Monday, April 1, 2013

Treatment for Infertility: When are the costs too high?

Jen at This is More Personal recently stopped blogging for the best of reasons: in December, she and her husband adopted a baby girl.

Jen's struggles have helped me so much in my own journey. After one round of IVF, which resulted in a chemical pregnancy, and a few canceled cycles, Jen and her husband decided they couldn't take any more. Jen's experience put words to something I had been thinking for a while: IVF has emotional, financial and physical costs that are rarely, or perhaps never, acknowledged by the medical profession. Reading through Jen's narratives of her IVF journey made me clearly see that IVF would break me. The stress of spending $15K on a twenty percent chance of getting pregnant, the mood swings that come with high doses of hormones (for whatever reason, I'm extremely sensitive to all medications), the anxiety of being constantly poked and prodded.....I knew I could not do that. The emotional, financial and physical costs of IVF would be too high for me.

(This actually had very little to do with most religious arguments against IVF. I'm not convinced that the unitive and procreative purposes of marriage should never be separated. As for the destruction of precious embryos....what was my body was doing with my embryos every month for a solid year? I was unlikely to produce dozens of eggs, and a couple embryos would probably have been safer in the hands of a competent embryologist than in my inflamed womb.) 

So instead, I turned to alternative therapies. I had always had a healthy diet, but for a solid year, I eliminated alcohol, sugar, refined grains, fried foods, and caffeine. I ditched exercise that I loved, like swimming and intense yoga and instead stuck to the brutally boring Fertility Yoga. I took my temperatures every single morning, stressing out when I ovulated a few days early, because of course, women with DOR "always" ovulate early (except when we are completely asymptomatic). I meditated, I prayed. I structured my days around what supplements I needed to take and when. My entire life became about trying to get pregnant.

It didn't work. Eventually, I realized that these alternative therapies also have high costs. When you give up activities and things that used to give you pleasure in order to get pregnant, and you don't get pregnant, month after devastating month, you begin to lose your soul. Eventually, I realized that I could not continue to live that way; even if I did eventually get pregnant, didn't my child deserve better than the person I had become: jealous, bitter, joyless?

So, I've stopped. I need to update my supplements page, because beyond a few vitamins for basic health, I've stopped taking them. I still do Fertility Yoga, but I also swim and go to Ashtanga Yoga once a week (even in the luteal phase). I'm still staying away from fried foods, because they really do make me feel sick, but if I feel no immediate benefit to eliminating a certain food, I just go ahead and eat it (in moderation).

More joy in my life makes it easier to face infertility, and the fact that I might never get pregnant. Because really, nothing--not even motherhood is worth my soul.

9 comments:

  1. Sarah, great sentiments! I agree 100%. I think God is able to finally give us peace when we stop running on the "fertility wheel". Being able to LIVE is essential but sometimes hard to do! I'm so glad you have more joy. That's a beautiful thing in the midst of life.

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    1. And yet....we still want to be parents. We're just getting started on the adoption wheel, but from what I hear, it's every bit as much of a roller coaster. At least it won't involve my body, which has defied all my best efforts to control it and make it submit to my will!

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    2. Yes, I know we will always long desperately for children until we have them in some way...but not taking my temperature and painfully analyzing it every morning sure is nice. And centering my life around things besides my follicular phase and luteal phase is quite a relief!! My body has never submitted either. :) I hope your adoption journey has lots of joys in it, despite the unavoidable ups and downs. It's exciting to have made that decision!

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  2. While our reasons for not doing IVF do center so much on maintaining the unitive and procreative ends of intercourse (and I am first to admit it is from 1) the damage caused by separtating them before and 2) witnessing the pain of someone else much as you described above), I found myself agreeing so much with this.

    The first few months of TTC, I acted as if I was pregnant for the entire 2WW. It almost destroyed me. I put my life on hold and I was miserable. Now, I drink wine whenever I want, I run and am training for a marathon, and I don't panic if I miss a pre-natal vitamin (they are actually really hard for me to take, emotionally...it's like that little pink pill is mocking me). I do keep my chart and take my other medications as prescribed, as I feel like if I'm going to pay for/bill my insurance for doctor's visits, then I have to do my part.

    Sometimes, it is the hardest part of infertility - trying to live the life I have, while pursuing the life I dream of. While I won't know until 10 years down the road the outcome, I truly hope and pray that when I get there, I look back and am mostly proud of how I walked this journey - whether it leads to children or not.

    The costs truly are much more than just financial.

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    1. "....trying to live the life I have, while pursuing the life I dream of." Well-said, Rebecca. I'm not advocating that every couple "give up" the way I have, but I do think every couple needs to understand their limits and stop before they get to breaking point. For a whole lot of reasons, my breaking point seemed to be way short of what other women have gone through.

