INFERTILITY IS…

Infertility isn’t just “We can’t get pregnant”, for me it was and is:

• trading intimacy and passion for shots, ultrasounds, and results
• people minimizing how i feel
• suffering the two-week-wait over and over and over again (39 times so far!)
• “pretending” I am pregnant during that two-week-wait (which ultimately equals out to half of every month!) just in case you really are, because you don’t want to harm your “maybe baby” in anyway
• making myself question my self worth and faith
• avoiding baby showers, pregnant women, and the baby aisles
• putting off vacations because we’re saving money for more treatments
• sitting in a room full of pregnant women while waiting for my infertility appointments
• taking a pregnancy test and never seeing a positive sign
• taking pre-natal vitamins every day for over 3 years, just in case I was pregnant
• taking time off work to go to appointments
• quitting my job to try to reduce stress and so you had more time for appointments
• quitting my job also because it was too heartbreaking to be surrounded by children all day long
• having my period come one day late, taking a pregnancy test, and finding out it’s negative, only to get my period the very next day
• spending thousands and thousands of dollars on fertility treatments
• gambling on treatments that may or may not work
• sitting at home waiting for my specialty fertility drugs to arrive via UPS so they don’t get too hot or too cold waiting outside the door
• finding out my unmarried close friend is pregnant and she wasn’t even trying
• finding out a family member is pregnant from another source
• hearing about yet another abortion of a beautiful, innocent baby (makes me sick to my stomach)
• having my doctor become part of your intimate sex life by telling us when and how often to have sex
• having that scheduled sex month after month
• arguing with my spouse because both of us are so tired and aren’t in the mood, but you’re ovulating so you HAVE to have sex or another month is wasted
• waking up after 3 hours of crappy sleep after falling asleep upset because I haven’t had sex yet like we were supposed to
• taking my basal body temperature daily to find out those peek ovulation times
• thinking that taking my body temp daily is not very fun and realizing that peeing on those ovulation sticks are much more enjoyable. (Because at least you see a positive sign at some point which gives me hope that I might see a positive on a pregnancy test someday!)
• realizing that honestly the daily body temperature and ovulation sticks both suck and deciding to stop doing both!
• spending a lot of time daydreaming about: when that day will be that I finally take a positive pregnancy test, the names of your future children, and where they might go to college.
• imagining and scheming up the most creative way to tell others when I finally am pregnant
• not going to my 10 year high school reunion because I’m afraid of answering all the “children” questions

MENOPAUSE AT THE RIPE OL’ AGE OF 29!

Getting the Lupron shot all ready!


This week I started the LUPRON (Leuprolide – pronounced “loo pro lide”) shot, which basically puts me into menopause. It over stimulates the body’s own production of hormones, which causes my “lady parts” to shut down.

What is Lupron?
Lupron helps shut off my body’s natural stimulation from my pituitary gland to my ovaries. Pituitary suppression is important for recruitment of multiple follicles or eggs. The more eggs I can grow during any given IVF round, the higher the chances of success. By desensitizing the pituitary's signals from the brain, Lupron blocks the natural tendency of the brain to allow only one dominant follicle to grow in each cycle. Also the medicine’s purpose is to prevent me from ovulating unexpectedly during the stimulation injection part of our cycle. Basically from here on out my entire cycle will be ruled by hormones that I'm injecting rather than the ones my body produces naturally.

Therefore, I’m going through the lovely side effects of menopause. I’ve had hot flashes during the day and night sweats while sleeping. Hot flashes are such a crazy thing. There’s really nothing to compare it to, really. You know how it feels when you’re outside on a really hot day in the summer? And you can feel the heat burning at your skin from the outside going in. To me, a hot flash felt just opposite, like this heat was literally burning, coming from your insides trying to get out. These hot flashes turned out to not be too bad for me since it’s mid winter. I like to think of it as free heat! And the night sweats aren’t too bad either. I’d wake up so warm and have to throw the covers off of me. Once again, this was fine for us because I was a personal heater for Nick!

I’ve also had mood swings, but I think I’ve had those for the past 3 years straight anyway, so I guess it’s not too much of a shocker (poor Nick!). Mostly I've been really tired. Naps are fun! I’m enjoying having these in my daily schedule. My lower back is really sore too, so I've been bugging Nick for a massage. Hopefully he gives in one of these days.

We’ve been taught how to give shots through Shot Clinics at Mayo, but Jesse’s still here to help me! I figured I better get the guts do it myself, since next week it’ll be up to 3 shots a day and would be a little inconvenient to go to Jesse’s at different times of the day to have her do all of them!

So I gave myself the LUPRON shot for the first time on Tuesday. This shot of 20 units is to be done at the same time every morning into the subcutaneous tissue in the stomach. (Subcutaneous tissue is the third of the three layers of skin. The subcutaneous layer contains fat and connective tissue that houses larger blood vessels and nerves.) It takes me a minute to talk myself up to go through with it, but then I think of what Jesse told me, “Pretend you’re a diabetic and if you don’t give yourself the shot right now – you’re gonna die.” Works like a charm!

P.S. The shots are going amazingly well. It's red and itchy after each injection but nothing drastic. A little bruising too, but nothing to complain about. It's actually getting easier to stab myself!

I take this injection daily until January 16th, which is two days before my retrieval.

Who knew I’d go through menopause at the ripe old age of 29? Seriously? Wow!

Ready for the shot. (I didn't smile while actually doing it!)

OVERWHELMING MEDICATIONS!

Here are photos of my dear sister helping me look through, count, double-check, and organize all the needles, syringes, and medications for IVF. It was overwhelming!

TEARS & THE HATRED OF INFERTILITY

I wonder how much my tears would all add up to? I’ve had tiny tears, sobbing tears, tears so gigantic I couldn’t seem to breath, angry tears with fists and kicking legs (okay, so yes, I admit I still have tiny temper tantrums), hopeful tears, happy tears, sad tears, and empty tears. Empty tears are ones that I wanted to cry, but there weren’t any left to let out. I cry for my baby I’ve never held; my husband who not only bears his own pain but tries to be strong for me; and for feeling weak myself.

I hate is a strong word. But yes, I hate infertility. Infertility is the most depleting experience I’ve ever faced. It’s slowing draining the life out of me. I wish I didn’t have to go through this and that no on one ever did. In fact, I don’t even wish infertility upon my worst enemy.

I’ve had friends/acquaintances who have gone through infertility at the same time as me. And after they’ve become pregnant – their contact with me lessens or stops. I often wonder if they totally forget those “infertility feelings.” How awesome would that be!?!? But then, the more I think about it – the more I know I don’t want to forget. That’s one reason I began journaling and writing. Even with all the heartache – I don’t want to forget the pain, because it’s made me who I am today…and I’m okay with that.

It’s heartbreaking watching friends and acquaintances have two children between my infertility of three years. I find myself thinking that if we got pregnant the first month we tried, right now we’d have a 2 ½ year old running around right now. Today I’m having a pity party. And I think that’s okay. I’m tired of people telling me HOW and HOW NOT to feel. Today I feel like having a pity party, so that’s what I’m gonna do…

GETTING PREGNANT: THE “UNCONVENTIONAL” WAY

People become pregnant by having sexual intercourse. Or at least that’s how I always thought I’d get pregnant. I thought I knew how to make a baby! People jokingly asked me if we were “doing it right.” Ha, ha, very funny. (not really!) So naturally I started questioning myself. I’ve only had one sexual partner, so honestly, I did start to think that maybe we were having sex “wrong.”

Without getting into detail (and here’s one of those parts I mentioned that you might not want to hear), we tried it all. I’ve layed in bed for up to an hour after, just to try to keep it all in. I’ve propped my butt up on pillows to keep it all from sliding out. I’m surprised we didn’t hang me up from the ceiling by my feet to let gravity take it’s course. (Trust me, I did momentarily contemplate it.) We tried at different times of the day.

It wasn’t until the “conventional” way didn’t work for us, that I realized I may be one of those people that would have an “unconventional” story. After two of my IUI’s, from the reproductive female nurses at MAYO, I was really hoping I could finally tell people that I got pregnant “from a woman without even having sex.” What a story for the baby book! Ha! After those failed and going on with our first round of in-vitro, I then found myself hoping that I could tell people that I got pregnant “from a man who isn’t my husband without even having sex.” Ha! Even better!

IT’S NOT ALL ABOUT ME

Today I’m realizing it’s not all about me. Maybe I don’t need to understand. I need to TRUST! Jesus gave up his life for me, so why am I not trusting my life to Him? (It sounds so simple, but why is it so hard to believe 100% of the time!?)

There’s always going to be seasons of hope and seasons of despair. We never know when they will happen or how long they will stay. But we can always be sure that God will work it for good. I’m looking to the future with anticipation and excitement. I’m trusting in God’s time and plan for our lives. I’m not ruining today anymore. I’m enjoying the time I have TODAY, as there’s no guarantees for tomorrow.

Anyone can give thanks and praise God during the happy times. It’s natural! But if you can give thanks and praise God during the sad times as well, then you are a shining example to everyone. I want to reflect and shine my light to others. I want people to say, “What’s Amy got? I want some of that.”

Well, I’ll tell you my secret – and it’s not even a secret at all. I’m a child of God. A child of God who wants to do His will and show others that God loves them too. This world and the people are too incredible to have happened my chance. We were created in His image. I pray and hope that everyone in this world has a chance to hear that they are loved by God. I’ve been blessed to be raised by loving, Christian parents. I’ve been blessed to have a member of supportive churches my entire life. But my greatest blessing is through Jesus. And because of that I have inherited eternal life and no one can take that from me.

