How do you know when you are done with infertility treatment?

I was asked a while back whether we would ever try in vitro fertilization (IVF) again. I had every intention of answering the question, but somehow this post sat in my drafts for the past year and a half. In a related question, another friend I "met" through blogging asked a question about how you know when its time to end infertility treatments. I was going to email her my answer, but the busyness of life got in the way before I had a chance to do so. Unfortunately, the answer to this question has become relevant again for her, how I wish it wasn't.

The short answer to the question of future IVF for us is no we would not, nor do I see that changing in the future.

So how did we know we were done? I want to say up front that anything I write here is the decision John and I made asking and seeking the Lord's guidance. However, that doesn't mean that our decisions are the ONE right way or that because the Lord led John and I in this way means that He will lead every one else in the exact same way. Others have sensed the Lord leading them toward different answers. Just as an example, many Christian couples, and just about all true practicing Catholics believe that IVF is morally wrong. While we see it differently, I respect the opinion of those who feel this way. Elaine has an excellent post, which can be found here, about how two couples, though both Christians can come to two different conclusions about IVF.

You can read a recap of our infertility journey here. In the beginning I was unsure about doing IVF; it truly seemed like (and is) a moral minefield. I was so afraid of making a wrong decision that I would later regret. I truly wanted to honor God at every part of the process. We prayed, asked others to pray, and sought wise counsel. I was so grateful that the Lord brought my friend Wendi into my life at that time; she and her husband provided much godly counsel to us.

What we decided up front was that we would do two IVF cycles. Again, I am not saying that two should be everyone's limit, but I do think it can be important to determine up front how far you want to go with infertility treatment. I say this because emotions run all over the place in the midst of treatment and the loss that so often accompanies it, so it can be difficult to make decisions at such a time. It is also not uncommon to get to a point where a feeling of desperation takes over causing a person to make decisions they would not have otherwise made. Another one of the limits we set was that we knew we didn't want to involve a third party. If donor sperm or egg were required, we knew this was not something we were comfortable with. I am not saying that it is never okay to change your mind, just that it can be helpful to have an idea of how far you want to go. Had we gotten to the end of two cycles and not felt done, I am sure we would have done a third cycle. We actually could have done one basically for free as part of the shared risk program we participated in (we would have had to pay for some drugs and my ultrasounds).

We believe that life begins at conception and so upholding the sanctity of life is very important to us and factored heavily into our decision regarding when we were done. Our first cycle went very well; 7 eggs were retrieved, 5 fertilized, and 2 embryos were transferred (we asked the doctor to limit the number of eggs they attempted to fertilize to 8). However, none of our other 3 embryos survived to be frozen for a later transfer. Our second cycle did not go as well; 17 eggs were retrieved, 16 of them were mature, 8 eggs were frozen, 8 eggs were injected, 5 fertilized, only 1 embryo made it to transfer, and again none of the others survived to be frozen. While it is true that part of our lack of success could be because we limited the number of eggs that we allowed the doctor to attempt to fertilize, however all over the blogosphere I have seen stories with less eggs retrieved but still healthy 5 day blasts to freeze. The fact that we didn't have this said to me that we had a problem. Yes, we could have gone "all out" as the doctor wanted us to in a third cycle playing a numbers game in the hope that if we retrieved enough eggs and injected all of them, we could have had one healthy embryo that resulted in a healthy pregnancy. But we just weren't willing to go there; it just didn't feel respectful of life to us given what had happened with our two previous cycles.

The second reason we knew we were done was that I couldn't cope with another miscarriage. This was probably the biggest reason we didn't want to continue treatment and why we never considered embryo adoption. My miscarriage absolutely devastated me; it remains one of the most traumatic experiences of my life.

