IVF's Moral Dilemmas

I found your blog through a friend's blog and it has been incredibly encouraging as my husband & I struggle with infertility. We're now discussing how far we will go down the fertility pathway. We're curious as to how you handled the ethical, biblical perspective as you approached IVF. There is obviously much to consider but with your experience we'd love to hear from you!

I'd like to answer this question, but I definitely want to begin with a disclaimer. What I write in the paragraphs to follow is only my opinion. This is a very deep topic with a lot of gray areas. I respectfully acknowledge that someone reading my blog may see things quite differently or may have even done things quite differently. In fact, I have very close friends who did things differently. I could not even begin to judge them. Each infertility situation is unique and requires its own set of praying and seeking the Lord's will. Please keep this in mind as you read what I have to say.

Also, please help me out by answering my question at the end of the post. I'd like help from readers with things I left out or didn't touch on in this post so that I can make this as complete as possible.

So, without further ado . . . here goes.

* * * * *

The very beginning
I can vividly remember every detail of the day that the words "IVF" were first uttered in my direction. We were sitting in the Reproductive Endocrinologist's Office at the Mayo Clinic in Rochester, Minnesota. I never, ever, ever thought that I would be "one of those women" who had to do IVF. That was for other women. Not for me. It was completely shocking and overwhelming and upsetting all at the same time. I felt like I could not catch my breath. IVF? JB squeezed my hand in an attempt to comfort me from the news we truly thought we would never receive, but I could tell that the news was just as devastating to him as it was to me.

Not only is IVF extremely expensive, usually around $10,000 per attempt at a minimum, but it is racked with moral and ethical decisions and dilemmas. While the Catholic church unequivocally condemns any form of IVF as stepping outside of God's will for your life, most protestants, of which I am one, believe that infertility treatments and IVF is morally acceptable if done within strict limits. Where those limits actually lie is the big question.

A Diagnosis
In the two years that had preceded that visit where we first heard "IVF" come tumbling out of the nurse's mouth, we had done a myriad of other infertility treatments. I had had an MRI on my pituitary to determine why I didn't ovulate. I had had blood tests and taken shots and been tested in any and all ways the doctors could think of. JB had been tested. In the end, all they knew was that I didn't ovulate due to a condition called polycystic ovarian syndrome. While I did not have the weight gain, hair growth, and acne usually associated with the condition, I did have the absence of cycles and the pearl like follicles in my ovaries that indicated PCOS was the reason we had been unable to conceive.

Clomid
They started me on Clomid with the hopes that it would help me to ovulate. All it did was make me go crazy. To this day, JB says that Clomid was the worst drug I had to take. I don't remember that I was that difficult to live with, but JB would definitely beg to differ. Three cycles later and we were no better off.

Introduction to IUI
We then moved on to IUI (intrauterine insemination) or artificial insemination. IUI is a procedure where the sperm (either the husband's or a donor's) is injected directly into the woman with the hope that it will increase her chances of conception. In my case, I was given drugs to help produce follicles (which contain eggs) and then I would go in for the IUI procedure and take a shot to help release those follicles. Technically I could have just taken the drugs and skipped the actual IUI procedure -- just trying on our own instead. However, once you spend so much on the drugs needed to help you ovulate, the actual cost of the IUI procedure is quite minimal, and it makes sense to add it to the schedule.
Where IUI gets tricky is that you want to have a good number of follicles. A good number is usually 3 or 4. Too few and you feel your odds are incredibly low. Too many and you worry that your odds are incredibly high . . . not for success but for too much success: multiples.

Multiples
A side note here about multiples. The first time I walked into Mayo Clinic, my Doctor said to me, "Triplets are bad, triplets are bad, triplets are bad ..." It was honestly, the very first thing he said! Now I know a few people who have had triplets, and their children are wonderful and definitely not "bad." However, my doctor's point was that in any pregnancy with triplets or higher, the chances of something being wrong with one of the children goes up incredibly. The odds of cerebral palsy, for instance, jumps by large percentages with every additional baby in utero. Mayo is therefore very cautious and attempts to prevent anything greater than twins from occurring.

We have all seen the stories on TV about families with 5, 6, 7, or even 8 babies born at once. Most of the time these occur during an IUI procedure -- where control of the number of embryos is limited. (The Gosselins are one of the most known examples.) Or they occur during a cancelled IUI procedure -- where the physician will not do the IUI procedure due to the high number of follicles present, but the couple try on their own anyway. They may also occur during IVF -- especially at centers that are not cautious about the risk for multiples. Octamom Nadya Suleman fits into this category. I strongly encourage people to find a physician who shares or at least respects your viewpoint so as to prevent heartbreaking choices or consequences.

In Kate Gosselin's book: Multiple Blessings on their brood of sextuplets. In her case, they had not seen what appeared to be 7 follicles (which hold the eggs) on ultrasound. It was only after she found out she was pregnant that they realized their count had been off. (One embryos did not survive resulting in 6 babies.) Figuring out how many are possible is not really a science. My doctor often told me it was more of an art. You have to be very careful when proceeding in order to prevent high order multiples.

Selective reduction
IUI is a difficult procedure for a couple who, like JB and myself, do not believe in "selective reduction." Selective reduction is a procedure where a doctor goes in and aborts a certain number of babies in a pregnancy which has multiple babies. Usually this is only attempted when the number of babies is 4 or greater. With 3 babies, the risks of something going wrong with the selective reduction procedure is equivalent to that of carrying triplets so it is often not attempted. But in 4 or more, doctors will advise that 2 or more of the babies are killed so the others will survive and/or have a better chance at a healthy life.

For JB and myself, this was not up for debate. We would never, no matter what, consider selective reduction. This meant that we knew we had to be very cautious when doing the IUI procedure. Too many follicles could result in too many babies and a possibly heartbreaking outcome.

