some time before I’d look through the neglected intentions idling in storage. I hope someday to amass the guts to go through the boxes, plucking out and remembering an item’s former life, displaying the meaningful or using the practical until the luster of nostalgia rubs off and expediency sets in.
Among my array are seven frozen embryos. They’re at a fertility clinic, stuck inside a capillary straw suspended within a nitrogen tank until my husband and I decide what to do with them. They are leftovers, seven untapped yet potentially fruitful embryos from our various in vitro fertilization (IVF) cycles. Unlike the inert objects up in the attic, the Betamax and LPs, the moth-eaten coats and the collar from a dead pet cat, the embryos have the possibility of an entire life before them, requiring neither resurrection nor retrofit.
* * *
The embryos exist precisely because we’ve been successful at IVF. We underwent five attempts, ending up with a beautiful girl on try number three, and twin ones on the fifth. My ovaries had been easy to stimulate, and each cycle produced a bounty of eggs, many of which fertilized. Each cycle, we chose to transfer three embryos from the Petri dish into my uterus, the right amount to up our pregnancy chances while not risking a too seriously complicated one. The day of each transfer, we were asked our intentions for the remaining embryos. My husband and I, discussing it briefly and always at the very last minute when I was already undressed and ready to get the procedure under way and over with, when we only just learned how many embryos had continued to develop overnight and how many cells they contained, agreed on cryopreserving the surplus. It was the only decision among those presented—donation to research or another couple, or destruction—that preserved them as ours until we were ready to make a thoughtful, measured choice.
It has been eight years since we froze five of the embryos and nearly ten since we decided to save the first two (a clinic mishap accounts for those older ones). In that time, our children have grown from babies to toddlers to these fantastic kids who are loveable and proficient at assorted skills, the sorts of people we enjoy conversing with, helping with homework, and treating to nights out at restaurants or the movies. We’ve even gone on a couple of not-disastrous trips and fantasize about other places we’d love to see together. We’ve forged unique relationships with one another, developed a kind of family linguistics of silly nicknames for commonplace items based upon charming toddler mispronunciations, the sorts we have difficulty dropping around other people who assume my pronouncing garbage as gawbage is a speech defect rather than simply a charmed mother.
We have a shared history, all five of us pulling away from those tough early days. When our eldest daughter was two, she had some seizures and a couple of emergency surgeries to remove infected masses in her bladder. And my pregnancy with the twins had been nearly catastrophic. After almost miscarrying them at twenty-one weeks’ gestation, I spent months on bedrest, scared stiff that my cervix would give way and too-young babies would come tumbling out. But we all survived, the eldest daughter given a clean bill of health, the twins emerging at week thirty-five. We’ve been a family with three children under two years of age, with twins who had various preemie issues, and who had weathered the typically “Terrible” years. We’ve outgrown the reflux and grown out the self-inflicted haircuts, and we’ve all gotten used to the idea of us as a completed family unit with a keen memory of dodged bullets and tested fate.
* * *
But my mind is far from made up. I’ve been mooning over those seven stragglers, missing the excitement and heightened physical sense that pregnancy, labor, delivery and nursing bring. I’ve been toying with names and the possibility of loving another child the way I love my daughters. True, the stage we’ve reached is a relative piece of cake compared with the relentless exhaustion of raising three very young children or those dark early days when I thought I’d never get pregnant. And I’m back on track with my own career, able to work while the kids are at school or asleep not just for the night, but for the whole, uninterrupted night. Our social life is once more in blossom. More importantly, my husband and I now have the time, and inclination, for a sex life. I remember, now, why I fell in love with him in the first place. He is funny and smart, warm and sexy, more than just another set of hands. And he is the only being in the house who smells like neither powder nor dog. I take him in and recall our early, heady days together, marveling that parenting could have obscured them.
Adding another child not only would upset our balance and boomerang us back to overwhelmedness, it’d tip us into another category: that of the Big Family, the sort that, despite how well-behaved the children or how fantastic the wife’s guacamole she brings over, simply entails too big a crowd. We would once more be anchored down by a needy, bawling, sleep-ruining infant who would inevitably turn into a demanding, throwing-silverware-on-the-floor-just-to-see-her-mom-fetch-it toddler. He or she would wind us back up and tether us back down to just the sort of enforced domesticity we’ve blissfully started to outgrow.
