Considering Fertility Options

August 5, 2016

In-vitro fertilization (IVF) is the process of joining a sperm and egg together outside of a woman’s body, then transferring the fertilized egg to the woman’s body so that she can become pregnant.  IVF is a very controversial subject among Christians and one we don’t take lightly.  My husband, Don, and I have been marinating on various fertility options on and off for years.  We have discussed, researched, examined, questioned and analyzed options from every angle and taken it before the Lord.  Don and I both believe that life begins at conception, and these are some of the questions that we have been pondering and answers we feel the Lord has brought us to.

 

Is using IVF playing God?

This brings up other questions.  Is medicine in general playing God?  Is birth control playing God?  We believe that God has given us resources and can work through alternative and conventional medicine to accomplish his purposes as long as it doesn’t go against his word or against his spirit (pray until arriving peace from the Lord about a decision).  God is still in complete control during IVF, and he will not allow any more babies to be created than what he desires or any less.

When Abraham and Sarah in the Bible couldn’t conceive they took matters into their own hands and agreed for Abraham to sleep with his concubine, Hagar (Genesis 16). Is using IVF taking matters into our own hands?

We don’t believe it is comparable to Abraham’s situation.  Sleeping with Hagar was engaging in an adulterous sin.

The bible says this about the creation of life, “For you created my inmost being; you knit me together in my mother’s womb” in Psalm 139:13. Since the union of the sperm and egg occurs outside the womb during IVF, does this go against the word of God?

We have really thought about and prayed about this one intensely.  We do not believe the outside union of the sperm and egg goes against God’s word because the embryo is then transferred to the womb where it then implants and is knitted together and developed.  Just as God’s word says it’s knitted, it is knitted in the womb even with IVF!

Should we just adopt?

We would love to adopt someday regardless of what happens on our fertility journey if that is the Lord’s will! We have always thought it would be awesome to have a child and then adopt a second one. Don and I even started down the adoption road but felt strongly that we should pursue conceiving biologically while I was still in my 30’s.  The older a woman gets, the harder it can be to conceive.  Obviously, God can do anything, but we felt strongly that we should pursue our fertility options while we could.  Adoption will always be there, and we don’t see it as an alternative or second choice.  It is simply another journey.  It is just as special as a biological birth and orchestrated by God.  I not only desire to be a mother and raise a child, but I also desire to carry the child.  I want to feel it growing inside and want to nourish it as it develops.  We want to experience God’s miracle of creation of life firsthand.  That may or may not happen with IVF as nothing is guaranteed, but we would like to try!

IVF can involve a lot of strong drugs that can cause the body to physically undergo a lot of stress, not to mention it can cause financial stress and even marital stress. Are we willing to embark on this journey?

The intensity of the drugs used has a lot to do with how many eggs the doctor is hoping to retrieve from the ovaries.  Don and I are not comfortable with having more fertilized eggs than we can use or will use, so our goal is not to have a ton of eggs retrieved.  Also, my body tends to be quite sensitive and reacts strongly to even small amounts of medicine.  Therefore, after exploring our options, we are leaning towards doing a gentle round of IVF which is referred to by doctors as a mini mod.  In addition to the terms gentle IVF and mini mod, I have also heard and seen this type of IVF referred to as abbreviated IVF, micro IVF and mini IVF.  In gentle IVF, only a few eggs are retrieved and fertilized, and there are only one or two leftover which can then be frozen for future babies.  We know we want more than one child, so this is a great option for us.  We have a consultation with our doctor scheduled for next week to learn more.

As far as the stress, yes, even the gentle IVF process has the potential to become stressful.  And, the medications could potentially mess with my moods, feeding the stress.  We know that with our focus on God, that he will give us the strength to get through any situation.  If, at any point, we feel like he is leading us to stop the process because it is harmful, inhibiting a healthy marriage or any other reason, then we will.

What about a natural cycle IVF as an option?

Natural cycle IVF, is IVF without the use of any stimulation drugs.  Stimulation drugs stimulate the ovaries to produce more eggs than typical.  In natural cycle IVF, only a couple eggs are retrieved that the body has produced without the use of any drugs.  We have decided that as long as we are going to undergo the procedure that we would like to increase our chances and therefore use mild stimulation.

