All Aboard!

Embryo transfer went really, really well. We met with the doctor, who gave us the news that two of the embryos arrested at four-cell development, which meant we had two to transfer today (one eight-cell, and one five-cell). We listened with mixed reactions, sadness for the little ones that didn't make it, but relief that we wouldn't have to face the possibility of high-order-multiples or freeze any embryos. We are so grateful for the two little embryos I now have on board, and we pray that we get to meet both of them in about nine months. The actual transfer was pretty incredible. The really kind ultrasound tech explained everything that we were seeing at each moment as the doctor worked. She showed us the "embryo condo" - my uterus with a plush lining. She pointed out the catheter as it entered. Then, she told us to watch carefully as the embryos dropped from the catheter into the uterus - plop! plop! Two little bright spots on a grey screen, two tiny carriers of hope, two minuscule lives winking at us. We were both awed and teary-eyed. What a miracle! What a blessing that we could see that moment when our hopefully-babies entered the womb! How amazing is our Creator God! We were given a picture of the screen with an arrow pointing to our embryos, and I will treasure that picture as we wait two long weeks to find out whether those little lights will grow or fade.

It looks like we have three winners of the Great Embryo Nicknaming Contest of May 2007. Since there are only two embryos at this point, there will have to be some negotiating on the nicknames. The nicknames will debut...sometime. The song, by the way, was "Ashes" by Harrod & Funck.

Unformed Substance (Updated)

Well, we still have four! I could hardly believe it when the nurse called today. Our embryo transfer is scheduled for 11:40 a.m. tomorrow**. Before the transfer, the doctor and embryologist will take time to update us on how the embryos are doing - if they are all still developing normally. We'll be given a recommendation about how many to transfer, but we will have the final say (according to the nurse on the phone today). If we ask them to transfer more than recommended, they'll confirm it with Dr. Peppy before giving us the go-ahead. We continue to feel giddy and petrified at the same time. These little embryos have surged past all expectations...

My faith for the possibilities ahead of us was strengthened this morning by Psalm 139. The Lord knows my frame and all my thoughts and emotions. He knows if I am physically capable of carrying multiples - even quadruplets, if it comes to that! He knows exactly what my response is to this "happy problem." The dark mysteries of life are like bright light for God - he sees clearly where I cannot. Even now, he is intricately knitting and weaving together the unformed substance of our four little embryos. He has planned exactly how many hours or years each embryo will live. Such knowledge is truly too wonderful for me, to lofty for me to attain. So I trust in the One who knows and who reigns and who loves.

*Winners of the embryo nicknaming contest will be announced after we know how many are on board, so it's not too late to cast your vote! (But don't cheat by looking for correct answers in the comments!)

**edited to add: We were not given the option of a 5-day-transfer when the nurse called, and we were glad to have at least one less decision.

Expert in Everything from Embryos to Empires

So I'm actually feeling far from being an expert in embryos right now. But if someone can name the tune/band that gave me my title*, I might consider nicknaming one of the embryos after you. One of the 4 embryos. All four eggs fertilized! I'm feeling very blessed and little overwhelmed right now. The nurse I spoke with didn't have any information on how those four are growing, so we have to wait until tomorrow's phone call for more details and instructions on when to come in for transfer. It will either be a 3-day-transfer on Wednesday, or a 5-day-blastocyst-transfer on Friday. A 5dt is more likely to result in pregnancy, because the embryos that make it that far are stronger, more developed, and more likely to implant. But not all the embryos will make it to day 5, so it raises all sorts of questions for us about what is most respectful to these little potential babies that are growing in petri dishes... This may all be a moot point, because I don't know if we have any say in when we do the transfer. We'll know more tomorrow. I am honestly shocked that all four fertilized. I know that God is sovereign over this, and I am praying that He will cause just the right number to grow and be ready for transfer. If all four keep growing, we'll be faced with some tough decisions about whether to push to transfer all four (yikes!) or to allow a couple to be frozen. We really don't want to freeze any, so we're hoping it doesn't come to that. But does that mean that I am asking God to stop some of these embryos from growing? I don't know, it's all so mind-boggling. Four. Four! FOUR! Lord, have mercy.

*enter your guesses in the comments

I Wanna Be Sedated

Egg retrieval - check. It all went fairly seamlessly. We showed up an hour early, as requested, and then did nothing but sit for an hour in the waiting room. Mysterious... Shortly after 11 a.m., our scheduled appointment time, they brought us back to the recovery room, instructed me to change, and claimed Aaron's specimen from him. We were asked by just about every person we saw, "So you only want 4 eggs fertilized? Is that right? We just want to double-check." Yes, please, just 4. They asked if we were okay with ICSI, which is their standard procedure. We said that was fine, although we were a little curious to find out if Aaron's sperm would be able to fertilize my eggs on their own. But we definitely choose better chances of fertilization over satisfying our curiosity. A very nice nurse took care of me, weighing me, asking me to empty my bladder multiple times (this when I hadn't had anything to eat or drink since the night before - per instructions!), taking my blood pressure, etc. Then she brought me back to the retrieval room. The anesthetist inserted the IV, then made small talk with me, and then I remember nothing. I woke up back in the recovery room with Aaron. He says I seemed awake when they brought me back in on a wheelchair, but that I didn't respond when he kissed me - I have no recollection of that. The friendly nurse brought us both some water, juice, and crackers, checked my blood pressure a few more times, and kept me until I could stand up and use the bathroom. We got 18 eggs - almost an embarrassing wealth when we only want four. But we are grateful that all went well.

I've been lounging on the couch all afternoon. The doctor who did the retrieval told Aaron that I couldn't do any cleaning, cooking, or housework of any form, and that I was not allowed to lift anything heavier than a credit card and a cell phone - cute! My midsection feels pretty sore, but nothing too bad. Aaron gave me the first progesterone-in-oil (PIO) shot tonight. The anticipation of Aaron plunging a long, thick needle into my hip was pretty nerve-wracking, but the actual injection was not so bad. Ice before, massage and heat after definitely seem to help.

I'll post again tomorrow (so many posts lately!) when we get the fertilization report. We're praying hard for just the right number of embryos...

IVF #1 - Mercy!

Small mercies - I did indeed trigger last night, and egg retrieval will be at 11 a.m. on Sunday morning! The voicemail from the nurse (not Nurse Answers, who is off work right now) was lengthy with instructions - trigger, antibiotics, when to eat, what Aaron needs to do, what to wear for egg retrieval (warm comfy clothes and, oddly specific, socks), what time to show up, etc. I'm a little worried that I'll forget something, but I'm sure it will all be fine. It will be nice to be emptied of all these eggs at last. Our biggest prayer right now is that we'll end up with just the right number of fertilized, growing embryos. I think we'll get a fertilization report on Monday.

Great mercies - after weeks of lackluster times in God's word, just when I felt I needed encouragement the most, I was blessed over the past two days by the richness of Isaiah 40:

Comfort, comfort my people, says your God.

My God is inclined, disposed to comfort me.

Every valley shall be lifted up, and every mountain and hill be made low; the uneven ground shall become level, and the rough places a plain. And the glory of the Lord shall be revealed, and all flesh shall see it together, for the mouth of the Lord has spoken.

The roughness of life will be smoothed away one day, if not on earth then in heaven. The valleys, the uphill climbs, the stumbling paths of infertility will play their part in revealing the glory of the Lord.

All flesh is grass, and all its beauty is like the flower of the field. The grass withers, the flower fades when the breath of the Lord blows on it; surely the people are grass. The grass withers, the flower fades, but the word of our God will stand forever.

Infertility, the inadequacies of my body, these are passing. They are temporal, not eternal. Even children, though their souls are eternal, are as fleeting as grass and flowers. If I am granted a baby, he or she will grow quickly, will one day leave me, will one day die. To nurture a soul will be an act of tremendous beauty, but only the Lord stands forever.

