Wednesday, January 2, 2013

Our Experience with Infertility Part I - Pre-diagnosis

Infertility is not something I ever anticipated dealing with. Strong fertility seems to run in my family. My maternal grandmother conceived 10 times, my own mother got pregnant with my brother on her wedding night and then again with me while nursing him at 5 months, and my sister conceived her daughter while still using contraceptives. The women I'd known personally that had dealt with infertility had been diagnosed with endometriosis, polycystic ovary syndrome (PCOS) or other issues that led them to know it would be difficult for them to conceive. These conditions are often accompanied by severe pelvic pain, irregular menstrual cycles, and other unpleasant side effects, so most of them are aware that having children will be difficult for them well before they start trying to.

I, on the other hand, have an extremely regular menstrual cycle. I hit puberty pretty young, about 10 and 1/2 years old. Up until the blessed miracle of this current IVF pregnancy, I had never missed a period in my life. Although it's common for girls to miss or to have irregular periods for several months after moving to a foreign country, I wasn't even late after moving to Italy to serve a religious mission. Until my 2nd year of marriage (age 26), I'd never been more than 2 days late. Since getting married I've been 6 days late 3 times, and each time I took a pregnancy test that turned up negative.

As for desiring to be a mother, I can't say I was ever one of those girls who always wanted to hold a baby whenever one was nearby, but I definitely wanted to have children someday. I never contemplated having a life entirely without them. I was always a bit uncomfortable around babies since I'm the youngest in the family and didn't have any experience around them, but I really like kids. While growing up I was much more likely to befriend someone younger than me than someone older. There's a natural part of me that enjoys teaching others from my own experiences, and I love watching children get excited from learning new things.

Growing up I wanted to be an attorney and eventually a judge, but my law career aspirations would change once I'd spent a year working my first college job at a daycare. Up to that point I'd never processed that having a law career might conflict with raising a family. My own mom started going back to work part time when I was 7, so I'd never seen what having a full time job was like for parents of children younger than school age. I knew that a law career would be a good deal more time consuming than my mother's part-time job, so it was likely I'd have to put my own children in full time daycare if I continued down that path. Although I believe some daycare/preschool is good for children in helping them learn socializing skills, it broke my heart to care for the children who were there all day long - sometimes as much as 6:00am-6:00pm, five days a week. I'd see their sad little faces when all of the other kids' parents picked them up first, and it bothered me to know I couldn't give them the kind of care and nurture they desperately needed from their own parents. I decided then that I was going to stay at home and raise my own children at least until they were school age. Since I wanted to have several children, it might be many years before the youngest was in Elementary school, and law careers don't lend themselves well to stay-at-home moms.

I didn't drop the idea entirely, though, since there was always the possibility that I wouldn't be married by the time I'd graduated. Although I wanted to be a lawyer when I began college, I declared my major in Vocal Performance since I love singing and performing and the University of Utah doesn't have a specific pre-law major. Law schools like well rounded applicants and will take students from many different majors. I figured I could keep pursuing music but would also take pre-law requisites so I could still apply for law school if I ever wanted to. A Bachelor's of Music degree at the U of U requires a lot of credits, and I found I couldn't take both music and law courses simultaneously, even while taking 18 credits a semester, the max my scholarship would cover. Fortunately I won another scholarship through my mom's work that allowed me to take an extra semester of classes after my 4 year scholarship had run out. My plan was to load up on my pre-law requisites in Spring semester of 2006 and possibly pay out of pocket for another semester or two, but all that changed when I met my husband in September of 2005. Within hours we knew we wanted to get married and start a life together, and since I didn't want to begin our marriage with 3 expensive, crazy busy years in law school, I never ended up bothering to take the pre-law requisites.

As for how long I would wait to start trying to have children after getting married, I'd always assumed I would use birth control for a few years, but I changed my mind about that shortly before meeting my husband. I'm an active member of the Church of Jesus Christ of Latter Day Saints, though we're more commonly known as Mormons. Our church is very family oriented. Although birth control isn't strictly forbidden, newlywed couples are encouraged to work towards having and providing for a family. Our leaders encourage us to prayerfully consult with God and with each other about when to have children and how many are right for our family, and they discourage us from waiting for a specific event such as "after I've graduated," "after I have a good job," or "after we've gotten to know each other better." They remind us that multiplying and replenishing the earth was one of the first great commandments, and they advise us to respond with faith and trust in God's promises to bless us and provide for us as we keep his commandments. The more I listened to this council, the more I decided I did want to start a family immediately. Since I was finishing school the same semester we were getting married, I figured there was nothing to wait for. My husband still had two years of college left, but he agreed that we should start trying for a baby as soon as possible.

