Creation of ART

“You failed!” The Dr said as he walked through the doorway, perplexed, throwing back in his large swivel chair, arms crossed, legs propped up on the desk. “We what?” I asked, laughing, thinking this certainly was some kind of joke. You failed the Sperm Penetration Assay, he said in unbelief; so it looks like you guys are in the right place! Pete and I just looked at one another in complete astonishment. You mean after 3 years, thousands of dollars, here we sat, right place or not, hearing that our chances of natural conception at any point in time, are little to none, is not only surprising and confusing, but heartbreaking to say the least. And so maybe we were in the right place, but what now? According to the Center for Disease Control, we were not alone that day, another 2.1 million married couples are infertile. (Infertile being unable to conceive naturally after 12 consecutive months of trying.) That’s 7.4% of marriages! Today, over 1% of all infants born are conceived through assisted reproductive technology (ART). ART is a term only used when both the man’s sperm and the women’s eggs are manipulated; this would primarily include IVF, and not other assisted reproductive techniques such as intrauterine insemination or alternative and less invasive forms of infertility treatment. (1) Not surprisingly, the statistics keep growing. In 1999, there were 30,629 infants born to ART verses 61,425 in 2008, and a whopping 148,000 women’s cycles underwent IVF. (2) The statistics are even more alarming when you realize that just recently the rates of a successful pregnancy with a fresh IVF cycle creeped up to 60-70% and only 30%-40% for a frozen cycle (3) , along with the average IVF fresh cycle costing on the upward of $12,400, and only 14 of our 51 states mandating some degree of private plan coverage. (4) Not something the average “Joe” can afford. Just like buying a house, there are loan options available; however, who wants a house payment, a car payment, and then a “baby” payment. Despite the costs, and the economic downfall, couples continue to pursue this doorway of opportunity. I suppose if you compare the costs with the average adoption ranging anywhere from $15,000 to $75,000, (4) IVF can look like a bargin…if it works, that is.  At the University of Utah, where Pete and I have undergone our infertility treatment, they offer a 100% money back guarantee program. (6) You’ve got it! If your willing to pay about three times the costs of an average IVF cycle, you can come back as many times as you like until you go home with your dream bundle, or less talked about, until you toss in the towel out of pure exhaustion. I suppose exhaustion is a simple way of describing the emotional turmoil infertility can take on a body, a marriage, and mind. Although, I couldn’t find divorce rates among infertile couples, I did find that 66% of divorced couples never had children. According to one website, some sociologists believe being unable to have children could be a cause for divorce, as it can lead to both loneliness and weariness among couples. (7) Whether the 66% of childless divorcees separated prior to children, they never wanted them, or they couldn’t have them, I don’t know. But it is an interesting fact to consider. Most resources will admit to the impending strain infertility and assisted reproductive technology incurs on a couple. Twice the amount of women admit to not being satisfied with their sexual life who have undergone, or are undergoing the stress of infertility. (5) There really is nothing that can take the romance, spontaneity, and passion out of a marriage like forced planning, forced timing, and the pressure of a fertility clock riding on your shoulders.

When Pete and I left our consult apt that day, few words were exchanged. This was not a death sentence, nor were not told we had cancer, or a serious illness. In fact, life was really pretty good. But we were dealt a stack of cards, I never imaged would turn up on my table. Meeting someone and falling in love is easy, its withstanding life’s circumstances that determine how that marriage might stand in the test of time. Fortunately, for Pete and I we share a common strength of our faith. This has helped guide and lead us down each road we have chosen to pursue. On the flip side, this has not come without much debate and ethical dilemmas. For two believers, life naturally never appears to be a choose, but rather a gift, and the writer our Creator himself. When not given that ability, you can’t help but question God’s plan for your life, and the ultimate “Are we trying to “play” God, or are we pursuing what God has given man?” Again, usually not a topic of conversation for most newlyweds, but quickly became a much heated debate in our home early in marriage. As a medical professional myself, I have gleamed on medical assistance and applauded where man and God have ventured over the decades. For Pete, the educator, and adventurer, I have had to respect his less motivated pursuit of the “unnatural”. When you begin to understand the details of IVF, you can really view it from two sides. The more I learn, the more I can see God’s ultimate control in all things. OR one might begin to see, man’s extreme will to solve what might be best left alone.

