I'm Still Here! Except I'm Over There.

My recent blog silence stems from two things: 1) We've had family visiting constantly since June 19. 2) I've been in the process of moving and redesigning my blog.

You're all invited to visit the new Entrusted!

I'm very excited about the new site. I'll still be tinkering for a while, so please browse around and give me your feedback. If you didn't show up on the new blogroll and would like to be listed, send me an email; I'm sure I missed people inadvertently! Also, please update your own blogrolls with my new site address (http://entrusted.wordpress.com), and subscribe to the new feed (there's even a handy button in the new sidebar now!).

Thanks, friends!

Bad News, Good News

When I called Aaron last Thursday to report the heartbreaking news of our negative pregnancy test, he suggested that I take the rest of the afternoon off from work and spend some time crying out to God. He specifically encouraged me to read a few pertinent sections from A Gospel Primer. As I sat on our front porch and wept in weariness of getting bad news again and again, I read the following through my tears:

"[T]he gospel is the one great permanent circumstance in which I live and move; and every hardship in my life is allowed by God only because it serves His gospel purposes in me. When I view my circumstances in this light, I realize that the gospel is not just one piece of good news that fits into my life somewhere among all the bad. I realize instead that the gospel makes genuinely good news out of every other aspect of my life, including my severest trials. The good news about my trials is that God is forcing them to bow to His gospel purposes and do good unto me by improving my character and making me more conformed to the image of Christ" (p. 31-32, emphasis mine).

It's challenging to cling to the good news of the gospel when the bad news feels so very bad. I don't think I'll ever fully understand, in this life, how the trial of infertility is being made good in God's hands. But I trust, even as my eyes are dimmed by tears, that it is so. I trust that the precious news that my Savior has given me all of himself, that I am his and that he won't let me go - that good news will be my everlasting story and song.

Vignettes

I dreamt the same thing twice in one night last week. In my dream, I was thirty-some weeks pregnant and needed to be induced early for some medical reason. We were sure that I and the baby would be fine, and we were excited to meet our little one. Each time, I woke from the dream to remember: my belly was swollen not with child but with hyperstimulation post-transfer. Still, it was a nice dream, and I hoped it boded well for our embryos.

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Our house has a detached garage, with a disheveled, rusty basketball hoop mounted above the garage door. Birds have built their nest in the space between the hoop's backboard and the garage wall. This morning, as I stepped through the garage door to go to the car and leave for my beta appointment, I noticed something near my feet. The small, broken body of a baby bird. It's still there now. I'll ask Aaron to take care of it when he gets home from work; I don't think I could bear it.

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Words from a song I listened to as I drove to the clinic:

So I lay down what I cannot hold in my hands
Every sorrow and hope spinning out of control
And here I find sweet resolution comes in letting go
And we will find shelter here

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Results: Negative.

So very tired of bad news.

Psalm 66

In my Bible reading last week, I encountered Psalm 66 and decided to camp out there until we get the results from this IVF cycle. I've been re-reading it every day, and it's been helping me to maintain trust in God as I wait. Here are some excerpts and reflections:

Shout for joy to God, all the earth;
sing the glory of his name;
give to him glorious praise!
Say to God, "How awesome are your deeds!
So great is your power that your enemies come cringing to you.
All the earth worship you
and sings praises to you;
they sing praises to your name."

God is glorious, and all the earth praises his name. "All the earth" includes me, whether this IVF succeeds or not, and "all the earth" includes our embryos, tiny beings whose microscopic cells magnify their Creator. God's power is great. My enemies as I try to conceive are his enemies: sin, sickness, sorrow and death. His enemies cringe before his power. Sin, sickness, sorrow and death cannot ultimately triumph over me, even if these embryos don't survive.

Come and see what God has done:
he is awesome in his deeds toward the children of man.

I want, whatever the results this week brings, to call others to come and see what God has done for me. I'm praying that I would get to see his awesome deeds toward my children, in bestowing and sustaining life through this IVF. But if that's not how he chooses to work at this time, I can still draw attention to his work in my life, giving me contentment and peace even in the midst of suffering.

