Excerpt of Encouragement

Back when we found out that our first attempt at IVF did not result in pregnancy, that our two embryos did not implant, we received many sympathetic calls and e-mails. One e-mail was one of the most encouraging notes I have ever received, and I wanted to share some excerpts of it here. Annika wrote of what she thought God would say to me if he were giving a Hebrews 11 type of testimony:

By faith Andrea believed in my goodness when time and again she felt all-consuming disappointment and sadness. By faith she remained focused on me, looking to the power of the cross rather than allowing herself to be surrounded and captivated by her grief, her anger, her perplextion, her jealousy, her self-pity. By faith she trusted me to carry these things, when she could have tried to carry them by herself and turned her back on me. By faith Andrea fought to hear my voice when the world said, "There must be something wrong with you. You must not be spiritual enough. You must not pray ferverently enough. The Lord must be trying to teach you something, or else you would be pregnant by now." She fought to hear my voice among the clatter, to remember my goodness to her in the sacrifice of my Son, to remember my love for her, to allow me to comfort her and soothe her, to fill her void. By faith Andrea did not waver in her belief in my ability to bring forth life, but rather trusted in my timing and my purposes, even when it seemed unfair and pointless. By faith she pressed on, rathen than sit down stubbornly and refuse to continue until she got what she wanted. By faith she matured and grew in her understanding of my sovereignty and love for her. Her faithfulness has brought me much delight; if only she knew what I good and wonderful things I have in store for her...

I believe He is boasting about You to those around Him, perhaps even to the little lives that are now with Him, saying, "Do you see her? That is your mommy! Isn't she so
amazing? Would that more of my children have her strength and perseverance! I love her so very much!"

Thanks, Annika, for such encouraging words and faithful friendship! It helps to have such a specific picture of how God is receiving glory from this trial of infertility.

Beach Read Recommendations?

Oh, Internet, I need your help! We leave for a beach vacation on Friday, and I don't know what books to bring along. Sad days indeed when a literature major doesn't know what to read. Can anyone recommend some good beach reads? I'm mostly looking for fiction, but non-fiction would work, too.

Here are some of my favorite novelists, to get the ball rolling: Jane Austen, Edith Wharton, P.G. Wodehouse, C.S. Lewis, J.R.R. Tolkien, J.K. Rowling, Dorothy Sayers, P.D. James, Elizabeth George, Madeleine L'Engle...

Balm

To Aaron.

My best beloved, these past weeks with you have been so sweet. You are my laughter in a time of sorrow. Our marriage grows more roots and branches, even as our dreams for a family seem to splinter. So many people have said, "Just enjoy the time you have together!" So much easier said than done. So easy to long for children and think that this unity, this one-ness we have is not enough. But we have had four years and counting of enjoying each other, growing in friendship and intimacy and fellowship. And I would not trade you, my husband, for all the children in the world. What a treasure to sleep in together on a Saturday morning, to savor a pot of tea in our pajamas, to take off on a whimsical bike ride, to look at each other and say, "We would gladly trade this freedom for a baby, but let's make this most of this; let's ride and smile together!" What a daily delight to sit down over dinner together, to share our days, what we have learned from God's word, where we have struggled, where we have found grace. What a haven to lay with your arm under my pillow and your knees pressed behind mine, as we close our eyes and I chatter to you of all the little things that I was too distracted to think to tell you until the darkness of bedtime. What a grace that right now - these weeks, these moments - the balm of your love soothes my heart. I am sick of deferred hope, but I am so content with you.

"What I'm trying to say in some clumsy way
is that it's you and only you -
not just for now, not just today -
but it's you and only you for always."
Nichole Nordeman, We Build

The Next Big Summer Blockbuster. Really.

Clark Kent takes off his glasses; voila - Superman! Peter Parker takes off his glasses - Spiderman! Me, well, I don't wear glasses. But like many meek men and women before me, I have discovered a hidden superpower. Behold, Spotwoman! She can spot a mere eight to ten days into her luteal phase! She can spot well before any scheduled pregnancy test for a medicated cycle! She can spot while injecting heavy-duty progesterone-in-oil shots after IVF! And now, she can spot with alacrity during her second week of pre-IVF birth control pills! (Nurse Answers says it's nothing to be concerned about, unless my bloodwork in early July shows elevated estrogen levels...) Spotwoman, an infertility superhero. Anybody else think they have a secret (infertility or otherwise) superhero identity?