To whom then will you compare me, that I should be like him? says the Holy One. Lift up your eyes on high and see: who created these? He who brings out their host by number, calling them by name, by the greatness of his might, and because he is strong in power not one is missing.

The Lord is high and holy, strong and mighty. He has created and counted the countless stars; he upholds them day and night. Yet he is also intimate, calling each star by name. I need to trust that this same God calls me by name and upholds me by his power. He knows exactly if and how and when I will have children. Though I feel a great gaping hole in my heart, not one child is missing.

Why do you say, O Jacob, and speak, O Israel, "My way is hidden from the Lord, and my right is disregarded by my God"?

How often I am guilty of the same questions and complaints. My heart frequently asks why God seems to be disregarding me, overlooking me. Does he know what agonies the way of infertility holds for me? Do not pass me by! Do not abandon me!

Have you not known? Have you not heard? The Lord is the everlasting God, the Creator of the ends of the earth. He does not faint or grow weary; his understanding is unsearchable. He gives power to the faint, and to him who has no might he increases strength. Even youths shall faint and be weary, and young men shall fall exhausted; but they who wait for the Lord shall renew their strength; they shall mount up with wings like eagles; they shall run and not be weary; they shall walk and not faint.

I cannot understand God's ways, how he is working all of these struggles for good, but I can trust him. He is the everlasting Creator, and nothing is out of his hands. He does not grow weary of working in the earth, in my life, and in my heart. I am slogging through the mire, longing for God to renew me and to lift me up on eagle's wings. Though I am weary, faint, and weak, though it seems incomprehensible that I can be restored to joy and peace, I wait on the Lord.

IVF #1 - Are We There Yet?

I'm getting really tired of the everyday appointment thing. I just want to trigger, already! Yesterday morning, I received a 6 a.m. wake-up call to alert me that I needed to go to a different office for monitoring (Wendy the Wander had to suddenly go on bedrest due to preterm labor issues - please pray for her!). I decided to forego the last precious hour of sleep so that I would not have to fight traffic to the clinic. The ultrasound showed about 19 follicles (not counting the biggie), all measuring 12-16mm. My estrogen levels had jumped from around 1100 to 1500, so I lowered my dose of Follistim to 100 units last night. This morning, I was back at my normal clinic, but they were double- and triple-booked due to rearranging all of yesterday's appointments, so I had to wait an hour before I could be seen! This is really unusual at my clinic; I don't think I've ever waited longer than 15 minutes. The large follicle is up to 36mm, and the rest are 17-22mm. I should get a call from the nurse this afternoon, either telling me to trigger tonight or to continue stimming and to schedule a monitoring appointment in the city for tomorrow. I'm really hoping for the former, but I probably ought to start preparing my heart to attend church on Mother's Day.

IVF #1, Still Stimming

(edited to add icon and link for the mention this post got in Mel's Friday Blog Round-Up; thanks for honoring my words, Mel!)

After today's usual ultrasound (big follicle up to 33mm!) and bloodwork, I had a mid-cycle consult with Dr. Peppy. She confirmed that everything looks good, and she said that I'll likely trigger on Friday or Saturday. That means egg retrieval on Sunday or Monday. We're hoping for Sunday - Aaron, because that means we don't have to fight traffic into the city and he doesn't have to take time off work, me because it would be a "Get Out of Mother's Day Free" pass. (What? That smacks of escapism? No, surely not...) This will be the third Mother's Day to see me childless since we started trying to conceive, and I'd really rather not experience that wrenching stab of heartache when all the moms are honored at church. The ladies over a GirlTalk put up a thoughtful post about infertility and Mother's Day. Here's my favorite part:

My heart cries out, “Why, O God, will You not answer this prayer? Why will You not do this simple thing for me and for Your own name’s sake? You do it for so many so easily. Your marvelous grace. Why not to me?” With thoughts like these, it is easy to fall into deep despair, and at times I certainly do. When this happens, God in His time and His various graceful ways, comes to me to remind me that I am not alone.

He does not, as so many do, tell me that “my time will come.” He does not say that if I will just relax and not try so hard, everything will be okay. He does not say, “If you adopt a baby, you’ll get pregnant.” He does say that He is with me. He weeps with me as Jesus wept for Lazarus. He reminds me that He is good and that He can be trusted with my heart. Any doubt of that was wiped away at the Cross.

If you're experiencing infertility, you'll find comfort in the GirlTalk post. If you haven't experienced infertility, you'll gain a little empathy from the GirlTalk post. And this Mother's Day, I ask you to remember those for whom the day is painful - those who don't or can't have children, those who have lost their moms, those who are estranged from their moms, and so on. I know those ladies (myself included) will need the comfort of Christ this weekend.

All the Pretty Bruises

A quick and relief-giving appointment today. Our IVF is not in danger of being cancelled. The lovely Wendy made the same comment as the city nurse, about "letting the big follicle go." I asked her exactly what that meant, and she said that they'll just let it grow to jumbo size, and then drain the fluid from it when they aspirate the rest of the normal follicles. She said it is totally normal and nothing to worry about. Thank goodness! The big follicle is up to 25mm, and the rest are between 10 and 13 mm, "right on track" according to Wendy.

The blood-draw gal "D" (I haven't come up with a clever name for her yet) commented on the bruise that has formed in the crook of my right arm. I keep forgetting to switch out arms for the bloodwork; D said she'll make sure to get the left next time. The bruise doesn't really hurt too much, but I have noticed it when I cross my arms.

Nurse Answers called with the results this afternoon and said we need to slow things down a little bit. She instructed me to lower my dose of Follistim to 150IU, and to stay on the 5 units of Lupron. I also need to start going in for daily monitoring this week. I think egg retrieval will be sometime around the end of this week, but we won't really know for sure until we're closer. I will, of course, keep you posted.

*********************************************

A quote that spoke to me today, from the chapter "Waiting for the Morning" by Dustin Shramek in Suffering and the Sovereignty of God:

"Why is the depth of Christ's pain significant for us?...In the midst of our pain we may feel alone and believe that no one has hurt as badly as we hurt. But it isn't true. Jesus Christ has felt such pain; indeed, he has felt pain that would have destroyed us. He is able to sympathize. ...Jesus himself endured the long night of weeping, and God promises to carry us even when we don't feel his arms around us." (p. 186, 190)

IVF #1, Stim Day 5

The monitoring appointment in the city was pretty much a non-event. Even though I wish a Saturday appointment hadn't caused us to miss out on Tulip Time, I'm glad we had the opportunity to find the downtown clinic BEFORE the day of egg retrieval. This office didn't have any needlecraft of zygotes or embryos like the north suburban clinic, but there were plenty of little fertility goddesses scattered about the place. (My husband knows; he was an archaeology major.) The ultrasound showed I still have that one lead follicle (20mm now) and several smaller ones (7-8mm). The nurse said they'll probably have to just let the big one go - whatever that means. Hopefully I can press Nurse Answers for more, well, answers at tomorrow's scan. In the meantime, I'm continuing on the same 5 units of Lupron and 200 units of Follistim.

After the appointment, we had a leisurely breakfast at this fun little cafe that we discovered last year. While there, we discussed how much rest has been missing from our lives lately. As a result of that talk, we decided to head home rather than going to the Cubs game. (Plus, it was a grey and chilly day, and we weren't really dressed for it.) But in the car on the way out of the city, I started to get anxious about whether we were making the right choice. Silly, in retrospect, but at the time I felt really paralyzed by worries that we weren't spontaneous enough, that we weren't taking full advantage of this season of life, that we were missing out on fun opportunities because it was easier to do the normal, dull, routine things. Thankfully, the Spirit prompted me to share these thoughts with Aaron, rather than stewing over them and waiting for them to pass. It was a little thing, but by humbling myself and being honest, I was able to get a little more clarity and peace as Aaron talked through it with me. And once we got home, we went ahead and purchased tickets for the game today (Sunday). It was my first major league baseball game (I've been to college and minor league games before), and it was at Wrigley (although the ivy isn't green yet), and the Cubs won in the 10th inning - quite exciting!