Lastly, we just had a feeling of being "done." We just couldn't take the idea of going through it again. One of the books that helped me the most when we were at the beginning of infertility treatment is The Infertility Companion: Hope and Help for Couples Facing Infertility. A great quote from the book about when it's time to quit is, "When it hurts more to go on than it does to quit, it's time to quit." This statement really resonates with me. I have never posted about what we decided to to with our eggs until now. For the first year, we were able to keep them at no cost. When our year was up, we decided to store them for another year, kind of an insurance policy even though we had no real desire to go back for them. We had begun the adoption process, but knew there were no guarantees with adoption either. Last summer just before Joshua was due to come home we received another bill to continue to store them. At the time we were caught up in the crazy 13 week long wait for EP approval and things felt very uncertain. We really weren't sure that Joshua was going to come home. Yet, in the end we decided to discard my eggs because we knew that even if Joshua didn't come home we had no desire to go back for my them. We had and have no desire to go there ever ever again.

When you get to that point when you feel done, there is almost a sense of relief about not continuing treatments.

I can tell you all with absolute certainty that I have zero regrets about not continuing treatment. I don't ever wonder if a third cycle would have led us to a baby. I am thankful that I have no lingering "what ifs?" I don't know whether anything I have said here will help anyone, my prayer is that it will. I can also tell you that the Lord is absolutely able to give true peace about ending treatment, leaving you with no regrets and no "what ifs?" It really is possible, even though it doesn't seem so at the time (at least it didn't to me), to reach a place where you feel completely okay with being done with infertility treatments.

Truth be told, it feels pretty darn good not to ever think about them again.

Edited to add: This should not be taken as "Just adopt" and every thing will be fine, as we who have dealt with infertility so often hear from others. There is no "just adopt," a statement which deserves a post of its own to adequately respond to why it is an inaccurate and insensitive thing to say. Nor is this post meant to imply there is not much grief associated with the decision to end treatment, this is also worthy of its own post.

One Year Ago....(on Saturday)

...our long summer of waiting came to an end. After an unprecedented 13 long weeks of waiting we had EP for Joshua!

John and I celebrated with champagne, after all it is one of the advantages of being an expectant mom via adoption. :)

Though I am not in the habit of daily journaling (I'd like to be), I did journal that day. On 8/11/2011, I wrote, "A great day today! We finally have EP for Joshua!!!!!! We waited 13 weeks. Today is also the anniversary of my unfulfilled due date - such grace that we received good news today." It was such a blessing to receive this news on a day that had been such a sad day for the previous 3 years as we remembered the baby we lost. I love when the Lord gives us these reminders that He sees us and knows just what we need. Last summer there were many times when we wondered if Joshua was ever going to get to come home; many times we wondered if we would ever get to be parents. It is hard to believe we are now coming up on one year of having him home.

There were many pictures from our trip to Korea that I never posted so I am planning on posting them as we hit the one year anniversary of each day (totally stole this idea from Grace).

"Firsts"

In my last post, I wrote about my sadness over missing many of Jonah's "firsts." During our wait for Joshua, I wrote something similar here.

While it is true that we missed many of the big firsts and there is some sadness associated with that, there are so many more firsts we have gotten to experience and will experience in the future. I thought I would celebrate a few of them.

First time trying to ride a tricycle (not quite tall enough):

First living room fort:

Discovering that the pantry is a fun place to hide:

First Air Show:

First super hero cape:

First time being "tortured" by one of his cousins:

First PB&J:

Discovering pockets for the first time:

First bowl of cereal:

First "tattoo":

First imaginative play moment, he would fill up his pail, put it on his arm and tell me bye!:

"Discovering" ants for the first time:

I have truly cherished each one of these moments. I thank God every day for the privilege of being Joshua's mom. Missing so many of the most talked about firsts has made these smaller firsts that much more special to me. I especially love seeing him make new discoveries.

If you are waiting for your child to come home, especially those of you waiting on your first little one, I hope you will be encouraged as you see that there are so many wonderful first moments ahead of you. I love this post by Lisa which lists even more of them.