Four more BFN's
We attempted the IUI procedure four times. Two times we achieved a good number of follicles (3 or 4) and we did the procedure. Both times this procedure resulted in a BFN (big fat negative). One time they scrapped my cycle altogether as I had way too many follicles. This was incredibly disappointing as I had taken all the drugs to produce the follicles only to have to stop everything and start all over again. A fourth time, they refused to the IUI procedure but told us that we could take the shot and try on our own instead. This was done "under the table" so to speak. The doctor said he would never officially admit that he had told us to take the shot. But he kept reminding us that it was in our refrigerator.

This was the first point in our infertility journey that we reached our first sort of moral crossroads. Was it smart for us to attempt to get pregnant knowing that we could possibly have as many as 5 babies, knowing that that was not safe, and knowing that it could potentially harm one of our children? We met with our good friends Dave and Lesley and had a long talk. We weighed the odds that it would work and the odds that all of the follicles would work and did decide to try on our own. In the end, we did not get pregnant. However, this crossroads was the first time where we realized that what we wanted needed to line up with what God wanted. We knew that we could not put what we selfishly wanted ahead of what was in God's commandments at any point in this infertility journey.

IVF
It was after this fourth failed attempt with IUI that the nurse asked us if we had considered IVF (invitro fertilization). I remember her saying the words, and I remember wanting her to take them back. IVF is the granddaddy of all infertility treatments. It was thing we thought we'd never have to do. And now, here we were. IVF. I had remembered lying in bed at night saying to JB, "What if we have to do IVF?" He assured me that that wouldn't happen to us. We were just dealing with my own ovulatory disorder. IUI would be all we needed. Now, here we were. Prime candidates for IVF.

I asked my doctor what he thought my odds were with success through IVF. "You," he said, patting my arm, "Are the woman IVF was made for." I was the healthy girl with no real problems other than a minor ovulatory disorder.

Our moral absolutes regarding IVF
The issue with IVF is that you aren't just injecting sperm and letting "nature do it's thing." You are creating life. My husband and I believe that life begins at the moment conception occurs. We therefore believe that we are creating life when doing IVF.

That being the case, when we decided to do IVF, we set the following guidelines for ourselves:

• We would not rely on our own understanding. We would pray and seek the Lord's face in every decision we made.
• We would not move forward unless both of us were 100% on the same page.
• We would seek the opinion of others. Specifically, JB and I decided to follow the statements of Focus on the Family and the CMDA or Christian Medical and Dental Association. It was our hope that by aligning ourselves with two organizations and making sure we never stepped outside of their viewpoints, that we would be giving ourselves an extra bit of accountability. We never wanted what we wanted to move in front of what God's commandments were. We knew that with the money and pressure we could be swung into a faulty line of thinking if we didn't keep things in check. I strongly suggest that any Christian thinking of doing IVF finds an organization or two that can help guide them in their decision making.
• We would never create an embryo (life) that we did not plan on giving a chance for life outside the womb. We therefore would limit the number of embryos that we fertilized. In our case, this most likely was the reason we had to do a second harvest for IVF. But for us, the extra money and drugs and headaches were worth it. Some people even choose to go farther and not freeze any embryos. I completely respect this decision. As one person noted in the comments of this post, the rate of survival in freezing and dethawing can be low. My husband and I came to understand through our own research that if they did not survive the freezing/thawing process, they would not survive had they been in the womb either. This is another topic that we should have done more research on, and I felt we probably "zipped" through too fast.
• We would never contemplate selective reduction. Ever. This meant that we would be very cautious when considering how many embryos to transfer.
• If for any reason we could not use the embryos we had created, we would (a) find a surrogate to carry the embryos for us OR (b) donate the embryos to another infertile couple. Reasons that we could not use the embryos would include my death or health.
• None of our embryos would be discarded or used for research, no matter what. We went as far as to create an "advanced directive" that left the embryos to my brother if JB and I were to both die. We wanted to make sure these embryos were not discarded. My brother has strict directions to donate these embryos to a Christian couple who would raise our biological children for the Lord.
• Mayo assured us that in their laboratory, they freeze before genetic transfer occurs. They therefore believe conception has not actually occurred when the freezing takes place. We decided not to believe this. If we were being overly cautious, then we were being overly cautious. We felt that we would continue with the thought that each embryo was life. If we got to heaven one day and found out that we were wrong, then so be it.

Harvest #1
IVF involves the "harvesting" of my eggs. After the eggs are harvested, they are fertilized in a test tube in a laboratory (thus the expression "test tube baby.") A select number of the fertilized embryos are then injected back into me in a process called a "transfer."

JB and I did 2 harvests and 4 transfers. For our first harvest, we decided to allow them to fertilize 12 eggs. Some couples do not have this luxury. They only manage to get a few eggs. However, in my particular case, I produced a large number of eggs when given the proper medication -- dozens actually. We therefore had to carefully contemplate how many eggs to allow the doctors to fertilize.
The doctors, of course, wanted to fertilize every single one. However, we held fast to our belief that we would only fertilize what we felt comfortable using. How did we decide on 12? For us this was based on "playing the numbers." I am having trouble recalling the exact odds that we were given, but we played with numbers on a pad of paper for days and weeks before deciding that 12 would be a good number for us. We were "banking" on approximately 10 of the embryos fertilizing, and of those 10, about 40% resulting in a successful pregnancy. This would give us approximately 4 children. That sounded about right to us.

Of course those of you following my story know that this wasn't the case at all. When they took those 12 eggs and fertilized them, to their great surprise, only 6 fertilized. They realized at this point that we were dealing with yet another infertility issue. We had a problem with sperm binding. We don't know if it was JB's fault or my fault or the fault of both of our materials put together, but either way, we only got 6 embryos. In the months and years to come, JB would insist that the problem was his just so that I would quit saying that our inability to have children was all my fault and he should go and find another wife. It was sweet of him.

Blasts
We transferred 2 of those embryos and did not achieve a successful pregnancy. In addition, 1 of those embryos was kept out longer before it was frozen. This is called a "blastocyst." Supposedly, these "blasts" have a higher rate of success. In our case, our "blast" died before it could be frozen. This is another area of moral dilemma. Some people do not believe you should allow the docs to create a blast. It was our belief that these embryos would live or die based on how good they were and that they would live or die inside or outside of me. We therefore did not have an issue with the blastocyst. If I were ever going to do IVF again, however, I would, personally, spend more time researching this particular issue. I feel this is one area we were not as knowledgeable about as we could have been.
Harvest #2
At this point we had 3 embryos left. We did a second transfer which also resulted in a negative pregnancy.