Oscar and I got married on February 17th, 2006 fully expecting to get pregnant immediately. My immediate family wasn't thrilled with that choice since we were poor and didn't have any insurance. I remember my brother telling me what I was doing was foolish and that I needed to either get insurance or get on birth control. We ignored this advice knowing private insurance was more than we could afford, and we figured there were plenty of young college couples out there who had children without insurance. We were sure a baby was coming around the corner any moment and that God would provide whenever it happened. But month after month my period was as regular as it's ever been. I'd been told though, that even a healthy, fertile woman only has a 20% chance of getting pregnant on any given month, so I figured this wait was just to be expected.

Oscar ended up changing both his major and his school, and we moved up to Washington in August of 2006. I picked up a job waiting tables at Maggiano's Little Italy in Bellevue. This was very beneficial for us since Washington servers get minimum wage plus tips, Washington has the highest minimum wage in the country, and Maggiano's is a nice restaurant in an affluent area. I made much better money there than in any job I'd ever had, and I had good insurance benefits too. My husband started working for Comcast in February of 2007, and his insurance was even better than mine. I thought for sure I'd get pregnant now that we had steady money coming in and insurance to cover our medical costs.

Shortly after we moved to Washington, I started taking voice lessons privately with Tom Harper, head of the University of Washington vocal department. He encouraged me to audition for the Master's program starting in late September of 2007. I told everyone that I was just waiting tables until I could gain Washington residency and go back to school (which is exactly what ended up happening), but deep down I still hoped that I would get pregnant before then and not end up returning to school until after my children were raised. Because getting my graduate degree wasn't my main focus, I ended up missing out on the opportunity to audition for a scholarship. I wasn't paying attention to the dates and focusing on what I needed to do to get myself ready to go back to school. I still held on to the idea that school didn't really matter because I was going to have a baby. What did it really matter if I missed the scholarship opportunity? I wasn't going to end up back in school anyway.

I've now come to realize I was in denial of even the possibility that I was infertile. Let's face it. In spite of scientific discoveries and the progression of history and feminism, many women (myself included) still value themselves highly on their own ability to bear children. Infertility is more common than we realize because women like me will say "we're not really trying right now" rather than facing up to it. We feel ashamed. We feel we are less of a woman, less valued, less capable as a wife, or not good enough to have a child. We blame ourselves. I've even had good friends unintentionally say tremendously hurtful things that contributed to my feeling that way. I can't tell you how many times I've been advised to "just be more righteous, pray, and have faith and it will happen," or "just relax and it will happen," or "don't think about it and stop trying so hard and it will happen." Though the advice is often kindly given with the best of intentions, it can be very painful because it implies that your infertility is your own fault. It's essentially saying you are doing something wrong that you need to fix. This makes those of us struggling to conceive feel awful from being informed repeatedly that we are actively preventing ourselves from getting pregnant. But the worst part of it is - we believe it. Even if intellectually we know it's wrong, we believe it. If we're religious, we believe that God is stopping us from having a baby because we are sinning. We are the problem.

Before I continue with my story, this myth that our sins are causing our infertility needs to be busted now! I have a friend with secondary infertility - she was able to have one child of her own but hasn't been able to conceive in the 5 years since then. A member of her husband's family told her God would let her have more children if she were only a better wife and mother to her husband and child. This is beyond offensive and extremely illogical. Not only is it a gross insult to all women who are aching to have children, it also implies that women who can have children easily must be amazingly righteous.

It's my experience that most fertile women aren't unkind enough to say something so deliberately offensive, but many women out there unintentionally say cruel things based on this same misconception. I personally cringe whenever I hear a mother say "I'm grateful God trusts me enough to care for His precious children." Whether it's intended that way or not, it implies not only that fertile women are saints but that women who struggle to have children are not worthy enough or trustworthy enough in God's eyes. And when you really break it down, a woman giving herself credit for her own fertility is a statement of pride, not a statement of gratitude. She is boasting of her own goodness as a mother, not of God's goodness for blessing her with children.

Any of you who know me well or who follow this blog know I am a great cat lover and that any cat would be lucky to have me as its owner. Since I know what a good cat owner I am, I could by this same logic claim that my lack of cat allergies is thanks to God trusting me enough to care for his precious kitties. My mother-in-law would love to have a cat, but obviously God could never trust her to take care of one or He wouldn't have made her highly allergic to them. This sounds absolutely ridiculous when I'm equating it to caring for cats, so why do we buy into it when it comes to caring for children?

