Excursus — Healthcare and IVF

This is a little off-topic for my blog, but I’ve had a couple people ask my opinion of the recent news that Quebec will fund 3 IVF treatments for couples looking to conceive.

I struggle with infertility and it has been an emotional, spiritual and physical rollercoaster to say the least. I have participated in certain infertility treatments, though not IVF specifically. So here are a few thoughts, for whatever they’re worth:

1. Infertility treatment is not just IVF. In fact IVF is usually the last treatment used when other resources have been exhausted. Clomid, hormone shots, IUI, and surgery are all options for increasing chances of conceiving.

2. IVF is not the “miracle” answer. Even with the invasive intervention of science, the chances of conceiving are pretty low. The Canadian Fertility and Andrology Society reports that the live birth rate for IVF procedures in Canada is about 26%.

3. The hormone injections required for IVF (as well as other fertility treatments) take a tremendous toll on the body. As well, there is daily blood work and daily ultrasounds. For each cycle it can be two weeks or longer of daily poking and prodding.

4. The reasons for infertility are often a mystery. Sometimes it can be a physical impediment (blocked fallopian tube, missing tube, missing ovary etc), sometimes it can be a hormonal impediment (PCOS etc), and very often it is an “age” impediment. A woman in her twenties has about a 20% chance of getting pregnant in any given month. A woman in her thirties has a 15%, and a woman over thirty-five has about a 10% chance of getting pregnant in any given month.

5. Infertility is not always the woman’s problem. For men, infertility can be caused by a physical condition, low motility and even stress (just to name a few).

6. The emotional toll is overwhelming. And unfortunately, many people don’t understand the struggle. The number one thing to NOT say to a couple struggling with infertility: “Just relax and it will happen.”

So how do I feel about Quebec funding IVF? (a similar proposal is being floated in Ontario, and Manitoba offers offers tax credits related to IVF). It’s an awful lot of money. True, many couples have exhausted all of their savings in pursuit of conceiving, but I don’t know that the government should necessarily fund it. If anything, if they are going to fund IVF, at a cost of $7,000 – $10,000 a cycle, I think there should also be a mechanism to assist couples in adopting. In many cases adoption can be just as expensive.

At the same time, if IVF is funded then it will most likely reduce the urge to implant several embryos in one round to increase the chance of success. Implanting multiple embryos increases the chances of twins, triplets or even more, which then not only increases the health risks to the babies, but also to the mother.

I will admit that the cost of treatments was definitely a deciding factor in choosing not to do IVF. But, it was not the only factor. (We struggled for a long time with the ethical and moral implications of excess embryos etc, and decided that it wasn’t the best choice for us).

I really hope that women don’t hear this funding announcement and think, “perfect, I can put off having a baby until I’m ready…until my career is set…until I am financially stable…etc”. As stated above, IVF is not the magic instant wonder that we sometimes think it is.

From a Christian perspective: I wish there was more support for couples struggling with infertility in the church. In many ways, being in the church while struggling with infertility can make the emotional stress even worse, especially since churches are extremely family-oriented. I wish that more churches had mechanisms to help encourage and lift up those who are affected by infertility. (And note: while it is well-meaning, saying “God will open your womb in His time, just like he did for Elizabeth and Hannah” is not comforting). And just because a couple has one child does not mean that they are now fertile and can get pregnant whenever they desire. Many times infertility can be worse after having a child (it is called secondary infertility).

So, that’s my rambling excursus. Now back to the regularly scheduled Cheese-Wearing weirdness…

  • http://www.ortlundsincanada.blogspot.com Erin

    Hey Amanda–what do you think that kind of support should look like in the church? I know of someone struggling with this issue but I don’t know how to respond, whether to ask about it, etc.

  • cdntheologianscholar

    There are several possible things the church can do:
    1. There needs to be a safe space where women who are wrestling with fertility issues can come together and discuss, pray, and cry out to God. A place where they don’t have to put on a bright shiny Sunday morning face. This could take the form of a cell group, or a specially set-aside church service
    2. Pastors could do a sermon or sermon series on the topic. Of course this has the possibility of going horribly wrong if the pastor takes the approach of “just be faithful”. But a big thing is having affirmation from the pulpit that infertility is not sinful or a sign of lack of faith. Very often in churches our identity in Christ as women is defined by motherhood.
    3. Some sensitivity in planning Mother’s Day services and Children’s pageants (Christmas and Easter). Very often, Children’s pageants are focused on the kids: “look at little Jimmy isn’t he so precocious” rather than directing the congregation to worship God.
    4. Providing a network of support. If a woman in the church is struggling with fertility issues, it would be good if the pastor or leader of cell group could point the person in the direction of someone else who is struggling/has struggled. Infertility is often a very isolating and private struggle. To be able to say, “listen, I want you to meet so-and-so, she’s been where you’ve been”. It’s amazing how many women struggle alone without realizing that the woman in the next pew over is in the exact same boat.
    5. On an individual level, the best thing to do to support a woman going through this is to just listen (and pray). Don’t try to rationalize or explain away their anger and the hurt and the confusion. Very often just being able to express it, without having someone trying to fix it, is healing.

    When I was in Hamilton there were plenty of secular fertility support groups, but not a Christian based one. It would be nice if there was a way to develop one, and to have a group of women (and men) wrestle through to develop a theology of infertility.

  • http://www.ortlundsincanada.blogspot.com Erin

    Good ideas! That would be helpful–I’m sure there are many more people who are/have struggled with this issue than we could know, since as you said, people tend to deal with it privately.