My internal debate over going to the Saturday game or going home is a small example of the recent pattern of anxiety in my heart. Troubles - big and small - are piling up right now, and I find myself doubting God's goodness and expecting the worst to happen. I won't be able to start working from home as soon as I was wanting, and my fleshly reaction is anger that the Lord would let yet another thing go wrong in my life (even though a month or so ago I was content without even knowing that working from home was a possibility!). I'm almost convinced that this IVF is going to be cancelled, either due to that loner follicle or to not having any eggs fertilize or some other unforeseen hitch. I certainly don't expect an end to suffering and sorrow any time soon. I've lost my hold on hope. I know that all the mounting major and minor mishaps - in work, in fertility, in relationships - don't alter the truth that God is working all things for good and that He is not giving me more than I can bear, but my grasp on that truth is tenuous at best right now. I know that God's kindess to me is shown clearly on the cross, but currently the cross seems dim. I keep reading the Word, singing to God, bringing my requests to the Savior, but light is only coming in glimpses and flashes these days. My soul is weary. Prayers and input are welcome and needed...

Whew! (a.k.a. IVF #1 - I'm losing track)

Apologies for dropping off the face of the (blogging) earth! You know it's bad when your own husband is threatening to post a comment demanding that you update... Here, in a nutshell, are the things that have been keeping me from blogging over the past ten days:

-car repairs (my car unexpectedly & expensively needed new brakes right after I got back from TX)
-visiting with Aaron's family, who are in town for the birth of our new niece, Zoe
-moving to new offices at work (read chaos, upheaval, and great big time vacuum - but the results will be very exciting!)
-scrambling to get tested for gonorrhea & chlamydia, as required by my fertility clinic before we can proceed with IVF, when my OB-GYN failed to perform the tests the first time I asked at my pap smear several weeks ago (thankfully, I was able to get this done just in the nick of time, and the doctor did not charge me since it was their error)
-care group gatherings
-unrelenting sleepiness & overwrought emotions (both perhaps due to Lupron and to the insane busyness, and the latter definitely due to some indwelling sin!)

It's probably a good thing I haven't posted in the midst of all this, because anything I wrote would most likely have been a litany of complaint. Thanks to the prayers and encouragement of friends, some time in God's word, and the counsel of my husband, I am more aware of the grace that is available to me even when I feel overwhelmed by the stuff of life. (Perhaps I will post more on that another time.)

So what, you ask, is going on with this IVF cycle? (Thanks, GLouise, for checking in on me!) The first ten days of Lupron are done. I might have had the infamous Lupron headaches; they were fairly mild, though consistent, but they might also have been due to the ridiculous amount of tension that has lodged in my shoulders and neck. My baseline scan was yesterday, and after Nurse Answers called to say that the ultrasound and bloodwork results look good, I lowered my dose of Lupron (5 units) and started Follistim (200 units) last night. My next monitoring appointment is Saturday, at the downtown office since my suburban branch does not have weekend hours. I'll be back at my normal clinic for an appointment on Monday, and Nurse Answers says I'll be there so much next week that I'll feel like I should move in to their offices. Let the real fun of IVF begin...

Here are a few questions that I forgot to ask Nurse Answers - do any wise IFers have any tips on these things? First, is it okay that I can't ever get all of the air bubbles out of the Lupron shots, and that I always end up with a small itchy welt at the injection site? The welt fades away by the time I wake up in the morning... Also, now that I'm doing two injections a day, can I keep poking the same old spots on my stomach? I know the thigh is supposed to be good for subcutaneous shots, but it's just not as "padded" as the tummy so it kind of weirds me out to think of plunging a needle into my leg. But my stomach is getting covered in tiny dots and bruises... Lastly, is it within the range of normal that I already had one 14mm follicle on day 6 of my cycle after taking Lupron for 10 days? There were some other smaller follicles, too. Wendy Wander's reaction made me think it might be a little strange (and worry that our cycle was going to be cancelled!).

The fact that I have to go in for monitoring on Saturday is somewhat disappointing, because we were planning to go here this weekend. I'm 100% Dutch, so Aaron needs to be initiated into the ways of my people. Alas, it will have to be put off yet another year. Instead, we'll take advantage of being in the city and we might try to catch a Cubs game. (I've lived in the Chicago area for nine years, and I've never been to a game!)

Two more items of note: I am writing and posting this FROM HOME. We've been living in the dark ages (or trying to save a little money) by not having an internet connection at home for the past three years - we've just gotten online at the local library or at work. But as part of the office move mentioned above, I will be working from home, which means we have internet at home now. Hooray! AND check out the link to Grace Covenant Church in the sidebar - same old link, brand shiny new website!

Now, I've got a late night date with some shots...

Have Needles, Will Travel

This weekend we went to Texas. Aaron has business in Dallas today and tomorrow, so we decided to squeeze in a visit to friends and family before his conference. It was a truly delightful time. In the span of 24 hours and 200 miles, we had fellowship with long-standing friends, ate a tasty breakfast with my mom, dad, brother and grandpa, surprised Adam & Brooke (see sidebar) for their much-anticipated baby shower, and enjoyed some Tex-Mex. I flew home this morning, while Aaron stayed on for work. Thanks to all who hosted us, laughed with us, encouraged us, stayed up late with us...

I took my last BCP and started Lupron last night - which meant I traveled cross-country with needles! With cooler pack, medicine vials, alcohol wipes, needles, sharps container, and note from my doctor in tow, I passed rather uneventfully through all the airport security lines. As the PA system blared about the elevated security level, TSA employees basically ignored my explanations and waved me on. One X-ray inspector asked, "Is that food in your bag?" Yes, you know me, I love ingesting sharp, pointy objects... Yesterday evening, we left from Waco at about 8:30 p.m. to head up to Dallas. As we started up I-35, I realized that we would not make it to Dallas before 10 p.m., thereby missing the 7-10 p.m. window in which I was instructed to take the Lupron. I contemplated injecting myself in the car of a 7-Eleven parking lot where we stopped at one point, but ultimately I determined that it was probably okay to take the medicine a little late. Ah, adventures! Nurse Answers said that my next cycle could start any day after I start taking the Lupron. Then I feel like we'll really get started with this IVF.

By the way, we decided to ask the clinic to attempt to fertilize only four eggs. Thanks to all who prayed for us as we made this decision.

IVF #1, Suppression Day 22

Today was the mock embryo transfer/saline sonogram; it went quite smoothly and I hardly felt anything. Dr. Peppy had no problems navigating the catheter through my cervix, so that bodes well for the actual embryo transfer next month. (Random note of interest: "saline sonogram" is the #1 search term that leads people to my blog, to this post.)

Yesterday I received the huge box of all the meds for this IVF. I currently work out of my pastor's home, and his kids are always very excited when I receive packages. When they asked what was in the box, I told them it was medicine. The oldest said, "That must be enough medicine for a whole year!" To which I replied, "Nope, it's only enough for about a month." Awed silence followed... When I looked at the receipt, I praised God for our insurance. The total cost of all the meds: $2153. What we paid: $153! This IVF really would not be an option for us without such excellent coverage.

