Journey to Baby: JOY and PEACE

'Twas the first night of December, when all thro' the house

Not a creature was stirring, not even a mouse;
The stockings were hung by the chimney with care,
Gifts were placed neatly, but one wasn't there.
This gift exists, though it's still quite small;

But to our family, it is the most precious of all.

Inside one body, beats two hearts;
It will be a little while before they part.
We're trading our silent nights for a bundle of joy!
And are thankful to the Lord above for this baby girl or boy.
We can't wait to meet our sweet little one arriving in June,

The answer to many prayers, who we already love beyond the moon.

My heart could burst!  What a joy it is to announce our pregnancy.  A big, fulfilling, wholehearted joy.  To share with so many who have prayed for this very gift.  Who have lifted us up and encouraged us along on our journey.  It's truly humbling to sit where I sit today.  To see just how many readers my blog posts have reached.  To have a collection of letters and notes that have lifted us up in some of our darkest hours.  And now to be able to share this good news with each of you. There are moments when I just can't quite crying.  Happy tears.  He is good, y'all.  And He has blessed us tremendously with family and friends that have loved us so well through all of it.  Thank you for that.  You mean so very much to us.

To the girl reading this who has experienced the loss of a baby or is longing for one this very minute, my heart is with you.  Though no story is just alike, I know of the aching you feel.  Of the tears that fall.  Of the disappointment and anger and frustration and hurt.  Of the prayers you pray.  Of the hope you hang on to.  I like how Melanie Fisher worded it when she said, "We may not know the sleepless nights of the newborn stage or the messy days of the toddler years like so many of our friends right now, but we do know what it's like to love someone who is a part of each of us more than we ever thought possible.  And we do know the sometimes sleepless, sometimes messy ache of not being able to watch that child live and grow."

I've also read and reread this from Emily Ley time and time again: "The heartache of infertility is one I know all too well.  And the hope and the joy that's on the other side of it is indescribable.  I'm a big believer that God puts a baby shaped hole in our hearts with the full intention to fill that hole in one way or another.  I've seen it happen in so many different ways time and time again.  But waiting on His plan to unfold is hard.  Over the past five years, I've walked this road and held the hands of dear friends who've walked it also.  The most beautiful part is even though I walked it, I never walked it alone."

Yes, it hurts down deep to the core when your greatest desire and most fervent prayer seems so far away.  And the waiting is hard.  It's one of the hardest parts.  But sweet girl, God has a plan for you.  A BIG plan.  Seek Him first always.  Trust Him, even when you don't understand.  He is right there with you.  "The pain that you've been feeling can't compare to the joy that's coming!" (Romans 8:18)

I'm better off when I begin to remember

How You have met me in my deepest pain.
So give me glimpses now of how You have covered

All of my heart ache, oh with all Your grace.
Remind me now that you can make a way.
That Your love will never change,

That there's healing in your name,

That You can take broken things and make them beautiful.
You took my shame 

And You walked out of the grave,

So Your love can take broken things and make them beautiful

...

You say that you'll turn my weeping into dancing,

Remove my sadness and cover me with joy!

You say your scars are the evidence of healing

That You can make the broken beautiful. 
-Ellie Holcomb, The Broken Beautiful

The story of this baby began on Easter Sunday.  It marked the start of our in vitro journey.  Thirteen days later, on Saturday, April 18, after two full weeks of injections, ultrasounds, and bloodwork, the teeny tiny egg that formed this baby was retrieved from my body.  Five days after that, on April 24, I got a call from a nurse at RBA to let me know that this baby had grown into a beautiful five day old embryo (called a "blastocyst").  It was graded "A" based on appearance (tight cells) and after genetic testing showed no known chromosomal abnormalities.

Because we were doing IVF with a "freeze all" (to avoid hyperstimulation), it was June before we transferred our first embryo (also coming from this IVF cycle).  Sadly, that transfer resulted in a tubal pregnancy (talked about here).  We were in a season of grieving and waiting.  Our hearts were sadden by another loss (I preciously suffered a miscarriage at sixteen weeks early in 2014 and a chemical pregnancy later that year).  I was treated with methotrexate, a form of chemotherapy, two separate times for the ectopic pregnancy that meant we could not try to get pregnant again for at least three months.

