Today it measured 15mm.

I am waiting for a nurse to call and let me know when I am to have the hCG injection (to induce ovulation) and when the IUIs will be.

For now, I leave you with a post I actually wrote on Saturday. I think this post will help you understand the biggest factor for us in deciding if we should try another IVF ovarian stimulation and hope and pray for more follicles.

*****

Some people call IVF “playing God”.

I, however, see IVF as a genius medical intervention that allows a woman to essentially combine a number of menstrual cycles into one, thus allowing the medical field to sift through the harvested eggs and then embryos and find the ones that have the most potential to produce a viable pregnancy.

In order to understand why I do not believe doing IVF “plays God” in any way, you need to first understand what naturally occurs in a fertile couple trying to conceive.

I’ve mentioned that I am reading the book In-Vitro Fertilization: The ART of Making Babies by Geoffrey Sher, M.D. in a previous post. (Excellent book!) When I read the part of the book about natural conception, it blew my mind away and helped me realize that IVF adapts the principals of human reproduction to achieve pregnancy in a faulty reproductive system!

Only about one out of every three embryos implants in the uterus long enough to delay the menstrual period. This means, in two out of every three pregnancies, a woman is not even aware conception has taken place! (Sher, 2005, page 29)

The actual fertilization process is such a complex process that many times egg and sperm do meet but something goes wrong in the fertilization process and the embryo is just not capable of producing a viable pregnancy. In other words, the woman has conceived, but she will never know it! In other cases, a woman may miss her period, but will have a very early miscarriage because the embryo isn’t capable of producing a viable pregnancy (among other reasons also mentioned in the book).

One reason IVF gets a bad reputation from some people is because people have a problem with embryos being discarded. (Please understand I am not referring to discarding frozen viable embryos.) Maybe people would have a different point of view if they understand the high rate of embryo wastage and early miscarriages that occurs even in natural conceptions!

These facts should only encourage someone standing on the brink of an IVF cycle.

While a woman’s natural menstrual cycle produces on average one mature follicle, a woman (under the age of 40) undergoing IVF produces an average of 10-15 follicles. (Sher, 2005, page 63) The way I see it, IVF essentially takes approximately a year’s worth of monthly menstrual cycles and combines them into ONE cycle.

For example, let’s say a woman undergoes IVF and at retrieval, twelve follicles are aspirated from her ovaries. Of those 12, maybe only 10 follicles actually contain a mature egg. Of those 10 eggs, let’s say 8 fertilize normally after being left overnight with sperm in a petri-dish.

Of those eight fertilized eggs, more than likely, a number of them will not continue to grow and divide properly and will not be able to produce a viable pregnancy. These embryos would be the ones in a “natural conception” that would float around in the woman’s reproductive tract but would not implant for one reason or another.

In an IVF lab, embryos are carefully monitored. When the embryologist finds embryos that are not growing after several days, the embryos are discarded just like non-viable embryos are discarded in nature without the woman ever even knowing she has conceived. In the example, let’s say of the eight fertilized eggs, three of the embryos stop growing by day three after retrieval. We are now left with five embryos.

The remaining five embryos continue to grow in the IVF lab and are carefully monitored for proper growth and cell division. On day five after retrieval, the embryos are now at the blastocyst stage and embryologists look for the healthiest embryos to transfer to the woman’s uterus.

If this example was me, most likely at my age of 27, the two most viable embryos would be selected for transfer. The remaining three embryos would stay in the IVF lab and would continue to be monitored. Let’s say of the three remaining embryos, one stops growing and there are two viable embryos left. Those two embryos would be frozen for a future IVF cycle and considered an added “bonus” to the overall IVF cycle.

Do you see how IVF weeds out the follicles with no eggs, the eggs not capable of normal fertilization and the embryos not capable of producing a viable pregnancy (most likely because of a chromosomal defect that occurred during the very complex fertilization process) in the time span of one month compared to the many more months it would take for a woman’s natural menstrual cycles to do the same?

Playing God? No.

In my own personal infertility case, we believe our ability to do IVF is a gift from God. It is a well-known fact that the largest playing factor in ANY woman’s fertility is her AGE. Throw endometriosis into that mix and that woman’s biological clock is ticking louder than Big Ben because it is also believed that egg quality in a woman who has (or has had) endometriosis declines sooner than a woman who has never had endometriosis. At the age of 27, I am standing in my “window of opportunity” to conceive and give birth to a biological child. That God would put together every necessary detail to proceed with IVF at this particular time in my life is nothing short of a miracle, in and of itself.