All the same, I’ve been eyeing babies for a couple of years now. The ones in my friends’ arms or in strangers’ shopping carts, the ones asleep in their strollers or crying on airplanes. I’m keen for the infinite shapes of their heads, the lengths of their eyelashes, their curled toes and grabby fists, and I’ve convinced myself that my attention is a sign to not give up the embryos unless I’m positive using them isn’t the best, most well-considered and most ethical option.
Indeed, my ethics seem to have shifted since we froze the embryos. Or maybe it’s just that the once-bright line separating more Platonic ideals of Right and Wrong from my own personal yearnings has dimmed, leaving me in the dark about the difference between doing what’s best and doing what’s right. Perhaps realizing that my children were once, even if only for the most fleeting of moments, cell clusters identical to these seven provoked this change. Intellectually, I appreciate that embryos are not very young fetuses, the storage containers at the fertility clinics aren’t nitrogen-rich orphanages, and thawing them out and letting them languish doesn’t amount to a prenatal massacre. Fertilized embryos are cell clusters, raw ingredients rather than a realized being. But I also know that frozen embryos have the potential, given the right conditions, to become fetuses who (that word creeps in) have the potential, given the right conditions, to become human beings.
We made our decision to freeze our embryos from a place of innocence and ignorance, a matter of putting practicality over bioethical or moral considerations. At that point, we didn’t know whether I’d end up pregnant, and the last thing we were willing to do was squander any unused potential children. I also couldn’t have deduced how deep my connection to my children would be before having them, or how frequently I’d think about the frozen embryos before creating them. But becoming a mother and loving my children has breathed life into what—when I was in an exam chair, trembling from nerves and drafts blowing through my untied and over-laundered hospital gown and being asked to make profound bioethical decisions—turned out to be an inert, unexamined personal philosophy and an abstract sense of the ethics involved.
Also, until becoming a mother, I couldn’t have anticipated how powerfully motherhood would impact my perspective on all sorts of things, bioethics and cryopreservation among them. Like an inmate who finds religion in the slammer, being a mom has caused me to reevaluate how I live my life and to think more about why I believe what I believe. For example, why had I assumed I’d have no problem donating biological matter, let alone my daughters’ full genetic siblings, same vintage and all, to an unknown lab for unknown purposes? Why hadn’t I at least recognized that, good cause or not, handing them over would be to extinguish them?
Looking back, I think it’s because I’ve always been pro-choice, pro-science, pro-pragmatism. Those were my fallback positions, ones I inherited and proudly averred. But becoming a mother has taught me that I am also vehemently pro-family and pro-child. Which, alas, leads me back to the quandary of what is the right and best thing to do, not only for our own family, but for others? Would helping to care for a new baby, exhausting as it would be, be a boon for our crew? Would we all look at each other and marvel that our beloved daughter or son, brother or sister, might never have been? (Family! Family! Sis Boom Bah!) Or would the time, energy and finances that a new baby would divert, particularly in these rough economic times, cause us to regret having chosen this path?
To be clear, I’m drawing a distinction between personal values, on the one hand, and fundamental morals on the other. The former is a personal code of conduct derived from multiple influences (parents, teachers, religion, philosophy, civics, etc.). It’s the code that allows you to figure out where you stand when there are good arguments to be made for multiple courses of action. Morals, by contrast, are less optional, a code of conduct that (ideally) would be espoused by all rational people. I view my frozen embryo dilemma as existing along the ethical continuum. Donating them to science, therefore, is an ethical course of action. But the way in which my personal ethics have evolved leads me to believe that donating them may not be ideal, at least not for a person who, like me (and unlike, say, Nadya Suleman), has physical and mental health, a manageable number of healthy children, resources to care for all of my children, and a helpful and willing family.
* * *
Putting aside religious doctrine (which I did many years ago), I am left only with my subjective sense of right and wrong. I am not capital P, capital L Pro Life, all of a sudden, at least not in the way of Phyllis Schlafly or Sarah Palin. But I recognize not only intellectually, but in a more complex way involving my heart, spine, and stomach, that fertilized embryos are not mere cellular gobstoppers.