With the first anniversary of our first baby's due date, the due date of our second baby, and what we had hoped would be a healthy pregnancy with baby three all falling during this time, we looked for a way to honor and remember our little loves in heaven and found it in the Lancaster Garden of Hope in Pennsylvania.  The garden was created as a place to remember precious lives lost to miscarriage, stillbirth, and early infant death with a memorial wall of plaques and those babies names.  The focal point of the garden features a beautiful life size sculpture of Jesus, sitting beside a mother as He cradles her baby safely in His arms.  We had a plaque made for our three and look forward to visiting the garden in a few months.

My prayer was a prayer for peace.  For a peace that would pass all understanding.  Peace for whatever would happen next on our journey.  For peace when we tried to get pregnant again.  For peace if we did get pregnant again.

I began to sense that peace all around me.  I felt a peace about moving forward.  I felt renewed.  Excited.  Hopeful.  Following a consultation with Dr. Slayden, I began prepping my body for pregnancy with a protocol that included Lupron injections, Estrace, Crinone, Baby Asprin, Doxycycline, Medrol, and Folate.

On October 8 we transfered our precious itty bitty one.  Much like our first transfer, I count it as one of the greatest days of my life.  It was magical when they displayed our embryo's photo on the television screen.  Happy tears!  Love at first sight!  Adornment!  The embryologist came in to talk with us and Dr. Robert Straub, who was on call this day, transferred the embryo to my uterus via a catheter, which we were able to watch on the ultrasound machine.  An incredible experience.

Sam began praying over my belly (one of my most favorite things ever!) and singing songs to our little one.  Peace continued in the days that followed.  We rested well and were well taken care of by family and friends that knew of our transfer.

On Monday, October 19, we went in for our beta hCG check.  Results came back with a good, strong number for which our doctor and nurses were very pleased and we were so grateful!  We toasted with 9 Months Love sparkling grape juice ;) and had dinner with some dear friends.

A more than doubling hCG level the next few blood draws were a good sign.  And we have since had three great ultrasounds with a quickly growing baby measuring right on track and a strong fetal heart rate!  Yesterday, Monday, November 30, we had our last appointment with Dr. Slayden and the sweet ladies who have taken such good care of us at RBA.  We "graduated" from our Reproductive Endocrinologist and have been released back to our OB/GYN.  It was a bittersweet afternoon saying "see you later" to the doctor, nurses, and staff we have come to love, but is also a super exciting step forward!

At 10 weeks, 3 days pregnant, God still surrounds me with His peace.  And I have been able to celebrate joyfully this pregnancy.  I'm human, and there have been moments, times occasionally, when I've allowed my wondering heart to stray with worry about things that have happened in the past happening again.  But those thoughts have NOT consumed me.  And through prayer, spending time being still in His presence, clinging to scripture, and encouraging words from family and friends, I've been able to focus on Him.  His peace.  And this sweet, sweet gift He has given us.

May the God of hope fill you with all joy and peace as you trust in Him, so that you may overflow with hope by the power of the Holy Spirit.

Romans 15:13

Your love and support have made us better.  You've prayed for, encouraged, lifted us up,  held our hands, cried along with us, and cheered us on.  For all of this and more, thank you.  From the bottom of our hearts.

"Happy Christmas to all, and to all a good night."

Joy and Peace,
Sarah, Sam, and Baby Ball

Special thank you to Paige Knudsen for a fun photo shoot to celebrate our news!!
{Noteven A. Mouse stuffed animal: Beaufort Bonnet Company}
{fun confetti popper from our friends The Copelands}

Journey to Baby : Ectopic Pregnancy, Trusting HIM, Prayer, Joy, & Remembrance

I want to be a woman who trusts that God has a plan, even when I don't understand. -Renee Swope

I concluded my most recent blog post with those words, and they've been heavy on my heart since.  It's so easy for me to trust God when things are going the way I had planned.  It's easy to trust when I receive an answer to a prayer, when I feel hopeful and renewed, when I’m seeking joy, when I can see light at the end of the tunnel I’m in.

