The Cost of Life

By Gracie Warhurst

On Labor Day, 1998, Denise and Chris Warhurst went to a movie theater on Spring Valley
Road in Dallas, Texas. September 7 was a warm day following a warm summer, with
temperature averages in the 90s and 100s for the last couple months. But Denise and
Chris loved to go on movie dates, spending one-on-one time together while Denise’s
daughter, Ashley, was at her biological father’s house for the weekend. So, on this day in
September, they did what they loved to do. The LED signs shined over the glass double
doors, cascading their reflections in light as they walked in. With their tickets checked,
they made their way to their seats.

During the movie, halfway through “Saving Private Ryan,” Denise needed to go to the
bathroom. She soon realized that something wasn’t right — something horrible was
happening. She was eight weeks pregnant, after a very sought after conception. “I always
knew from a very young age that I wanted more children,” Denise said. Three kids would
be the magic number. Her hormone levels had been high, Dr. Putnam said – possibly
multiples. When Chris heard of this possibility, he insisted that they were twins, he just
knew.

But now, in the movie theater bathroom, Denise was miscarrying. She was distraught, and
unable to let go of the child, or children, that she so badly fought for. In a blur of events,
Denise and Chris went home, with Denise having saved the fetal tissue as it came out and
holding onto it the whole time. “I’m not sure if I was cramping, or what brought it on — or if
it was just a normal potty break. But I couldn’t flush it. So I brought it home. Then I blank
out what happened after that,” Denise said.

With known pregnancies ending in miscarriage 10% to 15% of the time, miscarriage is a
fear that all expecting mothers know well. It’s the reason that doctors advise them to wait
before telling their loved ones that they're pregnant, the reason that many try to not get
their hopes up before they’re sure that the baby is healthy. But Denise and Chris were
already ecstatic, imagining the possibility of having kids of their own together. They had
been on a long road of infertility following their marriage in 1994. Despite their efforts,
they just couldn’t get pregnant. After a visit to a fertility doctor, and tests of Denise’s eggs
and Chris’ sperm, the verdict was clear — Chris’ sperm were too weak and too few for
them to ever naturally conceive. They would either have to accept the diagnosis of
infertility, or try an alternative.

Her and Chris had Ashley, whom they loved dearly, but there was also something in them
that yearned for more children. For Denise especially, having another baby wasn’t a
question of if, but when. The ‘when’ turned out to be prolonged with the in-vitro
fertilization (IVF) process, something that Chris was initially skeptical about. “It took a lot
of convincing, but I was super passionate about it,” Denise said. “ And, of course, it was a
financial obligation, as well. But nothing mattered more, and so, after some time, we were
in agreement that that’s what we were going to do.”

Despite push back from Chris, Denise knew she would do anything — go into debt, fight
with her husband, deal with doctors — to be able to have another child. His stipulation in
the first round was that they would use all the embryos that were fit for transfer, without
freezing any for back-up. Even while IVF technology became more commonplace in the
1980s and 1990s, the couple had to grapple with moral dilemmas that challenged their
world view and religious beliefs. For Chris, not freezing any embryos eased this dilemma.
But, Denise thought, “[they’re] already kind of playing God.” In their first attempt at
getting pregnant, they were successful. But when Denise miscarried, they had nothing to
fall back on, and would have to restart the entire process. With the prospect of doing it all
over again, Chris wanted to give up. Denise had been traumatized by the miscarriage, and
angry at her husband for throwing away their safety net, but Chris was also devastated.
He didn’t think he could withstand another loss in the same way.
“That was a harder battle for me to win, personally, because Chris was done. It was an
ongoing thing for a long time,” Denise said.

In the end, it was Denise’s sheer willpower to have another child that convinced him. This
time, they would freeze embryos — but they would make sure there were none leftover
after they had conceived. If that meant having twins, triplets or other multiples, then so be
it. In May 1999, in their second attempt of IVF, Denise and Chris got pregnant with their
son, Caleb. In March 2001, the couple used the rest of their embryos and got pregnant
with their third child — me. “It was a very emotional process, but I’m so happy that we did
it and I have two beautiful, smart children from it,” Denise said.

