I’ve heard that it’s as certain as, ‘Are you seeing anybody special?,’ when you’re single. ‘When are you moving in together?,’ when you’re dating someone. ‘When are you getting married?,’ when you’ve lived together for about a year. And, ‘when are you having kids?,’ when you’ve lived together for two years. And, really, after the first child, a second ought to follow. That’s the assumption for many. Some of my friends have even been asked right after labour.
I haven’t been asked yet. Other than this one time, theoretically, by a friend, who was also sitting there with a baby on her arm. In this case, it seemed less confrontational and just normally conversational. Perhaps it’s due to the fact that it was hard enough to have him the first time around that people don’t want to dig? Or assume that we can even have a second child?
But I’m thinking that I do want to assume that we’re having a second child. I actually just want to feel ‘fertility normal’ and think in matters of course. Even though I do know that it isn’t. There are no matters of course when it comes to reproduction, so I’ve learned by now.
So, when are we having a second child?
A few days after Eddie landed, Adam got the results of a blood test. He is carrier of the BRCA gene (we all do, but he’s got the BRCA1 or BRCA2 (he forgot which one), and that’s bad). An inherited gene mutation, which for women equals a highly increased risk of breast and ovarian cancer. For men; a highly increased risk of prostate cancer. For women with the gene, it’s, as far as I understand, a 50-60 % increased risk, why a screening is being offered from the age of 30, and preventive surgery is an option; a double mastectomy and an oophorectomy – removal of both breasts as well as ovaries and oviducts. What Angelina Jolie did, if that rings a bell. For men, it means screenings from the age of 40. However, the risk and the types of cancer are worse for women, even though you of course don’t necessarily get cancer just from carrying the gene. It’s all risks and calculations.
‘Fortunately,’ it’s Adam, who carries the gene mutation, and not me, if we look at it from the reproduction angle – that is, I don’t have to go through the very invasive, preventive operation. But because the gene is hereditary, he may pass it on to our children. May – it’s not a guarantee. But it’s still not super great to learn when you’re sitting there with three kilos of newly born huge love in your arms and already is crying because you have to take him home from the hospital – out in the polluted air. To think that he may already be carrying the gene and therefore the risk of the disease.
We have chosen to not have him examined for the gene – it has got to be his choice whether he wants to know, once he’s old enough to make that decision. But it does pose a question as to our ‘approach’ towards the next child.
At the 8 weeks’ post-natal check, it’s routine to talk about prevention. ‘Remember that breastfeeding doesn’t work as a contraceptive!,’ as they shouted after us on our way out of the sliding hospital doors three days after the birth. At that time, there are so many other things that do act as birth control, haha! But already when we were expecting Eddie did we decide not to use protection. When you’ve been fighting so long for the first child, it feels downright contra-productively to work against the next child. Que sera sera. Whether the next child would ‘catch on’ already a month after the birth (that is, if the natural birth control were to have stopped working at that point) – we’d welcome it.
Now, however, we’ve become wiser as to the genome in the home. And if you carry the BRCA1/2 gene, you’re offered egg selection at the hospital. A procedure that takes care of removing the fertilised egg, which may be a carrier of the BRCA1/2 gene. Wicked, right? That it’s already possible to see this sort of details at this stage. Just as you can make out the gender at this point as well.
Before you shout, ‘THIS IS CRAZY SCIENCE!’ it’s principally not that far from the help you already receive in the IVF/ICSI treatment. Just look at me, who had 18 eggs extracted the first time around. About half of them were ripe enough to be fertilised. About half of those developed correctly post-fertilisation – and about half of these were good enough to be inserted. A very normal ratio, incidentally. And, as a matter of fact, a selection between ‘good’ and ‘bad’ eggs. In principle, examining the eggs is just an added factor.
Something tells me that we need to use protection from now on so we don’t suddenly become pregnant – it is a huge burden to pass on. Especially if we were to get a girl, for whom the gene mutation would cause a bigger and worse risk. On the other hand – if Eddie had been deselected as an egg because he carried the gene – I can’t stand thinking of that. A child would generally choose life rather than the opposite, if given the choice. Right? (crazy question, really).
It’s damn weird, I tell you, to think this intensively about your eggs, haha! What they may and may not turn into. But to deselect a fertilised egg, because it carries the gene, could be compared to choosing an early abortion – ‘it isn’t anything yet,’ as many people say. It’s ‘just’ a pile of cell divisions (and I know that this is a huge ethical discussion, which I almost don’t dare to step into). But to me, knowing now what that pile of cell divisions might become – It’s hard for me to not already see a child there. The magic that’s already flowing.
I’m totally torn. Let’s say I’d 18 eggs taken out again, and we end up with three good, fertilised eggs, which all will have to be discarded because they carry the gene mutation. It’s definitely not without pain to be stuffed full of hormones and have eggs extracted with a giant syringe through the vagina wall. Goddamnit, it hurts (for some – definitely for me). Not to mention the concerns I have for the longterm effects of all of the artificial hormones, and the gigantic fuck-up in my hormone system that it is to force my body to ripen four eggs in one go. All of this chemistry in something that’s so fragile as the hormone system.
It encompasses so many ethical dilemmas and interesting thoughts, I think. We know more and more about our mutual genome. With simple blood tests, we can trace risks of diverse diseases. How much do we actually want to know? Do we know too much? How much is it healthy to know? Should we just shut our eyes, avoid selection? – after all, there are so many other diseases one could catch in a lifetime. So many other things you probably also could screen for; could eliminate fertilised eggs based on. ‘When the time comes, other treatment forms are sure to exist.’Or should you be hyper careful, stop the chain so the gene can’t be passed on and have this selection?
I really don’t know. It’s such a huge ethical question – and I’m biased because of my feelings for Eddie, my relief at the thought of trying to conceive normally with Adam. ARGH…
Talking about collecting bad statistics, right? Man! Approximately 3,500 Danes carry the gene. Goddamnit.
(Incidentally, I deplore the thought, ‘shouldn’t you just be grateful for the one child you have?,’ which some couples have been met with after successful fertility treatment. You will always be that, obviously – all parents are, I suppose. And we all face the ‘risk’ of just being lucky once. Risk meant in the way that you dream of having more – not that it’s bad to choose just to have one child, as that’s just as wonderful if that’s what you want. We just definitely dream of siblings for Eddie – just like many other ‘normal’ couples, who don’t need treatment, do.)