With just 1 embryo left, we decided to leave that 1 embryo frozen and do another harvest. This time we decided to fertilize 14 embryos. Twelve of them were successfully fertilized using a process called ICSI. This is where each egg is injected with a single sperm (instead of just throwing them in a tube dish together and seeing what happens.) Unfortunately, one of the blasts died this time again leaving 11 of embryos and 12 if you added our previous 1 to that batch. We transferred 2 more and did not have a successful outcome. We did one more with 3 embryos this time and did not have a successful outcome. This left 7 embryos remaining when we decided enough was enough! We currently have 7 embryos stored at Mayo Clinic in Rochester, Minnesota that we are 100% committed to returning for at some point.

Summary
It is our belief that the Lord is the creator of life. He creates follicles and sperm and eggs and embryos. Even with all the help the doctors provide, the Lord controls the final outcome. In our case, that was eleven negative results. Eleven expensive and extremely disappointing results. This is where infertility treatments are so difficult. No amount of money or prestige or power can give you a biological child. Only the Lord can do that.

We felt that morally, we needed to remember, at all times, that the Lord is the maker of life. We needed to not be selfish and put what we wanted in front of what the Lord had ordained at any point. To this day, I cannot tell you 100% that we did everything perfectly. I feel peace about our decisions, but I know that there is a chance we did something that was not morally acceptable. But we did the best we knew how to do with prayer and guidance from people and organizations we trusted.

Resources and questions
As I write this, I am not sure that I have answered all questions on this topic. I wanted to share three additional documents that helped guide us in our decision making.

• CMDA's stance on IVF
• Standards for Life
• FOF's Views on IVF and embryo donation
• Nightlight Christian Embryo adoption

Do you have a useful article? I'd love to add it to my list. Here are three articles posted in the comments during the original draft of this blog entry.

• Embryo Ethics: Does discarding unused embryos constitute murder?
• Ethics: In Vitro Fertilization (One Christian Minister's viewpoint on IVF)
• National Embryo Donation Center

These documents have a lot of great information from the two organizations I talked about previously. They also break down the Bible's viewpoint on infertility, adoption, and artificial reproductive technology.

I wonder if any of you who have read this whole post could help me out. I'd like to make sure I was very clear about everything in this post so that I can post this on the side of my blog as a resource. What additional questions do you have after reading? Please ask away! I will then go back through the post and edit it to reflect your questions (and also answer them in the the comments section.)
Thanks to my anonymous question asker. I hope I did a good job sharing our own journey and how we attempted to stay in God's will as Christians while in the midst of a very gray and murky area. Let me know what else I need to add!

'Tis So Sweet To Trust in the Lord

This post was originally written on January 31, 2006. I don't think I can attribute it to purely coincidence that our first biological son, Elijah, was born on January 31, 2009. Three years to the day that I wrote about learning to trust God in the midst of infertility. And somehow, I find myself ready to post this on January 31, 2012. God is in even the small things!

’TIS SO SWEET TO TRUST IN JESUS

’Tis so sweet to trust in Jesus,

And to take Him at His Word;

Just to rest upon His promise,

And to know, “Thus says the Lord!”

Jesus, Jesus, how I trust Him!

How I’ve proved Him o’er and o’er

Jesus, Jesus, precious Jesus!

O for grace to trust Him more!

O how sweet to trust in Jesus,

Just to trust His cleansing blood;

And in simple faith to plunge me

’Neath the healing, cleansing flood!

Yes, ’tis sweet to trust in Jesus,

Just from sin and self to cease;

Just from Jesus simply taking

Life and rest, and joy and peace.

I’m so glad I learned to trust Thee,

Precious Jesus, Savior, Friend;

And I know that Thou art with me,

Wilt be with me to the end.

How many times I have sung this hymn? How many times have we sung this hymn? As I write this now, this song is playing in the background on the website where I copied the lyrics from.

I must admit that all my life, I would sing this hymn, or something like it, and boom it with all my heart (or boom it quietly with all my heart as not to ruin it for those around me who sing much better than I.)

And all my life, I thought I did trust in the Lord. The Lord was great! He had given me two loving parents, a loving spouse, a roof over my head, a Christian school to attend, athletic abilities that paid for college, fantastic friends, great churches, health. Nothing bad had happened to me. Of course I trusted Him.

I was in the laundry room talking to a dear friend a few days ago. As we spoke, we both, in our own way, had come to realize that trust is easy when your life is going as planned. While my trust issue is infertility, your trust issue and her trust issue was something different, but it actually all boiled down to the same thing -- wondering what the heck the Lord was thinking?! Where are you Lord? What are you doing?

Recently I have seemed to face this with many people I know -- great Christian people I know who have lost a parent, lost a child, not achieved the career goals they had in mind, been unable to conceive a child, been hurt by something or someone in the church. Suddenly the words of the hymnal become painful to sing. Trust Him? Well, sort of. I mean, I want to trust Him, but why the heck is He doing things this way? Why doesn't He do them my way? Why did He allow that to happen? He defeated sin.

In my case, it is looking around me and listing all the people that God should give me a child to before they give it to them. Yesterday it was a little Brazilian baby thrown in the river in a plastic bag. (She survived and people are now lining up to adopt her.) It's the people who have abortions (126,000 each day and 55 million each year). It's the teenage mothers or those who don't seem to have the money to afford kids having kids. It's the men and women who allow their children to be emotionally or physically or sexually abused. "Wait!" I scream at the TV or at the Lord. "Here I am and here are all the women in my support group. Give us those babies! Bless us with their pregnancy! We want those children!" It's a moment when I look to the Lord and say, "Lord, I'm not sure I do trust You. Do you know what the heck you are doing?"

