In Glass, Part I

LES SILLARS, HOST: From WORLD Radio, this is Doubletake. I’m Les Sillars.

WORLD reporter Leah Savas recently met a woman who faced a really, really loaded question: How far should she go to get pregnant?

Lots of people are asking the same question. According to the Department of Health and Human services, in 2021 over two percent of babies in the U.S. were conceived using in vitro fertilization, or IVF. That figure is over 4 percent in some European countries. And it’s rising rapidly all over the world. And that’s raising questions about the limits of using medical technology to produce children.

Today, Leah has a story about someone who crashed into those limits: medical, emotional, and spiritual. And walked away with a lot more than she bargained for.

Here’s Leah.

D’LYNN HERTING: That was the best time in my life.

LEAH SAVAS: D’Lynn Herting is talking about the 18 months she spent—in prison. It happened about a decade ago. In 2014, a court in Oakland County, Michigan, sent her behind bars for felony drug possession.

HERTING: That's when I gave my life to Christ. I think every single day, I was just in the Bible. Every single day, all day. I wouldn't take it back for anything.

She’d had kind of a wild life before then. She now calls it “a life of crazy sin.” Drugs. Sex. But in prison, a godly woman who visited inmates began discipling her. When D’Lynn got out, she was ready to make changes.

She got engaged a few years later. Before their wedding in 2019, D’Lynn and her then-fiancee talked about having kids. They didn’t exactly settle on a number, but they were both on board.

HERTING: We were shooting for maybe two, you know.

They started trying to get pregnant a month after they married.

D’Lynn couldn’t wait to be a mom. She wanted someone to love and nurture—a child to train up to know the Christ she had submitted to while she was in prison.

HERTING: Do you want water? Coffee? I have apple cider.

I first met D’Lynn at her apartment in a Detroit suburb. It was October 2023. She was barefoot and wearing white sweatpants. D’Lynn’s a brunette, maybe a couple inches over five feet tall. She talks with her hands, laughs a lot. She could almost pass as a high schooler but is actually in her late thirties. She’s taking online classes at Liberty University while working as an assistant manager at a furniture store.

There were fall decorations all over her apartment: orange throw pillows, decorative pumpkins, wall signs with phrases like “fall breeze and autumn leaves.” Every few minutes, a smoke detector upstairs would chirp. You’ll hear it every once in a while in the audio from our interview.

HERTIING: Yeah. I don't know how to change it. It's been doing that for months.

We sat together at her kitchen table as D’Lynn told me about her own struggle with infertility.

HERTING: So we got married, we were trying to get pregnant for about six months.

But it wasn’t going well.

HERTING: I had a regular period. So it wasn't—er, menstrual cycle, I guess. And it was like clockwork, so I couldn't figure out what the issue was.

Her gynecologist recommended a test to check for blockages in her fallopian tubes.

HERTING: they place a dye in your uterus that then kind of goes up into the fallopian tubes and out through the ovaries. If the dye goes through the fallopian tubes and out the ovary and it releases, then there's no blockage. Unfortunately, my fallopian tubes were so scarred that the dye just filled them up. It was super painful. The doctor said this was one of the worst cases he's ever seen.

The pathway a fertilized egg would have to travel to get to her uterus… was blocked. It would take a miracle for her to get pregnant.

HERTING: I just remember being sad, just because I wanted to be a mom so bad.

She’d wriggle her way through the clothes in her small apartment closet, sometimes sitting crisscross applesauce, sometimes on her knees. Praying. If You don’t want me to be a mom, she told God, please take the desire away. She wrote her prayer requests on sticky notes and stuck them to the closet wall.

For many, many other couples, though, doctors can find no medical reason for infertility. Mike and Sarah Rosecky of Winchester, Virginia, started trying in 2020. Sarah went through surgery. She tried drugs to fix a hormone imbalance. Nothing worked. By 2022 Sarah had been diagnosed with “unexplained infertility.”

SARAH ROSECKY: Which is kind of crushing when you're just like, well, I fixed all the things you think like, now, we're going to be in a good spot.

The waiting was one thing. The frustration. But then Sarah would see a flurry of birth announcements on social media. A friend was unexpectedly expecting.

SARAH ROSECKY: Especially, I compare people like, Oh, they're younger than me. And they already have three kids. And I get really upset.