So, it’s not about me. But it is about how my life can shine to show others the light of God! As the saying goes, “Your life may be the only Bible some people read.”

MEDICATIONS HAVE ARRIVED!

Here they are! The medications have arrived. We're ready for IVF!


Now that is what I call a lot of needles and drugs!!

I BELIEVE IN MIRACLES

Nick and I, together have found hope in God’s time and His plan for our family. It is this hope that keeps us on our path. Even though at times we may waver, we soon find ourselves right back where we need to be. We’ve been tested to our limits, but we have survived. We’ve been strengthened together as friends, lovers, and future parents.

We’re proud of ourselves amidst this crazy ride. I’ve heard PRIDE described as: “Personal Responsibility for Individual Daily Effort.” It has taken that daily effort, those baby steps. We’re proud that we’ve taken it one day at a time, moving forward even when oftentimes, we so desperately wanted to stop. We’ve gone through and sacrificed a lot in order to make our family. But, we’d do it all over again….no questions asked. We’ve stood in faith for all these years and we’re not stopping now. And we know God will faithfully and lovingly answer our prayers according to His will.

A blessing from our infertility is that we’re stronger both individually and as a couple. We’ve leaned on each other and our faith and relationship with God has strengthened. The next steps are yet to be made, but we are certain that our love for each other and our future children will never diminish. So, we’re celebrating that love for each other, our love for our Lord, and our love for our future children.

If you told me in the beginning of our infertility that I would grow to feel a sense of purpose, pride, and passion for infertility– I would have thought you were crazy. But it’s true. As the years have passed, we’ve changed. Infertility resides in our hearts. Infertility is a part of who we are. And we’re okay with that.

I believe in miracles. And I know someday I’ll be a mother.

KEEPING IT ALL TOGETHER WHEN SPERM AND EGG STUBBORNLY REMAIN APART

There’s a book titled, “Infertility Sucks! (Keeping it all together when sperm and egg stubbornly remain apart.)” by Beverly Barna. I haven’t read it, but I can imagine it’d be a great one.

I came across the title online and it made me start to think about how Nick and I have kept it together. So, I’d like to tell you know Nick and I kept it all together during a time it felt like it was all falling apart…

Just like any other couple, we were quite unprepared for the journey of infertility. But I suppose you can’t ever really be prepared for something like this. We would have never chosen this for ourselves – but who would?

Many people just consider infertility to be stressful because someone can’t get pregnant. But there is so much more! Infertility tests and treatments are very physically, emotionally, and financially stressful and can oftentimes become entirely unbearable. Ultimately, it can put a great strain on your marriage and can cause a couple to grow apart. It can even cause a loving couple to separate or divorce.

The month after month of disappointments takes a toll on every aspect of your life. And who better than to take it all out on than your spouse, right? They’re there, they are part of what you’re each going through, so, it mine as well be them!

The infertility medications can make your hormones all out of whack. I had mood swings like you can’t even imagine. Poor Nick. I know there were many times I didn’t treat him well. And I don’t blame it ALL on the medications, I know there were things I could have stopped myself from saying and ways I could have stopped acting. I take responsibility for my “diarrhea of the mouth.” I’ve said things I’m definitely not proud of…things to intentionally hurt Nick so possibly he could maybe, just maybe, for a second feel just an ounce of the pain I felt. But after I said those things, I apologized. And I think he understood. He forgave me. I apologize a lot lately. And thankfully he forgives me a lot.

We keep it together by knowing that we’ll never be apart. Marriage is a lot about compromise. It should be full of a lot of giving and just a little taking. It’s about trust and support. It’s about working through the good and bad. It’s about always communicating. It’s never giving up. We remember our vows we made to each other on our wedding day, and we know that together, with God, we’ll make it through anything. Marriage is about love…unconditional love…and I know our love will never end…

NOTE TO SELF

I try to tell myself these things and make myself believe them, but of course it is way easier said than done. Hence, here’s my little note to myself…

Enjoy the time you have. Don’t waste it “over-wishing” you had children or being sad you don’t. Or else you might miss all the great things that are happening right in front of you. Try to enjoy what you have and where you are in life. You have control over your own happiness, even though being happy at certain times may seem impossible. Don’t minimize the heartache infertility causes, but do know that you can’t let it overcome you.

Don’t loose track of where you are coming from and where you are going. You’re learning a lot about yourself and you are standing on stronger emotional footing because you’ve allowed yourself to confront the horrible, scary stuff! Don’t deny your emotions. Allow yourself to feel scared and cry when you need to because it’s preparing you to be strong and positive when you really need to be.

Don’t worry too much about if you’re being selfish. It’s not selfishness, but self-preservation. Do what you need to do to make it through this. Sometimes you will want to talk about it and other times you won’t. This is okay. Just take it one day at a time. And someday soon you will find yourself smiling at little children the same way you hope to smile at your own someday.

PLEASE BE PATIENT WITH ME, GOD ISN’T FINISHED WITH ME YET!

I know I may have hurt you along the way. Infertility doesn’t just affect the husband and wife. It affects their family and loved ones as well. I’m truly sorry if I’ve hurt you along the way. I’m sorry if I’ve ignored or neglected you. I’m sorry if my own pity party has triumphed over the good or bad things happening in your life. I never meant to hurt anyone. I just wanted to survive this…

You’ve seen our tears. You’ve filled us with hope and prayers. And most likely, at some point, you’ve felt a piece of the giant holes in our hearts. We know it hasn’t been easy, we know we haven’t always been the happiest to be around, and we know at times, we’ve neglected others.

For those of you who have cried with us, prayed with us, and loved us – we can never repay you. For those of you who have cried for us, prayed for us, and loved us – we can never repay you. This experience is quite the defining chapter of our lives. We’re learning a lot about ourselves, each other, and our relationships with YOU!

So, please be patient with me…God isn’t finished with me yet…

WHAT IS ICSI – INTRACYTOPLASMIC SPERM INJECTION?

This information is from www.advancedfertility.com

ICSI is an acronym for intracytoplasmic sperm injection - which is a fancy way of saying "inject sperm in the middle of the egg". ICSI is a very effective method to fertilize eggs in the IVF lab after they have been retrieved from the female. A common reason used for performing ICSI is for a male factor of the sperm concentrations of less an 15-20 million per milliliter, sperm motility less than 35%, and very poor sperm morphology.

• IVF with ICSI involves the use of specialized micromanipulation tools and equipment and inverted microscopes that enable embryologists to select and pick up individual sperm in a specially designed ICSI needle.
• Then the needle is carefully advanced through the outer shell of the egg and the egg membrane - and the sperm is injected into the inner part (cytoplasm) of the egg.
• This will usually result in normal fertilization in about 75-85% of eggs injected with sperm.
• However, first the woman must be stimulated with medications and have an egg retrieval procedure so we can obtain several eggs for in vitro fertilization and ICSI.

How is ICSI performed?
1. The mature egg is held with a specialized holding pipette.
2. A very delicate, sharp and hollow needle is used to immobilize and pick up a single sperm.
3. This needle is then carefully inserted through the zona (shell of the egg) and in to the center (cytoplasm) of the egg.
4. The sperm is injected in the cytoplasm and the needle is removed.
5. The eggs are checked the next morning for evidence of normal fertilization.

Photos below are an ICSI fertilization procedure in progress.


About to inject the egg with a sperm
Holding pipette on left
ICSI needle on right
Sperm head visible in needle at far right, just below X
Polar body of egg at 7 o'clock



Needle is advanced to the left
Shell of embryo has already been penetrated by needle
Membrane of egg (oolemma) is stretching and is about to break
Sperm head is visible at tip of needle



ICSI needle has penetrated the egg membrane
A single sperm is being injected into the cytoplasm of the egg

WHAT IS IN-VITRO FERTILIZATION (IVF)?

This information is from www.americanpregnancy.org

In-Vitro Fertilization (IVF) is a process by which egg cells are fertilized by sperm outside the womb, in vitro. IVF is a major treatment for infertility. The process involves hormonally controlling the ovulatory process (injecting super stimulation drugs), surgically removing eggs from the ovaries and fertilizing them in a lab with sperm. The fertilized embryo(s) are then transferred into a woman’s uterus with the intent to establish a successful pregnancy.

There are basically five steps in the IVF process.

1. Monitor and stimulate the development of healthy egg(s) in the ovaries.

Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during on the woman’s cycles. This is often referred to as ovulation induction. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. Egg development is monitored using ultrasound to examine the ovaries and urine or blood test samples to check hormone levels.

2. Collect the eggs. (EGG RETRIEVAL)

The eggs are retrieved through a minor surgical procedure which uses ultrasound imaging to guild a hollow needle through the pelvic cavity. Sedation and local anesthesia are provided to remove any discomfort that one might experience. The eggs are removed from the ovaries using the hollow needle, which is called follicular aspiration. Some women may experience cramping on the day of retrieval, which usually subsides the following day; however, a feeling of fullness or pressure may last for several weeks following the procedure.

3. Secure the sperm.

Sperm, usually obtained by ejaculation is prepared for combining with the eggs.

4. Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.

In a process called insemination, the sperm and eggs are placed in incubators located in the laboratory which enables fertilization to occur. In some cases where fertilization is suspected to be low, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.