If you are reading this, I don't expect you to relate to the infertility part, but as a dear cousin told me, "I can't relate to the infertility part, but I can relate to never being given the job I want." Or maybe you lost a parent who didn't deserve to die. Or maybe your marriage ended despite everything you tried to do. Have you wondered what God is thinking?

I am reminded from a scene in Return to Me (the greatest movie EVER!) I don't want to ruin it for you if you haven't seen it. But if you have, I am sure you remember when Grace (Minnie Driver) is sitting in Bonnie Hunt's living room sobbing due to the events that just transpired and admist her tears she says, "What was God thinking?" I can so relate to that moment even though I can't relate to what happened.

Some of you know that I am in am in an infertility Support Group at my church. It's a group that I helped start with two other women. We now have about 15-20 women involved off and on. (It's not a group that I want to be a life-long member of by the way.) The group is called Hearts Like Hannah. Last night we held our quarterly "Caribou Coffee" meeting and a new woman joined us who had tons of questions -- tons of things that she wanted to know if "anyone else felt." We talked to her and answered her questions and completely understood every bit of where she was coming from. Another woman there has twins from embryo adoption. She looked at me last night and basically said, "I know what God was thinking. If I wouldn't have travelled the road I travelled, I wouldn't have these two boys -- and these are my boys."

As I was driving home, I had the moment I had wanted since this journey started shortly after my 26th birthday. I somehow, finally, trusted the Lord. I have been trying so hard -- every step of this journey, but last night I could honestly sing this song and mean it. I realized that while the Lord didn't cause this disorder I have, he is using it every day. Romans 8:28-31 says, "And we know that in all things God works for the good of those who love him, who have been called according to HIS purpose." Wait a minute! If I wouldn't have gone through this, I wouldn't have met this woman last night. If my friend with the twins hadn't have gone through this, she wouldn't have the twins she had. If I wouldn't have gone through this I wouldn't have reconnected with old friends. I wouldn't have the faith I have.

More than anything, I don't think I would be able to understand when a friend told me they were questioning their faith or grieving a dissapointment -- whatever it may be. But somehow, now, because of this, I understand. And somehow (and not to say I won't have days where I struggle with this whole trust thing all over again), somehow, I realize that the Lord has the greater picture in His view.

Wendi, trust Me. I've got your best interest in mind. I didn't cause this, but I will use this in your life. When you look back, you will understand, either on earth or in heaven, why things happened the way they did. Trust Me.

I am not saying I won't have doubts in the future, but for today, I am okay. I know that even if I don't have a biological child of my own, the Lord is real, and He has got my soul in the palm of my hand. I trust that.

-- Wendi Kitsteiner

How to help your infertile friend

Many of you have asked me my opinion on what you should or shouldn't say to someone struggling with infertility. I am speaking more to women. While this is a couple's issue, this is something that usually affects women much more than men.

So here is my short and sweet guide. If you follow these rules, you won't go wrong!

THE BASICS:

A couple will eventually resolve the infertility problem in one of three ways:

• #1 They will eventually conceive a baby.
• #2 They will stop the infertility treatments and choose to live without children.
• #3 They will find an alternative way to parent, such as by adopting a child or becoming a foster parent.

It is important that you understand that each of these three "routes" offers excitement, pain, and heartbreak in their own way. I have friends who have chosen or been forced down each of these different paths. It is important that you don't press them down any of these roads. Number 1 is racked with worry and fears after the amount of time and money invested. Numbers 2 and 3 are very difficult choices and usually not the first option.

Here are some things you should NOT say to them while you are struggling. Now if you have said any of these to someone, don't feel bad. One of my dear friends was struggling with infertility before I was diagnosed. Looking back, I said every one of these things to her. I have apologized, but she understands that I meant well. I understand that people mean well. However, the more educated you are, the better.

• Don't tell them to relax. This is called the "R" word in infertile circles. This is very rarely the problem for infertile people. While stress can be a problem, it is often not the issue for people who publicize their infertility journey. Stress is usually an issue that is quickly rectified.
• Don't minimize the problem or say there are worse things that can happen. Don't say this really isn't a big deal or shouldn't bother them that much. Of course there are worse things that can happen. Any life-changing event could be worse, but it doesn't change how much it hurts.
• Don't say they aren't meant to be parents. Well meaning Christians often say this trying to imply God's will is sovereign. Faith and God's presence is a huge issue for infertile women -- let them deal with this on their own or with a Christian counselor.
• Don't ask why they aren't trying IVF. IVF is very expensive with a lot of ethical considerations. It isn't an "easy" decision.
• Don't play doctor. Don't give medical advice unless you really know what you are talking about.
• Don't be crude. This should be obvious. Making jokes about "Do you need a lesson?" is just mean.
• Be tender when making a pregnancy announcement.The general rule here is to not make your announcement in a public place with your infertile friend in attendance. Instead send them a card or an email and allow them to digest it privately first. Or sometimes you can tell the husband and ask them to let the wife know. Remember that they are happy for you but they are jealous for their own frustrations.
• Don't complain about your pregnancy or your children. Obviously there are things to complain about but it is a wise move to find someone else to confide in with these problems.
• Don't push adoption (yet). The general rule is to not bring this up unless they bring it up first. This is a very wonderful and tender topic and when they are ready, they will share. Why do most people not adopt and have genetic children? Because biological children is the primary choice for most people. Your friend is no different in this desire.
• Don't start any story with ... "I know someone..." or "I had a friend who..." These stories often feature the exception, not the rule. The biggest culprits: "I know who a friend who went on a vacation and then had a baby", and "I know who friend who got pregnant right after they adopted." These cause chills down an infertile women's spine.
• Let them know that you care. Cards or caring acts are appreciated.
• Remember them on Mother's Day. Church is very painful on Mother's Day when you are infertile. John and I didn't go. We planned a fun day away from all the mother's with flowers. You can simply send a nice card that you are remembering them on that day like you would the anniversary of a loss. 
• Don't tell them that if they adopt, they will probably become pregnant. The fact is that very few couples conceive after adoption.
• Support their decision to stop treatments. Encourage them in whatever direction they choose. This is a personal decision. If they want advice, they'll ask.