IT'S SO DARN HARD to trust though when I don't understand.  When my heart breaks.  And then it breaks again.  And again.  And I feel sad and mad, broken and tired, frustrated and angry, when I question "why me?" and "why us?"  When I dabble in self-pity.  When I look around me and see how easy it seems for some people.  When the greatest desire of my heart and my most fervent prayer seems so. far. away.

This season is proving to be one of the most challenging yet as I pick up the pieces of an unsuccessful frozen embryo transfer, as I am in the midst of the two year mark of when we first began trying to grow our family, what would have been our first baby's first birthday, our second baby's due date, or when we would have "graduated" from our Reproductive Endocrinologist and been released to our OB/GYN (at the end of the first trimester) with our third baby - all if things had gone my way, our way.  But sweet friends, God has a different plan.  And I'm determined to TRUST HIM, EVEN WHEN I DON'T UNDERSTAND.

Asking God 'what can I learn?' instead of 'why me?' is a much better place to park our minds. -Lysa TerKeurst

Of course, the hours spent in the doctors office, the many panels of blood work and testing, the ultrasounds, the poking and prodding, the protocols, the medications and self-administered shots multiple times a day, egg retrieval and the days that followed that procedure, and changing hormone levels are a LOT to handle, but there's nothing like the "two week wait."  The T.W.W. (yes, that's a real thing) - the time between embryo transfer and your first beta hCG test.  Nothing.  So many emotions!  Such anticipation!  There are day dreams and dreams while you sleep.  It's difficult to think of anything else.  Fortunately, I didn't air on the side of worry and doubt that some women experience during the two week wait.  I felt things were finally looking up for us, that maybe, just maybe, this journey was coming full circle.  I felt so led to Reproductive Biology Associates.  Our in vitro cycle and transfer had gone so smoothly.  I thought this. was. it.  During my wait, I pictured carrying and giving birth to our baby - the first one we may get to have here on earth with us.

Even before I met Sam, I prayed for our future children.  I remember starting to do so in middle school.  I prayed for their daddy, my future husband.  I prayed for them.  I prayed that they would come to know and love the Lord.  I prayed for the people they would be and for their spouses.  Never for a second have I doubted that I want to be a mama.  I've known so for a long time.  I just didn't realize the journey we would travel down to get there!  But God is teaching me something.  He's working in me again.  He ALWAYS is.  And through it all, I want to glorify His name.  I WANT TO BE A WOMAN WHO TRUSTS THAT GOD HAS A PLAN, EVEN WHEN I DON'T UNDERSTAND.

"However distant your dreams may seem, God is working things out, and today is an important process." -Lysa TerKeurst

Nine days after embryo transfer, on Friday June 12, we went in to get our beta hCG level.  Several hours later, Dr. Slayden called with concerning news, that my hCG level was extremely, extremely low, that we had likely had implantation problems (another chemical pregnancy).  Our hearts were so broken and we struggled to make since of the news, having a difficult time wrapping our minds around what went wrong, why we were having to grieve another loss.  Per our doctor's request, I took an at-home pregnancy test the following morning that came back negative.  I stopped my medications (Estrace, Crinone, and Baby Asprin, that support pregnancy) and began bleeding.

Several days later, we realized my hCG level was rising.  It was rising slowly, not doubling every few days as would be ideal.  It was likely that I had residual tissue left or possibly an ectopic pregnancy, though they only occur in 1-5% of conceptions.  My hCG level was not yet high enough for growth to be visible on an ultrasound.  Sam and I had plans to spend the following week on Hilton Head Island vacationing with my family, so Dr. Slayden requested I have another blood draw to check my hCG level mid-week of our trip.

Tuesday morning, June 23, my mom, little sister, and I set out for a diagnostic center.  (I am so grateful for our supportive family who walks every step of this journey with us!)  Once we got to the lab, we learned I would not be able to get a STAT hCG level, so we ended up at the hospital on Hilton Head for quicker results.  On Thursday, Dr. Slayden asked that Sam and I make the drive home that evening for an early appointment at RBA Friday morning.  I would have an ultrasound and another blood draw.  My hCG level had continued to rise.

