A few thoughts on IVF

Despite every success story you’ve ever heard (and thankfully there are lots of them), statistically there are actually many more tales of IVF (In vitro fertilisation) not resulting in a positive conclusion. Recent statistics state that on average IVF fails 70% of the time and it takes almost four-and-a-half years to conceive using it. The highest success rates are for women under 35 where one-third of treatment cycles are successful. The landscape is actually far bleaker in reality than the common-held assumptions that I have come across in conversations over the years. Before we embarked on IVF ourselves, I knew very little about what the medical process involved, but I was well aware that the odds of success of IVF were very much not guaranteed so we took our time deciding whether it was the right path for us to follow. Being honest with you, when I come across the common perception that IVF “just works”, I find myself rather irritated because such ignorance has allowed for a fallacy to evolve that it’s an easy solution to infertility.

IUI (Intrauterine insemination) or IVF, like adoption and fostering, are not necessarily the right answers for couples struggling to conceive, and anyone daft enough to flippantly suggest IVF as the guaranteed solution to a couple struggling to start a family needs to get a reality check. If you haven’t been through IUI or IVF yourself and you want to encourage someone to consider treatment, please do so with caution, knowing that it’s not the equivalent of recommending a trip to the GP for a prescription for a sniffle. You only have to do a little googling to learn that IVF services on the NHS are grossly oversubscribed and painfully underfunded which makes it a stressful and difficult system to infiltrate – and the treatment process itself is anything but a walk in the park!

Whatever your Christian views on the subject, medical interventions for infertility are a brave, bold step into difficult, uncertain territory with the possibility of failure looming like a mountain. Even as I write this, my heart hurts for the couples I know who courageously invested their time, hearts and hope in IUI and/or IVF and had no success. I have absolute respect for those who decided it was not the answer for them and chose a different path to have a family. Our own time in the IVF process has been a hugely challenging, emotionally exhausting, rollercoaster ride. I commend any couple going through it right now and any considering it in the future. I salute your bravery and I wish you every success. Be kind to yourselves and surround yourselves with those who will be your cheerleaders in this time. It is good to have all the TLC, prayer and positivity you can get.

I can’t comment on IUI because I have no personal experience of it, but I can tell you about IVF, and the reality is that IVF is an incredibly stressful process for a couple to navigate – often full of twists and turns. It’s also an insanely intense physical process for the woman. The treatment plan for IUI and IVF is usually tailored to the needs of each couple, depending on the issues at hand, and all sorts of tests may be conducted to establish what is required. Here begins the invasion of privacy and the subtle erosion of one’s dignity. The self-administration of injections (and there are a whole range of them) can feel anywhere from hugely daunting to simply inconvenient. The medications fiddle with one’s hormone levels which in turn tinker with usual bodily functions. Suddenly headaches or hot flushes, tingles and insomnia can become the new normal (amongst many other more unpleasant symptoms), not to mention the emotional ups and downs.

A couple’s relationship can seriously feel the strain. The sense of loneliness or potential failure can intensify (even as it mingles with the hope and excitement of possible success). Sexual intimacy often evacuates the bedroom. The partner can feel like a spare part (nothing more than a specimen pot presenter after a visit to the ‘cupboard of shame’). Hospital visits take over, carefully slotted around work or personal commitments as the battle to keep life as normal as possible takes hold. Internal scan after internal scan becomes common place when they really aren’t for most women only used to putting up with a smear test once every three years.

Then there are all the pre-treatment investigations into all sorts of bodily functions, the blood tests and paperwork, the technical talk about drugs and hormone levels which can be presented too swiftly and clinically to be fully understood. There are discussions about follicle count and size, monitoring blood tests and embryoscopes, endometrial scratches and a whole host of other drugs and options which may or may not help. Statistics are thrown around about age and success rates for pregnancy and live births. Along the way, there could be good and / or bad news, and the impact of both creates a constant whirlwind of adjusting and absorbing, readjusting and re-evaluating. So often couples find themselves out of control and simply at the mercy of a distant medical team and their own bodies’ responses.

Once the treatment to stimulate hormones and ovaries has taken place, the process for egg collection and fertilisation usually commences, followed by a second procedure for embryo transfer. Some couples sadly never get this far – a massive blow for anyone hoping that IVF might provide the answer they’ve been longing for. It is heart-wrenching to be met at every stage with uncertainty, fear, disappointment or test results that have turned from good news to bad in a matter of hours. The process on paper can seem straight-forward, but the reality is that each individual couple will not be able to predict what their journey will look like or how long it might take.

Throughout it all there’s the relentless, endless, nail-ruining waiting – for appointments, for test results, for follicles to grow, for phone calls from the clinic or lab, for embryo development updates, for pregnancy test results. And then there are the risks, such as OHSS (Ovarian HyperStimulation Syndrome) and other complications when the medications or treatment plan go awry, not to mention last-minute cancellations of procedures when bodies don’t perform and the whole thing has to be abandoned.

I don’t mean to sound melodramatic now, but descriptions of IVF as brutal are not under-estimating the process. No form of medical intervention for infertility is for the faint-hearted, whether that’s an initial appointment with a consultant, to the medical options trialled before IUI or IVF, to these procedures themselves. It is a huge emotional and physical investment. And all the while in the background is the nagging, fearful question, “Is this going to work?”.