She had terrible headaches but avoided painkillers, just in case she was pregnant.

SARAH ROSECKY: Like, it shouldn't be this hard. So that's usually when I get that panic feeling.

She and Mike were stuck on a monthly roller-coaster. A cycle of disappointment.

But they kept hoping.

MIKE ROSECKY: And we always thought, especially in the last couple of years, that our desire was just because, as you know, God says Be fruitful. Multiply. So we're like, we're trying something very just here. Right?

They’d tried surgery. Drugs. All kinds of natural methods. It wasn’t working.

SARAH ROSECKY: … and you kind of almost feel like, I'm being disobedient. And it's like, we're trying.

Mike and Sarah considered in vitro fertilization. But they just weren’t comfortable with it…. It didn’t seem natural.

But when D’Lynn’s doctor recommended in vitro fertilization, she was open to the idea. And she discovered that her insurance through work would cover most of the costs. It seemed like an open door.

HERTING: I kind of was willing to do anything to become a mom you can see throughout the Bible, how barren women mourn, like I can relate to the emptiness of that, you know. So now I was like, Okay, if it if it's meant to be and this is God's will, quote, unquote, then I'll have a child, right?

She looked up the chances of ending up with a baby.

HERTING: Because again, all I cared about was pregnancy. And being a mom.

Not until later did she realize she should have had a lot more questions.

BRAVE NEW WORLD:
COMPUTER: Wrong. Wrong. Wrong. Cease all computer six order operations. Wrong button. Wrong button.

This is a scene from the 1980 movie Brave New World, based on the book by Aldous Huxley. Here, a woman is operating a machine that squirts liquid into receptacles on a moving conveyor belt. She’s making human babies… and… she’s messed up.

CHARACTER 1: What happened Anina?

CHARACTER 2: I don't know. I was supposed to be fertilizing a batch of gamma females and I think I turned them all into epsilon males.

When Huxley’s book first came out in 1932, the first successful birth of a baby fertilized in a lab was more than forty years into the future. But scientists were already attempting similar experiments with smaller mammals… like rabbits. They’d transfer embryos into the females after fertilizing them “in vitro.” That term literally means “in glass.” Think of the glass petri dishes you used to use in your high school science labs.

By the time the movie came out, making a human baby in a lab was no longer a thing of dystopian novels.

Sound here from the 1999 documentary “Witness to History.”

NARRATOR: July 25, 1978. Louise Brown, the world’s first test tube baby, made history today when she was born in London to parents Lesley and John Brown. Little Louise weighed five pounds twelve ounces and was delivered by Cesarean section.

Like D’Lynn, Lesley Brown had blocked fallopian tubes. Doctors extracted a single egg from Lesley’s ovary. They fertilized it in a laboratory dish then implanted the embryo inside of her uterus. Scientists had attempted this before, but Louise’s birth marked the first time a baby fertilized in vitro survived the pregnancy.

Here’s Louise in a BBC interview.

REPORTER: And what does it mean to you?

LOUISE BROWN: It’s amazing, the amount of parents that have now got children … and it just makes me feel really special.

It was a game-changer for the fertility industry.

NARRATOR: In the years to follow, there would be tens of thousands of test tube babies born with millions more to be born in the future, and all their parents can look back to July 25, 1978, when Louise Brown’s birth gave them hope to have their own children.

But IVF has had its critics from the beginning. Some feared the method would lead to babies born with genetic abnormalities. Others expressed ethical concerns about being able to manipulate the beginning of human life. And nobody knew where the technology would lead.

The process was expensive and didn’t often work. The same team that oversaw Louise’s birth tried again and again between 1978 and 1980. But out of 31 subsequent embryo implantations, only three produced pregnancies. And only one baby survived past birth.

Since then, though, IVF has accounted for the births of at least 12 million babies globally, according to 2023 estimates from the International Committee for Monitoring Assisted Reproductive Technologies. And each cycle comes with a price tag of anywhere from $8,000 to $21,000 or more. There are still no guarantees of a healthy child. This is Dr. Eric Forman from a March 2023 report on CBS.

DR. ERIC FORMAN: Even with our ability to get multiple eggs and make multiple embryos. Most of them cannot go on and make a healthy baby and so most IVF cycles are not successful.