Stay calmly conscious of Me today, no matter what. Remember that I go before you as well as with you into the day. Nothing takes Me by surprise. I will not allow circumstances to overwhelm you, so long as you look to Me. I will help you cope with whatever the moment presents. Collaborating with Me brings blessings that far outweigh your troubles. Awareness of My Presence contains Joy that can endure all eventualities. -Sarah Young, Jesus Calling, June 26

The ultrasound Friday morning did not show much – but gave us some very valuable information.  There was no sign of growth in my uterus nor concentrated area of blood flow and my uterine lining was also very thin.  Ectopic pregnancy became the probable diagnosis.  We had to wait several hours after the ultrasound for bloodwork to come back – and when it did, our doctor sent us to Northside Hospital that night for me to be treated with methotrexate injections.  Methotrexate is a form of chemotherapy that’s proven to be useful in ectopic pregnancies.  

Therefore, we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are acheiving for us an eternal glory that far outweighs them all. -2 Corinthians 4:16-17

Rest with me a while. You have journeyed up a steep, rugged path in recent days. The way ahead is shrouded in uncertainty. Look neither behind you nor before you. Instead, focus your attention on Me, your constant Companion. Trust that I will equip you fully for whatever awaits you on this journey.

I designed time to be a protection for you. You couldn't bear to see all your life at once. Though I am unlimited by time, it is in the present moment that I meet you. Refresh yourself in My company, breathing deep draughts of My Presence. The highest level of trust is to enjoy Me moment by moment. I am with you, watching over you wherever you go. -Sarah Young, Jesus Calling, June 27

Monday morning, June 29, I returned to RBA for more bloodwork.  Results came back showing an elevated hCG level. 

I. lost. it.  I had tried to trust (or so I thought).  I had tried to keep my head up.  To remain hopeful.  To know that “this too shall pass.”  But I was tired of having bumps in the road to get through.  I was tired of being in the valley.  I took a hammer and nails and hung a few pieces of art that had not yet made their way up on walls.  (Hey, it was better than throwing dishes.)  All while screaming and crying and shaking my fists.  I sobbed on my husband’s shoulder.  I cussed on the phone with my mama.  A few of my girlfriends showed up, sat with me and listened to me pour out all of my frustrations.  (Bless their hearts.)  It was not pretty.  AT ALL.  I felt so defeated. 

I had not savored and truly taken in the beauty of the words written in my daily devotional from a couple of days before (July 27).  If only I had, I might have reacted differently to the phone call I received just two days later on July 29. 

I began praying hard that night.  For forgiveness.  I had not trusted.  I had not trusted that He would fully equip me for what would happen next on this journey.  I had not focused my attention on Him.  I had not invited Him to meet me in the present moment.  I had let my emotions get the best of me.  I lost sight of Him and I lost myself.

We’re bound to have bad days.  And some really bad days.  But I’m learning that it’s what we do with those tough times that matters.  I began really praying for a peace that would pass all understanding.  That God would bless my mess.  That I would trust like never before.  That I would desire God more than I desired to have a baby.

I was hesitant to share the realness (and ugliness!) of that afternoon.  But in choosing to open up about our journey, I felt I simply could not omit it.  No, I do not always choose the high road.  I struggle and I stray.  But I am TRYING.  I am trying to do better today than I did yesterday.  I am trying to bring honor to the ways in which He is working in my life.  I want the girl who is struggling with infertility and/or recurrent pregnancy loss to know that she is not forgotten.  That she is loved.  And that even on her baddest of bad days, He is still there.  That He hears her prayers.  That He’s got her.  He’s got this.

But He [Jesus] 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. -2 Corinthians 12:9-10

Sam Ball is my rock.  He encourages me and makes me want to do better, to be better.  His faithfulness through all of this inspires me daily.  Sam is almost always right there beside me at appointments, especially appointments where we may receive news of any sort.  But my friend Brighton offered to take me to my Wednesday, July 1 follow-up appointment so that Sam could get some work done.

Whatever this day had in store for us, I was at peace with it.  I was okay with it.  I knew that He who created the universe had me in the palm of His hand.

