Thank you Ms. Kay. Thank you for taking the time to write the article entitled IVF for Obese Women is a Wish, Not a Right on the current debate surrounding obese women and In Vetro Fertilization (IVF) treatments in Canada. I thank you, not because I agree with you, because in fact, I most definitely do not agree with most of your comments about IVF. But, I did want to thank you for taking the time to write a passionate, well written column on that national scene, unfortunately on something you clearly don’t know much about. And, even more so, I suspect have never been impacted by.

First, let me tell you a little bit about myself. I am not an obese women and I am not a candidate for IVF, instead, no-one can help me with my “infertility” issue which is costing the tax payers of this country a very pretty penny. My husband and I suffer from recurrent pregnancy loss (RPL) – which occurs in less than 1% of couples trying to conceive. Recurrent pregnancy loss means we have had 3 consecutive miscarriages (for us 4 to be precise). After being poked and prodded, we have tested perfectly healthy and therefore are diagnosed as having unexplained recurrent pregnancy loss, which is a type of infertility, which is also the most common diagnosis for the 1 in 8 (possibly 1 in 6) couples experiencing infertility. We have no living children. We are currently seeing fertility specialists and are always amazed by how great our team of doctors are.

I take from your article, that you must live in a different province then me, because for me to undergo IVF most definitely is not covered by our universal health care. I will have pay out of pocket. To my knowledge, should I eventually go through IVF, it will not be covered by our medical system. So, as you focused on the costs to our universal medical system, I think it’s worth raising one more question – should we stop women like me from being able to continue to try for a healthy pregnancy because of the costs associated with miscarriage, let alone 4 of them?? In fact, I can unequivocally say that we are costing the medical system an absolute fortune. Probably more than most couples going through IVF treatments will cost the medical system. With 4 miscarriages, we’ve had 1 emergency D&C surgery which required 12 medical professionals in an Operating Room; one miscarriage alone required multiple ultrasounds with techs and 11 ultrasounds performed by Reproductive Endocrinology specialists which presumably cost a lot of money; another miscarriage resulted in 4 emergency room visits because we didn’t meet the criteria to be seen by a specialist until we went through 3 miscarriages. And that’s just the beginning of the list of procedures and doctor appointments I’ve endured over the last 19 months. So, how are we any different from these couples who are costing our medical system dollars by going through IVF? The only difference I see is that we are fortunate enough to be able to get pregnant without medical intervention and treatments and therefore fall outside of typical infertility conversations. So, this begs that question; should we now limit the dollars available to treat those suffering through losing their babies in order to save the system some money?

Although, I may not ever go down the road of IVF, I do know a whole heck of a lot of people who are. And I know their stories. And I know the heartache and pain and torture that their lives have involved in their desperate attempt to have children. I know the torture that goes into deciding to see fertility specialists, to undergo IUI and then IVF treatments. I know the complications women go through thanks to the amount of hormones that are shot into them, in an attempt to produce their own child. I know a number of women who have made incredible changes in their lifestyles to lose weight, to be healthier to help their chances of conceiving a child. Further, every single woman I know that is going through infertility, whether it be RPL or IVF, is taking better care of their health then almost any other women. We eat almost entirely natural foods to avoid unhealthy preservatives, we don’t go near caffeine, we don’t consume any alcohol or drugs, we don’t use pesticides, we don’t use harmful cleaning products – these women, myself included, all realize a healthy child requires us to be healthy! I also know that a number of couples who are going through IVF due to other medical conditions which prevent them from carrying a baby to term. There are many factors influencing why people go through fertility treatments including IVF. And I also know that while we are enduring invasive medical procedures and enduring a roller-coaster ride of emotions and physical pain, we are all doing everything humanly possible to increase our chances of having a healthy child. We care more about these unborn babies then some parents care about their living ones.