REPORTER NIKKI BATTISTE: For women under 35 the chance of having a baby after a single IVF cycle is about 41%. That drops to around 29% between the ages of 35 and 37. And by age 42, it's down to just 9%.

For women like D’Lynn Herting, those chances are better than nothing. But… you’ve gotta be dedicated. IVF can be grueling. And painful. At certain times each day, D’Lynn had to inject the drugs into her stomach. Using a needle. An inch from her bellybutton. The drugs would stimulate her ovaries to produce eggs for the fertility doctor to retrieve. The more eggs, the better chance of bringing home a baby.

She set phone alarms to remind herself to do the injections.

HERTING: And these are time sensitive injections. Didn't matter if I was driving on the freeway, if it's six o'clock, I need to pull over on the side of the freeway and I need to take this injection.

These injections didn’t exactly hurt. The needle was small, and the drugs went in easily. But her belly became pretty tender after a month of needle pokes left behind scar tissue.

Sometimes her alarm would go off while she was at work. D’Lynn would bring a cooler along to the furniture store. Inside, blue ice packs surrounded little glass vials of hormone medications.

HERTING: I could be talking to a customer and my alarm go off and be like, hey, I'll be right back. I have to go take these injections. And they would just stand there and wait. And then I’d come back and be like, ‘Okay, I'm done. I'm just trying to get pregnant.’

D’Lynn had so many full vials to store at home that she bought a mini fridge.

HERTING: So I did the injections for a full month. I had to go in every single day for an ultrasound because they had to make sure my ovaries were responding. They also did blood work to test all of my estrogen and progesterone. And so I did that every single day. They counted my follicles every single day.

A quick science lesson before we go on.

Ovarian follicles are little sacs in a woman’s ovary that house her eggs. Once mature, the follicle breaks open to release the egg. It then embarks on a trip through the fallopian tube and into the uterus. Normally only one egg at a time breaks out of its follicle. Sometimes two or three make the trip. That’s the origin story for anyone who is a twin or triplet. But the drugs like the ones D’Lynn used are supposed to produce a whole nest of eggs.

Once D’Lynn’s eggs were mature, they brought her in for the next step: retrieval.

HERTING: You go in to anesthesia, so you can't eat or drink before. They—you get put out. And so basically, they just stick a needle with a suction cup in your ovaries in the follicle and just suck out the eggs.

For D’Lynn the process wasn’t as painful as it can be for many women. But she started to feel sore while walking around. And for the next few days, going to the bathroom was painful.

HERTING: You would grip the toilet because it would hurt so bad.

This is Dr. Shahin Ghadir, a fertility specialist in California.

DR. GHADIR: So every patient that comes in has double verification checks. Our embryologist is here and is going to do an ID check right now.

He’s not the doctor who performed D’Lynn’s retrieval. But in this video from 2021, he explains the process as he extracts eggs from Sarah Lavonne, the YouTuber who posted this video. It shows Sarah beneath a white sheet on the operating table with her feet in stirrups. She’s under anesthetic. Dr. Ghadir holds up a white wand that almost looks like a curling iron.

DR. GHADIR: So this is the vaginal ultrasound that's placed in terms of getting the eggs out and there's a little port on the side where a needle goes through the vaginal wall and that's how we'll retrieve the eggs.

Ghadir points to the ultrasound screen. And honestly it’s hard to know what you’re looking at. But when he inserts the needle, it appears on the screen in the middle of a black bubble.

DR. GHADIR: So, that's an example of the follicles. Those little bubbles there are the future follicles, they’re the casing that hold the eggs. The needle goes in and it starts retrieving and aspirating the fluid from the follicles.

The needle sucks up the fluid, and you can hear it travel through a tube. An assistant uses the tube to fill up a tray of vials.

DR. GHADIR: The follicular fluid is then passed to our IVF lab where our embryologists check to make sure if there are any eggs in the in the tubes that we're passing.

In this retrieval, Dr. Ghadir extracted six eggs.

But D’Lynn produced a lot more. She remembers lying in the recovery room afterwards, only curtains separating her from other women.

HERTING: So I remember women, the day of retrieval. One lady crying, saying, honey, I only got three. He was like you did a good job, honey. Another one saying five. And then I have the doctor coming in and saying they got 17 from me. I didn't know what to say or think at that point. I was like, okay, because I didn't know what the next steps really were, what that looked like.