Scientific progress requires experimentation and a whole heaping mess of trial and error. So even though I’ve always believed it’d be wasteful to destroy the embryos—a brash smiting when scientific research was such a good option—I’m no longer as certain that scientific advance trumps baby number four. Certainly, if every scientific test yielded definitive, productive results, and if somebody could guarantee a medical breakthrough before dismantling our embryos, plucking them apart cell by cell or injecting them with an experimental solution, I’d likely feel differently about ceding them. But knowing that scientific advance is a matter of baby steps and missteps, and also recognizing that the symbolism of these embryos—the not insignificant space they’ve occupied in my mind and heart all these years—will be lost on whoever it is doing the dismantling, makes it that much harder for me to surrender these potential children and/or stem cells to the trial and error heap as if they were any other specimen.
Like the irrationally protective mother I can sometimes be, I have nightmares in which they end up in the wrong hands. I imagine unsmiling, begoggled technicians using them in unsavory experiments involving combinations of human nuclei and chimpanzee lysosomes. I envisage them for sale on black markets to skin care companies formulating embryonic potions for the wrinkle-phobic, or classified CIA-type operations trying to create a frozen embryo bomb, or simply misplaced or left to wither when somebody mistakenly unplugs their tank.
* * *
But I also have misgivings about keeping them around indefinitely. At $500 annually, it’s expensive. And as a mother who remembers keenly the miraculous moment when we first heard our daughters’ hearts beating, a sound we’d sought for so long and through such adversity, I tend to think magically about these cells. I think about them daily, envisioning them stuck to the sides of their straws inside their container, one shiny scuba-tank-looking receptacle among hundreds, within which lurk thousands of teeny tiny surplus. I wish I was copacetic with the idea of keeping them around indeterminately, dashing off that annual check and viewing them as thoroughly modern and ultra cool mementos of the earliest moments in our children’s path towards life. I wish I could see them, as my fertility doctor does, strictly as a perfect source of stem cells should any of the girls need some, or (and here the bioethical dominos start to topple) a potential child for one of my daughters should she inherit her mother’s fertility issues, end up in a same-sex relationship, or desire single parenthood.
But I can’t. The seven embryos remind me too keenly of the precise moment when the development towards life begins to unfurl. They also cause me to dream of flutters, kicks, contractions, tugs on my lactating nipples, teensy fingers wound into my hair. They represent seven potential daughters or sons, sisters or brothers, pureed peach-loving, hair-pulling, bathing, crying, sleeping, thinking, growing, struggling, achieving, sensing, smiling, brawling, bawling individuals.
But defrosting them and going for that fourth baby forces other sorts of ethical reckoning. The first dilemma surrounds how many to thaw, since not all embryos survive the process. It’s the cooling and thawing that cause the destruction. Even assuming a seventy-five percent thaw survival rate (the statistic our fertility clinic uses for embryos frozen at the blastocyst stage, as ours were), it’d be tough to decide how many to thaw in order to end up with one or two quality embryos. If we defrost them individually and they don’t survive, I’ll have prepared my uterus with a month’s worth of potentially cancer-causing injected hormones for naught. But if we thaw them out in slightly larger batches, I may end up with pregnancy upon pregnancy, or multiples upon multiples, and more children than we can reasonably handle. On the other hand, if we were to thaw them all out and implant only the best one or two, we’d need to dispose of the extras—you can’t refreeze them once thawed, nor can you donate them to science or even to another couple at this point, unless you have a buddy with a prepped uterus willing to accept the embryologist’s B team.
* * *
I’ve heard stories of how other people deal with their untapped, unwanted frozen embryos. I have a friend who retrieved her and her husband’s three extras from the clinic, wrapped them in a tiny drawing of rainbows made by her twin daughters, and prepared a box for them to be buried in. It was neither fancy nor macabre, involving neither decoupage nor a miniature casket. Rather, she used a metal tooth fairy box with a screw-off lid that she said a blessing over and buried in the backyard beneath a favorite tree. I have another friend who, after delivering two sets of twins and a singleton to boot, gladly signed the form to donate her two surviving embryos for research. She figured she owed her largesse to science, and if those two embryos were to offer any sort of scientific boost, their existence would not have been in vain. I’ve also learned of women who have their frozen embryos transferred into their bodies at a point in their cycles when pregnancy likely won’t occur. They say this feels like the most natural and least violent conclusion.