      I was just thinking of a post this morning in the shower titled "How to ensure a miserable 2WW." I think it involves taking pregnancy tests three times a day, telling DH I'm pregnant every time I get heartburn and putting myself on bed rest to help implantation. I'm back to drinking (in moderation), exercising, and generally trying to enjoy life no matter what the time in my cycle. And assuming I'm not pregnant until I definitely know otherwise!

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  3. Wait a minute. How can you not see the difference between willingly participating in the creation and destruction of tiny human persons ("embryos") through in vitro fertilization, and the accidental destruction, totally against your will, that is miscarriage?
    One is murder. The other is an accident. Of course if you know for sure that you will miscarry, conception is also completely irresponsible and carries a moral weight. But IVF is deliberate participation in killing your children.

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    1. Hi Kelly,
      I wouldn't be comfortable with creating tons of embryos and only using a few of them, but because of my specific condition (diminished ovarian reserve), my ovaries would be unlikely to produce more than one or two eggs on a given IVF cycle. This is one reason that IVF doesn't work so well with DOR women---the more embryos a woman produces, the higher likelihood of success in a given cycle. So if I produced one or two, both would end up in my uterus. None would be destroyed; none would languish in deep-freeze. (Actually, I'm not sure where you got the idea that embryos are deliberately destroyed in IVF. All the eggs that a woman produces are fertilized; some don't make it to a blastocyst because they stop growing in the petri dish. Others aren't good quality embryos. In a traditional IVF cycle, the RE puts the two best embryos in the uterus and freezes the ones that make it. But there is no deliberate destruction of embryos...that would be counter-productive.)

      DOR women usually have to seek out REs and embryologists who are experienced in working with them because it's a completely different ball game than IVF for women with normal ovarian reserve.

      Anyway, this whole conversation remains hypothetical because, as I state in my post, for a whole host of reasons, I am not pursuing IVF.

      As for the miscarriage conversation, do you think that women with unexplained infertility are irresponsible for continuing to TTC? AFter all, there is a chance that the embryos aren't implanting every month. Or what about women with recurrent miscarriage who are seeking medical treatment and doing everything they can to prevent miscarriage, but the treatment isn't working? What if they only manage to hang on to a pregnancy after the tenth miscarriage? Would you say that they should have just avoided pregnancy altogether to save the lives of the ten who didn't make it?

      If you do think that, that is a pretty extreme position.

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    2. I was just going to say "amen" to your post and agree that sometimes, you just have to live your life and go with the flow. It sucks to have your whole life revolve around trying to get pregnant.

      Then I see Kelly's comment and have to say that the narrow-minded, uneducated response she wrote is one of the reasons IF and the treatment of it is still such a taboo subject. Because people like her see it as a "sign" that people who can't get pregnant easily aren't supposed to be parents. Why then do teenagers get knocked up all the time? They are no way shape or form ready to be parents, and yet it happens all the time. What about the parents that abuse their kids or neglect them? So they are "hand picked" to be parents by God, but those of us struggling to conceive the baby that we want so badly just shouldn't try?

      My husband and I are about to go through our first round of IVF (our last shot at trying to become parents to a biological child). We are in no way going to let them destroy our embryos or choose to selectively reduce if we get pregnant with more than one. The embryos that make it to freeze will be frozen for use by us at a later date and if we have so many that we couldn't possibly use them, then we are going to choose to donate them to a couple(s) who cannot get pregnant on their own and have to adopt an embryo in order to carry their own pregnancy.

      I wish you would do some research before you spew out such hateful judgement.

      Sarah, as I've found, your blog is such an inspiration. Thank you for sharing your journey. I hope one day everyone can be educated on the fact that IF is an illness, a disease, and we deserve the chance at treatment without judgement from others.

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    3. Hi Zookers,
      Thanks so much for the kind words. I started this blog because I was hoping that others would benefit from my reflections, and it's nice to have this affirmation. I'm so sorry that you're going through infertility as well.

      I think it's important to recognize that many couples, like yourself, have thought long and hard about their values and limits when they have to turn to Assisted Reproductive Technology. The fact that we all come to different conclusion is because people are different. If someone doesn't share your conclusions, it doesn't mean that they are stupid or utterly lacking in morality.

      I'm just curious...have you discussed your values with your RE? How did s/he respond? I also don't know the stats about embryo adoption. How many embryos are adopted? Is there a high demand?

      I will say that I don't think that Kelly would necessarily say that some people are picked to be parents. She is just following through on the "embryos are people" premise that she starts with, along with some misinformation that I've encountered among a particular religious community.

      You are in my prayers as well as you start IVF. I know that it's a tough process, and I pray that things go smoothly. And most of all, that the cycle is successful!

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