Part one of this series discussed natural family planning (NFP) as a means of treating infertility and introduced readers to the basics of artificial reproductive technologies (ART). Parts two and three explained the Church's teaching on human sexuality, with special attention paid to the link between infertility treatments and the contraceptive mentality. A Response to Readers clarified the Church's teaching on the use of Intrauterine Insemination (IUI). Here, we enter into the heart of the mystery of infertility. If, as the Church teaches, children are the "supreme gift" of marriage, how are couples (like us) to understand their infertility as a gift?
Infertility: A Gift?
Tears were streaming down my face and they were not tears of joy. Clutching the freezer door with my left hand, I stood holding a tiny test tube in my right. With each attempt to spit, I struggled to see if my tears or my saliva were filling the vial. At any minute, I was sure I was going to fall beneath the weight of the pain. Only the cold of the door handle between my fingers kept me focused on the task. "They want a stress test as part of my infertility workup," I thought to myself. "Well, they're sure going to get it!" It was the week of my 30th birthday, and I'd never been more miserable.
The first year of our marriage seemed like an extension of our honeymoon. Jameson had a good job, and I was working part-time from home in expectation of soon becoming a mom. When we hadn't conceived after six months, we suspected something was wrong. Yet, we continued to hope that "things just hadn't come together yet" and "it wasn't the right time." Still not pregnant and nearing a year of marriage, I called one of the NFP organizations. "Give it a little more time," they said, "and if, after a year you're still not pregnant, go and see an NFP specialist."
Traditionally, primary infertility is defined as the inability to conceive after 12 months of noncontraceptive, targeted intercourse. We've come to learn, however, that for couples who are charting (or women over 35) the time frame is 6 months. If you have concerns about your ability to conceive, it's never too early to make an appointment with an NFP doctor.
Several months later, we finally met with one of the best NFP doctors in the country. Just like that, we were caught up in a whirlwind of testing — the spit test I mentioned above, as well as semen analyses and blood tests — and a strict schedule of targeted conjugal relations.
By now, we'd been married almost two years, and Jameson had been laid off. Then, I lost my part-time job; a publisher pulled out of a book contract we were counting on; and my parents lost the family farm. In the meantime, we switched doctors and started learning about the Creighton Model System. While we remain among the small percentage of couples who haven't conceived through Creighton's "NaProTechnology," thanks to our Creighton doctor we discovered that I have hyperprolactemia (elevated levels of prolactin). This condition, however, is also associated with brain tumors. Thus in addition to my already scheduled tests and surgeries — hysterosalpingogram, laparoscopy, transvaginal songrams, to name a few — I also had to have an MRI.
"It's no wonder you don't have kids," people would tell us. "Look at the stress you're under." As if having a good job or a book deal would result in having a baby. Sure, stress is a key factor related to infertility, but other people under stress seem to get pregnant easily. Besides, we'd enjoyed a time in our marriage when our stress levels were low. We'd also given up caffeine and alcohol; lost weight; taken Clomid; taken progesterone shots; targeted our intercourse — the list goes on and on. And still no baby.
Do we feel as if we've been handed a gift, or that any of this makes sense? Often, no. Our infertility makes no sense outside of God's plan for our lives — for us as an infertile couple. For all of us as infertile couples.
Part of the pain of being infertile lies in the struggle to understand how God can give us the desire to have children, and then prevent us from realizing this desire. Or, for those of you suffering from secondary infertility, how God can give you a baby only to take it away again. It's no wonder that, as we wrote in part one of our series, "infertile couples report equivalent levels of anxiety and depression as women with cancer, HIV status or heart disease" and that "the majority of infertile women report that infertility is the most upsetting experience of their lives."
The Gift of Faith
As if to add insult to injury, some time later we discovered that my prolactin levels had receded back to a "healthy level." Still, we were not conceiving. Just in case, our doctor ordered another semen analysis. While previous tests had come back as "essentially normal," the new specimens showed a defect with Jameson's sperm. At least three sperm tests are necessary to get an accurate picture of the health of a man's sperm. Even then, men produce new sperm every three months, so trouble can arise at any time. For us, this time came just as my own problems had apparently disappeared.
Soon after, the day came — a little more than a year ago — when our doctor told us he couldn't do anymore for us. "I have no other means of helping you. I've consulted all the experts. I don't know what to tell you," he whispered. The finality of it all was numbing. After a moment, our doctor continued, "I'm praying through this book. It's changed my life. It's called The Gift of Faith, by Father Tadeusz Dajczer. This is not a book you read. It's a book you pray — one you have to go over little by little because it's so tough."
We didn't read the book right away (as if a book could console our pain). For his part, Jameson felt as if God had tricked him. "God's a jokester," he protested. "Before we got married, I saw my children in my prayers. God's message to me was very clear: He told me I was called to the vocation of marriage and that I'd have kids. He duped me!"
What's God Doing to Us?