Like all categories of people, which include IVF patients (mothers, fathers, expectant mothers, children, elderly, cancer patients) there will always be outliers who are overweight. There will always be atypical patients who are obese and do not take care of themselves, but this doesn’t make them horrible people for wanting to have a child, as you imply in your column. There is so much more to fertility treatments then this. I’m not sure where the ethical line regarding treating obese women with IVF is. I do not have a medical degree and I suspect treating obese people for any ailment is more difficult. But, I won’t presume to know this and that is not the point of my letter. What I do know, is that every woman, every couple (male homosexuals included – note that the only reason I point this specific subset of the population, is that you chose to pick on a male gay couple for spending dollars that you implied would be better spent on palliative care for the terminally ill) have the right to wish for a child, and in this country, have the right to that child if they are willing to take the steps necessary. Any doctor can encourage their patient to get healthy and lose weight or stop smoking or doing crack prior to getting pregnant. This makes sense, but to single out obese women for choosing IVF later in life, is simply misguided.

Women undergoing IVF treatments are well aware of the medical risks, obese or not. They are also well aware of the mental health risks associated with living through infertility and the grief of failed cycles and miscarriage. Could you have not taken a look at that in your article? There is so much more to infertility then just the physical process of IVF.

However, the sentence that is the most misguided and evokes the most emotion from me is: –“The cost of refusal to treat choice-linked infertility is merely childlessness, a sad, but not existentially crippling reality. (I say “merely,” because nobody for whom the profound wish to have children is vitally important is foolish enough to ignore the natural window for fulfilling that drive.).” First, the use of the world “merely” is insulting. It completely invalidating and minimizing to the lifelong costs and losses of infertility. For a family to accept a childless life and to do the work of recovery to accept a childfree life still means they suffer from the lifelong loss of never becoming parents. Second, how dare you assume that the decision to have children later in life is foolish and make the comparison to playing a game of Russian roulette as they waited to have children until they were over 35 when complications arise. Let’s look at a few case studies – for us, we started trying at 29, after obtaining multiple advanced degrees and developing stable careers, as we wanted to be sure we could provide for our future children. We made responsible decisions to not have children at 18, 21, or 25, when we were both not financially or emotionally ready to be parents. How dare you assume that having children later in life was a selfish decision and not an educated calculated risk in providing the best possible quality of life for our children! Further, I’ve been advised that we are young (31 to be precise) and shouldn’t even begin looking at alternative treatments such as IVF with genetic testing for at least a few more years and more miscarriages. Meaning, all the sudden we will be “old” by your definitions at no fault of our own. And another example is many, many, women I know have been trying to conceive for years, starting in their 20s, and it didn’t work. Some didn’t seek treatment earlier because they didn’t know treatments existed or because they wanted to naturally conceive their children, etc. Another women I know who is 39 said, “I didn’t find the right man when I was younger, and I didn’t want to bring a child into the world that would be part of a broken home and the result of a one night stand, and not be a part of a healthy loving family.” Why couldn’t you have discussed this real side of IVF in your article? If life were as cut and dry as you imply with this particular comment, then maybe we really wouldn’t need IVF and many medical treatments.

The closing line of your article brought tears to my eyes – Becoming a parent at any age and at any size is a wish, not a human right. I’m not prepared to sit here and say that IVF is a right, because I think the wish / right part of this discussion is so much more than either of us have even touched on. I would suggest that by ignoring all the elements of IVF that I discussed in this letter, you have also missed the true understanding of the situation of desperately wanting a child when you cannot have one naturally. You’ve successfully ignored and neglected the emotional and mental health consequences of this situation. I respectfully request, that before making such profound judgements on people’s family choices, you look at all the factors that go into making family decisions.

But, again, thank you. Thank you for using your voice to raise awareness and drawing attention to the topic of reproductive rights, the costs of IVF and the government’s funding of IVF. Hey, any publicity is good publicity, right?

*Written by My Perfect Breakdown (www.perfectbreakdown.wordpress.com).

*This article has been reviewed by Justine Froelker author of Ever Upward (www.everupward.org).

*Note that this article has been submitted to the National Post in response to Barbara Kay’s article published May 5, 2014, entitled IVF for Obese Women is a Wish, Not a Right.