Na Messages - Infertility Style (Part 2)

(Last New Attitude post, I promise! Continuing with a recap of sermon notes and thoughts on application...)

Discerning Grey Matters - Eric Simmons (Mon. a.m.)
Col. 1:9-14
- grey matters are not areas where we do whatever we want, but areas where we seek harder to understand God's will
- 3 parts of discerning grey matters: (1) think biblically; (2) distrust your heart/motives; (3) imitate your Father
Infertility can be full of grey matters. I want to exercise discernment through ongoing evaluation of each step and each action undertaken in our quest to conceive. I don't want to make any assumptions (i.e. we did IVF in an ethical way before, so it's okay to keep attempting IVF as many times as it takes) without thinking biblically and examining my motives with grace-filled suspicion. As I write about infertility on this blog, I want to seek to imitate my heavenly Father rather than patterning myself after the subculture of the infertile. While I thank God for my companions in this struggle, I want to be identified more as a child of God than an infertility blogger.

Discerning What Pleases God: Himself - John Piper (Mon. p.m.)
- Who is the most God-centered person in the universe? God himself
- Who is uppermost in God's affection? God himself
- Is God an idolater? No
- What is God's chief jealousy? To be known and glorified and obeyed
- What is the chief end of God? To glorify and enjoy himself forever
- Do you feel most loved by God because he makes much of you or because he frees you to make much of him?
- Are you God-centered because he is supremely valuable to you or because you believe you are supremely valuable to him?
As I think about the trial of infertility, what confidence those questions bring, especially the last two! If God proved his love for me by making much of me, then hard, heart-breaking times like these would disprove his love. If God's primary purpose and best action were to value me and uplift me, this thwarting of my desires and yearnings would show that God was not very good at being God. But if God's demonstrates love by increasing my awe of him, if his goal is to make himself most valuable to me, then infertility is a mighty tool to accomplish his loving purposes. Infertility teaches me that life is not all about what I want, that I am utterly dependent on my Creator and Redeemer. I want my experience of infertility to act like a telescope, magnifying God by bringing his greatness into a close-up view.

Discerning What Pleases God: Personal Obedience - John Piper (Mon. p.m.)
- obedience that God abominates: (1) obedience offered as the ground of justification before God; (2) obedience offered as payback for God's grace
- obedience that pleases God: (1) faith in the gospel, by which we receive Christ's obedience; (2) obedience that magnifies our debt to fresh springs of future grace
As I seek to walk through this trial in obedience, I want to do so as a debtor to grace. Obedience is not a bargaining chip to get the children I want. All I can do is boast in Christ's mercy and benefits. He has already purchased all of the grace that I will ever need; I just keep asking for more of that grace to be applied like a balm to my sore and sinful heart. His grace will abound to me with perfect sufficiency for the good works of waiting patiently, of loving pregnant friends and young moms, of counting suffering as joy.

Discern How to Apply - C.J. Mahaney (Tues. a.m.)
James 1:22-23
- the priority of application: "knowledge is the prelude to action"
- the practice of application: effective application is (1) specific, (2) patient, (3) undertaken in the shadow of the cross
I want to be both optimistic and realistic about my spiritual growth. God is at work in my heart through this trial, and he will complete the good work he has begun. But change is not a one-time event; it is a painstakingly slow, ongoing process. As I persevere, I don't want to ever lose sight of Calvary.

Na Messages - Infertility Style (Part 1)

I've spent some time each morning (almost!) for the past week and a half reviewing my notes from the New Attitude messages, re-reading the scriptures that were central to each sermon, and jotting down some thoughts about how to apply. Here's a recap:

Discernment - Josh Harris (Sat. p.m.)
Romans 12:1-2
- discernment requires resistance
- discernment requires renewal
- discernment requires action
- discernment requires the gospel
I want to exercise discernment in the realm of infertility. As my circumstances seem to belie God's promises, I want to reclaim truth from the Word daily. I want to practice God's will - to get busy doing what I know he wants me to do - until his will becomes to me good, acceptable, and perfect. I want to blog about infertility by speaking truth, dying to the desire to appear sophisticated. I want to humbly remember that any insight I have into dealing with this trial is only because the Spirit has opened my eyes to the gospel.