Bless our God, O peoples;
let the sound of his praise be heard,
who has kept our soul among the living
and has not let our feet slip.
For you, O God, have tested us;
you have tried us as silver is tried.
You brought us into the net;
you laid a crushing burden on our backs;
you let men ride over our heads;
we went through fire and through water;
yet you have brought us out to a place of abundance.

Throughout these four-and-a-half years of infertility, God's hand has been active. He sent the test, but he has not let me fall and he has sustained life in my soul. When I feel like infertility might crush me, like I might burn or drown in the hardship of it, it brings rest to know that God is in control of this trial and that he will preserve me. Not only will he preserve me, but he will bring me into abundance. I pray that this IVF would yield an abundance of blessing in a child or in children, that he will have seen fit to keep at least one of our embryos' souls among the living. But if I'm not pregnant, he has still brought me the abundant blessing of knowing my Savior better, of sharing in his sufferings.

If I had cherished iniquity in my heart,
the Lord would not have listened.
But truly God has listened;
he has attended to the voice of my prayer.
Blessed be God,
because he has not rejected my prayer
or removed his steadfast love from me!

God listens to my prayers. He listens to my prayers because of his Son. Because I trust in the death and resurrection of Jesus, God has given me a new heart - a heart where sin is still present but where sin has no final power. I can't earn the ear of God, but my justification in Christ ensures that God attends to my voice when I pray. He has heard all of my prayers for children over the past five years, and he has heard my prayers for these three embryos over the past few weeks. I so hope that I will get a positive pregnancy test this week as tangible evidence that he has not rejected my prayer. But whether the results are negative or positive, I have confidence that God will never remove his steadfast love from me, because of my security in Christ.

It's Hard to Type from a Horizontal Position

I've now got three embryos on board (graded as B, B- and C). The transfer went smoothly. However, the nurse said I'm dehydrated and that my ovaries are very enlarged, so I've been upgraded to a high risk of hyperstimulation. I've been put on bed rest for 3-4 days, and I have instructions to add two bottles of protein shake to the 40 oz of water and 60 oz of Gatorade I was already drinking each day.

So now my daily intake of fluids and medications goes something like this: a 5000 unit heparin shot, a large glass of Gatorade, and an antibiotic and breakfast; water and protein shake throughout the morning; baby aspirin, prenatal vitamin, and another large glass of Gatorade with lunch; more water and protein shake during the afternoon; antibiotic and a glass of Gatorade with dinner; a 5000 unit heparin shot and a 1 mL progesterone shot right before bed. And I'm supposed to add estrogen patches to all of that in a few days. Phew!

My three embryos, it's all for you! Please grow and stay awhile.

5-4-3... and let's just stop the countdown right there, please.

Yesterday, the clinic called to let me know that, out of the 28 eggs retrieved, 25 were mature. They froze 20 and attempted to fertilize five with ICSI. Of those five, only four actually did fertilize.

Today, the clinic called to say that one of the four embryos had arrested at one cell, two of them had progressed to two cells, and one had progressed to three cells. The three still-growing embryos all showed some signs of fragmentation and were graded at B-. We're going ahead with a day-3 transfer tomorrow morning, and we'll transfer all of the embryos that are still developing.

When I first heard today's news, I was discouraged by the fact that we seem to have such poor quality embryos from this cycle. But then I remembered what I read and meditated on from Psalm 62 this morning. My soul waits for God alone, not for embryo development or a successful IVF. God is my refuge; I can pour out my disappointment in our embryo growth to him, and he won't let me be shaken by cell numbers or embryo grades. I can trust in him at all times, even when faced with what seems like a sub-optimal transfer, because all power and steadfast love belongs to him. And as Aaron reminded me when I called to pass on the embryo report to him, this could be an opportunity for God to show how great his power is by bringing a pregnancy out of even low-quality embryos. I still find myself needing to fight discouragement, but I'm trying to shelter myself in the Lord.