Several months ago, Pete and I began pursuing our second round of IVF. Fortunately, for us, we had enough embryos left over from our previous fresh cycle that we had several to choose from. Through the process, I began to understand the grades and imperfections in human embryo’s. I think our Dr. actually said, the fact of the matter is, “humans make bad embryos.” Pete and I pulled three embryos from our cryopreservation, one looked good, one looked ok, and one well, got donated to research. When the one embryo “took”, but then quickly stop developing, I realized there was so much more involved in human life than the ability to understand grading and quality of human embryo’s. Embryologists can give a pretty good prediction on the quality and likelihood of life transforming within any chosen embryo, but what doctors are having a hard time predicting is the genetics of the embryo, and the “other” factors in the implantation process. Today, these remain the “black hole” of infertility. This hole, may never be uncovered as, one might say, there are aspects of human life, left only up to God. I suppose, this is when one comes to the realization, man can do so much, but no matter, how much we as humans plan, prepare for, and implement, there is only One who has the last say, and no matter how far we get in ART, this is something we will never grasp. I do predict, genetic sampling in the future, as we are already in the beginning stages of this, and the success of IVF increasing to a nearly perfect percentage over the next thirty years. I’m not sure how miraculous this will look versus how spooky it will become. There is one thing you can count on, an increase in the number of births to ART babies, the number of infertile couples, and hopefully a government mandating insurance coverage on one of the most untalked about medical conditions out there.

From a personnel standpoint, I would say that every part of the road we have taken during the infertility process has been worth the side effects and negatives associated with my journey. Each center, Dr, and individual offer different expectations and a unique story of their experiences. I can only a tail to my own, and the “nitty gritty” along the walk many must take to have a child through ART. It is more than I would imagine many might bare easily. These are the things, less talked about, and often discovered through the process. Many women repeat this over and over again, sacrificing so much of themselves for the dream of a child. In many ways, it begins the process of loosing oneself, even before you hold that 100% dependent being in your arms. Prior to our first and only fresh IVF cycle, I underwent exploratory surgery, many hormonal medications that actually began to drive me into insanity with their extreme side effects, and months/years of waiting. I worked full-time to pay thousands of dollars out-of-pocket towards “waisted” experiments along the open road Dr’s only danced down. Pete and I spent hours at counseling, many days and nights arguing over treatment plans, and worked hard to keep our heads afloat during the journey. I became really good at self injections, predicting, charting, and obsessing over ovulation, and often walked around with scabby knees and red eyes from many long prayers and tears. Through the first IVF process, I became sick with over stimulated ovaries, spent a total of a week and a half on bedrest, and suffered all side effects of pregnancy before actually becoming pregnant. Both cycles, I quite all vices cold turkey, coffee, running, and wine, spent five days in bed,  and was not allowed sexual intercourse for two weeks all part of the recommeded protocol. This time around I had to have my mother fly in to help care for my toddler whom I was advised constituted heavy lifting, and it was recommended as little picking up as possible. My own caffeine withdrawal, allergic reactions and hives to some of the medications all occured during the dreaded two week wait before my failed pregnancy test. Not to mention, several blood draws to determine failing HCG levels, depression, and continued allergic reactions treated by a week of steroids. All for the “chance” of bringing home a child, nine months later. While others only need a romantic night out with their spouse to find out their expecting. The ultimate question is, Is it all worth it? Some would say, NO WAY! I would say, Yes, time and time again. There are days I have felt hit by a truck and left out in the road, and other days stronger and more empowered than ever. It is a card I can play, but I know some could not, and would rather choose a road less taken. I am not trying to minimize the effects and turmoil many women face with miscarriages, and their own natural yet rough pregnancies. No matter how you conceive risks are there, life is precious, and pregnancy can be hard. This story is shared to help others understand the process, pain, and prevalence behind this alternative form of creation, that is progresively increasing among our friends and loved ones. Despite the card you are dealt in this lifetime, you are here, and that means God has planned your life out perfectly by His design. May we all find the miraculous in the creation of life, no matter how it comes about.

“For you created my inmost being; you knit me together in my mother’s womb. I praise you because you are fearfully and wonderfully made, your works are wonderful, I know that full well. Psalm 139:13

(1) Center for Disease Control and Prevention: http://www.cdc.gov/art/

(2)  Society for Assisted Reproductive Technology: http://www.cdc.gov/art/ART2008/section5.htm

(3) University of Utah: http://healthcare.utah.edu/ucrm/documents/UCRM%202008%20Success%20Rates.pdf

(4) http://www.healthymarriageinfo.org/docs/infertility.pdf

(5) http://www.slate.com/id/2250361/

(6) http://healthcare.utah.edu/ucrm/: This was mentioned at a clinic visit but was unable to find on their website.

(7) http://www.divorcerate.org/

Helpful resources:

http://www.americanpregnancy.org/infertility/

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Times of Sadness

“Weeping may remain for a night, but rejoicing comes in the morning.”