We would covet your prayers as we finalize our decision about how many eggs to attempt to fertilize. Dr. Peppy and Nurse Answers informed us that the embryology lab recommends that we attempt to fertilize six eggs in order to end up with two embryos to transfer and none to freeze. Six seems a little high to us; we had originally thought to try to fertilize four. We are praying for wisdom, getting counsel from others, and trying to weigh out biblical principles and medical advice. For most of this week, I have been tempted to anxiety about all the decisions and all the procedures. I need to trust that God will not let me be overwhelmed...

IVF #1, Suppression Day 19

Yesterday's "injections lesson" with Nurse Answers was, well, much more than that. It was very informative, if the definition of "informative" is "an overload of overwhelming reams of forms, list of medications, and varieties of very long and sharp needles."

We set the tone well when, about to walk out the door to drive to the appointment, we remembered that we forgot to read through and sign the consent forms. So while we were in the car, I sped-read each one and summarized the options for Aaron. Some choices were rather obvious for us - like initialling the box that says we will not agree to multiple-fetal-reduction. Some were rather morbid - who would have legal ownership of our embryos if one or both of us were to die? Taken as a whole, though, I am glad that the consent forms put our wishes for IVF in writing - things like limiting the number of eggs fertilized, not granting permission for any viable embryos to be destroyed. It is assuring to have legal documentation that this IVF will be carried out within the boundaries that we feel are pleasing to God.

So after Nurse Answers witnessed our signatures to all the various and sundry contracts, she handed me my IVF schedule. Going through that list definitely brought home to Aaron and me how intensive this procedure will be. I thought I had a pretty good idea what to expect, but I was somewhat shell-shocked to find out how many things happen during IVF that I had NO IDEA about. I will be taking a LOT of medications! I knew about the Lupron (which I start on Sunday), the Follistim, the Ovidrel, the progesterone. But the antibiotics (because my body will be invaded by many foreign objects)! The immunosuppressors (so my body doesn't reject the embryos as hostile)! The baby aspirin (to increase blood flow to the uterus)! Oh my! I am about to become a walking pharmacopoeia*. Aaron and I exchanged many wide-eyed looks as we went over the schedule, and Nurse Answers kept reminding us that we won't be doing everything at once. Thank the Lord for that! I certainly don't feel like I will remember all the instructions we were given for each medication. And Aaron sticking a large, long needle into a blue foam block does not seem like enough practice for when he will be injecting progesterone into the muscle in my rear! But we'll take each bit as it comes, trusting God to provide the grace and strength for each day...

This IVF cycle finally feels real. We are actually doing this. We are so glad that we are resting in God's hands, that he is present with us in every moment.

*For the record, I spelled that right on the very first try!

Heard Around Town Last Week

Me to non-fertility-specialist nurse at annual check-up: "What prescriptions am I taking daily? Um, let me see... birth control pills... and prenatal vitamins."

OB-GYN who did not initially take seriously my concerns about infertility, whose office failed to diagnose my luteal phase defect, and who finally referred me to Dr. Peppy a year ago: "Hmm, I thought I'd be seeing you back here before now... Well, if you want to get pregnant badly enough, it'll happen." (Is that what he learned in med school?)

Five-year-old nephew to me: "You're not a real grown-up until you have babies." (This is the same nephew who has offered up sweet prayers for his uncle and aunt to have kids.)

Thank the Lord for a sense of humor!

IVF #1, Suppression Day 14

We had our IVF consult with Dr. Peppy yesterday morning, and it went pretty well. I had previously mentioned to her our preliminary concerns about doing IVF in a way that suits our conscience, and yesterday Aaron and I were able to talk about wishes out with her more clearly. She understands that we do not want to freeze or discard any embryos, and she will work with us to comply with our desires. She e-mailed the embryology lab to find out how many eggs we ought to fertilize to end up with 1 or 2 viable embryos to transfer, and I'm supposed to follow up with her next week to find out the response. Dr. Peppy's guess was that we ought to attempt to fertilize 3 or 4 eggs, which is in line with what Aaron and I anticipated. With an 80% fertilization rate, trying to fertilize 3-4 eggs should yield the targeted 1-2 embryos. (It is so strange to talk about the creation of life in terms of such statistics! I'm thankful that new life is really in the hands of our sovereign God, and not dictated by percentages.) We asked if the clinic would allow us to transfer back 3 embryos if we ended up with that many, and Dr. Peppy seemed pretty adamant that the clinic would not want to transfer more than two embryos, since I am under 30 and this is our first IVF. She didn't rule it out completely, but she copied the ASRM (American Society for Reproductive Medicine) guidelines for us. We also asked if they would be willing to transfer back non-viable embryos (ones that have stopped growing, no cell division) along with the viable, growing ones. Basically, we thought we would be more comfortable letting the non-viable embryos at least have a chance in the uterus, and we figured it wouldn't make a difference to the medical professionals whether those embryos languished in a petri dish or in my womb. However, Dr. Peppy said that is not an option, because transferring back non-viable embryos might interfere with the implantation and growth of any viable embryos. I feel okay with that, since a non-growing embryo is not really alive anymore, and we would not want to harm or hinder the embryos that are alive. The beginnings of life are so mysterious, but all we can do is operate on the principle that life begins at conception and trust God with all the miraculous minutiae.

Dr. Peppy said two things at the consult that particularly surprised me. One is that the lab might use intracytoplasmic sperm injection (ICSI) to fertilize our eggs. I thought that ICSI was normally reserved for more extreme male factor infertility, but I guess our fertility center uses it pretty much interchangeably with the more standard practise of allowing fertilization to happen "naturally" in the petri dish. In fact, Dr. Peppy said they could even do a 50/50 split between ICSI and standard fertilization. I had no idea that was ever done! The second surprising bit of information is that our odds of success are not lowered by the limited number of eggs we are allowing to be fertilized. I thought that surely Dr. Peppy would rescind her prediction of a 50-55% success rate for our IVF. But apparently that statistic is based on our ages and on transferring 1-2 embryos, regardless of the number of eggs fertilized. Pretty good news, I thought!

So after the consult, here is our IVF plan:
I continue birth control pills until April 22, then I will start Lupron shots for about 10 days. On April 16, Aaron and I will get an hour-long lesson on all the new injections from Nurse Answers. April 20, Dr. Peppy will do a mock transfer and saline sonogram on me. Sometime around the beginning of May, I will start Follistim injections to stimulate ovarian production, and I will go in for monitoring (ultrasound & bloodwork) approximately every other day. Once the follicles look ready, I'll take the Ovidrel trigger shot. All of the eggs will be retrieved, the lab will attempt to fertilize 3-4 of those, and hopefully we'll have 1-2 embryos to transfer back a couple days later. Then I will start daily progesterone-in-oil (PIO) injections while we wait two weeks to find out if any transferred embryos actually implanted to result in pregnancy.

If you didn't catch all that, don't worry - I'm sure I'll share plenty of details about each step along the way!

Like a Barren Tree, Part 4

Having seen the root of my sinful responses to the affliction of infertility, and having seen the effect of the cross of Christ on my heart, I can now turn to change with freedom and hope. The third tree of the Three Trees diagram has deep, rich, healthy roots and blooms with pleasing, sweet fruit.

Good Root - What SHOULD you desire, love, fear, believe in this circumstance? What truths should you believe about God, yourself, and others? What does Scripture encourage you to desire, fear, and believe?

I should desire that God be glorified through the trial of infertility, as he develops perseverance, character, and hope in me (Romans 5:3-5). I should believe that God is working infertility for good in my life (Romans 8:28). I should love my Savior more than the idea of having children. I should be satisfied in Christ.

Good Fruit - What SHOULD you feel, think, say, or do if you are loving God more than anything else?

I should trust God for my future and my family. I should be grateful for my salvation, my blessings, and my difficulties. I should rejoice with others and extend compassion and grace to others. I should seek refuge in my Redeemer.

Consequences - What are the consequences?

I will experience peace, rest, joy, and hope. My life will bring honor to God and encouragement to others.