Once we finally did read The Gift of Faith, we were inspired by what we found. According to Fr. Dajczer, God often "does just the opposite of what we would expect." In our case, we expected God to give us children because we were being faithful. The fact that God wasn't living up to His part of the bargain proved He couldn't be trusted. Our experience of infertility had thus distorted our image of God, which, as Fr. Dajczer explained, had been preventing our abandonment to Him. How could we abandon ourselves to a God who seemed so unfair? Fr. Dajczer helped us see that what we were most afraid of — was not what God was doing to us — but what he was trying to do with us. What we feared, in other words, was that our infertility might actually be part of God's plan for our lives, a gift from God necessary to the working out of our salvation.
Book in hand, Jameson rounded the corner into our office and declared, "Infertility is a gift." "I thought God was a jokester," I responded. "I do feel that way sometimes," he said, "but let's be serious for a moment. We know we're infertile. That's a fact. So, let's talk about what we're going to do about it now that we've been told there's nothing we can do about it."
Our choice was to give up hope or abandon ourselves to God, trusting Him completely. Sadly, many couples reject God's gift of infertility and turn instead to the world of artificial reproductive technologies. Others abandon themselves to their own suffering, becoming enmeshed in their pain. We wanted neither, so we decided to write, with the hope of understanding what God wanted from us. "You need to give God everything," counsels Fr. Dajczer. "You need to know how to give Him, that which is His; that is the program of our conversion." So it was. We had to give God ourselves — and our infertility.
Not long after, we had coffee with Fr. Mitch Pacwa of EWTN. While discussing our infertility, he told us that it seems as if God is asking infertile couples to do penance for the sins against life committed by others. "It's a sort of divine fasting," he said. "Would I fast if God asked me to?" I wondered. "God isn't a God of imposition — He created us with free will — so why didn't He ask me?" Without realizing it, I answered out loud, "He's trusting you." The choice comes in how we respond to God's offer.
The Gift of Infertility
As the mystery of the gift of our infertility has begun to unfold before us, we have come to see that children are not the only gift of marriage. Infertility, too, is a great and mysterious blessing. Just as much as fertility, infertility is a gift husband and wife can give one another. It is an affirmation that: "I still love you. I love all of you. And I refuse to allow anything to come between this love, whether it be fertility or infertility." Infertility is also a gift couples can give to God and to the world. Like Christ's crucifixion, infertility is a sign of contradiction in a culture in which human life has lost its value.
Instead of giving children to God, infertile families can give their suffering to Him, their unfulfilled longing to conceive a baby. God will use this suffering to glorify His name and bring about the salvation of souls (cf. Jn. 9:1-3). Likewise, infertility is the gift God gives couples for the salvation of their own souls, as well as the souls of any children they might eventually adopt. To reject this gift is to reject the specific means by which God wills to lead us to Heaven.
Of course, this is not to say that infertile couples shouldn't use every licit means they can to conceive a child or bring a baby to term. We also do not mean to imply that every infertile couple is called to adopt. Adoption is not a "cure" for infertility because even after you adopt you remain infertile. Each of us, however, is called to "give everything to God," and to serve Him, even in the weakness of infertility.
Given that children are the "supreme gift of marriage," it might seem strange to think of infertility as a blessing. No doubt, infertility contradicts nature's intention. The gift of infertility, however, is one that transcends the natural order. It is a sign of divinity, of God's power to bring life out of a situation where nature is powerless. In this way, infertile spouses are like empty vessels, vessels that can be filled only by the intangible gift of grace. Even more so than those who can have biological children, the infertile couple is called by God to be a channel of spiritual fecundity (CCC 2379). As such, these couples are a sign to the world that the fullness of life is found in the gift of love, rather than mere physical existence.
This is not to demean in any way the generosity of large families. Although their sacrifices generally go unappreciated, these families are nonetheless a tangible manifestation of love. Part of the pain of infertility, however, is that it is an invisible sign. In our culture, most people assume that if you don't have kids you're contracepting. If you're infertile, they suppose you can easily correct the problem through artificial means. The physical and spiritual suffering caused by infertility is usually hidden. To use an analogy, the generosity of the couple who chooses to have a large family is like a brightly burning sun whose beams produce beautiful flowers that everyone can see and admire. While their love might shine just as brightly, the infertile family has no flowers of its own. Yet, as Fulton Sheen perceives: "There is no sign unless something happens contrary to nature. The brightness of the sun is no sign, but an eclipse is."
Like an eclipse, the sign of infertility is incomprehensible without the gift of faith. It is a sign that is usually missed because it is veiled by disappointment and failure. God, however, is the master of bringing success out of failure and life out of death. If we allow God to reveal Himself in the poverty of our infertility, He will give us a harvest of flowers more beautiful than we could sow on our own. Oftentimes these flowers are not meant for us to keep, but to give to others. For the unwed mother, infertile couples impart the gift of hope. For the couple delaying childbirth, infertile families provide motivation. For the orphan, infertile couples present the chance of new life. Recommends the Church: "Spouses who still suffer from infertility after exhausting legitimate medical procedures should unite themselves with the Lord's Cross, the source of all spiritual fecundity. They can give expression to their generosity by adopting abandoned children or performing demanding services for others" (CCC 2379).