Discern Your Doctrine - Mark Dever (Sun. a.m.)
- learn what doctrine we must agree upon through the Bible, your church, & your conscience
- fourfold test for doctrinal importance: (1) how clear is it in Scripture? (2) how clear do others think it is? (3) how near is it to the gospel? (4) what would be the effects of allowing disagreement?

Discern Your Culture - Al Mohler (Sun. p.m.)
- 5 wrong ways of understanding culture (using the metaphor of water): (1) "let's get completely wet" - letting culture define reality; (2) "let's stay completely dry" - impossible, because we cannot talk, eat, etc. without participating in culture in some way; (3) "let's take a dip" - we can't carelessly drop into culture and emerge safe; (4) "let's take a sip" - we cannot understand culture without serious study; (5) "let's look at the aquarium" - we can't engage culture from a distance
- culture is a sea that we swim in; it can be poisonous, but we cannot jump out; we need a systematic theology to understand and relate to culture

Discern Your Heart - C.J. Mahaney (Sun. p.m.)
Ex. 20:2; Rom. 1:25; 1 Thes. 1:9; 1 Cor. 10:4; Col. 3:5; 1 John 5:21
- defining idolatry - a false, functional God
- discerning idolatry - through Scripture, by the Spirit, in the church, in circumstances
- the fruit of identifying idolatry - growth in godliness; growth in gratefulness to God
Idolatry is my chief temptation, whether I recognize it or not. I need new eyes to see the sacrifice Christ made to win me to worship and serve the true God. As I pursue hard after pregnancy and children, I need to be aware when those become ruling desires. When I am prone to envy friends who are pregnant or have children, I need to ask whether that is idolatrous covetousness. I want this test of adversity to wean me from idolatry. I need God's grace so that he - my professed God - truly becomes my functional god - the One who drives every desire that I have.

Na Worship - Infertility Style

My memory of the New Attitude worship times is fading fast when it comes to specifics. Generally, I remember the main theme echoing in my heart - as I filled with near-certainty that our first IVF was failing fast - was that if even the rocks and trees cry out to give God glory, then my tiny embryos too sang a song of praise to their Maker. Even as I grew more and more sure that those two sparks of life had slipped away, my cry was that they would bring God glory. If they bring God the most glory by failing to implant in my womb, then so be it. And that is, indeed, what happened.



For a full list of the songs we sang at each session, look here.

New Attitude - Infertility Style

We've now been back from the New Attitude conference for just over a week, and I'm still marshaling my thoughts and figuring out how to apply all I learned. The conference - primarily aimed at singles but open to young married couples - had a unique flavor for me as I spent most of the weekend with dawning realization that our first IVF had failed. I started spotting on our drive down to Louisville, and it continued for most of the weekend. As I struggled with the impending sorrow, I wondered why God wanted me at the conference at that particular time. The first few messages were all excellent, but they seemed to have no application whatsoever to my circumstances full of infertility and grief. But, even as I grumbled in my heart, the Lord met me in a very personal way. On Sunday evening - the halfway point of the conference - the worship time began with a few people sharing brief testimonies about how God has helped them in trials. Even then, my first reaction was to complain that I did not yet have a similar story about what God has done for me. Still, Aaron and I had a bittersweet time weeping before the Lord together. Then, Bob Kauflin sang a prophetic song for those experiencing a loss of some kind. The words he sang ministered balm to my soul and washed over me with awareness that my heavenly Father sees me, cares for me, and wants to speak to me. I knew in that moment that I was not just adrift at the conference but that the Savior had specific purposes for me there. The evening continued with a message on idolatry by C.J. Mahaney. (By the way, you can download all eight Na messages for FREE! from the Sovereign Grace Ministries website - link in sidebar.) Idolatry is a topic I have considered before, and one that is always helpful to hear again. C.J. spent quite a bit of time speaking about idolatry and tests of adversity, which definitely applied to me! One of the things he said that resonated most immediately was that tests of adversity are heightened when we encounter others who are undergoing tests of prosperity in the very same area. How true to my experience of infertility! Yet, what new eyes it brings to my situation to recognize that those friends who are blessed with children are facing tests, too - to be grateful and uncomplaining when nights with crying infants seem long, to keep the Lord as first priority rather than allowing children to be the little rulers of their lives, etc. As C.J. pointed out, biblical examples show that people tend to fail tests of prosperity more often than tests of adversity. So as God gives me grace in my affliction, I want to seek to help those friends who have had blessing poured out into their lives. I'm looking for scripture to renew my mind in that area and considering practical ways that I can put idolatry to death by serving others. We were encouraged at the conference to have one main application point, and that is mine - to be a blessing to those who are prospering with children and pregnancies even as I wade through adversity in that realm.

