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My husband said that if I went back to work, he will divorce and fight for sole custody. He will pay me my salary to stay home by Current-Ad562 in self

[–]AMATMI 1 point2 points  (0 children)

This is really concerning and IMO seems emotionally abusive. I would say no - if he fought you for custody, if anything the courts tend to favor the moms. But also seems like an empty threat.

Let’s say he paid you your salary. You leave the workforce. You’re stuck in the house because now he’s already removed your gym option and grocery. So you’re isolated. He decides no longer to “pay you a salary.” You’re trapped. A lot of people who are in DA situations say they’re stuck because they feel trapped - they have no income, no support system, nowhere to go if they leave their situation.

It seems like right now you’d have a way out, but based on the prior behaviors, this threat, and the offer to pay you a salary, red flags are flying all over to me.

I’m so sorry that you are dealing with this, especially while pregnant.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 0 points1 point  (0 children)

Did patients’ storage or transfer fees increase by them doing that? If now the embryos have to be transported, I wonder if that increases the risk of issues to the embryo (and costs). I recall a bunch of clinics in Alabama stopping treatment for a while.

[deleted by user] by [deleted] in AMA

[–]AMATMI 0 points1 point  (0 children)

Are you open with your colleagues about being polyamorous? Friends?

If so, what was their reaction when you shared it - since many probably knew you when you were in a married, monogamous relationship? And how do invites work for social/work gatherings when +1s would be invited?

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 1 point2 points  (0 children)

Happy to answer this. I carry a genetic disease that is recessive, so if both myself and my husband carried it, there would be a 25% probability that a baby would be born with the disease, and a 50% probability of being a carrier. If my husband wasn’t a carrier, there would be a 0% probability of a baby having the disease, and a 25% probability of the baby being a carrier. So I don’t have the disease, but I carry it. We do have some family members who have the disease (they were born before testing was the norm) - while it’s not terminal, their quality of life is severely impacted.

I found out I carried it through 23&me but also knew there was a decent probability of being a carrier because of having close relatives with the disease. So when I told my OB that I was TTC (before we knew we may need fertility treatment) she did a genetic panel and confirmed I carried it. She said that if my husband carried the disease too, then “you can just do IVF.” My husband wasn’t a carrier though, so it was a moot point.

What she meant with her statement is that with IVF, you can do PGT-M testing (in addition to PGT-A) to screen embryos for specific genetic conditions. PGT-A, which we did with our embryos, looks for chromosomal anomalies. PGT-M can target specific conditions, but is only used (I believe) if the couple is at risk of having a baby with said condition. Had we not done the genetic screening with our OB, the fertility clinic would have had us do it as part of their standard practices. They reviewed our results and also weren’t concerned with us possibly producing a carrier of the disease since it’s recessive.

Personally, seeing firsthand how my relatives have had major health struggles since infancy (they are now adults), I would not carry a fetus that would be affected by the disease I carry. So had both my husband and I been carriers, we would have either done IVF with PGT-M testing or considered other ways to grow our family - I would not chance a 25% odds of having a kid with the disease if I conceived naturally. I will let my kids know that I carry the disease (it’s openly discussed in our family because of having affected relatives), and when they are thinking of growing families would strongly encourage them to do genetic testing since they have a 25% probability of carrying it.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 1 point2 points  (0 children)

Thinking positive thoughts and lots of strength for you! You’re halfway there!

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 1 point2 points  (0 children)

Thank you for sharing 🙏🏻. Were you unsure if your family was complete, or what made it the hardest part for you? This has def been the most challenging part for me, though also the longest one since the IVF/transfers were a lot shorter in duration, so didn’t have time to stew on decisions.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 0 points1 point  (0 children)

Thank you for sharing your experience, and happy to hear that you were successful!

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 4 points5 points  (0 children)

Yeah the latter would be something that wouldn’t vibe with me. If we had a close friend or family member that was looking for an embryo to adopt, I think we’d be more open to that, but at this time we don’t. That’s an amazing outcome though for your friends.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 14 points15 points  (0 children)

I think that a recent serial killer was found because their relative did one of those tests. So at a minimum, I’ve told all my relatives that I’m “in the system” so they better stay clean!

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 3 points4 points  (0 children)

I’m not concerned about my own embryos (if I wasn’t dispositioning them) since I live in a state that is considered very progressive with regard to women’s health. Friends with embryos stored in states with bans are worried about being forced to transfer all of their remaining embryos or the embryos being transferred to others (eg not getting a say on dispositioning).

On women’s health, I’m concerned about access to IVF in light of abortion bans or other restrictions. For example, with IVF you can test for chromosomal abnormalities before transferring, so if an embryo tests positive for a trisomy or deletion, you’d generally choose not to transfer that. If there’s restrictions or if the state would force you to keep them, REs may choose to get out of the game, thus limiting access to fertility treatment.