And all of it – all of it – threatens to erode one’s faith constantly. From the first appointment and the beginnings of discussions around why one is sitting in front of a medical expert and what they might be able to do to help, the fight to keep choosing God’s truth as the benchmark is a very real one. Proverbs 29:25 came to be constantly in my mind in the early days of our hospital visits, “Fear of man will prove to be a snare, but whoever trusts in the LORD is kept safe”, as I refused to allow any doctor to overtake God’s authority on the matter of our fertility. We place so much respect and a near-reverence in the power of the medical profession – and with very good reason. God most definitely uses medicine to heal and restore and medical staff are incredibly knowledgable and capable. We’d be lost without them. But as we underwent investigations and considered options for our future family, the need to fix my mind always on God having the final word no matter what the doctors said had to be my priority. And sometimes I walked out of appointments or received telephone updates that left my faith in shreds as my natural circumstances presented situations which were so at odds with the heaven-perspective I was believing in. Medical interventions shake every element within us to the core and the battle to keep the promises of the Bible at the forefront when things are falling apart before our eyes is one that requires repeated strength – and in my opinion, an army of supportive pray-ers!

So is medical intervention really worth it? Wouldn’t it simply be better just to see what God brings in His own time and way? To be honest, this second question is not one that I intend to answer here. It’s far too personal a subject to give a catch-all answer to and requires personal prayer and consideration. Simply put, many who go through fertility treatement would say it was worth it – us included. I would rather have gone through these challenging years of IVF than have never tried it. However, we sought out and kept to two pieces of vital wise advice throughout the process: (1) set your own limits with how much treatment you’re willing to go through at the very beginning and don’t be tempted to go beyond what you have decided; (2) a second opinion may well be worth it before you’re pushed into the next treatment option.

My Christian faith, though tested in the hottest fire I have experienced so far, was given the opportunity to be refined as I clung on to God in it all. Furthermore, I maintain that this precious pregnancy is not the result of a bunch of clever doctors “finally getting it right” (though they were brilliant, expert, attentive and so kind) or something we achieved through our own actions, but is my mighty and majestic Father bringing His power and goodness into our circumstances for His glory. I trust that He and He alone holds the keys to life and death, even though I understand so little about His ways and whys.

If you’re reading this and considering going through IVF – give every careful thought to it and don’t be put off. It can and does work and I pray your endeavours are blessed with success. But go in with your eyes as wide open as you can and know that nothing will prepare you for the experience – not even the doctors who see it every day, because some seem to have forgotten that gentleness, compassion and patience are needed for every single couple walking through their door; and others that are kind may still discuss the medical implications of it all without paying much attention to how you might be feeling. You will simply need to take it one step at a time, ask lots of questions at each phase and go at a speed that works for you and where your faith is at, knowing that how you thought it might be and what it ends up looking like could require constant flexibility and resilience on your part.

If you’ve been through IUI and/or IVF and it didn’t work for you – know that my heart aches for all the effort, energy and emotion you invested and I mourn with you that the outcome was not what you longed for it to be. I’m aware that many couples for whom fertility treatment didn’t work go on to conceive naturally which is hugely encouraging. For those who are still waiting for family life to take shape, may God give you the comfort and assurance to trust in the bright, hope-filled future that lies before you.

I am aware that we are incredibly fortunate in the UK. At least one round of IVF is offered for free on the NHS to most couples. The fact that this service is available is amazing. But the truth is, medical intervention of this kind is unlikely to be considered a primary life choice by anyone who decides to embark upon it. No couple that I can think of had put infertility treatment on their bucket list of ‘Things To Do Before Turning 50’! And herein lies the real strain, the real crux of it all: for those considering infertility treatment, if we could conceive without help, my goodness we’d choose the ‘traditional’ route every single time!

And so behind the squaring of shoulders and matter-of-fact approach to medical intervention that is required, the truth is that the desire to be anywhere but here is why this is so very much harder. Reluctantly, couples face a decision they never wanted to make, entering a process that few friends and family really understand and which is hampered with challenges and low success rates. Thank God for every beautiful baby born via this incredible treatment. But I find myself thinking today, please God, hold every couple steady as they go forth into the confusing, daunting, unknown and lonely world of infertility treatment. It’s not normal, no matter how ‘normal’ we try to make it – or how normal it can become as the process starts to feel more familiar (as we found).

It is impossible to understand the world of infertility treatment without going through it oneself, and it’s far too complex and individual a medical process to try to explain to ‘outsiders’, so for that reason I understand that often general assumptions are based on the success stories. Moreover, it’s unlikely that couples will be quick to share the pain of failure. Speaking from personal experience – as I have done throughout this blog – it is totally and utterly devastating. But for that very reason it’s not ok for us to make general assumptions about the challenges and outcomes – or lack of – that couples might experience along the way. We are unlikely to ever understand what it’s really like to go through something unless we live it ourselves. Therefore, let’s see people as they deserve: with compassion, with love, giving a listening ear and a tender heart to the bravery they’ve shown and the hopes they carry in their hearts. IVF can and does work, but my experience is that for most couples it can be a path littered with disappointment, anxiety and agonising curveballs, and we need to acknowledge these as we journey with them as best we can. Absolutely, we must hold onto the stories of victory and success, but we must also consider (without judging) the cost and sacrifice made by those willing to risk their hearts, their bodies and their futures for the hope of holding babies of their own.

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