Response

BettyRubble wrote a comment:
To be honest, I think [the Georgia bill on embryo transfer limitations is] very reasonable. It is unfortunate that it took the birth of octuplets to "command" that a bill be nessessary when most doctors use common sense for how many embryo's to transfer. I could see an uproar if they said one regardless, but two is reasonable.

Note: Here is the bill. I recommend reading through it.

And I responded... not nearly as articulate as my original post, but this will do for the moment:
If it were JUST about limiting the number of embryos transferred I MIGHT agree with you IN THEORY. (Except that I will never agree with legislating something which I believe needs to be a discretionary medical decision - particularly in a state that does not have an insurance mandate. If the state of Georgia isn't going to mandate that insurance companies help PAY for IVF then limiting IVF in this manner is just plain ridiculous).

HOWEVER, they don't just limit the number of embryos to be TRANSFERRED in a cycle. They limit the number of embryos to be CREATED in a cycle. And that is ridiculous. This means that for a woman under 40, only 2 eggs can be fertilized in an IVF cycle and no one will ever have any embryos to freeze (they are specifically trying to avoid a case where anyone will ever have cryopreserved embryos - so that they won't have a Nadya Suleman who has six embryos frozen and decides to transfer them all at once - I get that, but it's stupid, because she's the EXCEPTION). (by the way, this is, I believe, the practice that Italy follows - and they have possibly the lowest IVF success rates in the world).

So if you only fertilize 2 eggs - and hey, guess what? That's going to mean everyone has to use ICSI from now on, so tack on $5K to every cycle cost at the expense of the individual since there's no insurance mandate in the great state of Georgia! Anyway, so if you only fertilize 2 eggs, you're now facing the well-known attrition rate that you always face in the embryology lab. Many women won't ever make it to transfer.

Yes, you can freeze the eggs that you don't fertilize. But there's a reason this isn't commonly done. Egg cryopreservation is relatively new - eggs are far more fragile than embryos and don't withstand the cryopreservation process nearly as heartily as embryos do. They don't survive at nearly as frequent a rate as embryos do, and we all know that even embryos have a pretty high attrition rate in the thawing process (though that attrition rate is getting better over time).

So say neither of your two embryos make it to transfer. Now you've got a woman who's lost a whole shitload of money on her IVF cycle and now has to scrape together money for an FET - oh wait! there IS no FET. But they'll thaw a couple of her eggs - IF they survive and hopefully make 2 more embryos - IF they can - and then she's stuck in a holding pattern on Lupron and estrace (PLEASANT drugs to be on LET ME TELL YOU!) while she's waiting to see if this is even going to work, and maybe while they sit around trying to see if this will even work, and hoping that her lining gets to be thick enough, and, oh gosh, that darned attrition rate, well, we only got one crappy embryo out of it because one of them didn't make it and the other egg was a little damaged coming out of the thaw process. So we'll transfer one in a patient who wasn't actually an ideal candidate for eSET.

Oh and I'm ALL FOR eSET in the ideal patient set, remember. But eSET is best used when you've got a bunch of embryos that you culture out to day 5 and let natural selection choose which one is the best one. And remember, I had 9 embryos growing on Day 2 for my last IVF cycle. By Day 5, I had 4 almost-blastocysts (morulas) I think. By Day 6 I had 2 blastocysts to choose from and a couple struggling ones. Nothing made it to freeze, including that second blastocyst.

Nothing.

So Georgia's worries about me having six embryos leftover to freeze from my 9 embryos I started out with? Hogwash.

Per the Wall Street Journal: The bill was drafted in part by Georgia Right to Life, an organization that opposes abortion and seeks regulation that would treat embryos as human beings. "To us it's a human-rights issue," said Daniel Becker, Georgia Right to Life's president. Embryos deserve legal protection "as living human beings and not as property," he said.

This is where I take issue. Turning IVF into a Right to Life issue gets my blood boiling.

The bill further states that the embryos are NOT the property of anyone and that any custody disputes arising about the embryos will be decided by the judicial body "in the best interests of the embryo." Now, that's a standard used in custody cases for children. How exactly is the judicial body going to apply that standard to a blob of cells sitting in a petrie dish?

"Nadya Suleman is going to cost the state of California millions of dollars over the years; the taxpayers are going to have to fund the 14 children she has," Republican state Sen. Ralph T. Hudgens, one of the sponsors of the bill, said in an interview. "I don't want that to happen in Georgia."

Tell me that isn't him admitting this was a knee-jerk reaction?

I can't condone a law that was written, not with the aide of medical practitioners with time and thought put into it, but in a knee-jerk reaction, with a mere month between the time of the birth of those octuplets and the release of this bill and written by politicians and the Georgia Right to Life.

The bill (if passed as written) will shut down the Georgia IVF industry as far as I can figure - because people will simply go out of state to get better, more successful, care - a multi-million dollar industry for their state.

And that is only the tip of the iceberg on what my issue with the bill is.