Embryos are People Too

This morning as I was reading this month's issue of The Lutheran Witness (a magazine published by the Lutheran Church - Missouri Synod) I came across an article called "Shaped by God" by Rev. Dr. Robert Weise. There are some things I really liked about the article, but there were also some things that made me pretty livid. I will delve into some of the issues in this post.  This month is the 40th anniversary of Roe v. Wade, so the entire issue was dedicated to life issues. The article was about a topic very much on my mind lately; it dealt with the question "Are embryos in petri dishes really human?" 

Of course, my answer and the author's answer is a resounding "yes!" An embryo is fully human - it has a complete set of human DNA and will grow into a human being if in a woman's womb. The point of the article was that if life begins at conception, it does not matter where conception takes place. Life is life, human life is human life, and all human life must be treated with the same level of respect. The article is about the bioethical issues that today's assisted reproductive technology creates. 

In a nutshell, the problem with IVF from a pro-life perspective is that in the process a set of embryos are created in a petri dish, they are allowed to develop for a few days, and then if they are determined to be "viable" they are implanted. The concern is that a doctor looking at embryos and making a call about which one is stronger or more able to survive and destroying the rest is essentially abortion.  Now, my doctor did tell me that when they say "viable" they mean alive. Most embryos created during IVF will die naturally before they get to implantation. But a doctor is still using his judgement to discern which ones are dead and which are alive. Now, since technically the embryos die on their own, no one has killed them and it's still okay, right? I have heard and completely agree with the argument that in a sense, IVF just simulates about 10 cycles of a woman's body taking place in one month instead of 10. It is likely that almost all women have chemical pregnancies at some point in their lives and never even know about it, so this is not really any different. If I was okay with this concept, then I suppose ethically it's still fine. But a major problem for me comes with what they do with extra, viable embryos if they have more than two or three survive. I am not okay with freezing embryos at all. The freezing and thawing process is harsh, and most of the embryos probably will not make it. Plus, how can you put a human life on hold for years just because you aren't ready for it? I personally cannot reconcile this with my pro-life beliefs. If an embryo is a living human being, we cannot freeze it and thaw it out at our convenience. 

Because my husband and I feel this way about IVF, I had a conversation with my doctor about if there were any ways we could do IVF taking these considerations into account. There were. We do have the choice to do a lower dose of drugs to produce fewer eggs, and then instead of having 10 embryos at the outset of the process we could start with five or six, or even just three. If we started with just three embryos, my doctor said that they can just implant all of them when the time comes, regardless of whether or not they look viable.  If we went with this route we would eliminate the issue of a person selecting. 

It makes me sad that the religious leaders who teach on IVF do not ever acknowledge that there are couples who do this type of thinking or take this kind of approach. In this article the description of how IVF works made it sound like there was only one way of doing this procedure or like the couple involved has no voice or say in how it is done. This is just not the case. 

Although I loved the fact that an article was written about this topic, and I feel that it is very important to educate about these important issues, I feel that the article was written in a very unfeeling way. The words "fertility" or "infertility" were nowhere in the article and the author continually used the phrase "assisted reproductive technology" to describe the practices he was condemning. That may be a correct phrase, but wouldn't mentioning infertility treatments or at least acknowledging that the people who seek out IVF are usually struggling with infertility have been more sensitive? To rub salt in the wound he used the word "parents" to refer to these couples several times! These people want to be parents so very, very badly. Most of them probably do not have kids, and you're already accusing them of being bad parents for considering IVF?! I really think the author had great intentions, and like I said, I agree with him on the science and ethics of it all, but I think the article was written with little-to-no tact. We really need to have people who have struggled with infertility themselves write these kinds of articles. 

Our Choice

I did want to take the time at some point to explain why we have decided not to pursue IVF. What I have said above does cover much of our reasoning. We are not comfortable with doctors determining which embryos are viable and which are not, and we are not comfortable with freezing. As I indicated, we still have a few options to do some low-stimulation IVF without raising these concerns. I certainly do not think that to do so would be ethically wrong. I see no problem with couples that do choose to do IVF by this route, and I certainly do not pass judgement on couples that do IVF. I understand the motivations and I understand the struggles. 