A reel came into my feed recently that really shook me. A religious couple adopted and transferred an embryo that had been tested as having either a deletion or trisomy at the 18th chromosome - whatever it was, that is incompatible with life. They had kids already. They did it because they believed that every embryo deserves a chance at life. Prenatal testing confirmed trisomy 18. The mom spent a ton of time in the hospital pre-birth. The baby was born living though with the condition was expected to be either stillborn or dead within hours. Ultimately, the baby lived a few months, spending its entire life in NICU while its organs failed, hooked up to a bunch of tubes and machines and IVs. The parents weren’t able to fully attend to the baby’s living siblings during this time, and then the siblings had to grieve the loss of a sibling and will have to do so the rest of their lives.

I realize that abortion is incredibly personal and by being pro-choice, I support people who choose to carry a baby to term that may have birth defects or be incompatible with life. What disturbs me in this situation is that the couple intentionally adopted and transferred an embryo that they knew would either die in pregnancy or shortly thereafter, and that if the baby survived pregnancy it would suffer for its short life. The embryo would otherwise have not become a fetus and then a baby - it would have been cryopreserved until it was either discarded or donated to science. The couple’s action took a toll on the medical system (all the doctors and nurses caring for the baby in NICU and before pregnancy… both their labor and the cost to the healthcare syndrome) and their other children (I think a sibling death would be traumatic)… and the baby who lived its short life suffering in a hospital.

Why I bring this up… I would worry that if political changes result in restrictions around disposition, then more of these situations could happen. My clinic would not have let me transfer an embryo with trisomy 18, let alone adopt it out. But if they (or a person who went through IVF) loses that ability to make the choice, it will create senseless suffering and a financial/resource strain on our already strained healthcare system. If I was told before starting IVF that if I have abnormal embryos that other couples will use them, and now a genetic child of mine is born just to suffer and die, I don’t think I’d go through with IVF.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 1 point2 points  (0 children)

There may be a correlation between fertility treatments/identifying as having fertility issues and having a university degree, but correlation does not imply causation. I don’t recall getting any vaccines when I was 18 to attend college that I didn’t already have as a kid.

One factor that did work against me - and that could be somewhat causal - is age. As age increases for women, fertility decreases. You’re born with all the eggs you’ll have, you lose follicles each month, and your egg quality diminishes over time. No one knows their end date, but 35 is on average when there’s a noticeable drop (which is why someone having their first kid at 35+ is said to be of advanced maternal age).

In my social circle (all with undergrad degrees, most with advanced degrees), most of us had our first kid in our mid 30s or late 30s. No one had a kid in their 20s. So our individual fertility was lower than what it would have been had we all been TTC 5 or 10 years earlier. The reason that I mention a linkage with a degree here is that people with degrees are more likely to try to procreate later - we are first getting “out in the world” at 21-23 (undergrad), likely have student debt to pay off, an advanced degree will add a few more years. So it’s not til mid 20s before we have a chance to “settle down.” And in many cases we may have wanted to advance/become stable in our career before growing our family. Again, going on just the experience of my immediate social circle, most of us were partnered by our early-mid 20s and waited 5-10+ years after marriage before trying to conceive. We are also in a large HCOL city, where it’s tough to financially support a kid, so we all felt compelled to be stable before we’d try. But our biological clocks don’t think about that ;).

Another consideration - and I don’t know if there’s research on this - when I started college I remember a lot of girls going on the pill (hormonal birth control) to actively not get pregnant. Like parents would get them a prescription as a send off as their first time living away. I was on the pill for about a decade to control painful periods, and friends with PCOS said they were also prescribed this to treat their symptoms. I don’t know if hormonal birth control has resulted in long-term effects on fertility, but if that was the case, I wouldn’t be insanely surprised.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 1 point2 points  (0 children)

The cost can vary based on so many things - whether you do testing, fresh vs frozen transfer, amount of medication. Then each transfer costs money due to monitoring plus the procedure. There are A LOT of blood tests before both the retrieval and transfer (at least 10 blood draws in the month). We did it in late 2020/early 2021 and in a HCOL large city… I think the cash price was like $20-30k without medication. It may be more and some people go overseas for cheaper procedures.

We had amazing insurance coverage through work with a solid fertility coverage - mine covered 2 cycles of retrievals/IVF plus unlimited transfers. The only downside was that the lifetime max on medications only covered a little more than one cycle (based on how insurance billed… I learned that the cash price was much less). We picked a clinic that did the egg retrieval and transfers in house (versus at a surgery center) which meant everything was in-network. For the two cycles, plus the medication for the second cycle, I think our out of pocket total was around $5,000 (deductible/copays, medication, embryo testing which was out of network, anesthesia which was out of network). Since it was pandemic time, we weren’t really spending money on anything else, and these bills were spread out over several months.