Now someone out there is probably reading this thinking "so you're saying it's prideful of me to be grateful I can have children?" I certainly don't believe that. Gratitude is always a good thing. I highly encourage all parents to thank God daily for the blessings they have of being able to bear and raise children. However, I believe this can be done in a way that is not insensitive to those of us who are struggling to conceive. Slightly changing the above statement to "I'm grateful that God has blessed me with children" is not offensive (at least not to me). I often have friends see my cats and say "oh they're so sweet and cute! I wish I could have one but I'm super allergic." They're not offended when I reply "I adore my kitties. I'm really happy I didn't inherit my dad's and my brother's cat allergies," though I bet they would be quite offended if I said "I'm glad God deemed me worthy enough to allow me to care for cats." Again, it's the statements of pride that are offensive, not the statements of gratitude.

A few years ago I mentioned to my friend Kristen that we'd been trying to have children but hadn't had any success so far. She seems to be able to have children at a whim, and her reply to me was "I must admit I'm grateful for our ease in conception." By making that simple statement she acknowledged that my trial was a difficult one and expressed her gratitude that she did not have to bear the same trial herself. This is not offensive to me. On the contrary, I appreciated her sensitivity to my situation and her expression of gratitude for her own blessings. And because of that, I did not begrudge her not having to deal with infertility herself (though I do admit it remained difficult to watch her family continue growing while we experienced our own fertility struggles). She also didn't try giving me advice on how I could be more fertile like she is. She showed sympathy and love for her friend even though she couldn't possibly understand the difficulties that I was going through. Your infertile friends don't need to be told what they should be doing differently (trust me - they've probably already tried everything you have to recommend). They simply need compassion from others and the reassurance that their merely desiring to have children is a manifestation of the natural goodness that is in them.

These false doctrines of righteousness equating to fertility ultimately spring from what we know about barren women in the Bible. Unfortunately they are based on gross misinterpretations of the principles being taught from the stories of Sarah, Rebecca, Rachel, Hannah, and Elizabeth. These women were initially barren but eventually able to have children after demonstrating incredible faith and patience. However, none of them were cursed with infertility because they had been sinful or lacked faith. All of these women promised God that they would be extra faithful were He to bless them with a child, but none said "I know you've been stopping me from getting pregnant due to my sinfulness. I'm going to repent and fix that now." They were good, incredibly righteous women during their infertility and after. They fervently pleaded with God to help them have children, some for decades. In addition to their enduring faithfulness, they were doing everything in their power to conceive. Sarah felt she could adopt children and tried to become a mother by giving her handmaid Hagar to Abraham (she was such a good woman, though, that she couldn't deny Hagar her own opportunity for motherhood and did not end up claiming Ishmael as her son). Rachel tried to increase her chances of getting pregnant by trading her night with her husband in exchange for her sister's fertility herbs (I bet it was a huge slap in the face when her super fertile sister got pregnant yet again during that extra night with Jacob that Rachel gave up). This is also what God fearing, infertile women are like today. They are not being denied children because they wouldn't make good mothers. They often want to adopt or use assistant reproductive services, but because both of these things are typically accompanied by long waits, intense heartache, and spending a LOT of money without necessarily resulting in a child, many women, myself included, are afraid to do more than fantasize. We just keep waiting in the hope that someday we'll finally get pregnant.

Though I've certainly learned a lot about how I can improve myself and my faithfulness due to this trial of infertility, I do not believe that I was cursed with infertility due to my sins or that I needed to learn more patience before God could trust me with a child. Though I'm far from perfect, I also don't believe I'm a greater sinner than my fertile friends. Hannah's sister wife mocked her relentlessly for not being able to have children when she herself had no problem conceiving. Those certainly aren't the actions a righteous woman would take. We don't get many details from the Bible, but I imagine she was jealous of Hannah, and she tried to feel better about herself by making fun of Hannah's infertility. There are plenty of insecure, fertile women today who would do the same.