The main reason why I could not bring myself to do IVF is that I couldn't stand to know, for example, that we had five or so embryos at one point and then we only ended up with one baby. Since I believe so fully that life begins and has value from conception I feel that I would see the four embryos that did not make it as losses. To me it feels like planning to miscarry. Because you know that your doctor will never implant five embryos, so you know that some of them are going to die, and that is the plan. I just can't get around that concept, and neither can Jonathan. I know that many women miscarry that early and never even notice. I know that this happens naturally all the time. But there is a difference between something happening that you never knew about and something happening because you planned and intended for it to happen that way. Again, I certainly do not think that all women who do IVF are planning to miscarry or hoping to miscarry, and I do not judge them for that. I understand the reasoning that it is a natural process and no different than what might happen over the course of several months naturally. It is just that for me, I know I could not live with that knowledge. I do not want to conceive babies with my husband and plan for them to not make it. I can't do it. I would rather adopt. 

So that is why we came to the conclusion that we did. And a great deal of that decision has to do with trusting God as well. I trust God that it will not be necessary for me to resort to IVF to parent a child. I believe that He has plans for me that are good and that He will reveal in his own time. Does this mean I am patient? Not at all. But I try. 

To Readers

If you want to know more about our reasons or reasoning about IVF, please do not hesitate to ask. I am more than willing to talk about it. If you were offended by anything I said, I am really very sorry. Please, please, please let me know so that we can talk about it. I certainly never want to be insensitive. I know many women who have done IVF and I promise I have great respect for them and do not think any less of couples who chose this route. 

Also, incidentally the author of this article is a professor here at the seminary my husband is attending. I think I will probably send him an email at some point, so don't think I am talking about him behind his back! I am sure he is a great guy and does not mean to be insensitive. 

A Plan?

Well, we kind of have a plan. For now we will be trying Clomid. It isn't overly expensive, and it might work, so really there is no good reason not to try the medication route. It does involve a little more than I originally thought it would, but if this ends up being it for us, it will be so very worth it.

You would think that it would feel good to have a game plan, but honestly my heart isn't in it. I still want a baby so much, but I am so tired of trying. It is just so discouraging every single month. Even when I work really hard at not being hopeful, I can't help but get my hopes up a little bit, and it always leads to disappointment. After over 18 months of disappointment after disappointment, I am really feeling done. I just don't want to try any more. I realize that this sounds like I'm depressed - I'm really not. I just don't feel like putting the emotional effort into trying this new Clomid plan. Because statistically speaking, it will probably fail, and I will just have to survive through more months of disappointment.

But on the positive side, I really believe that we will have a baby soon one way or another. We have talked a lot about what we are going to do if this doesn't work, and we have decided for sure that we will not do IVF. This means that there really isn't a lot left to try - since IUI is not going to be productive and IVF is off the table, this medication route is really the last option. Once we have tried this we are going to move on to considering adoption. And really, I am very, very excited about that idea!

Answers and Options

On Wednesday I had a phone call consultation with our doctor to go over our test results. I have been very busy, and Jonathan and I have been talking and trying to think through everything, so I haven't gotten around to updating until now. But we really did get a lot of our answers, and I think we're in possession of enough information to reasonably know what to expect and to begin to plan for the future.

At this point the test results show a combination of factors that give us a pretty low chance of conceiving on our own. (Maybe something around 5% or less each month. It's hard to know numbers like that exactly, but that's a rough estimate.) I will go ahead and outline what our options are.

Medication

One option is for me to take Clomid or another medication. This might bump our percentage up a bit. If we say for the sake of argument that we're at 5%, this would move us up to 7-8% chance of conceiving each month. It is not safe to take Clomid for more than six months at a time, though, and as I pointed out to the doctor, 7% each month for six months gets you to about a 42% chance of conceiving. Not great odds, but considering how affordable Clomid is, this could be worth trying. 

IUI

IUI is not going to be an option for us. Due to the test results, the doctor said that IUI would not increase our chances for pregnancy by any significant amount. It just wouldn't make sense financially. 

IVF

The doctor indicated that IVF would be the most direct way to address the situation, and by far has the best chance for success. IVF has a 60% success rate for couples in their early 20s. As much as we may be tempted to take this route as it is clearly the easiest emotionally, we are very, very cautious about the idea. I feel that my pro-life beliefs conflict somewhat with this option, and we are certainly not going to run into this right away. 