The Three Trees diagram has been such a help to me over the course of this battle against infertility and all the sin it unearths in my heart. If you are currently facing difficulty, if you are seeing negative patterns in your life, don't be disheartened. There is a great Savior who has borne the burden of sin and suffering, who extends a lifeline to lift us out of our dark holes. His Word promises hope: "Now may the God of peace himself sanctify you completely, and may your whole spirit and soul and body be kept blameless at the coming of our Lord Jesus Christ. He who calls you is faithful; he will surely do it" (1 Thessalonians 5:23-24).

Like a Barren Tree, Part 3

(See Part 1 here, and Part 2 here.)

So now that I’ve dug up the dirt and uncovered the gnarled roots of my sin, where can I find hope and help? At the cross. At the cross, where God in the flesh was wounded for my transgressions and crushed for my iniquities. At the cross, where the perfect, spotless Lamb suffered meekly in my place. At the cross, where Immanuel - God with us – was forsaken by the Father so that I would never be. At the cross, where grace flows freely with the blood of Christ.

(Continuing with the Three Trees diagram...)

The Cross – How does the reality of Christ’s finished work affect your circumstances and your heart? Will you turn from the lies you have practiced and believe? Will you believe the truth of the Gospel?

The cross reminds me that my worst problem is my sin, not my infertility, and the cross provides the solution for my sin. When I feel like I deserve the blessing of a child, the cross reminds me that I have already received much better than I deserve. Because of my sin, I deserved the just punishment of death; because of Christ, who bore that punishment, I receive a relationship with God and the hope of heaven, and this should be enough to fill me with joy. Through the finished work of the cross, God can change my heart to be content with whatever circumstances he ordains for my life.

On this Good Friday, I remember the cross. I mourn the death of my Savior, and I rejoice in the love and forgiveness he extends to me with outstretched arms and pierced hands.

Like a Barren Tree, Part 2

(Read Part 1 here.)

The Three Trees diagram has a few basic components. One is called the "heat" - the circumstances of our lives that beat down like a desert sun. Next, there is the bad fruit - the crop of ungodly behaviors and thoughts that ripen under the heat. The bad fruit comes from a bad root - the wrong beliefs and inordinate desires that yield rotten fruit. The bad fruit and bad root make up the first tree. The second tree is the cross. The cross represents the Savior's work that frees us, forgives us, and transforms us. Applying the cross to our lives leads us to the third tree. The third tree has good roots - true and right beliefs about God and ourselves. Good roots produce good fruit - actions and thoughts that are pleasing to God, blossoming even under harsh heat.

This post will describe the heat and the thorny tree in my life:

Heat - Describe the situation/trial you are facing. What happened? Who was involved?
My situation is 2+ years of infertility, with no definite end in sight. I have endured month after month of disappointed expectations. I have seen many other friends blessed with children. My husband and I have undergone lots of medical procedures and have been faced with hard decisions about how to build our family.

Bad Fruit - How did you respond? What did you feel, think, say, do? What does Scripture say about these responses?
I have felt jealous of others, thinking that I deserve children or wondering why others seem to deserve children when I don't. I feel self-pity as I watch time slip by and see milestones pass - holidays, birthdays, years, etc. I feel weariness, grow tired of the burden of ongoing affliction. I have fearful and anxious thoughts about the future, often expecting only more difficulty from God's hand. Scripture says that envy, self-pity, fear, and anxiety are sinful.

Bad Root - What did you want, fear, believe? What lies are you believing about God, yourself, and others? What does Scripture say about these desires, fears, and beliefs?
I want a child, and I want one in my own time and way. I fear that God will never give me what I want. I believe that I cannot be content or satisfied without a child. I believe the lie that God is not good or kind. I believe the lie that I need more than my Savior. Scripture says that I have no good apart from God, that I can be content in all circumstances, that I need to submit my desires to the Lord.

Consequences - What are the consequences?
As a result of the bad root and fruit, I experience anguish and disappointment. I lack hope and joy. I let my fearful thoughts spin out of control. I encounter challenges in friendships. I seek refuge in things other than the Lord. I complain. I judge others as insensitive or uncaring about infertility.

Oh, what a desperate sinner I am! But these questions distill the confusing barrage of emotions and thoughts that accompany my infertility into a clearer view of how barren my heart is without grace. Stay tuned for part 3, where the cross provides mercy in time of need.

IVF #1, Suppression Day 5

For the first time ever after a medicated cycle, I am cyst free! After yesterday's ultrasound and bloodwork, I have the green light to begin suppression for our first IVF cycle. For those of you unfamiliar with the IVF protocol, the first month of the process involves suppressing my hormones and ovaries. This will give the medical team greater control over my egg production when we stimulate my system next month, so that hopefully we can avoid over-stimming. For the purposes of suppression, I will be on birth control pills for 21 days (starting yesterday), and then I will use Lupron shots for about a week. I am praying for minimal side effects from both medications.

On April 11, Aaron and I will have a consultation with Dr. Peppy to determine all the logistics of the actual retrieval of eggs and transfer of embryos. I'm working on a list of questions to ask at that consult. One that I am most curious about is if there is an upper limit to the number of embryos they will transfer. If there is, that will automatically determine for us how many eggs we will attempt to fertilize, since we don't want to freeze or discard any embryos. For those who have done or considered IVF, are there any other questions you recommend asking Dr. Peppy?

As we begin this first IVF, we are praying that God will direct us each step of the way. As far as we can tell, it seems possible for us to pursue IVF in a way that honors God and that honors life. If there is some red flag we are not seeing, however, we are asking God to clearly stop us from going forward. During this month of suppression, we are holding our ideas about IVF with open hands and continuing to seek counsel from others. If you are reading this, your prayers, questions, and input are welcome!

Like a Barren Tree, Part 1

Lately in church and in our care group, we have been learning about a practical strategy for sanctification called the Three Trees Diagram. This model is based on Luke 6:43-45, where Jesus teaches that behavior grows out of our hearts just like fruit grows out of a tree. If a tree is producing rotten fruit, you have to do more than just get rid of the bad fruit - you have to find out what is wrong with the tree. In the same way, if there is sinful behavior in my life (words, thoughts, deeds) I need to find out what is wrong with my heart (the sum of my inner self). The fruit of my behavior grows out of the roots of my heart. Any attempt to address my thoughts and actions needs to begin by finding the problem in my heart.

All too often, I would rather look in other places for the problem. I would rather blame other people - "If that person didn't flaunt her pregnancy, I wouldn't feel so jealous!" Or I would rather blame my circumstances - "Anyone going through infertility has a right to the occasional pity-party!" Infertility is very trying. People who don't seem to understand or care what I am going through are tempting. But my response to those trials and temptations comes from my heart. Those outward influences can't force me into any specific thoughts or actions. In the realm of infertility, people have a variety of ways of reacting and dealing with their inability to conceive (anger, depression, determination, etc.). In my own life, I respond to the same circumstance - like a negative pregnancy test - in different ways (devastation, numbness, godly grief). What makes the difference? The heart.

It's not an easy thing to admit that my worst problem is my own heart. But if I try to locate the problem anywhere else, then I will miss the solution found in Christ. Seeing my heart as the root of all my good and bad behavior causes me to see that I am a worse sinner than I have yet dared to admit. But once I see that, I can see how great a Savior I have, how God has provided a much better solution than I dared to dream. And that brings hope. Even if I remain infertile for the rest of my life, my heart can change from a barren tree to a bountifully fruitful tree.

I plan to take a few posts to walk through an example of the Three Trees diagram in my own life. You can listen here (3/18 & 3/25) to the messages that explain the diagram.