My hCG level continued to rise, so I was admitted to Northside that afternoon for a second dose of methotrexate shots.  Brighton Patrick is one of those friends who has shown us the true meaning of Romans 12:15 – Rejoice with those who rejoice; mourn with those who mourn.  She’s such a trooper, too – leaving town at 6 a.m. and driving me home at 9 p.m., after two visits to RBA and hours at the hospital.  I will forever be grateful for her presence that day and in this season.

Following my second dose of methotrexate, we took a little getaway to Cumberland for the holiday (with an emergency plan for getting off the island in case I started having any pain, which fortunately, I did not!).

Several days later, Monday, July 6, I went back in to Dr. Slayden’s for bloodwork.  Results showed a slight rise in hCG level.  My level had not risen nearly as quickly as it had been though. 

That Thursday, July 9, I went in for an ultrasound and another hCG check.  The ectopic pregnancy was now large enough to be visible in my left tube, located outside the uterine cavity in the part of the fallopian tube that penetrates the muscular layer of the uterus.  It’s called an interstitial (tubal) pregnancy.  Dr. Slayden went ahead and scheduled surgery for the following day.  Surgery was contingent on hCG level – rise in level we would move forward, drop in level we would wait and monitor.  The plan was to remove my entire left tube to try and prevent complications and another tubal in the future.

Before going through it myself, I had no idea tubal pregnancies were even possible in IVF patients because in my mind, the embryo doesn’t “travel down” that path.  Dr. Slayden explained that the uterus is a muscle and contracts – it’s possible in our case that my uterus contracted and “bounced” our embryo upward to the tube, where it stuck and implanted. 

We got a call that afternoon that my hCG level had DROPPED.  Surgery was canceled.  It seemed the second dose of methotrexate was working.

In the weeks that followed, I continued to go in for bloodwork until my hCG level reached “below 5,” which clinically means “not pregnant.”  Dr. Slayden has proven to be so incredibly attentive and informative and supportive throughout this whole process – from our first sit-down appointment in January to now.  We love him and the staff at RBA!

God can do anything, you know – far more than you could ever imagine or guess or request in your wildest dreams! He does it not by pushing us around but by working within us, His Spirit deeply and gently within us. –Ephesians 3:20, The Message Bible

My job is obedience.  God's job is results. -Lysa TerKeurst

Though physically my body is returning back to its normal following a frozen embryo transfer that resulted in a tubal pregnancy, the spiritual and mental aspect and reality of what we’ve been through in our 24 month long baby journey is in full force.  I’m realizing more and more on this particular leg of the journey that prayer, clinging to the Word, and surrounding myself with people who lift us up is so, so important. 

It can be difficult to pray through a hard situation and feel like you’re not seeing answers.  I love this from Lysa TerKeurst’s blog post, 3Ways to Press Through Unanswered Prayers:

1. Know with confidence God hears your prayers.

1 John 5:14 reminds us, “This is the confidence we have in approaching God: that if we ask anything according to his will, he hears us” (NIV).

2. Trust that prayer makes a difference, even when you don’t see the difference.

It may take a while for you to see God answer your prayers. But don’t miss an “in the meantime answer” you can receive right away. Philippians 4: 6-7 reminds us of the immediate answer to every prayer:“Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.” (NIV)

Did you catch it? It’s the peace of God that will guard your heart and mind in the process while you’re waiting for God to reveal His answer to your request. When you pray, you can trust you are doing your part and God will certainly do His part.

3. Tell fear it has no place in this conversation.

These prayers are your gateway to feel an assurance you don’t see yet. But fear will beg you to focus on the problem more than God’s promises. Isaiah 41:10 says, “So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand” (NIV).

This summer, Sam and I’s small group has been doing a book study on Tommy Newberry’s The 4:8 Principle.  Centered around the verse from Philippians 4:8 – Finally, brethren, whatever things are true, whatever things are noble, whatever things are just, whatever things are pure, whatever things are lovely, whatever things are of good report, if there is any virtue and if there is anything praiseworthy, meditate on these things. – Newberry has written an inspiring little book about living a joy-filled life.  Here are a few take-aways that I hope will encourage your hearts tonight as much as they’ve encouraged mine:

Being joy filled does not mean that your life is perfect. Who could claim that? It doesn’t even mean that your life is great. What it does mean is that you emphatically trust God and believe that He has great plans for your life, regardless of what is happening right now.