Please join me in praying that all three of embryos will be thriving tomorrow morning at transfer time, and that at least one of them would implant and become a healthy baby. Thanks, friends!

With all this talk of eggs, Aaron asked if I feel like a hen.

Today didn't go quite as expected.

We showed up at the clinic at the requested 30 minutes before retrieval time. After a few minutes in the waiting room, they took me back to the prep room. Aaron was not allowed to come along. Once I had changed into the hospital gown, the IVF coordinator and the embryologist came in to confirm how many eggs we wanted to fertilize. I told them five and asked if the doctor had decided to go ahead with a transfer this cycle. The IVF coordinator had no idea what I was talking about.

While I've liked this clinic overall, my one concern is a sense that the left hand doesn't know what the right hand is doing; the personnel in different departments don't seem to communicate with each other very well. I've had to keep track of many of the details and advocate for my own care. Thankfully, I have enough experience under my belt to do so. But on egg retrieval day, it would have been nice if everyone was sharing information.

So the IVF coordinator scurried off the ask the doctor. Then she came back and brought me into the operating room. "What did the doctor say?" I asked. She replied, "Oh, he was interrupted by a phone call and couldn't talk." Um, this is kind of important stuff, determining whether we'd be fertilizing any embryos or freezing all the eggs. By now, I was on the operating table, getting an IV inserted and a blood pressure cuff and heart rate monitor put on, and having my legs tied into the stirrups. I desperately wanted my husband with me, but I comforted myself with the truth that God was with me.

Then the doctor came in. There I am, bound to a table by various tubes and tethers, feeling rather vulnerable. And Dr. Werthers starts questioning everything - saying we shouldn't fertilize more than 3 eggs, that maybe we shouldn't fertilize any, saying if we fertilized 5 eggs we might end up with 5 embryos which he absolutely could not transfer, and so on. I challenged him, asking what the odds were that we really would have all 5 eggs develop into viable embryos, bringing up our history. I asked him point blank for his recommendation, which he didn't want to give. I said, "We've been up front with you about our preferences from the start; why is this all coming up now?"

Finally, the doctor asked if I would like Aaron to come to the operating room so that we could make the final decision. When I said yes, he went off to the waiting room. In the meantime, the IVF coordinator started releasing me from the table so that I could sit up. As she did so, she kept rolling her eyes. "Are you rolling your eyes at me or at him?" I asked. "Don't let him pressure you," she said. "You go with your gut. You stick to your plan." Then the anaesthesiologist added a relaxer to my IV drip. "Your heart rate has gone up," he said. No kidding.

Dr. Werthers came back and said Aaron wasn't in the waiting room. (I had encouraged him to go get some lunch.) It was about 1:20 at this point, so time was becoming an issue. We needed to retrieve those eggs before the trigger shot induced ovulation. After a little back and forth and a couple phone calls to Aaron, we decided to go ahead and retrieve the eggs. When I woke up from the anaesthesia, Aaron and I would make the decision about fertilizing eggs.

The egg retrieval went smoothly. Remember how I said my follicles were immeasurable on the ultrasound? Well, they aspirated 40. From those 40 follicles, they got 28 eggs. No wonder I've felt so much more uncomfortable during this IVF!

Shortly after I woke up, Dr. Werthers came back and so did Aaron. Dr. Werthers seemed much calmer, and he said that fertilizing 5 eggs would probably result in 1-3 embryos, which he would feel comfortable transferring. We will go ahead with a transfer this cycle, Lord willing. My progesterone levels are borderline but not so elevated as to cause problems. With so many follicles, I am at some risk for hyperstimulation, but my estrogen levels are low enough that hyperstimulation is not too likely. At the IVF coordinator's urging, I'm drinking lots and lots of fluids to minimize the risk of hyperstimulation even further, trying to ensure that we will be able to transfer the embryos. I'm very achy and swollen, but glad to be through with the hardest part. I should get the first fertilization report tomorrow.

So all's well that ends well, I guess. I'm grateful for the presence and care of my good Shepherd today.