Round 10, Day 25 - Updated

These are the verses I read this morning to prepare for the day of results for this cycle:

Isaiah 43:1-2
But now thus says the Lord, he who created you, O Jacob, he who formed you, O Israel: "Fear not, for I have redeemed you; I have called you by name, you are mine. When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you."

These are the words that I am clinging to after a phone call with negative results.

I am grieving the end of another hope for pregnancy, but I know that I will not be overwhelmed by these sorrows because of my great and personal Redeemer.

Aaron and I need to decide tonight if we will go forward with IVF*. Please pray for us to be given much wisdom and guidance by the Holy Spirit.

*Update: To clarify, we needed to decide last night if we wanted to go forward with IVF right away, because of the time needed to get insurance approval. After we talked and prayed last night, I called the clinic this morning to ask them to start the paperwork for an IVF cycle. We will probably start the protocol next week.

Reading "The Infertility Companion"

The chapter I reviewed in my previous post gave overview guidelines for thinking about IVF; The Infertility Companion by Sandra Glahn and Dr. William Cutrer dug into the nitty-gritty details. Their book covers a lot of ground, from the emotional, marital, and spiritual aspects of infertility, to the medical process of diagnosing infertility, to the details and ethics of ART procedures.

In a section about the stories of barren women in the Bible, the following quote struck me: "Faith is not so much believing God will provide a child; rather, it's believing that nothing is too hard for him. And that involves believing that his ways, while mysterious, are trustworthy. He is still good, even if we don't have a biological child. If he knew it were the very best thing for us, he would cause us to conceive." (They were writing specifically about Sarah here, who laughed when an angel of the Lord told her in her 90s that she was about to have a child and who was later commended for her faith.) Throughout this trial, I've often wondered what hope and faith look like specifically in the face of infertility. If I lose my optimism that we will conceive, does that mean I am lacking trust in God? This quote helped me to make a better, clearer distinction. I don't know if God will provide a child for our family, and I don't know what means he will use if he does do so, but I do know that nothing is too hard for him and that all that he does is good. That kind of faith inspires me to keep asking for a child, even against the odds, while knowing that my trust in God will not be disappointed, even if I never have children.

After giving very specific details about various infertility treatments (where I learned that 50% of frozen embryos don't survive thaw - yikes! even more reason to avoid freezing embryos!), the authors asked whether we should do any of the ARTs that we can do. They offered both scriptural and general ethical principles for evaluation. In their chapter on biblical principles, I appreciated the recommendation to make your church part of the decision-making process. Another helpful recommendation is to make the commands to love God and to love others the foundation of all our decision-making (Matt. 22:37-39). They also addressed the importance of respecting the sanctity of human life. These are all principles that I want to apply as we consider IVF.

In the chapter on general ethical principles, the authors offered a construct that evaluates four factors: beneficence, nonmaleficence, autonomy, and justice. In layman's terms, that means asking if something does good, does no harm, respects the persons involved, and does what is right and equitable. Application of these principles yielded very specific recommendations for pursuing IVF:

Couples can do IVF while complying with all the ethical principles if they honor life at the one-cell stage. That means deciding that every embryo must get the best possible chance to live. How can couples make sure every embryo gets such a chance? They begin by allowing to be created only the number of embryos that they are willing to carry to term in that cycle in the event that all embryos implant. ... When and if fertilization takes place and cell division indicates that DNA has aligned, all embryos - regardless of "quality" - are then transferred, each having an equal chance at being carried to term (p. 174).

I am comfortable with that recommendation. Though I am still not completely sure that I want to do IVF, this informative book gave me a clearer handle on the practicals and principles involved.

ART and the Heart

I'd like to dedicate a few posts to reviewing some of the reading I've done with the intent of making an informed, biblical decision about what family-building path to pursue next (if this IUI is not successful). For some of my previous thoughts on this decision, read this, this, this, and this.

A short, but helpful, resource I found was the chapter "To Have or Not to Have Children: Special Issues Related to the Family (Part 1)" in Andreas Kostenberger's book, God, Marriage, and Family. The chapter begins by saying that "there is perhaps no one who can better appreciate the value of children today than a woman who is unable to conceive and who desperately wants to have children of her own." The section that specifically addresses artificial reproductive technologies (ART) kicks off with this sentence: "In light of the clear scriptural mandate for couples to 'be fruitful and multiple' (Gen. 1:28), one of the more difficult trials a married couple can face is the inability to have children." Clearly, the author has empathy for the infertile, huh?

After a brief description of various ART procedures, he gives some principles for evaluating the ethics of it all. The principles are 1) respect for the sanctity of human life, 2) respect for all human beings as image bearers, 3) respect for the fidelity of the marital bond, and 4) the heart of the one wanting to use ART. As relates to IVF, principle #1 means being willing to transfer and carry to full term every embryo created, and principle #2 means generally not freezing embryos. I agree with both of those applications. Principle #3 indicates that doing IVF with donor eggs or sperm is questionable, but I wonder if it has any implications for embryo adoption? I understand that combining the wife's egg with donor sperm or vice versa could be considered an intrusion into the exclusive bond of marriage, but would carrying an embryo with no genetic material from either spouse be a similar intrusion? Is embryo adoption essentially the same as standard adoption, or does pregnancy - the mingling of that embryo with the wife's body - make it different? We're not actually contemplating embryo adoption right now, but these are still interesting questions to consider. Principle #4 was the most illuminating:

A fourth and final principle that ought to guide the evaluation of whether or not to use reproductive technologies relates not so much to the form of technology but the heart of the one wanting to use it. While the desire to have and raise genetically related children is grounded in the created norms and cemented in God's imperative for us to "be fruitful and multiply," it is nonetheless important not to place one's hope or sense of worth too greatly on one's ability to have children. The final hope of the Christian does not lie in the ability to manipulate human reproductive systems, nor in the ability to have children at all. Whether it be through direct miraculous intervention (as in Hannah's case) or through the technological advancements made possible through the minds God has given us, children are a gift from God. Beyond this, Scripture indicates that our ultimate hope lies not in our ability to have children but rather in our Savior Jesus Christ (p. 147).

I need to hold fast to what is said here! As we consider the option of IVF, I need to keep asking myself: Am I looking for my identity in the experience pregnancy and childbirth, or in my sovereign Creator? Am I placing my hope in the possibility of a conception carried to full-term, or in my Savior who will bring me from this vale of groaning to the bliss of heaven? I think we could do IVF in a way that honors life. But if it is to be done in a way that honors God, I must make sure that my desire for a child is not blown out of proportion, and object to be won willy-nilly, but rather that it is in its proper place, submitted to God's good will.

Round 10, Day 18 - In Which Everything Is No Longer Perfect

Lovely follicles, perfect lining, excellent sperm count...

Abysmally low progesterone.

9.3 wupmL (That's whatever-units-per-milliliter, in case you need a refresher on my highly scientific terminology.) While this is still double my natural level of 4.5 wupmL, it is far below the level of 20 wupmL that my clinic wants to see on a medicated cycle. I guess Follistim needed to whisper at my ovaries a little more forcefully. So now I get to start using progesterone suppositories. Can I just say that I dread this much more than giving myself shots? I guess my pain tolerance is distinctly higher than my grossness tolerance. I mean, really, ew. But it will all be worth it if we get a positive result next week.

In case you want to read about something more interesting and less disgusting than progesterone suppositories, go check out Carolyn McCulley's blog, SoloFemininity (link in sidebar). She is starting a series on the topic of suffering, and her inaugural post quotes a chapter that is the best thing I've read about suffering. In fact, I had planned to post some quotes and reflections on that same chapter myself. Maybe I will still do so at some point, but Carolyn probably says it better than I could. Now, why are you still reading my blog? Go, read hers!