5. Transfer the embryos into the uterus. (EMBRYO TRANSFER)

The embryos are usually transferred into the women’s uterus anywhere from one to six days later, but most commonly it occurs between two to three days following egg retrieval. At this point, the fertilized egg has divided to become a two-to-four cell embryo. The transfer process involves a speculum which is inserted into the vagina to expose the cervix. A predetermined number of embryos are suspended in fluid and gently placed through a catheter into the womb. This process is often guided by ultrasound. The procedure is usually painless, but some women experience mild cramping.

A blood test and potentially an ultrasound will be used to determine if implantation and pregnancy has occurred.

YES, I’M TRYING TO GET PREGNANT AND I’M ON BIRTH CONTROL!

I’ve been on birth control pills since November. Which may seem crazy, but they want to totally be in control of my cycle. This month they had me skip the “inactive/placebo” pills, so I won’t get a period.

It seems extremely weird and contradictive to be on birth control while struggling with infertility. Just another one of those things you need to laugh at.

IVF ORIENTATION

In October of 2009, we had our first IVF meeting with our Mayo doctor. We had our Orientation IVF visit on December 4th, where we had individual meetings with one of the team doctors, an embryologist, a reproductive endocrinology nurse, and the business office representative.

With the doctor, we discussed the consent forms and went over the risks, complications, and side effects that can occur, etc. Next was the embryologist who told us what they do and talked to us about being in a research study which would study early human development before implantation. This means we’ll “donate” any cellular material that is going to be discarded. We chose to be involved in this if the opportunity presents itself. Another research study is to determine more information about hCG from 0-12 weeks of your pregnancy. If we are pregnant, we’ll probably chose to not be involved in this study, as it means I would drive to Mayo daily for blood tests and ultrasounds for 18 days. All of that is for free but of course not the time and gas money!

Next, we met with a nurse, who gave us one-on-one instruction for self-administration of the medications, step-by-step instructions for the treatment cycle, and went over our binder and outline of medications and prescriptions. This happened to be one of Jesse’s work friends and she was awesome! Plus she’s been through IVF herself and could relate…that makes all the difference! And finally, we went to the Business Office Representative to discuss the costs and arranging admission to the hospital for the egg retrieval and embryo transfer. One step closer…yippee!!

“TO IVF OR NOT TO IVF?” THAT IS THE QUESTION!

IVF is a time of hope for many couples. This may be the time and way that a couple becomes pregnant! A lot of time and money is invested into each attempt. But of course that comes with the uncertainty as to if it will be successful or not. Therefore, it is also a time of fear. There’s no guarantee that it will work, so going through these tests, medications, etc. is an emotional time full of hope and fear for most couples.

Undergoing IVF treatments is very rigorous. The woman undergoes many medications and shots with frequent appointments. There are many steps and each step coincides with the next. If one step along the way isn’t “right,” it may stop or slow down the whole process. (You need to take drugs to make more follicles, but it can result in too many follicles and over stimulation and then you have to stop all medications. You may get all the way to the fertilization after the egg retrieval and none of the sperm and eggs fertilize together to form an embryo.) Each successful milestone is just one step closer to the hopeful pregnancy.

With all the hype in the news, many people assume that IVF is a sure thing. But in fact, the odds of success are fairly low. Generally speaking, it’s a 50/50 chance. So, if it fails, which there is that 50% chance that it will – the blow can be devastating.

Probably the biggest factor of IVF is the financial strain. One cycle of IVF is extremely expensive. Especially if you do not have any insurance coverage for ART (Assisted Reproductive Technology), choosing to pursue these medical options is very difficult. Many have to pay for a large part of all of the costs out of their pocket. Many couples cannot afford to try for one cycle, yet alone multiples times.

IVF also raises ethical issues. Therefore, it can also be difficult for a couple to tell others about their decision to proceed with IVF as any people can form judgmental and uninformed responses. It’s a gray area in many ethical ways, and many of our moral leaders don’t yet even know how to answer the questions that have arisen from this technology. For many couples, IVF may be the only way they will ever be able to have their own biological baby. This is a huge decision. Try to put yourself in their shoes for a bit. How would you feel? What would you do? You have no idea how many times I've questioned myself as to if I'm trusting in science too much and not God enough. It can just tug your mind and heart in such crazy directions!

A couple who goes through IVF has a hard, expensive road ahead. They need support. The hormones, heartache, and financial burdens are enormous. They wouldn’t be going through this if there were any easier way. And the fact that they are willing to endure so much is proof of how much they truly want to parent a child.

Acknowledge that this is one of the biggest challenges life may bring someone. It’s effects shouldn’t be taken lightly...

KNOWLEDGE: AN IMPORTANT ALLY

Knowledge is an important ally on this journey. Even though the doctors told us and explained what was going on, usually it was so much information thrown in our faces at once, that we couldn’t take it all in. Or it was explained in such long, technical terms, we didn’t really understand what it all meant. I’ve never understood why most doctors talk to you like you have a computer dictionary in your brain, instead of just using normal words like a normal human.

Don’t be afraid to take notes during appointments. (I regret that.) If you don’t understand, ask him/her to explain it again. Ask for printed information, search online, and talk with people who have been through it. But remember that in the medical world, research is always updating and changing medical practices. So, just because you talked to someone who went through IVF 10 years ago, it may not be the same in today’s time.

Although, even if you’ve done all the research you can, I’ll give you a fair warning that you’ll never truly understand it all until you’ve been through it yourself! But I guess that’s true with any aspect of life! Experience is the best ally!

There are so many different doctors and clinics that practice varying techniques for infertility. Even when doing the same treatment, they can use different procedures, medications, etc. So, when researching online, it can be difficult because just because one clinic lists how they do it, it doesn’t mean the next clinic will be the same. But it gives you a good general idea and starting place, nonetheless.

Oftentimes, I feel that that I know more of what’s going on than the doctors do. Remember that this is your plan, you have a say in your treatment. Fight! No one will fight harder than you for you. So if something doesn’t sound right or feel right – speak up. You you’re your own body better than anyone else. Don’t be afraid to take control. Ask questions. Be annoying. (I like to think of annoying as “being prepared.”) Call. Do whatever you need to do. This is your body and your life. And that is worth speaking up for!!

INFERTILITY: THE THIRD YEAR: - Hope or Denial?

October 2008 through October 2009

Our third year started with renewed hope…or maybe it was just denial. We started doctoring at the Mayo Clinic in Rochester. I thought, if the “world famous Mayo Clinic” as they call it, couldn’t get us pregnant, than who could? We might as well give it all we’ve got. We went through more testing there with a more specific sperm analysis called “morphology.” The morphology came back with interesting results. Nick’s sperm count wasn’t necessarily “low,” but other issues were recognized with the motility. They look closer at "perfect" sperm. All of that was really confusing to me, but from what I understood, we were at around the 3%, where the chance of conceiving on our own was very slim.

I endured tests and more tests. We wondered if there would be an end in sight. We did 2 more IUI’s with no success. This year was difficult with fitting in treatments. Time just didn’t always work out for us. We’d be out of town during ovulation, peak times, etc. So, we’d be forced to take another month off. We voluntarily took some shorter breaks in-between treatments to regroup and rejuvenate.

At then end of the third year, when we started the process for in-vitro, I felt bewildered that we had really been on this journey for this long. I never imagined it would get to this point. I naively thought we’d be one of those couples who would start going to the doctor and naturally get pregnant by ourselves during the in-between times of non-treatments. I don’t know why I even thought that would even happen to us since I actually only personally know one person that has happened to!

So, now it’s been over 3 years since we started this infertility journey. Wow! We’ve done all we can medically available up to this point. Now on to the next step..in-vitro! Since it had been 1 year since Nick's last sperm analysis, they requested another. Apparently it was also a newer, updated "test." It can study more into the specific appearance of the DNA and how it binds to protein. (Blah, blah, all of this stuff I don't understand at all!) This time the results were different! The sperm seemed to have "improved." In fact, they told us that we may not have to go ahead with the IVF-ICSI, as we had discussed, but just to go ahead with the IVF. But after some more thought, our RE (Reproductive Endocrinologist) suggested that we still go ahead with the IVF-ICSI, just to maximize for best results! (The techniques for IVF and IVF-ICSI will be explained in a future post!)

We are optimistic that IVF should be successful for us! If we haven’t been able to get pregnant due to the sperm not being able to get into the egg, then this should work! Mayo stats show that it’s about a 50% chance we’ll become pregnant. And if we are pregnant, then it’s around a 20% chance it will be twins.

HOPE FOR TOMORROW

I don’t know how long our infertility journey will be. I don’t know the direct path that will take us there, but I know someday we’ll arrive. And God will guide us there, never leaving our side.

We’ve learned we’re more certain of God’s love, more grateful for very blessing, and more full of trust for His plan for our family. Throughout this whole experience, we’ve experienced questions, loneliness, doubts, and hurt. But more importantly, we’ve experienced answers, support, strength, and hope.

Remember that you are loved. You are blessed. Keep the hope as it is a foundation. And keep the faith as it draws strength. I pray you always hold hope close in your heart. And remember that while your arms may be empty today, there is always hope for tomorrow.

IT'S IN THE VALLEYS I GROW

IT'S IN THE VALLEYS I GROW
Poem © Jane Eggleston

Sometimes life seems hard to bear,
Full of sorrow, trouble and woe
It's then I have to remember
That it's in the valleys I grow.

If I always stayed on the mountain top
And never experienced pain,
I would never appreciate God's love
And would be living in vain.