Are we jumping to IVF too soon?

We first visited this doctor last spring.  He ran lots and lots of tests on both Don and me and didn’t find anything wrong.  I also had a hysteroscopy done which is an examination of the uterus with a camera, and everything looked great.  As a woman ages, her ovarian reserve (number of eggs) goes down.  Tests show that I have an excellent reserve which is great news considering my age of 38.  At that time last spring, the doctor instructed me to take baby aspirin daily, prescribed progesterone suppositories, instructed to test ovulation at home with over the counter strips and time intercourse with ovulation.  He said to try this for 3 months, which we have done.

The next step could be monitoring (sonograms to view ovaries and to ensure I am ovulating since home tests are not always reliable) and possibly IUI (intrauterine insemination).  I lost my left fallopian tube during the second pregnancy loss (ectopic pregnancy), and ovulation does not alternative between ovaries in a pattern.  For example, it might not necessarily be left side ovulation one month, right side the next month, left the next and so on.  Rather, it is random.  For example, it could be left side twice in a row or more.  When the doctor monitors ovulation, he is not able to tell which side the ovulation will occur until the third sonogram in the cycle.  Monitoring alone is $550 a month ($1100 with IUI), and, if I were to ovulate on the tubeless side, that month would be a loss before we can even try.  So bottom line, our chances are 50% with only having one tube.  IVF takes the tube completely out of the process.  The eggs are retrieved, fertilized and transferred to the uterus to implantation.

Is the cost of gentle IVF worth it, and are our chances of conceiving less with gentle IVF versus conventional IVF?

It could be argued that because gentle IVF retrieves fewer eggs, the chances of conceiving are less, and therefore isn’t as cost effective.  However, because my body doesn’t typically respond well to aggressive medications, it is likely that my body will respond more favorably to the gentle IVF therefore yielding better results. Also, the goal to retrieve only the eggs that we are going to use or will use is more important to us than cost in this case. Putting my body through less stimulation and stress is also a significant factor for us therefore impacting our decision regarding cost.  This is not to say cost isn’t a factor because it certainly is considering our medical insurance will not pay for any of this.

The cost of gentle IVF is about half of conventional IVF (gentle IVF is around $8,000 including medications).  From http://www.center4reproduction.com/our-services/mini-ivf.htm, “In select groups of patients (under the age of 35, normal ovarian reserve) pregnancy success rates for Mini IVF treatment is excellent, if not higher than with traditional IVF.”  Even though I am 38, I would classify myself in the age range under 35 due to the fact that I have excellent ovarian reserve.  Usually the reserve goes down as women get older which is one reason why their pregnancy chances go down.  As charts and statistics are reviewed, my ovarian reserve is not typical of someone my age.

When is the best time to start?

We have been trying to conceive on and off for 7 ½ years and we are ready to get this process started! We have a consultation with the doctor the second week of August 2016, and hope to complete egg retrieval in September.  The doctor will put me on the birth control pill, and then I will start medications, some of them being injections with possible egg retrieval in mid – late September.  Don and I have discussed this, researched this and prayed about it and both feel peace this is the right decision.  Of course, God can change our course of direction at any time, and if he does, we will embrace it, even if it’s different than what we were hoping for.  AND if we were to conceive in September, the baby would be born in June which would be a dream not to be pregnant in the heat of the summer!  But even if that weren’t the case, we won’t let that delay the process.

What if the first round is not successful?

We’ll cross that bridge IF we come to it.  We believe the Lord will show us if one round is enough or if we should continue on to a second round.

What if we end up with multiples?

We would love twins!  Yes, it would be more work, and though it would be “two for the price of one”, it would be double the expenses upon birth:  two cribs, two car seats, two of everything… But we would be overjoyed! In conventional IVF, triplets and more are possible.  It all depends on how many fertilized eggs are transferred to the womb.  Some people have several transferred and anticipate that some will not survive, but sometimes they all survive.  Since we will be doing gentle IVF, we most likely would not have more than three eggs transferred.  But even if we did end up with triplets, we know that God is in complete control, and he will get us through any challenge.

 

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