Bepa's Almond Koek

As promised, here is the recipe from my mom's grandmother:

*2 cups sugar
*2 cups flour
*5 eggs
*2 tsp almond extract
*1 tsp vanilla extract
*1/2 lb butter (softened or melted)

Mix all ingredients together thoroughly. Pour batter into a loaf pan, and bake at 350F for 1 1/4 - 1 1/2 hours. (This really varies by oven. I usually check it at 45 minutes and cover it with foil if the top is browning too fast. It'll probably take a few tries to get it so the edges don't come out dry; you can also use mini-loaf pans to make it easier to cook evenly.) Koek is done when a knife inserted in the middle comes out clean.

Enjoy the tasty Dutch treat!

Homemaking Meme

I saw this over at another blog and thought I'd give it a whirl:

Aprons (Y/N): Yes! I hadn't been cooking for too long before I got tired of splattering oil or batter or sauces all over myself when preparing to have company. (Or just tired of splattering myself, period. Because that means I have to wash clothes before I've worn them the requisite 5-10 times.) Just ask my husband - I love my apron and wear it almost daily. It keeps me fresh, it gives me a place to wipe my hands other than the dishtowel, and it makes a pretty decoration when hanging on its hook.

Baking (Favorite thing to bake): Pumpkin chocolate chip bars are what I bake the most. Followed in a close second by almond koek (family recipe for a Dutch almond pound cake).

Clothesline (Y/N): Umm, no. But in winter, the steam from our dryer makes a lovely, fresh-scented mist billowing out of our apartment building. That's got similar aesthetic charm, right?

Donuts: Growing up, my family used to have donuts as a special treat on Sundays. Store-bought, not homemade. (Although my mom occasionally made oliebollen, another Dutch dessert.) I've never attempted to make my own donuts, but I often wonder if it is kosher to just take the free donut without making any purchase when the Krispy Kreme "Hot Donuts Now" sign is on.

Every Day (One homemaking thing you do every day): Applying a loose definition of "every," it's a tie between making the bed and cooking dinner.

Freezer (Do you have a separate deep freeze?): No. See reference to apartment life under clothesline.

Garbage Disposal (Y/N): Yes, and we are still grateful for it 3 years after leaving our first apartment which had none.

Handbook (What is your favorite homemaking resource?): Everyday Food Magazine

Ironing (Love it or hate it?): I tend to put it off, so I guess that tips me toward the "hate" side of the balance. But it's not so bad now that we send Aaron's shirts to the cleaners.

Junk drawer (Y/N) (Where?): It's more like a whole junk area, and it is our desk and surrounding floor space.

Kitchen (Design and decorating): Considering that we rent and thus did not have a lot of choice in kitchen design, I like our kitchen. It has tile floor, faux wood cabinets, and is open above the countertops on the side that faces the rest of the living area (I especially like this feature when we have people over). The decorations are mostly contributed by Aaron - a wood-art-thingy depicting the four seasons, inherited from his great-aunt, and a water-color of a pear that he bought in Honduras. Also, the apron!

Love (What is your favorite part of homemaking?): Cooking. I never thought I would like it (I have a distaste for getting my hands messy), but my inner-gourmet fought its way out!

Mop (Y/N): Yes, although Aaron can't tell when the tile is dirty.

Oven (Do you use the window or open the door to check?): Both. I usually try to look through the window, can't see clearly enough, then crack the door for a better view.

Pizza (What do you put on yours?): Pepperoni. Or tomato and basil.

Quiet (What do you do during the day when you get a quiet moment?): Read. Oh, and did I mention that I read? And if I have a little extra time, I'll read.

Recipe card box (Y/N): Yes, but the recipes in there were collected before I really knew what to do in the kitchen, so I never open the box anymore.

Style of house: one-bedroom apartment

Tablecloths and napkins? I really like tablecloths (I have one that matches my apron!), but we don't use napkins too much - just occasionally for company.

Under the kitchen sink (Organized or toxic wasteland?): Decently organized.

Vacuum (How many times per week?): Once. Probably twice if we have had small group or nephews at our house - both tend to leave trails of crumbs.

Wash (How many loads of laundry do you do in a week?): Two or three.

X's (Do you keep a daily list of things to do and cross them off?): Only on Mondays.

Yard (Who does what?): Apartment = no yard. But I like to have potted plants on our patio, and Aaron grills.

Zzz's: We try to go to bed by 10 p.m., but lately 11 is the new 10.

Round 10, Day 11

Single, female gamete who likes Follistim and a fast-paced lifestyle looking for single, male gamete who wants to nestle up in a "perfect" plush home. No preference between type-X or type-Y personality. Might be willing to subdivide or to introduce my friends to your friends. Those with square heads or three tails need not apply.

Our IUI this morning went very well. We felt fairly peaceful all morning, worlds away from our first anxiety-ridden IUI. Everything happened according to plan. Aaron's counts were nice and high again - good volume and motility. From our limited human perspective, all the right factors are in place for conception. But we are very aware that "as you do not know the way the spirit comes to the bones in the womb of a woman with child, so you do not know the work of God who makes everything" (Ecclesiastes 11:5). We're praying that the Lord will see fit to begin a new life today, and we trust that no matter what happens he will be lavishing kindness on us. Let the waiting begin...

Round 10, Day 9 *updated*

My visit to the clinic went swimmingly this morning. Wendy (confirmed: she's pregnant, due in June) told me that everything looks perfect! I have two good-sized follicles on my right ovary (19mm, 16mm) and three medium-sized ones on the left (15mm, 13mm, 11mm - I think). I was nervous about overstimming on injectables, but apparently Follistim whispers sweet nothings to my ovaries where Clomid tended to make them manic. Also, my lining was a nice cushy 12mm, much better than the 5-8mm for our previous IUIs. I'm waiting for a phone call with results from my bloodwork to determine how many more days of Follistim and when I should trigger ovulation, but it looks like our IUI will be either Wednesday or Thursday.

*update*
Wednesday morning it is. Please pray for all to go smoothly, and Lord willing, successfully!

Round 10, Day 6 / Romans 6:12-14

Friday ultrasound & bloodwork: check. Veins in right arm acting rebellious: check. Veins in left arm giving up the goods: check. Enough follicle production after two days of meds to call for lower doses over the weekend: check. Hassle with various pharmacy representatives trying to get more of said meds by tomorrow: check. All systems go; prepare to repeat on Monday.

*************************************

Last Sunday, Tab continued our Romans series and preached on 6:12-14. He talked about resisting sin by presenting ourselves to God as instruments of righteousness. In light of my recent struggles with fearfulness, I was helped by the idea of specifically presenting my thought-life to righteousness, using my mind as a weapon against the enemy within. When I am tempted to imagine the worst-case scenario, I want to instead try to think on "whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable" (Philippians 4:8). When I irrationally worry that Aaron will die before I have the chance to bear his children, or when I start to assume that we will experience all the worst odds of infertility, I am trying to ask myself: "What is true?" The truth is that I don't know the future, and that such knowledge would be too much for me. The truth is that right now is full of blessing, even if it is also full of hardship. The truth is that I have a faithful God who sent his Son to die on the cross for me and who sympathizes with my sorrow and who works all things for my good. My frightful worries are not true, nor are they lovely. Finding shelter and rest in the hands of my Lord is lovely.

Perchance to Dream*

Aaron habitually asks me in the morning if I had any dreams. He often gets a lengthy, detailed answer. When I dream, I do so vividly, and when I start to recount a dream, all the crazy specifics start to come back to me. (Aaron's favorite dream of mine is one where I was a fork hiding out in a potted plant, kissing a spoon. Analyze that.) Over the past few weeks, the stage of my somnolent mind put on a couple of infertility spectaculars.