What's most interesting to me is that all of these righteous, barren women of the Bible ended up having incredibly righteous sons. Hannah's Samuel was a prophet, Sarah's Isaac was a prophet, Rebecca's Jacob was a prophet, Elizabeth's son was John the Baptist, and Rachel's Joseph, the same who owned the coat of many colors, is well known for his stalwart righteousness in the face of temptation, incredible graciousness in forgiving his own brothers who'd persecuted him, and his remarkable ability to interpret dreams. On the other hand, the sons of the women who mocked their infertile counterparts aren't exactly known for their tremendous righteousness, like Joseph's jealous brothers who sold him into slavery. Now I do not believe that any child is born bad or that sinful women will be cursed with sinful children, but because they were raised by mothers who held jealousy and anger in their hearts and proudly vaunted their ability to have children over other women who couldn't, it's no wonder their sons picked up on the same qualities of arrogance and bitterness.

This is my personal interpretation of the lessons we can learn from the barren women of the Bible based on my understanding of LDS doctrine. These women were already some of the greatest women out there, hence the reason their good husbands loved them so dearly. They would have made good mothers and probably had many children if they'd been fertile. But God didn't want them to just be good mothers - he needed them to be extraordinary mothers. He knew their sons had been foreordained to become prophets, seers, and revelators, and He wanted these already great women to become the incredible mothers these boys would need in order to help them achieve their full potential. The trial of their barrenness significantly increased their faithfulness, patience, and gratitude towards God, wonderful qualities that they would end up instilling in their sons from birth. The next time you have a friend struggling with infertility, don't tell her to just relax, or to pray harder, and certainly don't tell her she needs to repent. Tell her that God is preparing her for greatness because He has something extraordinary planned for her, which may or may not be children. She's already a wonderful person, and He's merely fine tuning and sculpting her (see note below).

Please do not misinterpret what I've said as meaning infertile women are somehow better than their fertile counterparts and that fertile women can't also become extraordinary mothers. God shapes all of us through trials. Infertility is simply one of his methods. And whether mothers ultimately become more righteous or more wicked through the choices they make in their own trials, their children still have their own agency to choose their own paths.

But I digress. Back to my own personal story of infertility. At that point it'd been one full year of not using any sort of birth control. Most fertile couples will get pregnant within their first year of trying, but 1 year doesn't necessarily mean you're infertile. There are many couples who are able to conceive after 2 or 3 years without fertility treatments, and occasionally you find those couples that are finally able to conceive after 5 or 7 or even 10 years. I was convinced our babies would just be little late bloomers. If a healthy, fertile woman only has a 20% chance of getting pregnant in any given month, statistically that means that 7% of all healthy, fertile women will not get pregnant in a year. I assumed I was a part of that 7% that just needed to be patient and keep trying.

Seven more months went by, and we still didn't get pregnant. The Fall quarter was beginning at the University of Washington, and it was time to face the reality that a baby wasn't coming for at least the next nine months. I did think about attending law school, but it would have meant needing to finish up my pre-law requisites, plus 3 super busy years in law school, plus internships, and so on. It's not a path you want to pursue if you think there's a good chance you might not see it through. I was definitely not going to commit myself to an all-consuming career choice while I was still sure I was going to have children soon. However, I knew I could always use more vocal and performance training, and I figured if having a baby forced me to drop out in the middle of my graduate degree, I would still have benefited from the voice lessons and music education I'd received during my time back in school.

Though singing and performing was definitely my passion, I lost a lot of my drive for it after I got married and began desiring to have children. Since it was merely a secondary focus for me, I had several technical issues vocally that I never seemed to make much headway on. My dream was to start a family, and with that going unfulfilled through no fault of my own, I felt out of control of everything else in my life as well. The constant cycle of trying to start a family and repeatedly not succeeding each month was incredibly frustrating. If doing everything in my power to have a child hadn't worked, why would doing everything in my power to fix my singing work any better? I began to feel like there was nothing I could do to get what I wanted, and even though I kept practicing, I lost faith in my own ability to improve myself. Additionally, my weight rose steadily as I began believing that my efforts were futile and that I was doomed to be fat forever. My infertility was affecting my life in more ways than not being able to have children.

By the start of my 2nd year in school, we'd never used any form of contraceptives and still hadn't gotten pregnant in 2 and 1/2 years. We hadn't been tested to diagnose the issue, so it could have very easily been an issue with my husband. I, however, still blamed myself. I believe this may be because society sees fertility as being a woman's issue, and at the time I did too. Throughout history, women have been blamed, punished, or even killed if they didn't bear sons for their husbands. Infertility is actually just as likely to be an issue with the man as with the woman, but most people remain ignorant of these facts, and the world's overall attitude towards fertility hasn't changed much. These beliefs caused me a lot of pain and shame to think that I must be some sort of inferior woman. In truth I couldn't face up to the idea of being tested since that might mean confessing to infertility (even if I told myself and everyone else that it was because it was too expensive and our insurance probably wouldn't cover it anyway).