The next step was fertilization. Combining egg and sperm in a petri dish. In conventional in vitro fertilization, the lab staff wait for a pair to come together on their own. Other times they will use a tiny needle to inject sperm directly into an egg. That’s intracytoplasmic sperm injection, or ICSI. From there, they watch as the cells divide and the embryos grow.

Some simply stop growing. Less than half will continue to develop to the blastocyst stage. By then the embryo has as many as 200 to 300 cells. A trained eye can distinguish the cells that will form the baby from those that will form the placenta and embryonic sac.

The clinic called her daily with updates. Out of D’Lynn’s 17 eggs, ten of them fertilized. She had, at that point, ten children.

But three stopped growing. They died.

That left D’Lynn with seven tiny humans. She was amazed that seven made it. But at the moment, she didn’t see them as her children. They were just seven chances to end up with a baby.

The next step is to implant the embryos into the mom’s uterus. But for D’Lynn, there was a problem.

HERTING: However, my estrogen levels were dangerously high to where it would hospitalize me. Because of the way my body was responding to the medication.

So the clinic advised freezing her embryos and waiting one menstrual cycle before implantation. This would allow her hormone levels to even out. It’s a pretty common practice for IVF clinics. Allowing a woman’s body to return to normal lowers the chances of miscarriage.

But this brings up another issue: the risks of leaving babies on ice.

PHILIP RIDGEWAY: It’s almost hard to wrap your mind around that I was five years old when God gave life to Lydia and Timothy.

That’s Philip Ridgeway. In November 2022, his wife gave birth to twins Lydia and Timothy. The pair set a record by being the oldest known babies…to be born. Before the Ridgeways adopted them and had the twins transferred into Rachel Ridgeway’s womb, the pair had been stuck in a tank of liquid nitrogen at negative 323 degrees Farenheit for thirty years.

RIDGEWAY: In a very real sense, they’re our oldest children even though they’re our smallest children.

Today there are an estimated 1.5 million human embryos frozen in what’s called cryogenic nurseries across the United States. In the case of many of these humans, their parents are simply done having children. So… these children are just… waiting.

Some within the IVF industry know this is a problem. Dr. John Gordon co-owned a fertility practice in Washington, D.C., for 20 years. Some of the scenarios he encountered on the job began weighing on his conscience.

JOHN GORDON: We had these women coming through using egg donors. Maybe the woman is 48, 49, 50. And the egg donor makes 27 eggs, and they fertilize every egg. And so now she has 18 embryos. So what do we what are we going to do with those embryos? And the answer is sometimes the patients just abandon the embryos. In other words, they don't want to use them. They don't want to throw them out. Because now even if they're not believers, the embryos do represent something to them, but they don't know what to do. Most clinics have a huge problem with then these abandoned embryos.

Gordon now owns the fertility clinic in Knoxville, Tennessee, formerly affiliated with the National Embryo Donation Center. The NEDC. It’s a faith-based organization that helps connect donors with families looking to adopt an embryo. The group facilitated the Ridgeways’ adoption of those 30-year-old embryos.

Gordon’s clinic is also more conscientious than most IVF clinics. They limit the number of eggs they fertilize. When parents abandoned their embryos, they used to go up for adoption at the NEDC before Gordon’s clinic split from the donation center this summer. He also offers natural cycle IVF, which involves using fewer medications and only retrieving one egg matured through a natural menstrual cycle.

But he knows the work at the clinic and donation center doesn’t solve the problem.

GORDON: The mission of the NEDC, of course, is to try to allow those babies, you know, all those embryos are frozen in liquid nitrogen to have a chance. But obviously, it's going to be hard to catch up, given the numbers that are frozen around the country.

It also doesn’t rule out the possibility of human or technological error putting those frozen humans at risk.

Back in 2018, clinics in Ohio and California informed patients that liquid nitrogen tank malfunctions had compromised thousands of frozen embryos. It’s rare, but it happens. Here’s a patient named Kate Plants. Audio from CNN.

KATE PLANTS: I think about who they could have been and what they would have been like. So yeah, those were our future children.

REPORTER: Future children that are now gone.

And another incident happened in Alabama in December 2020. It resulted in a headline-grabbing state Supreme Court ruling earlier this year affirming the personhood of frozen embryos. Sound from the TODAY Show.