I have so much to learn
And my growth is very slow,
Sometimes I need the mountain tops,
But it's in the valleys I grow.

I do not always understand
Why things happen as they do,
But I am very sure of one thing.
My Lord will see me through.

My little valleys are nothing
When I picture Christ on the cross
He went through the valley of death;
His victory was Satan's loss.

Forgive me Lord, for complaining
When I'm feeling so very low.
Just give me a gentle reminder
That it's in the valleys I grow.

Continue to strengthen me, Lord
And use my life each day
To share your love with others
And help them find their way.

Thank you for valleys, Lord
For this one thing I know
The mountain tops are glorious
But it's in the valleys I grow!

I WANT TO BE A MOMMY

Call me a maniac. That’s fine. I used to think I was too. But, after over 3 years of infertility, I now know I’m not a maniac. I’m just a woman who on a quest to become a mommy. I’m simply in pursuit of motherhood and there’s nothing crazy about that…

I think when you decide to have a baby, in a way, you’ve already become a mother. Your heart is open and ready to give all the physical and emotional love you possess to that precious little infant that you dream of someday holding in your arms. (Some of us just have to wait a little while longer than the typical 9 months.) And if you have infertility, you may go through years of doing anything and everything it takes to achieve that goal. If only just to be given the chance! You’ll already do anything for that baby that isn’t even “real”…it’s simply the baby that exists only in your heart. That’s true love…

UNANSWERED PRAYERS

Even through our “unanswered prayers,” we ultimately know our prayers have been answered the entire time. God has blessed us and lead us in other paths we had never imagined. Here are just a few examples…

Many blessings have come our way through our infertility. If we would have gotten pregnant right away, I wouldn’t have left my job at the preschool until I had the baby. Therefore, I wouldn’t have ever started my own website selling crafts that I make. (Check it out at www.vincellidesigns.com) But, I’m at home, able to do my hobbies that I love for a little profit. A blessing in disguise! (Although it is 12 months later from leaving my job and I continue to be at home, but there’s still no “mom” about it!)

Another wonderful blessing has been our faith. Nick and I have grown as individuals and together in our marriage and in our relationship with God. We’ve been tested and we’re making it through. We’ve become very active in our church and know it is a strong foundation for our lives and our future children’s lives. Ultimately, we know this journey will make our marriage stronger and someday, our lives and abilities as parents!

I’m thankful that I’ve been able to spend a lot of quality time at home doing whatever it is I feel like doing! I’m very grateful for this opportunity, as I know it’s not common in this day and age. I’ve spent more time with family and especially my precious nieces. And without a full time job, I have been able to volunteer and give a lot of my time to various organizations in the community and many at church. If I would have had children when we first began trying, I probably would not have gotten involved in these groups and missed out on meeting wonderful people. But I’ve gained these friendships and have given of my time and talents. It’s something I’m very enthusiastic about now, and want to keep giving, even after children arrive for us!

And ultimately, from our infertility journey, I know that I want to tell our story to help others along theirs. I know not everyone can identify directly, but I hope in some way or another, it will touch, if even just a few people…someway, somehow.

So, thank you, God, for our unanswered prayers. Even though they were always truly answered...

AWKWARD EXPERIENCES = HURT FEELINGS

I’ve had more than my fair share of awkward experiences involving people who didn’t know of my infertility. I’m not blaming them at all – how were they to know I was an overly sensitive woman on a long time quest to become a mother?

The following are a few of those lovely times, I’m sure I won’t soon forget.

At a family reunion in July of 2009 – wait, pause this story. I must tell you that family reunions are big in my family as my mother is a very active and dedicated genealogist for our family history. Family reunions have changed since my infertility. Before it was a fun time to get together with those familiar and/or long lost relatives and share in fun times together. You made new memories while reliving the old and those of past generations before you – ultimately, the reason you are here today. Only now, for me, reunions seem to be a reminder of how I may never have children and therefore, there may never be any family reunions of my descendants.

Okay, back to my story. At a family reunion in July of 2009, an extended family relative in his 70’s asked me, “Do you have any children?” After I answered no, he said, “Well….what are you waiting for?” (I thought he asked it in a snotty sort of tone, but maybe it was my wild imagination playing tricks on me again.) I was caught off guard, but amazingly answered back sanely. I replied saying, “We’ve been trying for a few years.” Another woman understood immediately and chimed in with, “It took us a long time to get pregnant too.” We all briefly chatted about it and I don’t remember the exact details. But after chatting, I was proud I handled it so well. If he would have asked me this the year before, I probably would have ran off crying hysterically. Maybe I am getting over “this.” Whatever that really means!

Another happened during my time at the preschool/daycare. One of my favorite kids there (Wait, did I just admit to favorites? Sorry, but it’s true!) looked up at me and asked, “When is your baby coming out?” I was in shock. This didn’t really sting deep. More than anything I was afraid that this little preschooler was basically saying I was fat. Come to find out they were talking about being pregnant in class and she must have decided to ask everyone she came across that question. Looking back now, this story is pretty funny. Kids sure say the darndest things!

Another experience was at a craft fair in the fall of 2009, my sister was chatting with an acquaintance at a booth where this individual sells natural products such as lotions, shampoos, etc. for babies/children. She was planning on giving me her spiel. She started by asking me if I had any children. I responded, “no.” She then asked me if I was married.” I said, “yes.” Next she questioned how long we had been married. I replied, “5 years.” (I already knew where this was probably headed.) She looked sort of confused or shocked and proceeded to ask me, “Well….do you WANT kids?” I think I quietly said, “yes” but I don’t remember anything else or how I got out of the rest of the conversation. It would probably be a normal question for a normal situation. But for me, it hurt. It really hurt.

At my grandfather’s funeral, a family member, whom I’ve only seen once in the last 15 years, asked me why we didn’t have any kids. A simple question that deserves a simple answer. But it was something that stung really deep. I thought to myself, “You don’t have enough time in the world to sit here and listen to my honest answer to that question.”

During another experience, I had a friend who I had just told about our infertility. This friend was recently pregnant from their first month of ever trying. (Must be nice!) After I was complaining about the scheduled sex, she said, “I know exactly how you feel. It was just exhausting having so much sex that month. I just couldn’t stand it anymore.” (Really? Wow…that one month of frequent sex must have really been rough. Talk about a hamper in your life. Now try that for 39 months straight and then tell me how you were exhausted.)

During our infertility, one of my closest friends, who wasn’t married and wasn’t trying, had a baby. I’ll never forget the day went met for supper in a restaurant and she told me she was pregnant. The feeling of my heart sinking into my stomach was something I had never experienced at that point. It almost felt like a betrayal of some sort. I felt like I was going to throw up inside. I sobbed and sobbed on the drive home. Not because I wasn’t happy for her…but because I was so desperately sad for me.

At one of my appointments at Mayo, a nurse said to me, “So, you have a son, Luke, at home?” I’m not sure why she thought this or where that came from at all. I said, “nope, no children.” It didn’t hurt me too much at the time, because I was focused on what was happening during my appointment. But after, it made me tremendously sad. Thinking back, I thought I could have said something like, “Nope. No children at home. But you can please pull the knife out my from bleeding heart.”

On multiple occasions, I’d be out and about with my two nieces. Of course various people around town assume they’re my children. It’s natural. You see a woman with 2 kids, they most likely are hers! They’d say something to the girls like, “Oh, are you having a special day with mommy?” We’d just laugh. But it did hurt. Although I didn’t take too much offense because I’d take those adorable girls as my own any day…

GIVING THANKS

I know I have many blessings in my life and I’m truly grateful for each one. Even in our story of infertility, there are parts that could be much worse and we are thankful for these amazing gifts…

I am thankful for…
- a large support system of loving family and friends (sadly not everyone has this)
- the financial means to be able do undergo treatments (this isn’t even an option for some because of financial struggles)
- being able to leave my job to focus on trying to start on family by “de-stressing” (this isn’t even an option for some because of financial struggles)
- being within driving distance of MAYO, a renowned clinic (some may have to drive hours and hours, and therefore not be able to seek medical help)
- resources of online sites, blogs, newsletters, and books (because without them, I’d feel like I was the only one going through this)
- living in a time with technology and treatment available for infertility (if it were 30 years ago, I don’t know what options would be available)

I’M PLANNING TO STOP PLANNING

I’m an organizer. I’m a planner. I’m a list maker. I love to know what’s going to happen, when it’s going to happen, how it’s going to happen, and why it’s going to happen. In fact, Who? What? Why? Where? When? are some of my favorite questions!

I think being a “planner” has made this infertility process all the more psychotic for me. Yes, I like surprises – but only every once in a while. And definitely not surprises that are about my future. If I could just know for sure that’d I’d get pregnant sometime in my future, even if it’s 10 years down the road – awesome, bring it on. As long as I knew it was going to happen someday, I could be content. Even if I couldn’t “plan” that, at least I knew the outcome and could “plan” up until that time.

I like to keep things under control, I like calmness, and keeping away from anything hectic. I’m slowly realizing that instead of planning for the future, I just need to step back and let it fall into place. I’m making it a point to focus on the present and appreciate the blessings right in front of me – right now.

But ultimately, to really make this confusing and contradicting, even though I am planning to stop planning so much (because I know I still need and am going to plan…but only for certain things) - I still will plan for infertility. You have to plan ahead and make that next appointment “just in case,” because if you don’t – you’ll miss out on another month of trying. So all the while during that two-week-wait, you have to be hopeful that you are pregnant, but you still have to plan ahead and make appointments “just in case.” (Turns out that “just in case” happened all too often for us.)