I do not, however, know anybody who has donated her leftovers to another couple, something I considered only briefly and then dismissed as not for me. The idea of somebody else raising my biological child under these conditions bothers me. In part, it’s because I fear a molested conscience, the monotony of what if, what if. Putting aside the pure desire other couples have for taking frozen embryos off someone’s (sinful, selfish, blasphemous) hands, I don’t think I could give them away to another potential family when ours is relatively high-functioning and my uterus is still intact. Perhaps if there were a test we could conduct, a way to predict my pregnancy chances versus that of a potential donee, I’d be amenable to giving them away for a likelier shot at life. But all things being equal, I’d be hard-pressed to let another couple raise our children’s full genetic siblings. I can’t help imagining what those brothers or sisters would think if they looked us up one day, got our address and drove up and saw our plenty big-enough house, the charming public school down the tree-lined street, and the couple of dogs lying around the well-kept yard.
Perhaps I’ll reach a point when the idea of not using them doesn’t bother me. But I don’t have the luxury of much time. If I’m going to have another child, I’d like for him or her to be as close in age as possible to the current pack (me and the mister included). And if I’m already convinced these embryos are potential people—which my current baby lust and the fact my mind jumps so easily from the babies I encounter to my own supply of raw material proves—isn’t it safe to assume that I’d mourn their loss, even if giving them up proves most practical?
But there are other risks beyond exhaustion and upset balances. Fertility drugs are potentially dangerous to the women who use them, upping the odds of ovarian cancer, this when the usual odds strike this semi-hypochondriac as scarily high. Worse are the ongoing, multitudinous studies on the health risks to children resulting from IVF. While there’s no unequivocal correlation, several world-class institutions have found convincing relationships between assisted reproduction, particularly IVF and its component procedures, and rare childhood diseases, retinal and bladder cancers chief among them.
I remember the terror of having a daughter with serious medical problems and how I’d automatically assumed the IVF was to blame. When her doctors shook their heads, unable to pinpoint the source of the troubles—the seizing was neither from fever nor epilepsy, just anomalous shakes that disappeared as quickly as they’d come on; the cysts were remnants of an embryonic structure that should have turned into the bladder by birth—I’d suppressed the urge to comfort them by letting them know she’d been conceived using IVF and therefore undoubtedly had been packing some not-completely-normal parts.
But my children seem so normal. Beyond normal, really. They’re extraordinarily kind, sociable, and clever. And I’ve pored over them, their bodies, and their development. They’ve hit the normative milestones, crawling and walking and talking according to schedule. They’ve learned how to read, beg for turtles, guinea pigs, and rabbits, and have started wondering where babies come from. I observe each landmark with a mixture of celebration and relief, hoping that, someday soon, expediency will set in, and I’ll start to forget about unexploded landmines and other thorny residue.
* * *
Still, knowing what I now know, having read the studies and experienced the anguished helplessness of having a sick child, how could I choose to use these possibly toxic embryos. Not only had they resulted from IVF, but they’ve been frozen for the better part of a decade. If the dusty taste of waffles that languish in the freezer are any indication, quite possibly there would be something “off” about our preserved embryos, too.
I imagine an alternate, more perfect world, one without ghosts or the pain of lost lives. In it, every maternal woman would be gloriously fertile and no child would ever know disease. I’d be a young, energetic mom with three healthy and happy children who resulted from spontaneous and hot, hot sex. There’d be no health risks associated with producing life, no overwhelming decision still to be made about the fate of cells that are too often viewed as property, and not enough like somebody’s past and future. Our cat would still be alive, jumping up on the kitchen counter as I pour tea into my grandmother’s cup. She’d be sitting at a table near the window, smiling as she watched her great-grandchildren run around outside, then raising the cup to her mouth, stamping another coral scallop upon its rim.
* * *
Author’s Note: I wrote the bulk of this essay long before the term “Octomom” entered the lexicon. And as I say in the piece, I feel like I’m in a completely different logistical boat than Nadya Suleman, making my decision a matter of choosing amongst decent options as opposed to forging ahead without due consideration and ignoring practical considerations to a harmful degree. Having said that, when I heard Ms. Suleman talking about her frozen embryos as her future children, I couldn’t help but empathize. I know what she means, even though she took her argument, and then its consequences, to a point far beyond the limits of my ethical comfort zone.
Beth Kohl lives in Winnetka, Illinois with her husband and three daughters. She is working on her first novel.
Brain, Child (Summer 2009)