In November of 2008 I found a flier advertising for participants in an HGV vaccine study. It would include being given the testing vaccine for 7 months and being observed for 3 years to observe its effects. They would do multiple gynecological exams, urine tests, and blood work. At this point I'd never had any sort of gynecological exam since a nurse had informed me that it wasn't necessary until I'd been sexually active for 3 years. That 3 year point was coming up, and this study would actually pay me to have the exams I was going to need anyway. I assumed if there were something wrong with me they were bound to find it in all those examinations, plus I'd earn some extra cash. The only catch was I was required to be on some sort of contraceptives during the 7 month testing period. They didn't want to risk the effects of an experimental vaccine on a vulnerable fetus. I wasn't thrilled about this, but since I wasn't getting pregnant anyway, I figured I didn't have anything to lose.

The nurse who examined me did end up finding something that could have been affecting my fertility. I had a recurring infection which can create a hostile environment for sperm. At last I had an explanation! I was sure that had to be the problem since I had no other issues. I could now tell people that I wasn't getting pregnant because of a recurring infection that wasn't easily treatable. It made me feel less ashamed of my infertility than when I had no explanation at all. This excuse wouldn't last long though. The infection eventually tapered off, and I later learned that it typically only causes minor conception problems, not complete infertility.

Though the study only required 7 months, I ended up staying on the contraceptives for just under 2 years, stopping in October of 2010. My husband had gone back to school and said he felt more comfortable knowing we weren't getting pregnant while he was still figuring out what career/schooling path he wanted to pursue. Additionally, I'd put on a lot of weight by this point, so I told myself I was okay with not having children yet because pregnancy would only make me gain weight. I figured I just needed to lose significant weight before we started trying again. Again, pride and shame stopped me from pursuing my deepest dream, but this time it was because of my weight, not my possible infertility.

I graduated with my master's degree in May of 2009, and I had no idea what to do with myself afterwards. There's plenty more I could have done and many vacations I could have sacrificed in order to pursue a professional career in opera, but it wasn't my focus, and at this point on contraceptives, neither was starting a family. It was a very stuck period of my life. Whenever I was around my friends' children or serving as a nursery/primary worker at church, I let the children irritate me more than I should have because I wanted to believe I was better off without them. I'd quit my serving job in the middle of my degree, and it was the last thing I wanted to return to. I had a few voice students, and I began working really hard towards my weight loss and my vocal improvement, but I was still very bored and felt bad about not bringing in much money. I picked up a serving job at a closer restaurant from November 2009 - June of 2010, but I eventually quit since it only made me feel more stuck in a rut. By late 2010 we stopped the birth control, and I decided we would go to a fertility clinic if I still wasn't pregnant after trying again for a year. In the meantime I did some more auditioning, including a big trip back east, and I was able to get my first paid gig with the Leavenworth Summer Theater during the summer of 2011.

When the shows were over in September, I made two significant decisions. I needed to have more regular income and get a steady job, no matter how low end it was or how miserable it made me, and I needed to figure out why I hadn't been able to have children after almost 4 years of trying. Although I struggled to find work that wasn't in the food service industry, a lot of good stuff did happen. I got a few new students for my music studio, I had successful auditions and performed 3 more roles in November 2011, March 2012, and June 2012, but best of all, we found out our insurance covered infertility. It even covered 3 rounds of the expensive IVF process for up to 90%! It's a $20,000 operation per round, so that was huge. Once we learned this, we contacted Seattle Reproductive Medicine (SRM), met with our doctor, and began the testing process.

After we became patients at the fertility clinic and made having children our top priority, the other stuck areas of my life began falling into place. My voice started improving dramatically, and by the time I got pregnant, I had lost over 40 pounds from the heaviest weight I'd been since getting married. I'd finally begun to believe in myself and my own ability to change my situation, which enabled me to work through my vocal issues as well as my food addictions. Additionally, I was able to find a job as a delivery driver for Edible Arrangements. It's a low end job that certainly doesn't require a masters degree education, but it's flexible around my performances and random scheduling, it's low stress and allows me to listen to music and audio books while I work, and people are thrilled to see me when I come to the door, so I remain happy throughout the day and come home with good memories. God really blessed me once multiplying and replenishing the earth became my top priority. It just took me 5 and 1/2 years to figure out that top priority meant a lot more than simply not using birth control.