So, I’m planning on reducing my need to plan. I imagine this will be harder than I think. I’m going to stop being so selfish and start trusting in God’s plan rather than my plan for myself.

MIRACLES FROM GOD

I hope everyone knows how much of a phenomenon becoming pregnant is. It’s truly nothing sort of an absolute miracle. And I don’t just think this because I can’t get pregnant. It doesn’t even have to do with me. I’m just amazed when I think of how a baby grows. It just perplexes me. God is so amazing!

Did you know that a fertile woman only has a 20% chance of becoming pregnant every month? If she has sex at the exact perfect time during ovulation and everything else is perfect, there’s still only a 20% chance of becoming pregnant. 20%!!!

Babies are a precious gift from God. If you have a child, I pray you never take him/her for granted. Never let a day pass without them hearing, “I love you” and more importantly always let them feel that love by your actions!

I have a friend from college who suffered the loss of her baby girl, named Hope, the day she was born. My friend wrote an honest and heartwarming blog that really touched my heart. One thing she wrote said, “It’s my shot at hope that maybe God is really working miracles up there. What that miracle is, I can’t say for sure, but God knows, and that’s what matters.”

That sentence has really given me a lot of comfort in my journey. I don’t know what’s going to happen, but I am reassured in knowing that God knows.

So in the meantime, I keep waiting for my miracle…

“GET A PET AND YOU’LL GET PREGNANT.”

I can’t even count how many times someone told us to get a dog. Seriously!??! Well, if that’s the only way we’ll get pregnant – then I guess we’re never meant to have a child! Don’t get me wrong, I like dogs – I just don’t want one living in my house.

We’re not into superstitions, but nonetheless, we decided to go with the hype by trying it out and get a pet. What could it hurt, right? So, we bought a beautiful crowntailed beta fish that was looking so sad in it’s little plastic jar at the end of the aisle at Walmart. What a joy our little fishy was!

We got out the baby name book I bought at a garage sale for a quarter and searched and searched. We settled on a perfect name and it was 100% Italian, of course. Vincenzo Vitale Vincelli! Vincenzo means “conquering” and Vitale means “life.” It was our sign of how we’d “conquer life” and soon become pregnant with a little human of our own.

But years passed, with no pregnancy, and our dear sweet Vincenzo died in the fall of 2009. We gave him a nice burial “toss” out into the empty lot next to our home! Go ahead and throw out that theory. We learned that pregnancy isn’t guaranteed if you get a pet. (As if we really didn’t know that already.) If only it were that easy!

DON’T PUSH ADOPTION (YET)

Here’s a great article I came across on www.resolve.org. It’s by Vita Alligood and has some great information about talking infertility and adoption.

Don’t Push Adoption (Yet)
By Vita Alligood

Don’t push adoption. Adoption is a wonderful way for infertile people to become parents. However, the couple needs to work through many issues before they will be ready to make an adoption decision. Before they can make the decision to love a "stranger's baby," they must first grieve the loss of that baby with Daddy's eyes and Mommy's nose. Adoption social workers recognize the importance of the grieving process. When my husband and I went for our initial adoption interview, we expected the first question to be, "Why do you want to adopt a baby?" Instead, the question was, "Have you grieved the loss of your biological child yet?" Our social worker emphasized how important it is to shut one door before you open another.

You do, indeed, need to grieve this loss before you are ready to start the adoption process. The adoption process is very long and expensive, and it is not an easy road. So the couple needs to be very sure that they can let go of the hope of a biological child, and that they can love an adopted baby. This takes time, and some couples are never able to reach this point. If your friend cannot love a baby that isn't her "own," then adoption isn't the right decision for her, and it is certainly not what is best for the baby.

Mentioning adoption in passing can be a comfort to some couples. (The only words that ever offered me comfort were from my sister, who said, "Whether through pregnancy or adoption, you will be a mother one day.") However, "pushing" the issue can frustrate your friend. So, mention the idea in passing if it seems appropriate, and then drop it. When your friend is ready to talk about adoption, she will raise the issue herself.

ONE OF MY MOST PRIZED POSSESSIONS, MY PILLOW.

I’ll let you in on an interesting fact about me. And for those of you who know me best, you already know that I absolutely adore my pillow. I take it with me everywhere overnight, except on flights. And I really don’t like it when other people try to use it or yet alone, even touch it. It’s weird, I know…but it’s true. I wouldn’t call it a fetish, but I definitely cherish it above most of my other physical possessions. It’s just the ideal pillow for me; perfect size, smooshieness, smell, temperature, and softness.

I had my ‘old’ perfect pillow for many years. I think I most likely had it since high school, so by the time I retired it in 2008, I had it for over 10 years. I know what you’re thinking, “That’s totally gross.” And it probably was, but I loved that thing. I didn’t care if people said it was full of bed bugs and germs. But one day in a silly rage of “infertility psychoticness,” I imagined that could be the cause of our infertility! So away it went. I found a new pillow to try out and was in shock. I loved it even more than my ‘old’ perfect pillow! And being the intelligent woman I am, I thought ahead and bought another of the exact pillow so I can switch it out before the next 10 years pass again!!

If you know me, you know I love to sleep. You know I’m not chipper in the mornings and that I don’t enjoy being woken up on other people’s terms. (I know that you’re thinking, “And she wants to have a baby!”) So you can definitely say - I’m NOT a morning person! In high school, my older sister, Jesse, would practically have to drag me out of bed each morning. She’d yell at me, “If you don’t get up right now, I’m never waking you up again.” I guess it worked because eventually I did get up. (Thanks, Jesse, for your years of torment!)

Some people had their baby blankets they were attached too while young. I never went through a phase like that. I sort of imagine that maybe I’m going through that phase just a little later in life. And instead of a blanket or pacifier giving me comfort, it’s my pillow! If you think about it, you really do spend a lot of time with your pillow. I’ve cried a lot of tears on that thing during these years of infertility.

I know that many people have a hard time sleeping when they’re stressed. I’ve never experienced insomnia and I think that would be awful. But sleeping for me = not…a…problem…at…all! 9 out of 10 times, I’m asleep night as my head hits the pillow. My problem is the waking up part. I could sleep in everyday if I let myself. And during these infertility years, I force myself to get up even though it would be way easier to just sleep through it all. But I know someday it will get easier.

Oh, and just so you don’t think I’m absolutely crazy – my youngest sister, Corrie, has a similar relationship with her pillow. So, don’t think I’m crazy, I guess it’s just part of our genetics! HA!

THE STIRRUP-QUEEN

Being poked and prodded at is one thing. But being invaded in the most intimate part of your body is another. I’m tired of stirrups, I’m tried of clamps, I’m tired of vaginal ultrasounds, I’m tired of numerous doctors, nurses, and techs looking at me “down there”, and I’m tried of hearing, “scooch down and let your legs fall open.” I don’t even want to think about the number of people who have watched me spread my legs and taken a look. I just pray that someday I’ll be putting my feet in those stirrups while giving birth. Just call me the “Stirrup Queen” because that’s what I feel like! But I don’t want that title…I don’t want a crown…I just want to be “normal”…

“WORSE” THINGS COULD HAPPEN…

I’m not trying to diminish other people’s hardships. So, please don’t judge me. I’m not saying my pain is worse than yours. But please try to understand me. Do you appreciate my pain of wanting a family? Of wondering what’s so bad inside of me that God wouldn’t want a piece of me to go on? What did I do so horrible in my past that I deserve this? These are questions I often ask myself. Questions that make me question myself, my feelings, and my worthiness. I know God isn’t a punishing God, but why do I keep asking myself what I did to deserve this?

Whenever something is going bad is someone’s life – people say something like, “Just remember what’s most important in life – your family and children. As long as you’re together – that’s all you need.” Exactly!! So, imagine for a moment how one would feel when all you want is to start your own family – but you can’t make that happen. If the most important thing in life is “family,” then why can’t we make our own?

I know people can say that there are much “worse” things out there that could be happening to me. But really, who is the final authority on what is the “worst” thing that could happen to someone? Is it going through a divorce? Watching a loved one die? Getting raped? Losing a job? Having cancer? Having depression?

I read an article about how different people react to different life experiences in different ways. To someone who has trained his whole life for the Olympics, the “worst” thing may be experiencing an injury before the event. To someone who has walked away from her career to become a stay-at-home wife/mom for 40 years, watching her husband leave her for a younger woman may be the “worst” thing. And to a woman whose sole goal in life has been to love and nurture a child, infertility may indeed be the “worst” thing that could happen.

So, we all have difficult and heartbreaking things that happen in our lives. But never diminish another’s experience just because you haven’t gone through it or fully understand the emotional heartbreak. People wouldn’t dream of telling someone whose parent just died, “It could be worse. Both of your parents could be dead.” Such a comment would be considered cruel rather than comforting. In the same way, don’t tell someone that she could be going through worse things than infertility.

Please don’t judge me – whether you’ve gone through this or not. We all have our crosses to bear. And as we know, they’re all different and unique. The exact same situation for two different people can be experienced in extremely different ways. And you never really know when someone is experiencing that “worst” thing that will happen in their lives as we never know where life will lead us. But we can support and try to understand along the way. Because yes – something “worse” could always happen…but who are we to judge what the “worse” really truly is?

Infertility may be my “worst” thing. Or maybe not. But for now it is…

INFERTILITY HUMOR

Here are a few infertility jokes I found online!!

