How We Chose IVF

by Jessi Chiu

How we got here

There have been several times during our journey of infertility where I wondered — Will we have to do IVF someday? Will we ever be able to have children someday? Those thoughts mostly crept in during moments of fear, when I let myself really consider the weight of my PCOS and Hashimoto's diagnoses. Those thoughts are when my mind wandered to the "worst case scenario," and would get ahead of where we actually were in that moment. All along the way, the doctors kept telling us that it would not come to that because they believed one thing or another would work, but sometimes my heart wondered.

Then one day, in March, 2015, after trying to get pregnant for a year and a half, our doctor finally asked us to consider In Vitro Fertilization (IVF). At that point, we had miscarried our precious Avery and had 3 unsuccessful Letrozole/Ovidrel cycles, and there were still other less invasive fertility options. As Christians, IVF posed many ethical dilemmas for us, and we were not sure that we would be able to resolve these issues. We began talking about them with our doctor, but at that time, decided that we would rather take the less invasive options, which also came with less ethical concerns. We chose to pursue Inter-Uterine Insemination (IUI), instead.

However, before we could start IUI, we found out that during the break we took to make our next fertility treatment plan with our doctor that we had gotten pregnant on our own. We were only pregnant with Hayden (read more about our story with Hayden) for a short time before I had a cyst rupture, causing me a lot of pain, and we found out that it was an ectopic pregnancy (meaning that the baby implanted in the fallopian tubes instead of the uterus), which could not survive. After an ectopic pregnancy, your risk of another ectopic pregnancy is much higher in the future.

After our ectopic pregnancy, we had tests done to assess for if there was damage in my fallopian tubes that would prevent us from the possibility of conceiving on our own. Thankfully, my tubes and uterus were clear, which meant we had options. Our doctors, however, for many reasons still considered IVF our best chance of pregnancy and a way to reduce the many risk factors I have. We were also blessed to be living in a state that had insurance coverage for IVF, and since we would only be living here for two more months, my husband and I again began to prayerfully consider this option.

IVF Concerns

We had not given it as much thought previously, and needed to decide:

  1. Whether we, as Christians, could come up with an ethical way to do IVF?
  2. Whether we were actually hearing God leading us to do this now?
  3. Could God be calling us to a different mission, such as - adoption, increased ministry, waiting for God to provide us a biological child in a different way?

Embryos and reduction

Ultimately, we had several concerns with traditional IVF. First, traditionally, the goal in IVF is to make as many embryos as possible to increase the likelihood of making a baby. There are multiple issues with this method, as typically multiple embryos are transferred at a time, resulting in multiple babies in one pregnancy. However, with multiples there is a much higher risk to the babies' and mother's health, and for that reason doctors often try to reduce the number of pregnancies via abortion. Additionally, any left over embryos must be frozen for future use. This can become problematic if the couple has extra frozen embryos remaining after they feel their family is complete. What do they do with those embryos? Discard them? Donate them to science? Donate them to other infertile couples? These are tough decisions. Also, what happens to those extra frozen embryos if the couple dies before they are used?

Life begins at fertilization

For us, as Christians, we strongly believe that life begins at fertilization, and as such, the answers to these questions are very important. So, in that, my husband and I knew that we could never and would never reduce pregnancies via abortion, which meant that we would not be willing to transfer more than one embryo at a time. Luckily, our doctor was recommending a one embryo transfer for us based on my age and health conditions, so this was not a difficult decision.

What to do with extra embryos

Secondly, we knew that we would not ever be willing to donate an embryo to science or discard an embryo. We strongly believe that each embryo that is fertilized deserves a chance at life, and we were committing to giving each one a chance. We knew that it would be too difficult for us to let one of our biological babies go to another family while we were alive to care for them. Therefore, we also knew that part of the decision to give each embryo a chance at life, included a willingness to bring each baby into our heart, homes, and life. We were not willing to create more embryos than to whom we could uphold that promise. Another issue we had with making a lot of embryos and freezing them was figuring out what would happen to these embryos if we died tragically before we were able to follow through on our promise.

We prayed, searched scripture, did our research, met with our pastors, sought counsel, and prayed some more. Ultimately, to manage these issues, we made a plan with our doctor to come up with a balanced protocol that honored life and these ethical issues in a way that we were comfortable with. I share our journey and our decisions in the hope that, if you're making these difficult decisions, it could offer you ideas and hope that there may be a way for you to balance these issues. However, this is a personal decision, and I hope that you prayerfully consider each issue for yourself. I found there was not sufficient material out there for Christians attempting to navigate these waters. The only material that I found helpful and would highly recommend was The Infertility Companion: Hope and Help for Couples Facing Infertility, which written by a Christian Reproductive Endocrinologist and a patient and endorsed by the Christian Medical Association.

The Plan

The protocol we developed with our doctor was that we would harvest as many eggs as possible, but only attempt to fertilize 6 eggs. Statistically, 30-50% of eggs fertilize and develop into mature embryos (blastocysts) that are ready to transfer. Fertilizing 6 eggs gave us the best chance at getting either 1 or 2 embryos, and we chose to freeze any that were left over. We were not willing to attempt to fertilize any more than 6 eggs, because we knew we could not commit to giving more than 6 embryos a chance at life in our lifetime. Yes, it is a statistical improbability that we will have that many embryos to transfer, but because of how much we value life, we wanted to take responsibility for the life God might choose to create. Also, since the harvesting cycle is so strenuous, we asked the doctor to freeze our extra eggs to be used in the future if we needed them. Since eggs are not lives, we had no qualms about harvesting and freezing as many as we could. This would make future IVF cycles less difficult on my body and more cost-effective. Our doctor said she had never had a couple suggest this, and thought it was a creative way to do a partial fertilization to honor our view of life and her need to protect our health. Freezing eggs is typically only done for patients preparing to undergo chemotherapy or other treatment that may harm the undeveloped eggs within the ovaries.

Caring for the frozen embryos

Additionally, it was important to us to set up preparations in case we were to die suddenly before we were able to transfer any frozen embryos. We strongly believed that each embryo deserves a chance at life, even if we were not around to see it. So, we set up a living will that states that our family would have the option to keep the embryos themselves. If that was not possible, we set up a plan to donate our embryos to a Christian family via the Snowflakes program at Nightlight Christian Adoptions. We have written our potential little ones letters that they would get if this was the occasion that describes how much we love them, how wanted they are, how much we wished we we had the opportunity to know them, laid out the story of the gospel and praying for God's plan in their lives. Obviously, we hope this circumstance never happens, but we wanted to make sure that each precious embryo has its best chance at life.

Our Committment

At this point, we have committed to attempting 2 cycles of IVF with our current doctors before we move. We have also committed to doing as many cycles as needed to give each embryo created a chance at life. However, if after these first 2 cycles, we do not have any additional embryos, I'm not sure how we will proceed. Ideally, we will be blessed with a baby in one of these 2 cycles, but we trust the Lord's plan.

We will cherish, love and grieve each and every embryo that does not make it through the fertilization process, every embryo that does not implant after transfer, and every embryo that transfers that we miscarry. We pray for God's hands over each life and believe that only He is able to create and sustain life. Each life is in His hands and His alone. To Him be the honor and the glory forever.