Update: 04/12/13
Originally part I of my post ended here. Part II explains everything we learned and attempted at the fertility clinic up until our invitro fertilization attempt (IVF), and Part III details that process as well as what pregnancy has been like for me so far. As I've been editing and revising these posts, I realized I never answered the question many couples using assistant reproductive services get asked - "why didn't we just adopt?" Adoption certainly was an option we thought about, and even though we would be willing to adopt and may very well still do so one day, we opted to try IVF first. There are 6 main reasons we took this path, and I'll list them in order of least to most importance.

6 - Desire to have my own biological child

I'm sure I could love an adopted child just as much as a biological one (look at how much I love my cats, and they're not even my same species!), but there's still that curiosity to see what the combination of my and my husband's genes looks and acts like. Will my children take daddy's skills with numbers and/or mommy's singing abilities? Will my sons go bald young like their daddy or will they still have a full head of hair at 68 like mommy's daddy? Will my daughters love science and math like daddy or reading, writing, and music like mommy? Can I see myself in my child's face or will they look as much like their daddy as my husband looks like his? Those questions would go unanswered were I to never have a biological child.

5 - Wanting to experience being pregnant and feeling a child grow inside me

A lot of women think I'm crazy for wanting to be pregnant when pregnancy has so many unpleasant symptoms associated with it. Complaining about the difficulties of pregnancy and telling infertile women they're lucky they don't have to deal with it is one of the worst unintentionally cruel things fertile women do. Sure morning sickness and fatigue would be miserable for us too; sure back pain, acid reflux and bloating would exhaust us as well; but no matter how much we realize that, it doesn't make us want to avoid the miracle that is having a child growing inside you. We recognize that discomfort comes along with that, but we still want to experience feeling our bodies adapt to protecting and nourishing new life. When you're infertile, you often become very bitter against your monthly period. You detest suffering through the regular annoyance of that just to never have your body get the chance to do the very thing it prepares itself for each month. Our bodies are biologically/spiritually created to perform specific functions, and we innately desire those experiences.

I'm currently 8 months pregnant, and even though it's had its share of difficulties, I wouldn't give up this experience just to eliminate the discomforts. Were I one of those women who feels sick her entire pregnancy or has to go on bed rest from 4 months on, I might feel differently. But even then, I still think I'd want to experience being pregnant once. It's truly been a miracle to feel my child moving inside me, to see that unborn he already has a personality and preferences, and to talk to him, sing to him, bond with him, and know that my body is naturally nourishing and caring for him. After he's born I hope to be able to nurse him for similar reasons. Women talk about pregnancy and nursing as a natural part of motherhood. It hurts adopting mothers to feel left out in motherhood groups because they were never able to experience pregnancy or breast feeding. Although those who can't bear children of their own can still experience the most important aspects of motherhood - loving, caring for, and raising a child, they can't know what it feels like to bond with their children in these natural ways. Many women who can't produce the eggs needed for IVF end up opting for egg/embryo donation implantation, which makes some people ask "if the child isn't biologically yours anyway, why not just adopt and not have to deal with pregnancy and child labor?" I can definitely understand why someone would make that choice. They want to physically bond with that baby whether it contains their own genetics or not. Having a biological baby certainly comes with the benefits I've mentioned above, but they're nothing compared to the experience of carrying and nursing a baby.

PS: This would rank higher on my own list of reasons for choosing IVF over adoption, but since it's the least important for my husband, I ranked it at #5. He enjoys talking to and watching/feeling the baby move around in my belly, but it really wouldn't influence his decision to try IVF over adoption.

4 - There was no cost benefit to choosing adoption over IVF

This is not true for most couples. We are extraordinarily fortunate that our insurance covers so much of our infertility treatments. Most insurance won't cover infertility since having a child or not doesn't typically influence your general health. Although adoption isn't cheap, it's still a lot less than the full cost of one IVF attempt that has no guarantee of even being successful. IVF may have high success rates for couples like us, but  it also has very low success rates for many other infertile couples. A friend of mine was told IVF only had a 15% chance of working for her. Since her insurance wouldn't cover any of the cost, she didn't give it a 2nd thought and is now hoping to adopt. 

Our benefits through Comcast would give us some reimbursement towards an adoption, and we may very well take them up on that one day. But when we weighed the out of pocket costs that IVF would demand of us versus adoption, they were more or less the same. Since we'd been told we were ideal candidates for IVF, we figured we might as well give it a try.