Why did the RE cross the road?
Because there was a wealthy, infertile woman in her 30s on the other side.

One ovary says to the other ovary, "Hey, did you order any furniture?"
The other ovary says, "No, why?"
"There are a couple of nuts outside trying to shove an organ in."

Why does it take 50 million sperm to fertilize one egg?
Because they won't ask for directions either!

You know you are trying to get pregnant when:
You look at your vegetarian sandwich and the alfalfa sprouts look like sperm . . .
or . . . Someone asks you today's date and you reply "Day 21" . . .

RE: Reproductive Endocrinologist

After the first appointment at the Mayo Clinic, I realized that there is a big difference between a general obstetrician/gynecologist with a specialty in infertility and a RE: Reproductive Endocrinologist. A reproductive endocrinologist is a type of medical doctor who specializes in treating people with reproductive disorders. It’s their specialty – so it’s all they focus on. They are highly gifted, competently trained, compassionate, and devoted to providing the best treatment available. (Or at least they should be!)

I was relieved to be at a specialty clinic where infertility was all they dealt with, every day, all day. I wished I could have been here from the get-go, but you need to start with the “normal” clinic before you can be referred to the big guys. How nice to sit in a waiting room with other people who you knew were going through some sort of the same thing as you. What a blessing to not have to sit there next to some big ol’ pregnant bellied lady like at the OB/GYN.

I’d often find myself looking at the others waiting in the room, thinking of how far along they were in their infertility journey and what appointment they were on. We received blue binders of information that we were supposed to bring to each appointment. And each had initial labels on the sides referring to what was inside. So, I’d try to peek and see if they currently matched mine. Were they having an IUI? Were they starting IVF? I wondered what their stories were and how long they had been trying to conceive.

I am very thankful for our experiences so far at Mayo. The 45 minute drive back and forth from Mayo has actually given me a lot of time to debrief over appointments, which is nice! The medical staff has been very knowledgeable, supportive, and caring. We feel very blessed to live so close to and doctor at such a prestigious clinic/hospital.

HOPING FOR THE FUTURE

People often say that you need to visualize what you want in life and ‘see’ yourself accomplishing those things. No need to tell me to do that – you could tell me that there’s a 0% chance of me getting pregnant and I’d still find myself daydreaming of my little kiddos running around. Even though there were times I’ve felt far from hope, there was never a time I was completely hopeless. And I praise God for that!

I’ve bought baby name books, baby books, booties, and even a really hip diaper bag that I just couldn’t pass up! I daydream and I hope for the future. I think about what how I can decorate the nursery and baby names. In fact, we already have a middle name picked out for both a boy or a girl! But one of my favorite things to daydream about is how to tell people we’re pregnant. Oh, how that will be such a long awaited joy. I get goosebumps just thinking about it.

As I sit in church, I wonder when it will be that we will be up there by the alter watching our baby get baptized. I even think about to when we have teenage children and picture them being involved in sports, band, etc. I wonder what hobbies they will like and what their personalities will show. I wonder if we’ll still be living where we are and if our children will get married in our church. I wonder what age we will be when we become grandparents and get saddened by the fact that we probably will never be great grandparents.

I choose to hope for the future. I may not know what the future holds, but I know who holds the future…

SILENT STRUGGLE

My biggest anger with infertility is that it’s such a silent struggle. Most people who see others going through it don’t talk about it. It makes them uncomfortable. They don’t know what to do, they don’t know what to say, they don’t know how to act. They don’t ask. They figure not saying anything at all is a better choice. Personally, I think that’s the worst thing to do.

People going through infertility need support! They want to know that they’re not alone. And when you’re struggling with anything in life, I believe the worst thing to feel and believe is that you are truly alone.

I read on a fact sheet (from the” American Society for Reproductive Medicine”) that many women who are being treated for infertility have as much stress as women who have cancer or heart disease. I’ve often thought that infertility doesn’t receive the appropriate support from others. I’m not saying that infertility is more tragic than having cancer. Not at all. But - I’ve often thought it is very disappointing how individuals who have a medical condition, such as cancer, often get a lot of verbal and face-to-face support from family and friends, and even people who do not know you at all.

Infertility is also a medical condition, but it oftentimes does not receive that same support. Why is there such a difference? I think it’s because infertility needs to be shown to the world. People need to realize the extent of it’s pain and suffering. They don’t understand how much of a heart wrenching and traumatic experience it truly is. I know it may not make sense to you, looking at it from the “outside” (if you have not gone through infertility personally), but I can assure you, it is more complex than you imagine.

I hope someday infertility steps out from it’s category of being a “silent struggle.”

NOTHING DEFEATS HOPE

Nick and I have gone through our fair share of feeling as if we don’t belong. We’re at an interesting stage in our lives. Here we are now, married for over 5 years. Most of our friends are either single without kids or married with kids. There aren’t many “like us,” who are just married with no children. This can make it difficult in spending time with friends. Single friends hang out with single friends because they don’t want to feel like the third wheel. And friends with children can’t always hang out as easily, or they would rather hang out with friends who have children so when they get together their children can play together. Needless to say, oftentimes, we feel left out.

We don’t blame anyone and know it’s not anyone’s fault. We just keep plugging away, knowing that someday we’ll have children of our own. We keep that hope because we know that nothing defeats hope! And although that hope builds, but then also falters as we go through each disappointment, we know that ultimately, it’s going to be okay. Graciously, God has turned those disappointments into appointments with Him. We are learning a lot and trusting a lot. We pray this journey leads us to a life long ministry of being able to support and comfort others in their times of need.

So, I’m choosing to keep believing, to keep trusting, and to keep hoping. I’ll do anything to become a mother. And I know that day will come and will be worth every second of the hardships along the way.

MY REPRODUCTIVE STORY

I’ve read that we all, from an early age, have an unconscious narrative of our reproductive story that we’ve written. It’s our story of how we think our life as a parent will all unfold. It starts in childhood and is modified and rewritten as you become an adult. And when it doesn’t unfold as you hoped it would, that certainly explains some of the emotional pain of infertility.

I never imagined that after 5.5 years of marriage, at the age of 29, I still wouldn’t have any children. My ideal life plan was to meet the man of my dreams by sophomore year of college, get married right after college, and have a baby 2 years later. Ultimately, God has had different plans for me than I had for myself! I did meet the man of my dreams in college, at then end of my junior year, just one week before he graduated from college! And we did get married 3 years later after we met (2 years after I graduated from college.) So, I was just a few years “behind” my dream plan. Not too bad! But when the whole baby making thing came along, it pushed my plan behind…far behind. Goodbye baby that was supposed to be born when I was 26 or 27!

So, now that I’m 29 years old, I guess my story continues to rewrite itself, without my approval. It’s been three years of our infertility struggle. It’s a little uneasy to keep watching the months and years pass and to still not know the miracle of pregnancy, birth, or the joys of parenthood. People tell me to relax and stop worrying because I’m young and have plenty of time. But that’s hard to take in, as they’ve never been through this situation themselves. In fact, it’s very patronizing and hurts deep. Once a married couple wants to have a baby, then faces years of challenge trying to get there, their age becomes irrelevant because the pain and frustration is so very genuine. Even though I understand that we have years left and that my biological clock hasn’t run out yet, it’s difficult when you’ve already seen three years pass and wonder if that chance will ever come – no matter how much time I have left…

PASS THE TEST…Good news: It’s Open Book!

This is a test. And I’m going to pass this test. Fortunately this test is an open book test. Yippee! Because the Bible has all the answers I need…for now! (I’m saving up to ask those other questions for when I’m in heaven.) This test doesn’t have any time limits and I can ask others for help. As a Christian, my faith is being tested more than ever before.

“Now faith is the substance of things hoped for, the evidence of things not seen.” Hebrews 11:1

Through this bible verse we believe that even when the proof is not provided and the questions aren’t answered, we still have faith.

I know God won’t give me anything I can’t handle. I know He won’t leave my side. I’m going to keep plugging away and learn as each day passes. I don’t know how this test will end or what grade I’ll receive. But I do know that I won’t give up. My faith is being strengthened and my walk with Jesus has never been sweeter.

I read that two-thirds of those who undergo treatment for infertility will have their journey end in a successful pregnancy. Dear God, please let us be in that two-thirds! Please keep our burdens light and our hopes high! Help me to walk by faith, not by sight and guide me to understand that no matter what happens, your will and your plan for our family will make our hearts whole.

INFERTILITY SUCKS!

Infertility makes me feel like a bad person. I feel selfish. I feel empty and unworthy. I’ve discovered I have a lot more jealous bones in my body that I ever had imagined. I fear that infertility is changing me for the worst. It’s altering my perceptions and changing my dreams. It’s changed me to the point where sometimes I’m afraid I’ve forever lost the parts of me that were so hopeful and positive.

Infertility has made me humiliated to admit that I’ve been angry with God. I’ve questioned my faith and I’ve struggled to accept His timing. At times, I’ve even felt as though God has turned His back on me. I’ve spent way too much time trying to figure out what I did so horrible to deserve this.

In an article, I read this simple sentence that gave me peace. “Infertility is a medical condition, not a punishment from God.” It made me think more about the fact that I’m not being punished. Bad things happen to good people. It’s just a fact of life! God’s not trying to hurt me and He works good through all circumstances. We may not ever know the exact reasons why things have to happen the way they do. But we can be assured that He knows what He’s doing. “And we know that in all things God works for the good of those who love him, who have been called according to his purpose.” Romans 8:28

Yes, infertility sucks. But we’ll make it through this. And we’ll wait for this baby…I didn’t say patiently wait…but we’ll wait…for our little beautiful, incredible, miracle…however long it takes.