We see this IVF cycle as a blessing from God in that IVF will allow me to harvest a number of eggs, and hopefully, at the end of this month end up with at least one viable embryo capable of implanting in my uterus and producing a viable pregnancy.

There is something else that must be taken into consideration when doing IVF. At the end, when it comes to transfer time, it is not so much the number of embryos that you have available to you, but your embryo quality, that is extremely important.

In other words, while I am praying earnestly for “lots of follicles to be retrieved”, in the end our goal is not “lots of embryos in the IVF lab” but “several GOOD QUALITY embryos available for transfer”. I would rather only have two perfect, good quality embryos at transfer time than TEN not-so-good or even poor quality embryos.

The simple fact here is that we need “lots of follicles” to start with in order to increase the odds of weeding out the “bad eggs” and continuing the IVF process with the “good eggs”.

It is not the number of embryos you have at the end of an IVF cycle that matters – it is their viability that makes all the difference in whether the IVF cycle ends in a pregnancy or not.

That and, of course, if God wills to bring another life into the world. Even taking all the meds required for an IVF cycle, harvesting many eggs and paying the big bucks to do the cycle does not guarantee a pregnancy.

In an IVF cycle, God is still the creator and sustainer of life and He will never hand that role over to any medical professional.

*****

Side Note:

Knowing what we know now, apart from a miracle of God, my ovaries are never going to produce enough eggs for my IVF cycle to mirror that of the example I gave above. Dr. L predicts, if we choose to go through IVF ovarian stimulation again, we can expect no more than three follicles to mature.

If even one, two or three follicles mature, are retrieved, fertilized and even produce one viable embryo, we have good odds of a pregnancy.

The thing is, we won’t know the quality of the eggs in the follicles until the follicles are retrieved. Retrieval is one of the most expensive aspects of IVF, which is why we cancelled before retrieval this time. At this point, I can’t justify going to retrieval for one follicle that may or may not have an egg in it!

I know God has placed this deep desire in my heart to be a mother. There is no experience that can possibly compare to pregnancy and childbirth. I was the little girl growing up with pillows constantly shoved up my shirt playing “pregnant” and dreaming of the day I would actually “have a baby in my tummy”.

I think it is pretty obvious that I am willing to fight and do whatever it takes to make this dream become a reality. However, I am surrendered to the fact that my dream may not be God’s marvelous plan and ultimately, I desire His plan, not mine.

Until He says “stop”, I will persevere and claim the promise found in Psalm 37:4.

Delight yourself in the Lord and he will give you the desires of your heart.

Also, please be sure to read the special prayer request below.

Written by Dave, my wonderfully understanding and supportive husband:

How I discovered infertility
The first time I ever heard infertility mentioned was when I was in high school. A couple at my church had been trying to conceive and had been unsuccessful. They were told that the only way they would be able to conceive would be by going through In Vitro Fertilization (IVF). Despite the wife’s father offering to pay for the procedure, the couple decided they would rather put their faith in God alone. Amazingly, God was faithful to them! The last time I saw them they had 2 children with a 3rd on the way. Although I didn’t really know much about infertility, seeing that miracle happen before my eyes really shaped my early thinking on the subject.

Of course, the first thoughts I had as Elaine and I struggled to conceive were that we needed to just put our faith in God and trust Him to give us a child, and that was definitely a good place to start. I wasn’t completely closed to the idea of some kind of treatment if we needed it, but my main concern was keeping our focus as a couple on God. Fortunately, I can say that our stance on that has never changed.

Diagnoses and treatments
As Elaine and I went to the doctor and found out more about ourselves from a fertility standpoint, we began to realize that our problems conceiving stemmed from more than just some hormone imbalance. When Elaine was diagnosed with polycystic ovaries, I was told my sperm were a little below average, and the RE recommended intra-uterine insemination (IUI). This was really the first time I had to decide for myself whether I thought the treatments were right for us or not.

I ended up being fine with IUI more quickly than I would have thought. The first positive I thought of for IUI was that only God can form a child from a sperm and an egg. IUI essentially just helps put the two together. It’s not trying to play “God” in my mind to do that, especially in the sense that the procedure was more in the realm of corrective medicine. Like stitching up a cut helps to correct the alignment of skin tissue and ward off infection, IUI helps a higher percentage of sperm reach the egg.