3 - IVF is an option for us now that might not be in the future

IVF success rates decrease significantly with maternal age due to the decrease in egg quality. There's also some decrease in sperm quality from paternal age, but maternal age is the biggest factor. I was 30 when we made our attempt, which is significantly younger than most of their patients. Egg quality does not start changing significantly until you're over 35, and even though they've certainly had success impregnating women who are older than that, your chances of successful conception are higher the younger you are.

As mentioned in part II of this post, I have low egg count. This doesn't affect my monthly fertility since I still release an egg regularly when I ovulate, but it does mean the amount they can retrieve from me during an IVF attempt is about half that of most of their patients. Although I got less eggs than most IVF participants, because of our youth and lack of physical fertility issues, 3 of my 9 eggs developed to the embryonic stage (blastocyst) required for implantation or freezing (a much higher percentage than the average). Egg quantity also decreases with age, and were I to try IVF after I'm 35, I might only have 4 or 5 eggs total. Since they'd be lower quality as well, I'd be lucky if 1 made it to the blastocyst stage. And even if it did, there would still be a 20% chance that it wouldn't result in pregnancy. If we were ever going to try IVF, now was the time to do it.

2 - We felt better actively trying for a baby with IVF than waiting an undetermined amount of time for a birth mother to pick us

When we first started working with a fertility clinic, I had this brilliant idea to also contact LDS adoption services and get on the waiting list for adoption. I've heard of it taking as long as 5 years to get a baby, so I figured the sooner we got on it the better, and we could always take ourselves off the list if we were able to conceive on our own. I was informed it would cost $1,000 non refundable to enroll in the program, and it's 6 months of education before your profiles are even put in the pool of candidates for a birth mother to choose from. If you are able to conceive on your own and still want to adopt, it's another $1,000 since they have to educate you differently now that you're a parent wanting to raise another woman's child. I told the lady I was speaking with that we had good insurance coverage for IVF and would be trying that, and she encouraged me to exhaust our attempts to first have a biological child before turning to adoption. She said "if you are able to get pregnant - great! And if you're not able to, then you'll be that much more ready for adoption than you were before." One of the first things they ask you is "have you fully mourned the loss of your unborn child?" If we'd truly done everything in our power to conceive, we'd be better able to respond to those types of questions. Since it would have been very complicated to try doing both IVF and adoption at the same time, we felt IVF was the more active choice as opposed to an uncertain waiting time for adoption. We also learned that there are up to 36 couples waiting for every 1 child put up for adoption, most of whom don't have assistant reproductive services as an option for them. We felt that since we did have a chance of conceiving a biological baby, it was more fair to take it than to add ourselves to the list of couples who are waiting for a baby and don't have the resources we do.

1 - "Just adopting" isn't nearly as easy as people think it is

If you could just walk into an orphanage and pick out a baby, we would have done so long ago. In fact, we wouldn't have even insisted on a baby. We would have been willing to take a child up to about 5 years old. If it were that easy, we might not have bothered with IVF at all. Although I'd miss the perks that come from having a biological child, I could give those up in order to be a parent for a child who desperately needs one.

Unfortunately the real road to adoption is often long, costly, and heartbreaking, whether you're waiting for a baby or for a foster child. Private adoption comes with the risks of getting your hopes up only to have the birth mother decide to keep the baby after it's born, or to have the family of the birth mother pressure her into not going through with the adoption. Plus there are all the horror stories out there about unscrupulous people who will take advantage of vulnerable, childless couples as easy scamming targets, even within a legitimate adoption agency. As for becoming a foster parent, the main goal of the foster system is to provide temporary care for children until they can be returned to their rehabilitated biological parents (though there are some children that can be adopted immediately if their parents have completely lost/given up their custody rights). If you're going to foster, you need to accept the likelihood that you will become attached to your foster child only to have him sent away. It's also very common for foster children to come from abusive homes where they have been severely neglected. Although they certainly need the love you have to offer them, this will come with many additional challenges for you. Fostering children is a noble road to take if you're willing to travel it, and although I'd like to do it one day, I don't believe I'm quite ready for it. Since I have the option to do so, I'd much rather start with a baby whom no other parent can claim. I just wish it were an option for other infertile couples who aren't as fortunate as we are.