GOD’S STRENGTH IS MADE PERFECT IN OUR WEAKNESS

Infertility makes me scared. I feel weak. I’m scared of the unknown. I’m scared of the tests and the doctor appointments. I’m scared we’ll never get pregnant. I’m scared of how my body will react to all the medications. I’m scared I won’t be able to deal with all the emotional stress. I’m scared other people are looking at us thinking we don’t have any children because we’re “those kind of people.”

I don’t know if what I’m feeling is normal. But what is “normal” anyway? Maybe this is what “my normal” is. I don’t think I can necessarily stop these feelings, but I do think that I have a choice. We all have a choice. Be sad, feel what you need to feel, but don’t let it take over your life. I realize I need to stop feeling sorry for myself. I’m sensitive, I can’t change who I am, but I can control it. I have a choice! Today is a new day and it’s up to me to make it count.

Even though I feel weak, I know God is working in me. I may not know exactly how, but I know His strength will be perfect in my weakness. So for now, I’ve decided to try to smile more, pray more, and complain less. I know I’ll be stronger. I know I’ll survive…

2 Corinthians 12:9-10
But he said to me, "My grace is sufficient for you, for my power is made perfect in weakness." Therefore I will boast all the more gladly about my weaknesses, so that Christ's power may rest on me. That is why, for Christ's sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong.

I HAVE INFERTILITY, BUT IT DOESN’T HAVE ME!

It’s easy to get so wrapped up in infertility that you forget how to live. We need to consciously remind ourselves that there is so much more to life. Find those things that make you happy and don’t let infertility take that happiness away from you.

Fight! Fight for what you love. Fight for what makes you happy. Don’t let infertility steal the fight in you! Don’t give up. Keep pushing on. Realize the strength in yourself and know it’s okay and imperative to draw from the strength of others.

I’ve realized that no matter what happens infertility will be with us forever. We can’t run away from it. Sometimes it will be hiding in the shadows and sometimes it will be glaring us in the face. But it will always be there. We’re not ashamed of our negative feelings from infertility, because we know that’s part of the process. But we do want to avoid the bitterness and cynicism as a result of it. We know this whole journey has made us more compassionate and more understanding. It has changed us for the better and for that we are thankful.

I have infertility, but it doesn’t have me…

UNINVITED GUESTS: GUILT & DESPAIR

Throughout these three years, I’ve gone through many spurts of guilt and despair. I don’t want to call it depression, because I’ve heard depression often associated with “hopelessness.” And even though there were times I felt so far from hope, there never was a time that I was completely hopeless. There was always a tiny glimpse of hope that I held onto even in the weakest times.

Oftentimes, the guilt I experienced was in response to feelings I would have. I felt guilty for being upset when I heard of another’s pregnancy news. I felt angry with myself for feeling that way. One day a good friend told me to stop being so hard on myself. I didn’t realize until then that much of my guilt was unrealistic. I was being too hard on myself for having “natural” feelings that I should have allowed myself to feel.

One thing I do know for sure is that infertility will have you experience every single emotion known to mankind! I’ve learned to appreciate each emotion and know that without the “bad,” how would we truly know what the “good” feels like? The good feels better because we have the bad to compare it to. All of these emotions, good and bad, are making me realize and truly appreciate being able to feel these things.

INFERTILITY ISN’T CONTAGIOUS!

Throughout our infertility, as time went on, I found myself reaching out to many people. We didn’t try to keep infertility a secret. We wanted and needed love and support. We understood that not everyone would be comfortable knowing. And I know that not everyone who has infertility is going to be as open about it as I am. I’m not sure exactly why I’m not so shy about it, after all, it is a very intimate and personal part of someone’s life. But, I do know that by putting “myself” out there, I’ve found unexpected support from the most unexpected people. And what a true blessing that has been.

And on the contrary, we now know that the people we most thought would WANT to understand, really didn’t seem to want to understand at all. Maybe they didn’t have the time. Maybe they were afraid of what to say or how to act. Some individuals who were close to us, seemed to back away after finding out. I started feeling like I had an evil plague and if anyone talked with me about infertility, they might catch it too. Am I contagious or something?

It hurt to be cut off from friends. It hurt when people didn’t ask. It hurt when I started talking about infertility and they changed the subject. It hurt when I would email people, straight up telling them I was struggling and needed help, and never got a reply back.

Infertility isn’t contagious. You don’t have to say anything miraculous and philosophical. Just say something, because something is better than nothing…

HOW SHOULD A CHRISTIAN DEAL WITH INFERTILITY?

I found this online and thought it was a great article!
http://www.gotquestions.org/infertility.html

Question: "How should a Christian deal with infertility?"

Answer: The problem of infertility can be a very difficult one, especially for couples who have looked forward to children all their lives. Christian couples can find themselves asking “Why us, Lord?” Surely God wants Christians to be blessed with children to love and nurture. For physically healthy couples, one of the most heart-wrenching aspects of infertility is not knowing whether it is a temporary or permanent situation. If it is temporary, how long must they wait? If it is permanent, how do they know that, and what should be their course of action?

The Bible depicts the problem of temporary infertility in several stories:

God promised Abraham and Sarah a child, but she did not bear a son, Isaac, until age 90 (Genesis 11:30).

Isaac, Rebekah’s husband, prayed fervently, and God answered, resulting in the births of Jacob and Esau (Genesis 25:21).

Rachel prayed, and at long last God “opened her womb.” She bore two sons, Joseph and Benjamin (Genesis 30:1; 35:18).

Manoah's wife, who was infertile for a time, gave birth to Samson (Judges 13:2).

Elizabeth in her old age gave birth to John the Baptist, the forerunner of Christ (Luke 1:7, 36).

The barrenness of Sarah, Rebekah, and Rachel (the mothers of the Israelite nation) is significant in that their ability to finally bear children was a sign of the grace and favor of God. However, infertile couples must not assume that God is withholding His grace and favor, nor should they assume they are being punished in some way. Christian couples must cling to the knowledge that their sins are forgiven in Christ and that the inability to have children is not a punishment from God.

So what is an infertile Christian couple to do? It is good to seek advice from gynecologists and other fertility specialists. Both men and women should live a healthy lifestyle to prepare for pregnancy. The mothers of the Israelite nation prayed fervently for conception, so continuing to pray for a child is certainly not out of line. Primarily, though, we are to pray for God's will for our lives. If His will is for us to have a natural child, we will. If His will is that we adopt, foster-parent, or go childless, then that is what we should accept and commit to gladly doing. We know that God has a divine plan for each of His loved ones. God is the author of life. He allows conception and withholds conception. God is sovereign and possesses all wisdom and knowledge (see Romans 11:33-36). “Every good and perfect gift is from above...” (James 1:17). Knowing and accepting these truths will go a long way to filling the ache in the hearts of an infertile couple.

I WANNA KICK MY OWN BUTT (The result of mixed emotions!)

I feel like a complete basketcase. I really don’t even know how I should feel anymore. In one moment, the longing for children is too much to bear. And within the next, I’m trying to convince myself I don’t even want kids anyway. I see a newborn baby and I can’t decide whether I want to hold that baby and gaze at it’s beautiful face or close my eyes and pretend it’s not there.

It seems that I can’t go in public once without seeing a pregnant woman. Every other posting I see on facebook is news about a pregnancy or new baby. And every commercial and show on TV has to do with pregnancy, babies, or kids. Are these things true? No. But when you’re hurting from infertility, your perceptions may be faulty. It seems like everyone is intent on making you hurt, but that’s not the case.

We need to recognize that some of our feelings will be unpredictable. There may be some days when you feel like talking about it, and others when you don’t even want to think about it. And that’s okay. But of course this fact makes it difficult for others to know what to do. They just can’t look at you and know if you want them to ask or not ask. Sometimes I find that the days I want to talk about my infertility, are the days no one seems to care or ask. Then the times I don’t want to talk about it, it’s all they ask about. But who am I kidding? Honestly, it can depend upon the HOUR! Ask me. Don’t ask me. Either way I could be upset about it. But I can guarantee it hurts when people just pretend nothing’s wrong and ignore it altogether.

It’s like I’m “infertility bipolar.” One minute I’m the total optimist and the next I’m the total pessimist. Needless to say, that is why I sometimes want to kick my own butt!

WOMEN VS. MEN

It’s not difficult to notice that infertility is different for men and women. I read in a book that many women see motherhood as an essential part of their identity. It mentions that for a woman, having a child is as basic of a function as eating, breathing, and sleeping. And men need to be aware of the vicious torment infertility inflicts on a woman.

It didn’t take long for me to realize that Nick didn’t hurt at the same intensity I did. And with that realization came some resentment and feelings of increased isolation. Don’t get me wrong. I know Nick cares and is sensitive to my needs. And he desperately wants a baby too. We both realize we’re in this together. We’re happy together, we hurt together, we pray together, and we support each other. But it’s just different for women than it is men.

I know these feelings are not unusual for many women going through infertility. It’s usually the woman who feels the greater involvement and suffering. After all, she’s the one on all the medications. She’s the one who has to be at every doctor appointment. And she’s the one who has to physically go through it. Women are the ones invited to baby showers, not men. Women are typically the ones hearing of another’s pregnancy or story of delivery, not men. And women are asked, “When are you planning to start your family?” Women are the ones who see another pregnant woman and listen to their stories. Women come across it more in their daily lives. It’s just a natural part of being a woman.