I do not believe in freezing embryos, and I do not believe in doctors choosing which embryos they think have the best chance of survival. I did talk about my concerns in our phone conversation, and our doctor was extremely open and respectful of my beliefs. We talked about some options for lower stimulation IVF and ways that we could do IVF so as to eliminate these concerns. While that's great, it would dramatically decrease the chances of success each month. Depending on how exactly we decided to go about things, our chances of pregnancy could be more like 40% or even just 20% each cycle. It is very hard to calculate these percentages, however, because not enough couples do IVF with these considerations in mind to have a significant pool of data. 

I would be happy to share more about IVF and the specifics of why I have these concerns and feelings in a future post, but for now I will just say that this is not something that either of us are thinking of jumping into right now. 

Adoption

With only these options, we have started talking and thinking a lot about adoption. But that's something that the two of us need to talk about and think about a lot more before I say any more.

So those are the options we see at this point. In a nut shell, these are our choices:

1. Do nothing. Keep on going as we have been and probably not get pregnant any time soon. But who knows? God can do anything. At this point I would consider getting pregnant naturally to be nothing short of a miracle.
2. Medication. I can start taking Clomid or another fertility drug and we can try that for six months. This would slightly increase our chances and we could pray for a miracle. I would still consider getting pregnant under this option to be a miraculous and wonderful work of God.
3. IVF. This might be an option for us, but we are still thinking, praying, and studying about whether or not this is something we feel ethically and morally comfortable with.
4. Adoption. This is something that we cannot do right away because of the cost factor, but it is a route that we could consider and start researching for the future. 

So that's it. The answers we've been waiting for. We would love your prayers and support as we consider our options and try to discover what God's will is for us at this point in our journey to start a family. 

Keep checking back. We will hopefully come up with some kind of game plan soon! 

Looking Forward

Over the past week or two I have been doing pretty well. Two weeks ago today my husband and I decided that it was time for us to share our journey with our friends and family. It just felt like the right thing to do. From the moment that I decided that we would let other people know about our struggles I felt an immediate sense of relief. I never felt like I was keeping a secret before, but I suppose it was weighing on me more than I realized.

A week ago we posted a note on Facebook, although we limited the privacy settings so that not everyone on our friends lists would see it. Just knowing that we are not alone and that people now have some idea about what is going on in our lives is very comforting, and it really lifted my spirits, even if I did not talk with many people about the note at all.

If you are friends or family (or anyone!) and are reading my blog, feel free to follow it, subscribe at the bottom of the page by entering your email address, or comment on posts. I would love to hear from you!

I believe I mentioned this before, but we do have a consultation at the Sher Institute in Saint Louis on October 24th. My hope is that they can start us on a good plan. We have already done some tests with our respective doctors in Wisconsin, but I do not feel that we have a diagnosis or a clear explanation of what the problem is. I am hoping to (1) get a clear sense of the problem through testing as they recommend, and (2) make a plan for treatment.

I do not know what they will recommend for treatment at all, but I do know about some of the more common fertility treatments. I know what problems we do not have, and this leads me to think that they will probably suggest either IUI or IVF. I would be very happy if there was something much simpler that we could try first, and I am definitely hoping that that is the case, but if you know me, you know that I like to think ahead and be prepared, so I am already thinking about these two different courses and trying to decide how I feel about them - just in case.

I am assuming they will start with a suggestion of IUI since it is cheaper and less invasive, but it will depend upon the precise nature of the problem, obviously. As a Christian and someone who is strongly pro-life, I have some ethical concerns with IVF that would certainly need to be satisfied before I would consider pursuing it. I am considering doing a post or two on the ethics of IUI and IVF and what a Christian view of these treatments could be. (I do want to say that even when my husband and I reach a decision about what treatments we would be willing to pursue, we will never pass judgement on another couple who makes a different decision. These questions are very tricky and very involved, and in many cases there are not clear-cut answers.) With that being said, we naturally want to feel very good about any course we decide to take in our own marriage.

So to sum up, I've been feeling better about all of this lately! We have an appointment coming up and I'm hoping it will help make our path a little more clear-cut and concrete. And look out for upcoming posts about IUI and IVF in Christian (and more specifically Lutheran) perspective.