I once read an opinion on an online pro-choice forum that said "the success of assistant reproductive measures like IVF means fewer couples are willing to adopt babies, so giving your child up for adoption means it will go into the foster care system. Since we all know how unhappy foster kids are and that foster parents are just in it for the money and really don't care about their foster kids, you'll show more love for your baby by aborting them rather than giving them a miserable life." I have no idea where this girl got her ideas from since her claims are far from true. IVF has certainly had a lot of success, but it doesn't work for everyone, many couples can't afford to try it even if it could work for them, and many of them would rather adopt due to moral objections to the procedure. The adoption system is not lacking for adopting parents due to the success of IVF; it's lacking for babies due to the vast numbers of pregnant women who choose abortion. In the US alone, there are over 2 million couples waiting to adopt a baby each year, and there are 1.37 million abortions performed each year. These couples waiting to adopt a baby are desperately longing for a child, and they are definitely not in it for the money. They've already spent a lot just to get on the waiting list to adopt, and they'll spend a lot more for the birth mother's medical fees and, of course, the costs of raising that child. Private adoption does not come with government subsidies like the foster care system. They are very different systems, and those who are adopted as babies grow up in much more loving homes than the average foster child whose biological parents have proven themselves unfit to care for them.

Some of you reading may think I'm about to go off on a big anti-abortion rant. Believe it or not, in spite of my religious views, I'm not against the legality of early abortion. If abortion were made illegal, then yes, a few more birth mothers would choose adoption. However, many others would choose illegal/unsafe abortions as we've seen throughout history, and it's my guess that the bulk of them would choose to raise their children as single mothers. Certainly there are many single parents that love and care for their children as devotedly as anyone else in spite of the extra difficulties that come from raising a child alone, but there are also many parents that raise children only to find they are mentally, emotionally, and/or financially unable to provide for them. Typically these are the parents who feel forced or obligated to keep their unwanted babies, which makes them more likely to neglect and resent them in the future. I believe legally requiring young girls to carry their babies to term would most likely create more of the latter group than the former. If my predictions are accurate, changing abortion law would result in only a few more babies being adopted and significantly more children being put in foster care. I believe that promoting adoption and infertility awareness is the ideal solution both for reducing the number of abortions performed and the number of children being raised in unfriendly environments.

As much as I stand by the pro-life movements ideals, I've never been able to support their tactics. Shaming girls with "it's your mess, now clean it up or you're a murderer" does little good and in the end just invites anger and backlash. We certainly won't encourage more girls to choose adoption with name calling and insensitivity, and changing the law won't change society's misinformed attitudes towards adoption. We can only create positive changes with positive measures - empathizing with, educating, and encouraging girls considering abortion to choose adoption. Only 1% of those calling America's Pregnancy Helpline even inquire about adoption. Something has led our youth to believe that adoption is the worst possible alternative, worse than abortion. The good news is that the law does not force these girls to have abortions. They can still choose adoption. Let's do our part and help them make that choice. We need more stories about successful adoptions, more improvements within the private adoption systems, more education for our youth about infertility, and more compassion shown for these single, pregnant girls and the desperate situation they find themselves in. Shaming them and calling them murderers will not help; but love, education, and encouragement will.

A few months after I originally published this post, my sister said to me "I understand the need to get it all written down, but what motivated you to publish something that was so personal to you?" At the time I wasn't sure how to answer, but I know why now. We childless couples often feel ashamed of our infertility and keep it to ourselves. We tell people we're not trying to have children when in truth we'd love to have children but are struggling with the reality of our situation. Maybe if we were more open about our struggles and our desire to care for children, we could help show these young pregnant girls the good that adoption can do. We can help them turn a terrible situation into a blessing for themselves, their unborn baby, and a childless couple. I hope this post will serve as the beginning of my part in that.

1 comment:

  1. Wow, Stacy...I am reading your post, for the first time, tonight. What an amazing journey you both have had. I did not realize the challenges you went through. I've really enjoyed reading your post and have appreciated your convictions and insights. Mark and I got pregnant with Chloe fairly quickly, however, we experienced the secondary infertility you mentioned your friend went through. Our infertility lasted for a year and a half and seems quite insignificant compared to yours. But I do understand some of the struggles and disappointments you talked about. I'm so excited for you both, to be pregnant and expecting soon. I too was so amazed and delighted to feel our babies moving inside me. There's nothing like it. It's difficult to describe, but it is so incredible. Your words have been powerful and I really liked how you mentioned the women from the Bible. Thank you for sharing your story. I haven't read Post II but I will be reading it soon. Take care. Your cousin, Krissy :)