If your friend (or an acquaintance) brings up their infertility to you, they are wanting to talk to to you about it. From that point on, the conversation is probably welcome. Start off by saying, "If you don't want to talk about it, it's okay, but how is everything going?" Most of the time, once a couple decides to share, a woman wants to talk about it.

Okay, so that's a lot of things NOT to do. But what should you do:

• Pray for them.
• Remember their "calendar" and send an email or card on a big day.
• Put them in touch with other women "in their situation". (Ask them if they want to be contacted or do the contacting.)
• Provide encouragement for them to seek support. A great online support group is: www.hannahsprayer.org. 
• Attend Support Group meetings with them if they would find this helpful.
• Invite them to all events but give them the option to "opt" out of events that might be painful (baby showers, baptisms, etc.)
• Invite them to special child-free events whenever possible.
• Give them poems or even books that you think might be helpful -- try to have another infertile friend give a "stamp" of approval on the book. Don't have a friend? I'll be your friend. Email me at: flakymn@hotmail.com. 
• Offer to go to appointments with them if their husband is unavailable. 
• Recognize that not being able to have a child is the loss of a dream. It is the same as a single person who wants to get married not finding "the one" or an athlete having a career-ending injury. It's a loss. They will move through stages of grief (ups and downs) including a time when they question their faith. However, they will cycle through this with love and prayer.
• Read books that will help you understand the infertile woman's heart. I strongly recommend Water from the Rock to understand the grief process infertile women go through.

Unforeseen

I recently received a link to a video from Tyrone Howard. I don't know Tyrone personally. He found me through my blog, and he sent me a copy of a short film he had done that he wanted my opinion on. He also hoped I would share it with my blog readers if I found it appropriate. "Unforeseen" was actyally designed to illustrate a life of second chances. However, Tyrone found that it was gathering good support amongst individuals who lost a child before he/she was born.

After watching the video, I can see why. While I have never experienced pregnancy loss, I do believe my history with infertility allows me to be a fair judge of the appropriateness of this video. I am asking my readers, especially those with a similar history to mine, to watch this video and help provide Tyrone with some feedback. Butbe forewarned that if you have faced pregnancy loss or even infertility, it may make you quite emotional. It is incredibly well done (in my opinion) and I believe very accurately portrays this difficult part of life. Please leave a comment that I can share with Tyrone -- either positive or negative. Here is the link to the video. We need more individuals opening up dialogue on this part of life, and I think Tyrone's video is worth your time.

Held

I am so excited to have my second piece on the Hannah's Prayer Blog: Held* Please hop over and visit by clicking here. If you missed it, here is the link to the previous piece I had featured on their website. As most of you know, infertility and adoption are my passions, and I am so blessed to be a part of this ministry.

*Held is a blogging outreach of Hannah's Prayer Ministries* and is here to offer support and encouragement to families seeking peace through infertility, pregnancy/infant death or adoption loss, and to provide a resource for our extended families, friends, church communities and larger support networks. If you are a married Christian woman dealing with the heartache of any of these fertility challenges, we also invite you to join us on the Hannah's Prayer Community Forums.

My testimony

I received an email from a friend going through infertility treatments right now. I often have many women that I am connected with via Hannah's Prayer, email, or in-person. This friend had read these words in a devotional and she shared it with me. I was so blessed to read these words. I often wonder who I am right now. What is my mission? I don't feel like I really fit in with mom groups. I feel like I will always be slightly different. And yet, obviously, I am no longer a part of infertility cycles, technically speaking. This email from my friend reminded me that my testimony is part of who I am. Infertility and adoption are my passions. They always will be. Just because I am a mom now doesn't change that. Thanks friend!
*****
"Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our affliction so that we will be able to comfort those who are in any affliction with the comfort with which we ourselves are comforted by God." 2 Corinthians 1:3-4

Have you ever read a really good book? I mean a really good book? One that you can’t put down? You envision what every character looks like, what they sound like when they speak, and even how they walk. You feel like you know them! When you get so engrossed in the story you block the outside work and immerse yourself in the story line. There’s nothing quite like a really good book!
Did you know you are an author? That’s right! Sign your name at the bottom of the page, for you, my friend, are a writer! What are you writing? You’re writing your testimony.
Infertility can really take a toll on your life. It can consume every waking moment, every thought, every interaction. You may find that you are surviving trials that you never would have imagined you were strong enough to conquer. How has God worked in your life? How is God working? Who are the characters in your saga--people who have said really stupid things, or those who wrap their arms around you and understand? Have you learned things about God through your battle with infertility that you never had even considered before? Maybe you found yourself searching Scriptures for answers--and actually found them! Infertile couples have to figure out new ways to communicate and make decisions. Who knew when you stood at that altar that day that you’d have to make decisions like how many embryos to freeze or where the money would come from for all your medications? So many twists and turns in the plot!
Infertility changes you. When you’re in the midst of the battle you cannot see how you are better for it. It helps when someone who has been there understands what you feel, and shares with you how they coped and survived. Do you realize you can be that someone to another person? One day, infertility will be a part of your past, and not your every waking moment. You’re learning things now in infertility’s classroom that you never even considered before. Every trial you face, every month you survive, you are writing your testimony. Every time you pick yourself up and face another month, you’ve written another part of your testimony. You pray and ask God to help you--and He does. There’s another chapter. Another story to tell of how God provided again.

Someone needs to read your story. Someone somewhere is going to need to hear how she is not alone in her battle, and that someone with a similar struggle has survived. You may be in the midst of your fight today, but one day, your story can encourage someone else. Maybe you can see how, maybe not yet. But the day will come when someone new to infertility will look to you for answers. Your story may just be what gets them through that month, or that day.

When you share your story of how God sustained you through trials, you are lining up beautifully with Scripture. Comforting someone else with the comfort you received. Telling someone else, “I know it’s hard. This is what helped me,” is being the hand of Jesus extended.