A few more general Na thoughts to come...

Here We Go Again - IVF #2

Just a quick update to say that we are beginning the process for IVF #2. My baseline ultrasound and bloodwork yesterday showed all reproductive organs and hormones back to normal, and Nurse Answers confirmed that our vacation at the end of June should not interfere with any appointments, so we have the all clear to start the suppression protocol. Since the first month of the process is so low-key - just BCP for three weeks, and then Lupron shots for ten days, but no daily appointments or major procedures - Aaron and I feel good about starting right up again. Supression is sort of a built-in lull in the intense storm of IVF.

Also, I will have a consult with Dr. Peppy on July 2 to discuss our first IVF and if we will make any changes to the protocol for this round. I'm compiling a list of questions to ask then - What exactly was our embryo quality? Was there anything obvious that caused the IVF to fail, or is it just a mystery why the embryos did not implant? Why is it taking such extremes of treatment to correct what seems like a relatively minor problem of low progesterone? Is there some part of the problem that we're missing, that we haven't tested for yet? Let me know if you have any suggestions for other questions to ask at a post-IVF consult.

Afflicted but Not Crushed

Yesterday morning, God kindly led me to read 2 Corinthians 4. Even though I expected negative news in the pregnancy department, I found myself full of fresh encouragement in the gospel through these words of the Lord...

For God, who said, "Let light shine out of darkness," has shone in our hearts to give the light of the glory of God in the face of Jesus Christ. But we have this treasure in jars of clay, to show that the surpassing power belongs to God and not to us. We are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be manifested in our bodies.

God made light to shine out of the void of un-creation. He made light to shine out of the black of sin. And this same God can make light to shine in my bleak experience of infertility. Because of the gospel, I have been given the light of the glory of God in the face of Jesus Christ. No darkness can ever extinguish that light. Though I am afflicted by the loss of my two babies-that-could-have-been, I am not crushed because the Father chose to crush his precious Son in my stead. Though I am perplexed that this IVF did not yield a pregnancy, I am not driven to despair because I have Christ in me, the hope of glory. Though I am persecuted by this enduring trial, Jesus was forsaken on the cross so that I will never be forsaken. Though I am struck down by the disappointing news we received yesterday, I am not destroyed because my soul is held secure in my Savior's wounded hands. Though I have now literally carried death in my body, I trust that the life of Jesus will be manifested through my body in all of its brokenness. Though my frail womb could not hold two embryos, my frail body can hold the treasure of the gospel because God's love and grace will never let me go. Though I am weak and weary, the surpassing power of the Lord is being shown in my suffering for his glory.

So we do not lose heart. Though our outer nature is wasting away, our inner nature is being renewed day by day. For this slight, momentary affliction is preparing for us an eternal weight of glory beyond all comparison...

In the Dark

Sadly, the two pinpricks of light and hope have been swallowed up in darkness. I grieve, dear embryos, that you could not live.

If You should speak or should remain in silence

Should give me light or lead me through the dark

Whatever cost, whatever joy or sorrow

I'll worship still, because of who You are.

(Starfield)

It seems that silence and darkness will remain yet longer. The cost is great, but I will keep fighting to trust and worship my Savior and Creator in the midst of sorrow.

"The Lord gave, and the Lord has taken away;

blessed be the name of the Lord."

(Job 1:21)

Tastes Like Chicken

Checking my Sitemeter stats recently, I discovered one of the funniest Google searches that has ever led a visitor to my blog: "chicken reproductive system pictures." I'm pretty sure my blog falls way, way down the list of results, so someone was searching hard for those pictures!