After four failed cycles of IUI (1 of which was a cancelled cycle), the next step was to do some exploratory surgery and look specifically for endometriosis. I had no problem with this even from the start for the same reasons I had come to grips with IUI. When the doctor found and removed endometriosis I was glad, knowing we had made the right decision to do the surgery, but after learning more about the effects of endometriosis and learning that IVF would probably be our best option going forward, I had three main issues to work out.

I don’t want quintuplets!
The initial problem I had with IVF was all those TV shows you see where someone had 5 kids through the procedure. This concern was quickly dispelled when I found out that they would only put 2 eggs in Elaine at a time. Those irresponsible doctors that put a lot of eggs in at once give the other REs out there a bad name. If the IVF cycle is done right (i.e.. the appropriate number of eggs transferred depending on the age of the patient), scenarios like the woman who recently had 8 children from a single cycle just don’t happen, and since our doctor is so conservative, we are confident that he will protect us from that type of thing.

What about the extra eggs?
The next problem I came across when thinking about going into IVF was what would happen to the extra eggs if we ended up having any. Knowing that Elaine might produce upwards of 20 eggs for one retrieval, and that they would only put in 2 at a time, I was starting to do the math and get a little scared.

Then I remembered that not all of the eggs the doctors retrieve will successfully become fertilized. Those eggs don’t bother me because if they won’t fertilize surrounded by my sperm in a lab, I doubt they would do any better trying to swim through Elaine’s tubes. Besides, every month that Elaine isn’t pregnant another egg dies. It’s not a baby yet.

Also, as I learned about the process of IVF, I learned that just as many “naturally” fertilized eggs don’t implant or miscarry, many lab-fertilized ones die in the process as well. And because Elaine has had endometriosis, its adverse affect on egg quality will make having extra eggs after one cycle a miracle in and of itself (although, we would welcome that because we’d like to have 3 or 4 children).

It’s just not natural!
The biggest conflict I had with IVF was the fact that it just seems to go against nature. I felt that man is not supposed to go messing around trying to create life in such an unnatural way. I could rationalize IUI since everything was still happening inside of Elaine’s body, but to take everything out and put it in some science lab seemed crazy to me.

However, once the initial shock of that wore off, I began to realize a few things. We do things every day that are not natural. From simple things like shoes to more complicated things like building automobiles, open heart surgery, and even the keyboard I am using to type, we people do things that go against nature every day. Nobody says to the auto mechanic, “How dare you mess with God’s Creation and put those parts together that way to make people go really fast! That’s just playing God!” Likewise, nobody criticizes the doctor who performs a bypass on a man’s heart.

So how could I wake up to an alarm clock every morning, drive to work in my car, sit at a computer for 8 hours creating programs for others to use and be against taking advantage of the problems solved by reproductive medicine? I concluded that while God’s Creation is exactly as he intended it, we are part of it. He gave us brains to be able to solve problems that arise from every day life. Problems like travel, heart-attacks, and information dispersal have all been helped along by man-made inventions, and those advancements are still glory to God because he gave us those wonderful brains!

So, I decided that the area of fertility is no different. If one person can have surgery to correct a faulty valve in his heart, another can undergo a medical procedure to correct or help along a faulty reproductive system.

We’re ok with IVF.
This is for the people who were like me before going through this with Elaine. The decision to go through with IVF was definitely not one that we went about flippantly. I know if I were on the outside looking in I would have some misgivings about the morality of the whole “test-tube baby” thing. Honestly, it all comes down to having walked in the shoes we have walked in for the past year and a half. While a year and a half ago I thought much differently about IVF, I’ve learned that when it comes to complex decisions such as our decision to go through with IVF, it’s best to withhold judgment about what is right and wrong until I’ve walked a mile or two down the path.

*****

Now it’s me again…

I want to request prayer for a blogger friend of mine.

Erin went through her first IVF cycle last month and on February 25th she found out she is pregnant!

Her first beta was 86 and her second beta (yesterday) was 137. Those of you who have gone through this before know everyone looks for doubling numbers and these numbers did not double over a 3 day period.

PLEASE PRAY for Erin and her baby(ies). Please pray for God’s peace upon her heart at this time. Pray that her numbers continue to rise and she does not loose the pregnancy.