Perhaps your story is not ready yet. It will be. One day, God can use your story to heal the wounds of someone else. Maybe today, you need the healing. Wherever you find yourself, know that God is working and moving. And writing your testimony with you.

Infertility in the Media

Last night while I was falling asleep, Julie & Julia was playing. I loved this movie because it combined blogging (something I love) with cooking (something my husband loves) while also so perfectly including infertility and living life as a tall woman. Only her being an athlete would have made this movie more fitting for me.

I had written previously about this movie on my blog here. And while I could not find a copy of the exact two infertility clips that really moved me in Julie & Julia, I was able to find a video on youtube that did have the clip, albeit no dialouge can be hard.

On the video below, check out the fourth and sixth scenes that come up in the montage. The fourth scene shows Julia and her husband, married many years, receiving news that Julia's sister, who had just married, was expecting a baby. Julia Childs (played by Meryl Streep) so perfectly demonstartes how it feels to be not have children and watch those around you receive that gift. I don't know who wrote this scene or how Meryl did it, but I felt someone had been spying in my own living room when I received pregnancy news over and over again while our own womb stayed empty. Julia is happy for her sister but finds herself crying out of sadness. An incredible mixture of emotions done unbelievably well.

In the sixth scene, Julia and her husband are walking down the sidewalk. They pass a baby carriage, and she glances back and then tries to compose herself. Her husband pats her hand without a word shared between them. Again, the movie portrayed the feeling of infertility perfectly.


After watching these scenes again last night, I realized how beneficial they were to the cause of childlessness. These scenes educate the public on how infertility feels. I decided that I wanted to try and compile a list of positive media sources for infertility and adoption. This can be "famous" people who struggled with infertility or shared their journey. This can be books or movies that portrayed this part of life positively. I really don't want to put up limits as to what I am hoping to compile. Adoption can be included as well -- although I would really like to focus more on the infertility aspect as it is a lot easier to find positive adoption language and concepts than it is infertility.

Can you help? Please leave a comment, or, if you feel more comfortable, you can email me at flakymn@hotmail.com. Thanks everyone! I look forward to developing this list with help from you and research of my own.

LIST IN PROGRESS

Movies

• UP: Recommended by many readers for the opening montage about life without children.
• Baby Mama: Has many references to infertility although there is a surprise pregnancy at the end that can be difficult for those in the midst of infertility
• Meet the Robinsons: Older child adoption
• Immediate Family: Some harsh language but an infertility movie
• Maybe Baby:
• Funny about Love:
• Serious Moonlight: Dark comedy with frustrating ending but good infertility plotline.
• Did You Hear About the Morgans: I saw this; not a great movie but it does show what infertility can do to a relationship. It also has the "happy ending" that isn't always very realistic. 
• Facing the Giants: Infertility storyline, although ending was a little bothersome.

TV Shows

• Giuliana and Bill: features E host Guliana and Apprentice winner Bill's journey through IVF including their subsequent miscarriage.
• The Little Couple: Chronicles fertility journey including IVF and surrogacy. Click here or here or here for video clips of their struggle.
• Grey's Anatomy: About 4.5 minutes into this scene, you see Meredith have a conversation with her husband in the elevator showing, quite accurately, the feelings of jealousy that often accompany infertility.
• Friends: Chandler and Monica's infertility and adoption
• King of Queens: Infertility
• How I Met Your Mother
• Brothers and Sisters: Contains an IF storyline

Celebrities

• Celion Dion
• Nia Vardalos

Myth: Adopt and you'll get pregnant

My friend Amy participated in the "Bust a Myth" Infertility Challenge sponsored by RESOLVE just like I did a few days ago. It's funny, but I was just contemplating the wording to write nearly the exact same post when I hopped over to Amy's blog and realized what I was thinking had already been said.

"Adopt, and you probably still won't get pregnant" she wrote.

I couldn't have said it better myself.

It's funny hearing this coming from Amy and then from me since we both have two little boys one year and less than one year apart. I met Amy online (In fact, it was through Amy that my friend Stebbs and I met each other before either of us relocated to Turkey) while we were knee-deep and needles and doctor's appointments. Failed IUI's. Failed IVF's. A turn to adoption. For both of us.

And then, pregnancy.

But the truth of the matter is, while it may seem like women who adopt get pregnant all the time, it is actually the exception. I've written about this before. How many times have you told my story to someone else? Now how many times have you told the story of another friend you have that adopted and never did go on to have other children? My story passes quickly. Stories of adoptions that do not result in pregnancy do not generate as much "buzz." That's really what it boils down to.

I especially liked when Amy wrote the following:

Soon the comments began. "You hear about this happening all the time," and "See, you relaxed about having a baby and then you got pregnant," and "I knew this would happen." I know people mean well, I really do. I always pray to respond from a place of grace.

I pick my battles. Sometimes I say, "Yes, it does happen," and sometimes I cite the statistics, "Actually, only 5-10% of parents who adopt due to infertility go on to conceive and bear children." And sometimes, perhaps not often enough, I present the answer I believe the strongest.

I believe that we were able to conceive after years of infertility and adoption because God meticulously planned it out just so.

AMEN!Amy, I totally agree. You completely echoed my heart. I hesitate to tell our story because I know what is coming next. JB corrects these people all the time. I correct them most of the time. Sometimes I just don't feel like it. Sometimes they are Turkish, and I know the language barrier will prohibit me from saying what I am thinking.

But either way, the truth is as follows:

• Adoption is awesome in and of itself.
• There is no proof to indicate that adopting results in pregnancy.
• The 5-10% statistic is actually a lower success rate than what a woman who tries on their own faces during any given month.
• No one can say for certain whether a woman who gets pregnant post-adoption would have conceived anyway.
• Telling your friend who is adopting "Watch and you will get pregnant" is NOT recommended. In fact, it can be hurtful (even though that is not your intention). It implies that adoption is not good enough and the "good enough" will come after the adoption.
• Repeating my story or Amy's story to people is great. It shows the Lord's blessings. But please help educate people when you tell it. Please inform people that this is the exception not the rule.