REPORTER: The case involves couples whose embryos were destroyed when a patient removed them from the freezer and accidentally dropped them.

Unthawing embryos also has some risks. Survival rates for frozen embryos have improved with technological advances. Johns Hopkins Medicine says more than 95 percent of embryos survive the thawing process. But that’s still between 1 and 5 embryos out of a hundred that don’t make it.

Embryos face other perils in the IVF process. Since Gordon first started practicing in the 90s, genetic testing has skyrocketed in the field. The point is to test the genes of human embryos to pick the ones most likely to result in a live birth of a healthy baby. But that makes two large assumptions, Gordon says.

GORDON: That assumes that the biopsy of a human embryo does not hurt that embryo.

The second assumption is that the cells doctors take out for testing from the part of the embryo that will become the placenta actually match the DNA in the rest of the embryo.

GORDON: And we don't know that's true. In fact, we're pretty sure it's not true.

He said doctors might be extracting the cells for testing from an area of the embryo where abnormal cells end up. Meanwhile, the normal cells remain in the inner cell mass, the part of the embryo that develops into the baby.

Worse, at his practice in D.C., he saw patients abuse the information from the tests. Some couples wanted their embryos tested for hearing impairments. Others had even more frivolous goals.

GORDON: And so patients were coming to me, and they wouldn't tell me what their plans were. And then they would say, Dr. Gordon, you know, we didn't tell you this, but we just want to have a girl, so you could just throw the boy embryos in the trash. And I was like, Whoa, I mean, I didn't sign up for this.

Gordon said that at his current practice in Knoxville they don’t throw away embryos or do any genetic testing. He sees patients who wonder why you would want to do it any other way.

For many believers struggling with infertility, the kind of precautions Gordon takes is enough to mitigate their concerns about IVF. But D’Lynn hadn’t really thought about all the complex ethical questions that come with the process. She knew she didn’t want any genetic testing for her babies. To her, it seemed too unlike the experience of conceiving naturally.

So after waiting for her hormones to even out, the clinic unthawed two of her embryos. They both survived, so she came in for the embryo transfer. It was quick and painless.

HERTING: I mean, they did it with you awake. They just gave you some Xanax to kind of calm down. You just put catheter in, boom, that was it. It was like a two-minute thing.

While the medical staff inject the embryos into the uterus, they don’t actually implant them. Within a few days the tiny humans inside D’Lynn would either do that on their own… or not. If they didn’t, she would miscarry. Meanwhile, she took progesterone injections every morning at 6 a.m. to help ensure that didn’t happen.

Those weren’t painless. Her alarm would go off at 5:58. First thing, she’d prep the thick needle and lay on the bed, stomach down. Her husband had to press down on her skin to make it tight. Then, he’d inject the progesterone slowly into her behind. She could feel it going into her muscles. It burned—especially after days of doing it.

Then there’s the waiting game.

HERTING: I actually did research to show when I should be feeling cramping, when I should experience or, if I do, what this looks like. And so I kept track of that. And I felt the implantation, I felt the menstrual cramps and so like, because that's what it feels, like I didn't get implantation bleeding with him. And then every single day after that, I just kept taking pregnancy tests at home.

D'Lynn says she would take at least five pregnancy tests a day, just to see if the babies had implanted. She bought the tests from Walmart—until they ran out. Then she switched to CVS.

HERTING: I spent about $200 a day on pregnancy tests, peeing on the stick every time I had to go….

At this point D’Lynn was a mother. A bearer of new life. She had been a mother since the lab fertilized her eggs. But now, two of her children were inside of her. She’d dreamed about this for a long time.

But it was only part of her dream. She had no guarantee that the rest would come about. That the two tiny human lives would ever be born. Or cry. Or nurse. Or crawl. Or grow up to say, “Hey Mom, can I borrow the car?”

And she hadn’t yet wrestled with the implications of what she was doing. Of the five human lives still … waiting.

SILLARS: All that’s next time on Doubletake in Part II of this series.

Leah Savas wrote and reported this episode. I’m Les Sillars, and I produced it. Please, don’t forget to follow, rate, and review us on your favorite podcast app. And let us know how we’re doing and what you thought of this episode. We really do want to hear from you. Write to us or, better yet, send your voice memos to us at editor@wng.org.

Thanks for listening. We’ll see you next time.

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