My inbox is peppered with articles about the BRCA gene these days.  The latest was from my mom who saw an article in the New York Times with a personally thought provoking paragraph (below).  
“It is also possible for women who are mutation carriers to avoid passing the gene to their children, by undergoing in vitro fertilization and having embryos screened for BRCA genes. Then, only embryos free of mutations can be implanted.”
Now, I have a huge game changing decision ahead of me.  Do I explore the world of IVF in order to prevent my third child from the 50% chance it has of inheriting my BRCA1 mutation? 
I have been very lucky in that my husband and I have been able to conceive our children naturally.   They were intentional.  I charted my ovulation and we knew the times of the month when we had the best chances to conceive and fortunately, the fertilized eggs grew into our mostly uneventful pregnancies and the births of our two girls.  This is not a privilege lost on me.  
So it is with my usual guilt and uncertainty that I face the potential for IVF.  If I can conceive naturally without complications, why would I go down the IVF path?  I didn’t know of my genetic mutation before I had my girls, so now that I know, is it nearly an obligation to protect my unborn child from this?  I don’t feel that my positive BRCA1 result is the ticking time bomb of death that I felt before I had the double mastectomy.  I took care of it.  Yes, I still have one more major surgery to go, a tattoo (or two) to get and the hysterectomy/oophorectomy in my future, but I feel those are all manageable.  But do I want my children to have to go through them?  And in 20 years when they actually have to start weighing their options and assessing their own risks, will there be other medical breakthroughs that mitigate their risks less invasively?  Are there risks with IVF that could outweigh the benefits in my case?  Would I wind up with multiples? (I don’t know what the fuck I would do… I don’t think I’m Mom enough to handle that although I’ve watched several friends and family members be the best, most attentive and caring moms of multiples… I don’t have the bandwidth to even think of it for myself right now.)
As I was discussing this whole new thought process with a friend yesterday at a Memorial Day BBQ (what better place to have an in depth conversation about fertility?), he said, “You work with what you know.”  He’s right.  I know that I have the potential to pass this damaging gene on to my children, I know now that I have an option to eliminate that risk, but I don’t know what risks/rewards come with IVF.  I have so much research to do now with this new option.  I’m exhausted and overwhelmed just thinking about it.  With that and the headache I just got from too much self-reflection, at least I can rule out conceiving the next kid naturally tonight.

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