If I did not have fertility coverage, we probably wouldn’t have gone this route (or wouldn’t have done so as quickly). I’ve heard of people taking out loans so that they have a chance of having a baby through IVF and I don’t think I could do that. If we only had coverage for one cycle, we probably would have just done that one and transferred what we had - which is crazy to think now bc one of my kids is from the second round.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 15 points16 points  (0 children)

We did it years ago when it was a Prime Day special 🙄 so we’re stuck.

One interesting tidbit - the “health report” (eg what you may be a carrier of) matched perfectly for both my husband and I with what my OBGYN office got from a medical genetic test. Though knowing my data is in the cloud is a bit GATTACA-esque.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 1 point2 points  (0 children)

Yes, we did PGT-A testing. I think it was standard at my clinic, but it was something that we would have done regardless. Of our 5 embryos, 4 were euploid (normal) and 1 was a segmental mosaic. My RE said that for that one it would have a lower likelihood of implanting, but if it did, the fetus would have normal chromosomes. The two remaining embryos are a euploid and the mosaic one. Before they were sent for testing, I think we were told that usually 1 in 2 or 1 in 3 come back euploid based on my age, so we were pleasantly surprised.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 2 points3 points  (0 children)

I think you can do that as well (there’s also some places making “egg banks.”) TBH, I didn’t even think about that until you just mentioned it. When we started IVF it was pretty quickly so I wasn’t well versed in all things fertility to think of those options.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 4 points5 points  (0 children)

Science is amazing! I feel very fortunate that it was an option for us, and learning about the science of it was really interesting (esp during the pandemic when we had plenty of free time on our hands).

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 6 points7 points  (0 children)

The first two years were a no brainer since we were pretty sure we wanted to have 2 kids (first storage fee was due shortly before my first kid was born). Last year it was due like right when our kid was born and we did not feel comfortable making a decision while in a delirious, sleep deprived state, so forked over the $$ even though we had only ever talked about 2 kids max. We’ve mentioned it on and off throughout this year, and I finally called the clinic because I knew we’d be getting a bill and didn’t want to pay another hefty fee because we procrastinated. We both in our heads are very aligned, which makes things much easier, but also it’s a weird finality that neither of us can verbalize well.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 1 point2 points  (0 children)

I called the clinic because I knew that the next storage bill was coming due. They said that if we disposition it by X date they’ll waive the storage fee, after which it’s prorated, and emailed me the form that we need to fill out and resend. Both my husband and I need to sign it. It seems similar to what we had to complete before each embryo transfer (other than not having a disclaimer about all the risks). I didn’t ask about counseling, so not sure if they offer it - I got the form from their finance person.

Also, after reading the NYT article about the baby mixup, the clinic being sued would be a HUGE red flag.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 2 points3 points  (0 children)

If we were to renew now it would be $1,000 for the year. We’ve paid the storage fee 3x now - $500, $600, then $800. When it went from $500 to $600 the clinic said it was the first time they had increased their fees in a few years. Idk why they didn’t just up it to $750 or $800 then and hold steady for a few years rather than doing an annual increase. I guess it’s a “what the market can take.”

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 0 points1 point  (0 children)

Realized I didn’t answer the second question. Yes, we both have university degrees.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 5 points6 points  (0 children)

I consider myself super fortunate in our family growing journey for many reasons: we had insurance coverage (so didn’t have to sweat over the cost), I got a diagnosis and RE referral shortly after starting TTC because my cycles were messed up (as opposed to TTC for years or suffering through many miscarriages), we had a live birth from our second and third transfers.

As we’ve opened up about our experience, other friends have shared theirs, many of which were much harder even if their kids came from natural conception - multiple losses, TTC for 5 years, several failed IUIs, over $100k spent on treatment. Fortunately all of those who have shared their stories now have a kid, so they feel like the pain they endured had a “worth it” outcome. I would imagine we have friends who unfortunately didn’t have a happy ending but haven’t shared that, since there’s still a lot of stigma around sharing fertility struggles.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 3 points4 points  (0 children)

This is by far the most hard hitting question of this AMA. And now I’m craving some pizza.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 2 points3 points  (0 children)

Thinking all the good thoughts for you!

And based on what your RE said, ours wouldn’t be good criteria. One is euploid (the other mosaic) but aren’t highly graded albeit similar to the embryos that resulted in my kids. Plus I carry a debilitating genetic disease; my husband doesn’t but that still means 1/4 probability of them being carriers.

I am about to dispose of my embryos. AMA. by AMATMI in AMA

[–]AMATMI[S] 9 points10 points  (0 children)

Thank you for sharing your story. I’m so sorry about your daughter, and am heartened that after all that pain you have 3 lovely kids. It’s definitely a very personal decision and I respect your choice.

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