For more information on infertility, please click here. This blog post is part of RESOLVE: The National Infertility Association's National Infertility Awareness Week® (NIAW). Click here for more information on this organization, the largest nationwide non-profit improving the lives of people diagnosed with infertility. This post is part of RESOLVE'S"Bust an Infertility Myth Blog Challenge."

To be fruitful

While working through Beth Moore's Breaking Free Bible Study, I was touched to discover that she was going to devote an entire day to infertility in this study. I wanted to take the opportunity to summarize some of what I learned during this study for those of you who haven't take it before.

Every little girl has at least four main dreams:

1. To be a bride
2. To be beautiful
3. To be fruitful
4. To live happily ever after

Of course, for those of you have been following my blog for any significant portion of the six years I have been writing, you know what my focus is going to be on. Number 3 it is.
Beth Moore actually writes: "Without a doubt, some of the unhappiest women I've ever known have been those who wanted children and were unable to have them." She goes on to say that Shame is Satan's game and that her friends dealing with infertility have asked themselves questions like "Why me? Why my husband? What did I do to deserve this? Is this my punishment for sex before marriage? Is this my punishment for having an abortion? Would I have been such a terrible mother? ..."
Beth goes on to make four fantastic points regarding barenness:

1. Barrenness does not imply sinfulness. Here she uses a scripture from Luke 1:5-7. How I travelled the infertile road without ever seeing this scripture, I have no idea. In the time of Herod king of Judea there was a priest named Zechariah, who belonged to the priestly division of Abijah; his wife Elizabeth was also a descendant of Aaron. Both of them were righteous in the sight of God, observing all the Lord’s commands and decrees blamelessly. But they were childless because Elizabeth was not able to conceive, and they were both very old. This was incredibly powerful to me! Elizabeth and John were walking with the Lord and barren. There was no sin that caused this.
2. Hearts not surrendered to God can seldom be trusted. Beth Moore writes that, "Until we surrender our hopes and dreams to Christ, we really have very little way of knowing what would fulfill us." She goes on to explain that if we are relying on a circumstance to make ourselves happy, we may end up bankrupt. Unhappiness is not solved by any one thing (marriage, baby, job, etc.)
3. God created every life to be fruitful. Beth Moore encourages us to remember that the dream of being fruitful is more than just one of physical offspring. I do believe this is true. I believe we are called to the widows and orphans. We are called beyond what our womb can bear.
4. I believe our girlish dream to have babies represent even more than the obvious. I love the way she explains this. She writes: "[Dreams] represent a desire to have fruitful lives, to invest ourselves in something that matters. Something that affects. Something that grows. It not, wouldn't God be cruel to allow any woman to dream of children yet disable her to have them? I don't believe God allows surrendered hearts to continue to long for things He will not ultimately grant in one way or another. Our disappointment with God is often the result of our small thinking."

Another thing Beth Moore mentioned that I never really thought of, is that one day, all of us will be barren. In other words, I will reach an age (soon in my case) that I will not be able to physically have children anymore. Am I to assume that at this point my fruitfulness ends? So true!***

I have been thinking about this. One day my boys will not need me. It's hard to believe that now. But they will lead their own lives. In my case, I feel lead to be a mother for a long time. We see ourselves adopting for many years to come. What about you? How will you continue to be fruitful when the time for physical fruit has passed?***

... just a few notes to share with you that ministered to me. I hope you find something in these words that minister to you.

***A note which I left out prior but might be helpful if you have done the study. I did find that Beth Moore (and other women in our group agreed) trivialized infertility in the sense that she felt that it could be "replaced" by a role of a spiritual mom. I decided not to focus on this in my outline here on the blog and instead just focus from what I did take. That being said, there was quite a bit that I had to leave behind that just wasn't accurate.

Infertility: The Disease We Need To Start Talking About

Silence might be golden in some circumstances, but in the case of infertility it has been downright destructive.

Recently RESOLVE, one of the only organizations dedicated to infertility, made a bold announcement on its website: "People with infertility are being ignored." I always knew that insurance coverage for treatments such as in vitro fertilization (IVF) is scant at best, and that many doctors still don't treat infertility as a major health issue. I've learned that blatant misconceptions persist when it comes to our reproductive health. And it's no secret that the media doesn't cover this subject as often as it should.

However, what I didn't realize is that infertility patients' reluctance to discuss their struggles and advocate for change is directly preventing those affected from getting the support and funding they deserve. As Barbara Collura, executive director of RESOLVE, explains, "Infertility is not being discussed in the general public health realm -- it's not taught in health classes, it's barely touched upon in medical schools, and it's not a priority of any government entity. Yet how can we expect health care providers, educators, our government, and insurance companies to pay attention to infertility when the patients themselves aren't even talking about it?"

Why the silence? People battling infertility are certainly not alone -- a staggering one in eight couples face it -- yet many feel like it is an extremely personal matter not to be shared with anyone but anonymous women and men on message boards. Some say they feel shame for not being able to procreate or for having faulty plumbing, so to speak. Also, in our somewhat still Puritanical society, we've been brought up to believe that sex is a private matter. Discussing it in some circles, even when it pertains to a medical condition, is taboo.

Of course, not everyone feels that way. For instance, while plenty of celebrities would never admit having gone through IVF (even when so many give birth to twins in their 40s), Giuliana Rancic has helped break the mold by publicly sharing her fertility battle via her reality show Giuliana & Bill. "We had signed on to do this show and when we started having trouble getting pregnant, we decided we were going to be honest and reveal what was really going on," says Rancic, who suffered a miscarriage last year after undergoing IVF treatments.

The result of her candidness was both surprising and inspiring. "I started getting up to 100 emails a day from people telling me that I helped them because hearing my story made them feel less alone and ashamed," Rancic explains. "I was shocked by the fact that so many people go through infertility because so few talk about it. And while experiencing it myself has been more difficult than I could have ever imagined, I've found there really is a comfort in numbers."