A couple blogs that I read regularly mentioned their "blogiversaries" this week, which caused me to curiously check my own records. My first post ever was on May 23, 2006, so that means this past Wednesday marked one year of blogging for me. Happy belated blogiversary to me!


We leave tomorrow for the New Attitude conference. I'm definitely looking forward to the teaching, worship, and fellowship - what better way to spend the last few days before beta day! (For those unfamiliar with infertility shorthand, beta refers to the qualitative HCG pregnancy blood test that most clinics do at the end of IUI or IVF cycles.) We'll be at the conference until Tuesday, and my beta is Wednesday morning. Thankfully, the wait has not felt too long and God has kept my heart fairly peaceful.


Speaking of the two embryos that are hopefully thriving in my uterus right now - whatever happened to the Great Embryo Nicknaming Contest? Well, honestly, I'm stymied. 3 winners and 2 embryos does not for easy nicknaming make. I've tried to think of clever combinations or monikers from the winners' names - Jonska? Robi? - but I'm not coming up with anything I really want to call my embryos for a while. And then, what happens if only one of the embryos implanted? How do I cut one of the nicknames? So, dear readers, I'm petitioning you. Suggest clever nicknames! If you're a contest winner, your suggestion gets extra weight. Cast your votes in the comments, which I'll tally when I get back from the conference. You have 4 days to let your imaginations run amok!

Trial by Prayer (3)

When we face unanswered prayer, we join the company of the Savior himself. Jesus - knowing that he was about to take the sins of the world upon his innocent self, anticipating the wrath of God that would be poured out on him as he hung upon the cross - pleaded with his Father, asking if there was any other way to accomplish the redemption of mankind. There was no other way, and Christ endured the utmost agony. Yet looking back on those events, Hebrews 5:7 can say, "In the days of his flesh, Jesus offered up prayers and supplications, with loud cries and tears, to him who was able to save him from death, and he was heard because of his reverence." Jesus prayed fervently to be spared the gruesome death on the cross, and his prayer was seemingly unanswered, but he was heard. He was saved from death, but that salvation took the form of resurrection after the cross, so that such salvation could extend to sinners like you and me. God the Father answered the prayers of God the Son, not specifically in the way that Jesus asked, but in an infinitely better way. What sweet solace, then, the gospel provides to us when our prayers seem to linger unanswered! The Savior, too, has cried loudly and wept deeply when his Father seemed to turn a deaf ear to him. He suffered the anguish of yearning and waiting and being denied, and he sympathizes with me when I petition over and over again. In fact, he now presents my petitions to the Father, intercedes on my behalf. I can trust that I too am heard, not because of my reverence but because of Christ's reverence. And I can rest assured that I too will receive an answer that far surpasses the best solution that I can imagine. In the midst of unanswered prayer, I have a blessed confidence in my Savior because "although he was a son, he learned obedience through what he suffered. And being made perfect, he became the source of eternal salvation to all who obey him" (Heb. 5:8-9). As I keep pleading for children, I hope to learn obedience through my suffering, and I know that God has already bestowed on me the best blessing in the hope of the gospel.

Trial by Prayer (2)

Many of the thoughts on prayer that I shared in my last post took shape in my mind as I read the chapter on prayer in Wayne Grudem's Bible Doctrine. Here are some notes that I took from the section about unanswered prayers:

- God keeps his wise plans hidden until the time he has decreed. When faced with unanswered prayer, I need to humbly admit that God need not let me know what he is doing.

- Sometimes we do not pray as we ought, because we think one plan is best when God has a better solution.

- When our prayers are unanswered, we join the company of Paul - who prayed for his thorn to be removed from him and it was not - and Jesus - who prayed for the cup of God's wrath to be removed from him and it was not.

- When our prayers go unanswered, we must continue to trust God, casting our cares on him and remembering that his strength is sufficient.

- We must continue to pray. Sometimes a long-awaited answer will suddenly be given, as was the case with Hannah when she at last conceived Samuel.

- Sometimes prayer will remain unanswered in this life or for eternity, but the faith of prayer still brings glory to God.