Wives shouldn’t assume that their husbands understand the depth of their pain. That’s why it’s so important to communicate. Without the communication, you won’t be able to deal with it effectively. And if you don’t let your feelings out, you may become fuller of that grief, which will in return, make you frustrated and angry.

And husbands shouldn’t assume their wives understand the depth of their pain. Tell you wife how you feel because sometimes she feels like infertility doesn’t even affect you. It hurts husbands to see their wives in such emotional pain. But you need to realize that we don’t need you to fix the pain. We want to know that you hurt with us. We need your support and comfort. We need to know that you care too and that infertility affects you as well.

GRIEVING TO HAVE A CHILD

I read in an article by the Cleveland Clinic Foundation that said, “Many people do not recognize that infertility is a source of grieving. The loss of a child who was wanted and imagined but never conceived is a legitimate loss, much like suffering a miscarriage or a stillborn baby.”

I think one of the hardest things for an “outsider” to understand about someone going through infertility is the constant battle with grief. In infertility you are constantly going through that process of heartache and sorrow. You are grieving to have a child. And every month you are grieving over a child that didn’t happen yet again. It is extremely hard to explain, but, in some sort of way, you feel like you lose a child every month.

I read in the book, “When The Cradle Is Empty,” by John & Sylvia Van Regenmorter, that grief associated with infertility is called, “disenfranchised grief.” That means that your sense of loss will not be openly acknowledged, socially sanctioned, or publicly mourned. Chances are no one will offer you condolences. It is the slow death of a dream; the death of your hopes and aspirations. It is the death of a child you never had.

Please don’t misunderstand what I’m trying to explain. I am, in no way, saying that suffering the loss of a loved one isn’t as horrible as infertility. I do believe it would be far worse to lose someone you already know and love, than to lose the dream of someone you have never even met. But when you lose a loved one, there is a process of grief that you work through. And with infertility, you go over that process time and time again, sometimes month by month. It doesn’t really allow for that “healing” time in the stages of grief.

The journey of infertility is an interesting grief process to go through. It’s a grief experience, but you can’t truly go through all the stages and have it come to an “end.” (That’s because you have no idea when the end is sight. You don’t know if you ever will conceive a child.) It is unlike the grieving process of a death. In a death, you know that person is not coming back. But it’s different when you’re grieving so deeply over someone who was never there. I know that thought may sound extreme, but in the mind of someone with infertility, it’s a true feeling. And during your different stages of “infertility grief,” you will resurface many of your feelings over and over again…even after you think you’ve conquered them…and they may come with a vengeance.

You may have tried every treatment available and now you need to try to bury that specific hope or dream. You try to look for new possibilities of new plans and new dreams. Perhaps this means adopting a child or maybe even deciding to all together stop your plans for ever having children. This process is hard. And I don’t know if the pain will ever truly be gone. But I pray that if this is what it comes down to for us, that infertility will no longer be the dominating force it once was. I pray that we will find other wonderful goals and blessings to take its place.

WHAT NOT TO SAY

I’ve heard a lot of hurtful comments. I know people don’t mean to be offensive, they’re just naive. But naive makes is sound so negative…it’s not that their necessarily naive – they just don’t know. They’re just trying to say something…anything…and sometimes it just comes out wrong.

But please, please, please, avoid saying these things that truly hurts someone going through infertility.

• “Just don’t think about it and it will happen.”
• “You’re lucky. We’d love to have time without our kids.”
• “If you’d stop stressing out about it, maybe it would happen.”
• “I know exactly what you’re going through, it took us 3 months to get pregnant.”
• “You can take my kids!”
• “So & So prayed, and they got pregnant right away.”
• “This was an accident. I didn’t want to be pregnant in the winter.”
• “All I have to do is look at my husband and I can get pregnant.”
• “Maybe you aren’t meant to have children.”
• “Just go on a vacation.”
• “Adopt and then you’ll get pregnant for sure.”
• “Get a dog and then you’ll get pregnant.”
• “Are you sure you’re doing it right?”
• “You’re so lucky you don’t have to use any contraception.”
• “You don’t want to get pregnant anyway. It totally ruins your body.”

HOW TO SUPPORT SOMEONE WITH INFERTILITY

The best thing to do is to let them know that you care. People struggling with infertility most commonly feel ALONE! Just knowing you’re there let’s them know that they aren’t alone. Not saying anything is the worst thing to do. You don’t have to be a poet; you don’t know to know the right words to say. Listen a lot, but speak less. Ask questions without pressuring them. But do let that person know that if and when they want to talk about it – you are there. And if that time isn’t right now, let them know you are available whenever they need you.

Oftentimes, you don’t have to give advice; they just need to vent and to know that someone cares enough to listen. If you’re the “touchy feely type,” then give hugs and share tears along with him/her. Let them cry on your shoulder. But if you pretend nothing’s wrong or never ask, it’s like you’re ignoring that person and can make them feel like you forgot or that you don’t care.

Simply saying, “I’m thinking of you” can mean so very much. Send them cards. Any emails, texts, or cards that I receive that just say something like, “I love you and am thinking of you today.” mean so much. They don’t even have to say that it had to do with my infertility struggle. I just knew what they meant and that touched my heart. Let them know you are praying for them. Offer them the same kind of support you would offer a friend who has lost a loved one.

Those little notes, emails, or texts really touches and uplifts the soul. And you may not know it, but they usually come at the perfect time when people need it the most. Days where I get my period or received news I didn’t want to hear from the doctor, were days I oftentimes would find these messages. Some people may call that a coincidence, but I know it’s a God-incidence.

Overall, just be there. Show support, show you care, and do it often. The worst thing about infertility is the terrible feeling of being alone. Don’t ever let anyone feel alone…



Below is a great letter for families and friends of those experiencing infertility. I read it on www.ivf.com by Mark Perloe M.D.

Letter to Family and Friends

Dear Friend:
I realize that sometimes it's difficult for you to know what to say to a couple who has a fertility problem. Sometimes it seems like no matter what you do, it's the wrong thing. I'd like to give you a few suggestions that may help you be the friend I know you want to be:

1. Be ready to listen. Infertile couples have a lot on their minds and need someone to talk to. Sometimes a good ear helps people get things off their chests. A good listener can help people express their anxiety, anger, and guilt; or help people work out solutions to problems. Without offering any suggestions your attentiveness and interest may provide the comfort and reassurance these couples need most.

2. Don't offer advice unless you are really well informed. Infertile couples read everything they can get their hands on. Sometimes it seems as though they know more about fertility treatment than their own doctors. So talking off the cuff about something you don't really know about will only make them angry and defensive.

3. Be sensitive and don't joke about infertility; attempts at levity will only anger them. Joking about infertility is as inappropriate as joking about death at a funeral. Remember, infertile couples are hypersensitive about many things. Try to put yourself in their shoes whenever you insist they come to a baby shower, when you brag about your children's achievements, or when you tell them about your friend's daughter who got pregnant at fourteen.

4. Be patient. This couple may experience mood swings with every treatment or monthly cycle. One week they may be high because a new treatment promises hope; the next week they may be in mourning for the child they lost (didn't make) this month. They may be riding an exhausting emotional roller coaster which makes their actions and moods unpredictable. Try to understand and flow with their changes. And remember that when they want to be alone, they are not rejecting you. Don't get your feelings hurt by the preoccupation they have with their problems; keep in touch.

5. Show that you understand their difficulty. Say things like, "I know this is difficult for you," "I don't envy what you're going through," or, "If there is anything I can do to help, don't hesitate to ask." If you aren't sure about what they are experiencing, read some articles and books that discuss the emotional aspects of fertility problems.

6. Be realistic and supportive of their decisions for or against fertility treatment. Once they've reached a difficult decision, don't say, "Shouldn't you see another doctor?"; "Are you sure that you really want to adopt?"; or, "I'd never consider doing that!" These couples usually weigh each issue as though it were a life-or-death decision. Don't take their decisions lightly unless you have good reason to.

7. Don't put down their doctor or choices for treatment. Refrain from making comments like, "I never heard of a doctor doing that. Does he know what he's doing?" or, "You don't need surgery. What you need is a vacation." Unless, from your reading or experience, you are certain that their physician is not using accepted methods, keep quiet about these topics.

8. Be truthful. Don't, for example, try to hide a pregnancy in the family. The truth does not hurt, provided you are not brutally frank.

9. Let them know when you don't know what to say. The couple will appreciate your honesty and will probably suggest how you can help them in that particular situation, even if it means remaining quiet. Admitting your problem will help establish honest communication.

10. Be an advocate for infertile couples. Educate others and speak up for the couple's decisions. Promote your local RESOLVE chapter. If you do not have a support group in your community, help form one.

11. Understand that individuals and couples respond to fertility problems differently. Learn to recognize the normal emotional stages they are experiencing—denial, anger, depression, mourning, acceptance, and so forth. And realize that they may cycle through these stages with each new round of treatment and with each lost opportunity. Accept them when they are angry accept them when they are depressed, and accept them when they feel guilty. Unless they remain in a single stage for a prolonged period of time, don't become overly concerned.

12. Above all, be there when they need you and show them that you care.
This is a stressful time for everyone. Don't underestimate how important you and your relationship are to this couple. Your understanding and support can make a significant difference during this difficult period.

Mark Perloe M D
Atlanta, GA.