I grew up not knowing the story of my parents' struggle to conceive. In the midst of their
marital problems and eventual divorce, they didn’t tell us about the initial miscarriage, the
doctors appointments, the hormone shots or the embryo transfers. But, when I was 12
years old, my mom finally told me an abridged version of this story. Being an “IVF baby”
became a large part of my identity, causing me to consider the value of life and my parents
desire to have me.
Similar questions have floated around the recent political landscape along with access to
birth control and abortion rights. In June 2022, the United States Supreme Court
overturned Roe v. Wade. The language of the court case that secured abortion rights also
unintentionally considered IVF. Now, states would have the power to decide how many
rights “unborn human beings” had. Even before this summer, IVF has been controversial
for sometimes involving the destruction of embryos, the reduction of multiple
pregnancies, and, as Denise put it, the circumstance of “playing God.”

However, many couples defend this fertility treatment as a legitimate option to grow their
family. Lejla and Darko Hadzidedic, who also struggled to conceive in their thirties, felt like
IVF was a “natural next step.” They recalled insurance not providing coverage for the
treatment at the time, because of lobbyists’ arguments about the controversies.

“If people are willing to take technological advances and pharmaceutical advances to treat
other medical conditions, why not apply the same approach towards infertility?” Lejla
asked. And Darko agreed: “It wasn’t a question at all.” As for the “playing God” rhetoric,
Lejla laughed. “If you think that argument, then people should be dying from heart
disease.”

The process hasn’t come without its personal moral questions, though. Denise and Chris
ended their process with no embryos to keep stored, but Lejla and Darko still have one
frozen. They say that their storage facility became unresponsive, and the matter of what
to do with the embryo, if it is still being kept for them, weighs on them. “It’s a big moral
challenge, what to do with it; whether we donate it to science or let it [expire]. Now it may
have legal consequences,” Lejla said.

Despite these considerations, Lejla and Denise share similar outlooks. “I think medicine is
given to us as a gift. And the longer the world goes on, the more they’re discovering and
the more things they’re able to do. I believe in it. I believe it’s there for the people who
yearn to have children and can’t, for some reason, naturally. They have hope because of
this procedure,” Denise said.

Dr. Winifred Mak, a faculty member at both UT Dell Medical School and UT San Antonio,
has extensive experience in the field of genetics. She specifically researched how IVF
affected imprinted genes on a mouse model and now does clinical work for recurrent
pregnancy loss.

As a physician, Dr. Mak personally acknowledges the dilemmas associated with IVF, but
knows that it is the choice of the patient, and her job to facilitate that choice. “I think
autonomy is one of those things that is important. So, everyone has autonomy to have a
baby and whether they freeze their eggs. Every woman has a right to reproductive
planning,” she said.

Though, in her practice, she is also faced with choice. Something that wasn’t available for
Denise and Chris, or Lejla and Darko, that is now common in IVF is genetic testing. “Me
personally, as a physician, if we start selecting out embryos that, because they’re more
likely to have diabetes, then we’re in this slippery slope of only keeping the ones that are
perfect,” Dr. Mak said. She doesn’t help selecting at that level, or in family balancing, but
will refer the patient to a doctor who does. “As a physician you also have your own ethical
boundaries.”

The future of IVF, Dr. Mak has observed, is moving into eugenics, or “designer babies.” “I
think that there should be some framework to keep things so it's not like if you want to do
it you can do it,” she said.

Things in the doctor office look different than they did 24 years ago when Denise and
Chris first started their IVF journey. When faced with the thought of going through
treatment in this landscape, Denise isn’t sure what choices she would make. However, she
knows one thing for sure — she got the brightest, most beautiful children along the way. “I
would’ve made the choice no matter what. I would’ve taken out every line of credit that I
needed to fulfill bringing children into the world. No matter what it took, beg, borrow or
steal, I would’ve done it.”