However, Rancic is still in the minority: It seems that for most men and women facing infertility, it's easier to deal with something so emotionally, physically, and financially draining without having to field questions and opinions from every well-meaning friend, co-worker, or family member. Such comments like "Just go on a vacation, relax, and you'll get pregnant," or "You can always adopt," are far too painful to even acknowledge, so people figure that by remaining silent they'll avoid opening themselves up to such commentary in the first place.

It doesn't help matters that there's no general consensus on how to label infertility. In 2009, the World Health Organization officially defined infertility as a disease. Yet many individuals, organizations, and insurance companies still say that having children is a lifestyle choice and that infertility is not a serious medical issue. Some even liken fertility treatments to cosmetic surgery. But ask the millions of couples desperately trying to get pregnant whether or not having children is a necessity. Why would they subject themselves to months or years of such turmoil if, to them, it weren't essential that they try?

Certainly, there are plenty of valid reasons while this secret exists, but it needs to end. Thirty years ago, breast cancer was where infertility is today -- women just didn't talk about it (a topic I touched upon in a recent blog post). There weren't countless support groups, fundraising walks, and an entire month enveloped in pink. Women battling breast cancer did so in silence and, in turn, many felt isolated and ignored. However, now because there is such an international dialogue about the disease, breast cancer receives multi-million-dollar grants each year in research funding and patients are inundated with an outpouring of support and understanding.

Other cancers, AIDS, and many other illnesses follow the same path from shame to global support and advocacy: Once people start talking about it, the awareness, funding, and answers follow. "The silence is one of the key reasons why the infertility movement is not where it should be," says Collura. "By people speaking out and letting the world know that these are real issues affecting real people, that would impact advocacy, public education, and public policy."

What will it take to bring infertility out of the closet, so to speak? Possibly it would help if more celebrities like Giuliana Rancic came forward and if the media started covering the topic more extensively (as SELF magazine did with a groundbreaking piece on the subject). Maybe we need thousands of infertility patients and advocates to come to Washington D.C. for their Advocacy Day on May 5th rather than a few hundred like in years past. Or perhaps we just need the domino effect -- once a few people experiencing infertility open up, more will follow suit.

I don't know what the magic ingredients are that will take infertility from an issue no one talks about to a banner "pink ribbon" type of cause. The bottom line is that far too many people are suffering. But by suffering in silence, the stigma persists and the advances we need to overcome infertility will never become a reality. As Collura points out, it starts with those struggling with infertility saying, "We matter."

And when they do, the rest of the world must start listening.

Dina Roth Port, a freelance writer for publications such as Glamour, Parenting, andPrevention, is author of Previvors: Facing the Breast Cancer Gene and Making Life-Changing Decisions. Visit her website at www.dinarothport.com. 

Turkish Infertility

I continue to be blessed by the presence of women in my life travelling the road I have previously travelled. I say blessed because their presence reminds me that our own journey through so many difficult years of infertility had reason. It had purpose. They may think for me for standing along side them, but truly, I find I have so much to thank them for. While I was blessed with many people who stood alongside me despite not knowing at all what infertility felt like, the people who can minister best in the darkness are the people who have been in that darkness and know all too perfectly what it feels like. It isn't pain that can ever be explained.

So many women have said to me, "Wendi, I watched you go through it. I felt for you. But I didn't get it until I did it myself." That is very true. Just like I cannot understand the loss of a child, the loss of a parent, the grief of a divorce -- so only those who have walked this road can truly understand the devastation of being barren.

Two of the women that I am praying and joining with in this journey are here in Turkey. There is no REI (Reproductive Endocrinology) department on Incirlik. In fact, if you remember, there isn't even an OB department (thus my departure to Germany in June). These friends are having to traverse the world of a Turkish REI Clinic -- a whole new ball game! I was honored to accompany one of my friends to her appt. prior to her first procedure and will be visiting the Clinic again with another friend who is beginning the search for answers.

Never, ever, did I think I'd find myself in an infertility clinic in Turkey of all places!

A few things jumped out at me during my first appointment:

• There is definitely a language barrier. There is one doctor who speaks very good English, but even that English is accompanied by a thick accent that can make deciphering difficult at times. But how blessed these ladies are for this one English-speaking doctor. Attaining a translator can take up to two weeks of paperwork. Not really possible when you are playing a spur-of-the-minute game like IUI and IVF. There is also a gal who speaks English who works at the front desk. However, despite how kind she is, I have to wonder what defines something as being able to speak English. Her definition is a stretch!
• The Clinic is sparse, as is most Turkish architecture, but very clean, and very comfortable. The one major difference was that on our tour of the facilities, we noted you were to remove your shoes prior to going into the operating room. This was how it was in Nigeria too. There continues to be more of an emphasis on feet than hands when it comes to germs.
• The cost is incredibly less than that in the USA. One round of IVF in the USA runs approximately 10,000USD. One round here in Turkey, closer to 3,000USD. Quite a big difference.
• Childlessness and the desire to fix this issue is a problem everywhere -- around the world. This is a country that looks lightly on abortion and uses it as a means of birth control. People often only have 1 or 2 children with many years inbetween. And yet the desire to have a child is overwhelming, suffocating, and real enough to fund this many floor building in down-town Adana where people who make only $10,000 a year are spending $3,000 of that in trying to have a baby. Adoption is also not done here. It is very rare. I often do not even tell people I am adopting here. They view me as some sort of angel who did a favor to someone. Oh how untrue that is!
• The lingo and protocol is nearly identical to my years doing IUI and IVF. I was amazed at how quickly all the words and phrases came spinning back into my head. Every word he was using. Every phrase. I knew these phrases. I knew these words. I lived these words. Being able to speak the lingo, to understand the lingo, is incredibly helpful when living this journey.

I want to ask you to join with me in prayer for these three friends. Two are here in Turkey. I am standing along side another family friend who is currently at a stand still in their journey. There is the couple we are sponsoring with Because of Isaac. I have another friend waiting for her son via adoption to come home. I have two friends who have been unable to get answers for their issues due to financial setbacks. I don't want to share names as these journeys are intensely personal for some. But would you add these women to your prayers? Please pray for answers. For peace. And, for miracles.
Amen.