For those of you that don’t know what “betas” are all about…

When it would be time to take a home pregnancy test, women who have undergone an infertility treatment go have blood work done to measure the pregnancy hormone hCG in their blood. Typically, if a woman is pregnant and the pregnancy is viable, the beta level doubles every 48 hours or so.

Just pray for Erin, please.

I am going to write from a Christian’s point of view on this matter, because I am a Christian.

People who tend to be quick to judge in this matter do not take into consideration that when a Christian couple makes the decision to proceed with IVF, typically, it is a decision that is made with much prayer and seeking God’s guidance in the matter. The decision to do IVF is not made flippantly. Our decision was certainly not made flippantly.

I also believe that people who are quick to judge are most likely people who have never walked down the road of infertility. People may think they know how they would walk a certain road if ever they had to walk it, but the truth is, until they have actually walked the road, there is no way possible for them to know what decisions they would be forced to make along the way and what choices will be made.

As I wrote in a recent post, the general public, being that they are fertile (because infertility only strikes 1 out of 6 couples in the USA) do not have a clear definition and picture of what infertility really means. This is understandably so! Why would a couple who decides, “It’s time to make a baby!” and then several months later is pregnant need to know about infertility, IVF and all the other lovely things that come with it? They don’t!

What most people do not realize is that infertility is a disease. Heart disease is a rampant disease here in America. Infertility is just as much a disease that negatively affects the reproductive system like heart disease negatively affects the circulatory system.

Quick frankly, I did not even fully realize that infertility is a disease until my surgery in November and I had been walking the road of infertility for over a year! It wasn’t until I had the surgery and Stage 2 endometriosis was found that it really hit me that I have a disease and because of this disease, I may never get pregnant and give birth to a biological child.

That is a hard reality to swallow – especially for someone who has dreamed, since childhood, of being pregnant and having a baby!

I am an infertile but I am first and foremost a Christian. Long before I realized I had a disease called endometriosis, I realized that the heartache and pain I was experiencing by going through infertility was not a curse in any way but was (and is) God’s way of allowing His glory, His power and His strength to shine through me as I walked this very dark road. It was when I realized this truth, shortly after starting my infertility journey, that I chose God.

I did not choose bitterness, anger, jealously, rage and hurt, although all of those emotions have certainly played a role at some point during this journey.

Infertility has a way of knocking you down flat on your face, month after month after month. However, I am a Christian, and I knew beyond a shadow of a doubt what was (and is) available to me …

God’s love, God’s peace, God’s joy, God’s strength, God’s power. I knew all of that, and more, was available to me if I chose to give up my own will and surrender to God’s will.

Giving up my will for God’s will also requires something else. It requires seeking God’s guidance and direction for every decision that must be made. This is why a close walk with God is so important! Knowing God’s will and seeking His guidance takes close, daily fellowship with Him. It also takes prayer. A lot of prayer. Talking to God and, most importantly, listening to God. And then following God’s leading – no matter where He leads you to go.

It sounds cliché but to say God lead us to IVF is the absolute truth! Which is why I also believe two dedicated Christians seeking God’s will, can come to two different conclusions when deciding to do IVF or to not do IVF.

God’s plan and purpose behind my infertility journey is not the same exact plan and purpose behind another couple’s infertility journey.

Dave and I know a couple who contemplated doing IVF. After much prayer, consideration and even an offer from a parent to pay for the complete procedure, the couple decided God was not leading them in the direction of IVF. They were obedient to the calling of God in their lives and did not do IVF. It wasn’t long and God blessed them with three pregnancies that were completely a surprise!

Now, the argument here could be that God blessed them with children because they chose not to do IVF. I do not believe that is what happened at all. I believe God blessed them because they were obedient to God’s will for their lives. God’s plan all along was to give them children in the way He did and the way he chose to give them children was not through IVF. Had they gone through IVF, they would have missed out on the miracle God desired to perform in them through surrendered, obedient hearts seeking to know, and follow, God’s perfect will.

Remember the story of one of my readers named Jess? She and her husband sought God’s will in deciding whether they should do infertility treatments or not. They believed God was telling them to not do anything and later they learned why. God’s plan all along had been to bring them four children through adoption! After the adoption of their four children, God gave them an unexpected surprise – a biological child. Once again, Jess and her husband were obedient to God and His time clock. Had they done their own will, who knows where four of their children would be today!