In the first one, I had finally managed to get pregnant and gave birth at 19 weeks, and the baby was fine! (Subconscious probably influenced by the story swirling around in the news of the preemie that had survived birth just before 21 weeks.) We were so happy, and I kept my baby boy by my side at all times. At one point, I dreamt that the baby was nursing; I peeked under the blanket covering us and gazed in awe at his little head as I felt him latch and thought, "Wow! I can't believe we're really getting this nursing thing so well!" Flash to a new scene - Aaron & I are driving to meet some friends (mostly people we were RAs with in college) at a coffee shop for a concert. Baby is in a sling with me in the front passenger seat, because his unexpectedly early birth meant that we hadn't had a chance to buy a car seat. We made a wrong turn and started up this mountain road made up entirely of hairpin turns. Since the road behind us was clear, we decided to reverse down the road rather than executing a very tight turn-around. I got out of the car to direct Aaron, and I stood on the side of the road munching a piece of toast. Suddenly, in that weirdly clear dream-logic, I realized that the piece of toast was my baby, and I was half-way through eating him! Panicked, I tried to hide what I had done by shoving the remaining portion of toast back into the sling, pressing it to my body, and praying, "Please grow back, please grow back." I got back in the car with Aaron and we drove on to the coffee shop and met our friends, and all the while I am fearfully keeping secret the half-eaten toast-baby, trying to deftly avoid all questions and requests to see the baby. That's when I woke up, feeling horribly unfit to ever be a mother. Disturbing and vivid, no?

The second dream, I woke up laughing. We were in church, and our friend James was speaking a prophetic word to all the infertile women in the congregation. (Um, that would be me. But in the dream I wasn't the only one.) He was fervently pacing the stage, microphone in hand, shouting, and generally carrying on in a rather disorderly manner - in other words, not like his real self at all and not in a way that would ever be permitted by our pastors! As James hysterically prayed for all the infertiles, he suddenly burst out in a strange language, commanding, "Eine...Nova...Nueve...APPLE!" Which translated, meant, "One...two...three...OVULATE!" At this point, I surfaced from slumber to hear Aaron asking me what was so funny. I wasn't conscious enough to tell him before I fell back asleep, but when our alarm went off later in the morning I told him, barely able to squeak out the last part as laughter prevented normal breathing.

I like the dream behind door number 2 better, don't you?

*Unprecedented! Three posts in as many days! And I'll probably post again tomorrow!

Round 10, Day 4

Ultrasound this morning revealed absolutely no cysts - yippee! We can proceed with our first cycle of injectibles and IUI. Daily self-administered shots, here I come... I didn't realize that injectibles require more monitoring, so I was surprised to find out that I will now have ultrasounds and bloodwork every two or three days instead of once a week. More reasons to be grateful for a flexible job and fantastic insurance. On a side note, I think Nurse Answers and Wendy the Wander are both pregnant. Wendy was out today, so I didn't have the chance to observe if the belly that seemed to be lurking under her scrubs last month has grown. Perhaps she was taking the day off for a prenatal appointment? Nurse Answers normally looks very fit and trim in a tracksuit of sorts, but since I last saw her she seems to have acquired some extra bulge around the hips and stomach. Her belly isn't rounded enough that I could safely identify it as a pregnancy, but the way her hips have filled out just looks like that expectant kind of widening. I don't know either of them well enough to feel comfortable asking, but I wonder if it will be weird to see a couple of pregnant ladies for all of my infertility treatments. What is the etiquette of that situation?

Even though we see this a more of a stop-gap cycle while we make decisions about IVF and adoption, I'm doing my part to make this a success. In obedience to the recent findings that high-fat dairy foods increase fertility, I had a Starbucks almond creme and a bowl of ice cream yesterday. I think I could probably persuade Aaron to trek to Bolingbrook to visit our friends' custard franchise sometime this week, too. You know, for the cause. See the great sacrifices we're willing to make to have a baby?

Adoption & the Gospel

Listening to John Piper’s message on adoption encouraged me. I still feel like my heart is a long way from embracing adoption, but I have more faith that God will move my heart into the right place if adoption is how he wants us to build our family. As Piper outlined eight ways that our adoption of children reflects God’s adoption of us through salvation, I felt grateful afresh for the gospel. God paid a great cost to choose me, to take me out of the worst circumstances – my sin – so that I could call him “Daddy” and become an heir with Christ. Through this message, I recognized the significance and purpose of the way God likens his act of salvation to adoption. He could have described salvation in terms of new birth alone, but he purposefully inspired the writers of his Word to also use the metaphor of adoption. It uplifted me to see the value of adoption in God’s eyes. Piper’s elaboration on Eph. 1:4-6 brought tears to my eyes:

“Now I know it is sweet and uniquely precious to have children by birth, and that if you can’t, you look sometimes to adoption, so then it can feel like this is Plan B. God did not save you that way. He didn’t say, ‘Now, Plan A is to have lots of kids this way. But they blew that in the garden. So, Plan B, I’ll have to save them from slavery by adoption.’ That’s exactly not what happened. … His Plan A was, ‘I will save them at the cost of my Son that they might understand how much I love them.’ Which means, for our own experience, that we should think in terms of two uniquely precious realities. One is having children by birth. It’s unique; nothing is like it. And having children by adoption is unique; nothing is like it. You don’t need to weigh these off against each other as though one is better or worse. There are unique things that are precious and beautiful about [each]. God uses both terminology to describe how we become his children. We can think of both. And if we are moving toward adoption as our first choice or our second choice, they don’t need to be ranked like one is better or one is worse than the other. God is able to give you the grace to embrace adoption as equal to Plan A. Even if it wasn’t sequentially Plan A, it can now rank as a Plan A, equal to Plan A.”

Adoption certainly isn’t Plan A, sequentially, for us. But seeing God’s intent from the beginning of time to adopt me as his child, that gives me an ounce more faith that I might come to see adoption as a blessed plan for us.

Past Hope for Present Fears

Last Sunday, Tab spoke on Romans 6:11 - "So you also must consider yourselves dead to sin and alive to God in Christ Jesus." We need to know that our union with Christ makes us new creations, so that we will have faith for sanctification. We need the Jesus' past (his perfect life, his atoning death, his resurrection) to define our present battle against sin. It is only as we believe what God has already done for us in his Son that we believe what he will do for us.

As I listened to the message, I was convicted about my growing fear about the future. Infertility has revealed in my heart an underlying sinful anxiety. Although I think of myself as a pretty optimistic person in general, I have lately felt stuck in a state of expecting the worst. I believe that God is good, but I have managed to twist that belief into a perverse kind of foreboding. It goes something like this in my mind: "God works all things for good, right? Infertility has been really hard, but it must be good somehow. God knows the future, and it is obviously not best for us to have a child right now if he is sovereignly causing us to wait." All okay, so far, huh? But where I get into trouble is when I start playing the mental game of imagining the reasons why we're not supposed to have children. Trying to second guess God's reasoning, I start to wonder if maybe Aaron or I is soon going to die or be paralyzed or something else that would make it really difficult to care for children, or if my sister- and brother-in-law will be in a plane crash so that we will adopt our nephews which would obviously be an easier transition if we don't already have children of our own, or all kinds of other bizarre scenarios usually involving someone's death or debilitation. How do I manage to get from affirming God's goodness to expecting such horrible things to happen? (My sinful heart, that's how!) And once I start imagining those things, I have a hard time taking those thoughts captive. Sunday's message convicted me that those fears are sinful and reminded me that I am not bound to those worries. I am united with Christ and therefore I have hope for change, for growth, for a more genuine trust in God's goodness. Infertility cannot make me a fearful or pessimistic person; it can reveal sin in my heart, but my Savior has paid for that sin and promises to make me more like himself. Instead of looking to the immediate past of our struggles to conceive as an indication of what is to come, I need to look to the far-off but ever-present past of the cross. That's where I see God's goodness displayed, where I see fear defeated, and where I see hope for the future.