Words are insufficient to express how grateful I am - we are - to all of you who have earnestly prayed along with us during this season of affliction and waiting. We have especially felt the effect of your prayers in the past week; the encouragement has been tangible. Whatever the answer to our prayers, whatever the outcome of this IVF in particular and of this fight against infertility in general, I take great delight in knowing that all these prayers of faith offered up on our behalf are bringing significant glory to the One who saves.

Trial by Prayer (1)

Infertility has presented me with plenty of occasion to pray and to consider the topic of prayer, especially unanswered prayer. What does it mean that all my prayers for children have gone unanswered for so long? Am I praying wrongly? How do I continue to pray - just repeat the prayers I have been offering up for years, or look for new ways to ask, or give up asking? I know I am not the first to ask these questions, and nor will I be the last.

In all my petitions for a child, I identify myself with the persistent widow of Luke 18. The widow faces a wicked judge who will not give her justice. Yet she returns to him again and again, repeatedly asking for justice until he finally gives in. Jesus says that he tells this story so that we will always pray and not lose heart; if a reluctant, hardened man will answer such faithful requests, how much more will our faithful God give justice without delay?

So, like that widow, I ask again and again. And yet - is my desire for a child really a yearning for justice? It is not unjust that I am childless. It certainly feels like it at times, when I want to whine, "God, it's not fair! Why does so and so have a child, and I don't? Don't I deserve it? Haven't I pleaded long enough? What am I doing wrong, that you will not bless me?" But the Lord does not give to or withhold from me based on my merits; he relates to me on the basis of Christ's merits, so I receive much better than I deserve. So when prayer goes unanswered, I must examine what I am really asking. James 4:2-3 says, "You do not have, because you do not ask. You ask and do not receive, because you ask wrongly, to spend it on your passions." I've certainly begged for children, so my lack of children is not due to lack of asking. So then am I asking wrongly, selfishly? Is it possible that I could only want a child to "spend on my passions"? Well, yes, sometimes. Sometimes, if I am honest, I want a baby for base, earthly reasons - so I can buy cute baby things, so I won't be left out of conversations with friends who are moms, so I can impress people with my parenting skills. I want to want children for holy, eternal reasons - for the sake of the gospel - but my motives are often mixed. So is that why my prayers linger unanswered?

A few months ago, in the midst of evaluating whether or not to pursue IVF, I read the account of Paul's "thorn" in 2 Corinthians 12. Paul says he pleaded three times with the Lord about this, and then received the answer that power is perfected in weakness. Paul's thorn - whatever it was - was there to stay, and he would be content with that. Umm, three times, Paul? You asked three times, you didn't get what you asked, and that was that? I've asked for children a few more times than three. About, oh, 80,000 times more than three. So as I read that account, I wondered - have I been asking too long? Had I already received my answer? Have I been carrying on in denial? Would trying IVF merely be an attempt to manipulate around God's negative reply? These questions weighed on me as we considered our options - IVF, adoption, or remain childless. Still, I did not feel like my prayers had received an answer one way or the other. The Lord spoke directly to Paul, saying he would not remove Paul's thorn and wanted Paul to rest in his sufficient grace. I don't think I've gotten that kind of specific answer yet. It seems that God wants me to keep praying, keep waiting.

As I have sought to understand how to pray and how to respond when my prayers go unanswered, I try to take the whole body of Scripture into account. There are examples like Paul, who learns to be content when he is told no. Then there are examples like Zechariah, who in his old age was visited by an angel who said, "Your prayer has been heard, and your wife Elizabeth will bear you a son...And you shall have joy and gladness, and many will rejoice at his birth." How long must Zechariah and Elizabeth have prayed for that baby! How disheartened they must have gotten! Yet here, at long last, comes joy and gladness when prayer is heard.

I don't know yet how my prayers for children will be answered. I pray daily for God to sustain both of the embryos that are in my womb right now. Perhaps these will be the prayers that are finally answered with a triumphant, resounding, "Yes!" But perhaps not. Will I be like Paul, or will I be like Zechariah? Am I to persist in asking, or am I to recognize that my prayers are too selfish, not in line with God's will? I do not know. But until I do, I keep knocking, seeking, asking. I seek to live by the following words from 1 Thessalonians 5: "Rejoice always, pray without ceasing, give thanks in all circumstances; for this is the will of God in Christ Jesus for you."

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!