A woman and her husband in my church struggled with infertility for a decade. In speaking with her I learned that God began working in their hearts and they knew God was leading them to do IVF. They are now the parents of a beautiful IVF miracle baby!

Eighteen months into my infertility journey, I still do not have the complete picture to be able to know God’s plan and purpose for placing me on this road. But this I have learned in these past 18 months:

Anyone who makes a judgmental statement towards a dedicated Christian couple and their decision to proceed with IVF after seeking God in the matter, is to essentially judge their personal relationship with God. The Bible clearly states that it is only God who can clearly see into the heart of a man and his motivations.

God has plans for us that far exceed anything we can ever plan for ourselves. If we are to discover these marvelous plans that God has mapped out for our individual lives before we even live one day on this earth, it is going to take having a close, personal relationship with Jesus, a surrender of our wills for God’s perfect will, and an obedient heart that follows the lead of God.

That leaves no room for judgmental statements.

Either the couple says it is time to start trying to conceive, they time things appropriately and, within a few months, a home pregnancy test comes back “Positive” or the couple says it is time to start trying to conceive, they too time things appropriately and month after month (year after year) goes by and every single home pregnancy test is “Negative”.

It’s the difference between being fertile and infertile.

Statistically, a couple has a five-in-six chance of falling into the fertile category and a one-in-six chance of falling into the infertile category.

Which means, there are way more fertile couples out there than infertile couples.

I believe this simple fact can explain why infertile’s constantly hear things like, “Oh, just relax. Give it time. It will happen!” or “They just need to stop trying and it will happen.”

I believe it is also another reason that the general population’s view of Assisted Reproductive Technology (ART) is tainted. The general population has never had the need to pursue ART in order to conceive, because, well, they are fertile mertiles! Consequentially, the general population’s knowledge about ART procedures, such as IVF, is greatly influenced by the media and judgmental statements made from ignorance.

I am extremely fortunate to be surrounded by real life family and friends who are extremely supportive of us as we deal with our infertility by seeking God with every decision made. No one has ever said one of the insensitive comments above to me or been judgmental about any decision we have made concerning infertility treatments. To all my family and friends who read this blog, I cannot thank you enough for the love and support you have given us in the past 18 months. Whether you realize it or not, not having to face this part of infertility has only made our journey easier to walk.

The sad reality is I know many of my infertility blogger friends are bombarded by this part of infertility on a daily basis.

So the purpose behind writing this post (and several more that will follow) is my futile attempt to help solve this massive problem because I firmly believe the solution to any problem of ignorance and a distorted view of something is to become educated about the issue from a reliable source.

News Flash: Learning about IVF through what the media has to say about it? Probably not a good idea. Take the most recent story about the California mom who, at the age of 32, had 6 embryos transferred (not “implanted” – a doctor cannot “implant” an embryo into a woman’s uterus) into her uterus, which resulted in all six implanting and two of them splitting to form identical twins. Eight babies resulting and eight babies giving the general population a distorted view of the IVF process.

Contrary to what the media wants everyone to believe, this is not the usual outcome of an IVF procedure performed under the guidelines that are in place to keep something like this from happening.

I am working on a post strictly dedicated to inform whoever might be interested in learning what in-vitro fertilization (IVF) is, step-by-step. If you choose to read this post, by the end, I think it will be very clear that I am not up at all hours of the night worrying if after my IVF procedure I will become the next “Octuplet Mom”. In fact, it wasn’t even worth my breath to even ask Dr. L about the “possibilities of such a high risk birth occurring during my IVF treatment” because I know it won’t. Period. After reading my “IVF 101” post, anyone will see that octuplets are not, under normal circumstances, the product of an IVF treatment (or an IUI treatment done right for that matter!)!

I also plan to write a post about what infertility really is. Again, I think the general public does not realize that infertility is a disease that affects the male and female Reproductive Systems in many various ways making Assisted Reproductive Technology the only option to achieving pregnancy, apart from a miracle of God, for one out of every six couples in the United States of America.

And I plan to write a post about how I believe two different couples suffering from infertility and seeking God in the direction He would have them go can either decide ART is the way God is leading or they could also decide ART is not the way God is leading and neither decision would be wrong if the couple has truly sought God’s Will for their lives in the matter.

Who knows when all three of these posts will be written, but just know they are coming! I pray God will use the posts in some way to help people have a better understanding of IVF and everything that comes with it!