Just as with physical fertility, spiritual fecundity requires the elimination of any barriers of bitterness, resentment and discouragement that might be obstructing your relationship with God. Although it's okay to be angry with God, at some point it's necessary to "forgive" Him. Ultimately this "forgiveness" rests in realizing that God has not committed an offense against us in allowing us to be infertile. The fruit of such forgiveness is trust.
God will forgive you, too, for not trusting Him — whether by using contraception, or in vitro fertilization, or, as is easy to do, letting the desire to have a child become a god in itself.
Forgiveness is the fruit of prayer, which is also a gift of infertility. Without prayer, the heart will never be able to discover, as one anonymous infertile woman puts it, that God is enough to love. Because we can't understand why God doesn't give us what we want, we often go in search of it on our own. By doing so, we risk overlooking the shocking truth that the gift of infertility is God Himself.
Infertility Terms You Need to Know
(Primary) Infertility: The standard medical definition of infertility is the inability to conceive after 12 months of noncontraceptive, targeted intercourse, but for couples who are charting (or women over 35) the time frame is 6 months. The definition should also include mothers unable to carry any pregnancy to term.
Secondary Infertility: The inability to conceive and/or carry a baby to term after doing so at least once before.
Sterility: A permanent condition inhibiting conception.
Zygote: A fertilized egg in the single-cell phase — i.e., an undivided fertilized egg.
Embryo: A fertilized egg that has begun the division process that will result in a fully formed person; used by scientists to refer to a baby until it reaches the fetal stage.
Fetus: Term used by the scientific community to refer to a preborn child 8 weeks or older.
ART (Assisted Reproductive Technologies): Any procedure in which both eggs and semen are extracted from a woman and a man and manipulated with the intention of producing a baby.
IVF (In Vitro Fertilization): From the Latin, "in glass," the fertilization of an egg with a sperm in an artificial environment, namely a petri dish, and the subsequent implantation of the embryo in the uterus.
AIH (Homologous Artificial Insemination): Injection of a husband's processed semen into his wife's genital tract.
AID (Heterologous Artificial Insemination): Injection of a donor's (not the husband) processed semen into a married woman's genital tract.
IUI (Intrauterine Insemination): Technique by which processed sperm are injected into the uterus with a catheter.
Multifetal Pregnancy Reduction: A euphemism used to describe the abortion of one or more children (at 8 to 12 weeks) sharing the same womb. Unlike most abortions, the dead baby's body is resorbed by the mother's body.
Embryo Cryopreservation: The freezing of leftover embryos produced via IVF.
Assisted Hatching: An IVF technique of micromanipulation that uses an acidic solution to dissolve the shell around a 2- to 3-day-old embryo to improve chances of implantation.
ICSI (Intracytoplasmic Sperm Injection): A technique by which a single sperm is injected in vitro into an extracted egg; used in cases of acute male infertility.
GIFT (Gamete Intrafallopian Transfer): An ART procedure in which multiple eggs and processed semen are placed into a catheter and then injected into the fallopian tubes so that fertilization may occur.
ZIFT (Zygote Intrafallopian Transfer): An ART procedure in which multiple eggs are actually fertilized in the laboratory with processed semen; the resulting zygotes are then injected into the fallopian tubes. Also known as PROST, pronuclear stage transfer.
TOTS (Tubal Ovum Transfer with Sperm): An ART procedure in which semen is collected from a perforated condom (rather than masturbation) and placed with one or more eggs into a tube where they are kept separate from one another by an air bubble. The semen and eggs are then injected into the fallopian tubes. This technique is rarely performed anymore.
Where to Turn for Help
Natural Family Planning Techniques
The Creighton Model System (NaProTechnology)
Pope Paul VI Institute for the Study of Human Reproduction
Phone: (402) 390-6600
The Couple to Couple League International, Inc. (Sympto-Thermal Method)
Phone: (513) 471-2000 or (800) 745-8252
Billings Ovulation Method Association (BOMA-USA)
Phone: (651) 699-8139
Locate an NFP Center or Teacher Near You
One More Soul
Phone: (800) 307-7685
The Bible and Birth Control, Charles D. Provan
Donum Vitae, Congregation for the Doctrine of the Faith
Empty Womb, Aching Heart, Marlo Schalesky (While some couples profiled in this book have used artificial technologies, reading their personal struggles with infertility might prove helpful.)
Fertility Cycles and Nutrition, Marilyn M. Shannon
Full of Grace: Women and the Abundant Life, Johnnette S. Benkovic
Humanae Vitae, Pope Paul VI