– Psalm 30:5

This week I went through a time of sadness. As my heart ached for a moment I could not change or a destiny I had no control over; I also experienced something that I had yet to walk through. Receiving unexpected news, or heartbreaking words, present in a new way when caring for children. When you want to crawl into, or under your bed, sleep in late, and care about nothing, you are forced to put one foot in front of the other much sooner than desired when there is a young mouth to feed, wet diapers to change, and temper tantrums to console. There is nothing pretty or fun about this role, and bucking up to parenthood is the least desirable ideal when you’d rather not be noticed or needed. I don’t know why I have not processed through this concept, its bound to happen in all parents sometime throughout one’s life whether it’s when you loose a loved one, job, illness, conflict, or simply a joy that turns into a sorrow. No one ever trained me to be a mother, and they certainly didn’t prepare me on what to do as a parent when you didn’t want to or couldn’t do for yourself. But this week, I was grateful for grace, nap time, and prayer. I would like to say, all my weeping was done in the darkness of the night, and my joy shined in the morning, but it didn’t always work like that. When the monitor came crashing down on Ella’s head, we weeped together, when knees were bruised, I cried and hugged her (mostly because I needed the hug); and when Ella slept, well I did too. I tried to refuse to read the book “If your happy and you know it” (it’s her favorite) but pushed through with some tears and hand clapping, and waiting at the lab to have blood drawn was the perfect ice breaker for her to throw the tantrums I couldn’t rationalize as an adult but deeply wanted to have. This was a week, where I wanted to be the one year old and have someone else care for me. But maybe in the darkness of our weeping and sorrow as adults, it’s during these times as parents, that we have to ask ourselves, what will we be like in the morning? If there is no rejoicing, in the light of the day, eventually we will be swallowed by our own darkness. I think its ok, to let our children see us in all facets of emotion, this shows we are real, we are imperfect, and we need one another and God. But, I guess, I am now thankful that there is something forcing me to get out of bed, rejoice, and move towards the light. There is hope in a new day, there is hope in the promises of tomorrow, and there is hope in the one God, our Redeemer.

Frozen in Time

There have been so many events in my life I have wished for time to stand still. I can remember being at our wedding reception wishing I could freeze the night to sit for hours capturing the emotion of the moment. I remember the few minutes I was able to hold Ella after she was born, before they rushed her to the NICU, wanting to hold on to the moment forever. So often, time seems to pass us by without a blink, and there is no replacement for what was, or prediction of what is to come. Two years ago, I had the unique option to freeze time. After, undergoing our first round of IVF, Pete and I were left with fourteen five-day-old embryos. After implanting two, we made the choose to freeze the remaining. As we begin to consider having a second child, I can’t help but ponder the lives that could be, as they lie deep within the walls of a freezer. The concept, I admit, is frankly bizarre, frightening, and amazing all in one. Fourteen embryos, that if implanted at the same time would be twins, but implanted years later become siblings. Now that I have watched this life before me develop into this beautiful little girl, I feel the obligation to give twelve other embryos the same chance Ella had. The ethics and moral behind IVF and cryopreservation is debatable and full of great discussion and frustration. It’s hard to know, what to believe when it comes to your own infertility mixed with a deep desire to love children of your own. I don’t know the right answers or choices for everyone who stands in these same shoes, but I do know that I have had the privilege to put time to a stand still. A choice that we made two years ago has not dissolved, it has not died away, it remains the same as it was back then. Is there an effect on the twelve remaining embryo? Yes, supposedly, the defrosting process can be harsh and the likelihood of pregnancy after cryopreservation is less than with fresh embryo. I worry that another life may not come to be from what remains. I now understand that unleashing this timetable could mean finding out the realization that Ella may be the only survivor from the group selected two years ago. Being reminded of the miracle needed to create a life, has given me the opportunity to again be thankful for my own life, and the life’s placed along my path, and in my home.

Plus One

Ever since I was a little girl I wanted a big family. And I mean big. I can remember dreaming of 11 kids, living on a farm, and teaching school. Now my husband is the teacher, I live in a city, and up until a year ago had no kids at my fast approaching age of 30. Not at all what I had planned. I don’t really remember if Pete and I talked about how many kids we wanted before we got married. We might of, I just can’t recall it being a large part of any defining discussion we had. And we most certainly didn’t talk about what would happen if we couldn’t or didn’t have kids. Somewhere in the mix of our infertility and moving to a state of large families; Pete’s desire for kids decreased. My dream for a large family, became a desperate plea for at least one child. And one I got; a perfect and beautiful little girl whom both Pete and I deeply love. However, when given the ability to save and plan for your children, you are then able to ask yourself the hard questions like; Do we want more? Can we afford more? Is it wise to have more? When do we want more? Some have this pleasure of intense planning and others don’t. I guess fertility and infertility come with advantages and disadvantages. Although, I don’t think any of these thoughts or questions are wrong or bad; they at times seem very American and a little pretentious. On the flip side, trusting in the Lord to meet all your needs without any forethought or planning seems a little too Christian and somewhat naive.

So the debate lies within much thought and planning. Is plus one enough? Ultimately, we know the answer lies in God’s hands and His perfect plan for us. But until we know the end of the story; we would love your perspective on the matter. How do you afford however many kids you have? Do you save? Do you plan for the future? Do you work day and night to put food on the table? Do you spend most months on your knees in prayer trusting the numbers will balance out? Is it always “just enough”? Would you have as many kids as you could despite the cost? Do you live in debt? Personal, yes, controversial, yes. But if we can’t begin to be honest with ourselves and each other; how will we grow and learn?