Think the thoughts you would think if you trusted God’s promises completely.

Where you have been, what you have done, and where you are now matters far less than where you are headed.

Speak as if you believe in your prayers.

Anyone can be happy when circumstances are wonderful, but joy is different. Joy is proactive happiness. It is the learned capacity to display your faith ahead of time by means of your daily mental attitude. The bible gives us many examples of people who believed God’s promises and let that shape their attitude – even when they couldn’t yet see how God would act. Abraham and Sarah were elderly before God gave them a child, yet “by faith Abraham, even though he was past age – and Sarah herself was barren – was enabled to become a father because he considered him faithful who had made the promise” (Hebrews 11:11).

I have underlined nearly every single word on every single page in this joyful book.  It’s good stuff.  Despite the tough moments, hours, and days, I have a choice, and I want to choose joy.

If you dig in and fight the changes, they will smash you to bits. They’ll hold you under, drag you across the sand, scare and confuse you. But if you can, in the wildest of seasons, just for a moment, trust in the goodness of God, who made it all and holds it all together, you’ll find yourself drawn along to a whole new place, and there’s truly nothing sweeter. Unclench your fists, unlock your knees and the door to your heart, take a deep breath, and begin to swim. Begin to let the waves do their work. In all our lives, there are waves. They threaten to take us under, but we’re always protected by a God who loves us so deeply. –Shauna Niequist, Savor, August 9, “Riding the Waves”

Today, August 11, we remember what would have been our first baby’s first birthday, his “due date,” a year later. 

Several weeks ago, it was around the time our second baby was to be due, if I had carried to term.

And last week, I could have entered the second trimester with baby three.

Not a day goes by that we don’t think about and miss our sweet loves in Heaven.  The babes we prayed for and dreamed about.  The babes we sadly never got to hold in our arms.

But the babes we’ll meet face to face one day.  In eternity.

The babes who get to spend their every moment with Jesus.

Is there anything sweeter? 

Though I long for you, I know you’re in the greatest place. <3

Two years ago we began trying to grow our family.  Because of the chemo drug I took as treatment for my ectopic pregnancy, we’ll have to wait several months before moving forward.  

Yes, this is my wildest season yet.  There have been difficult days, and I know there will be difficult days to come.  I don’t understand.  I don’t need to understand. 

I just need to TRUST HIM.

And I'm aiming to.

Whatever you’re facing today, will you join me?

<3 Sarah

Journey to Baby : IVF Round One

"But He [Jesus] 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." -2 Corinthians 12:9-10

Friday, January 16, 2015: "You ARE going to have a baby" were the first words out of Dr. Slayden's mouth at 9 a.m. this morning.  It was our very first appointment at Reproductive Biology Associates.  I was a ball of nerves.  As if Atlanta traffic isn't enough to rattle a person, we were meeting with our new doctor this morning to discuss possible diagnosis and treatment options.  I knew we were going to have to discuss our journey thus far, including the loss of our  first and second babies.  Was I prepared to relive that?  Was I ready for what the specialist might say?  Might recommend?  I was emotional.  I was jittery (though I had given up caffeine long before!).  I signed in and proceeded to put the check-in sticker on shirt, when really was for the receptionist to keep (guess I've been in too many elementary schools - ha!).  The ladies in the front were so kind though!  Big smiles.  Very welcoming.  As I was filling out paperwork, I kicked over my water bottle - then dropped my pen and it rolled under the couch we were sitting on.  "Get it together," I told myself.  Sam just smiled and shook his head.  He grabbed my hand and said one more prayer before my name was called.

Peace began to come over me as we walked the winding halls back to an exam room.  I let go of my worries and doubts and fears.  We meet Nurse Jennifer, who weighed me, checked my vitals, and reviewed some of our medical history.  We were then led to Dr. Slayden's office.  I knew what he looked like.  I already knew his voice.  I had watched an interview of him and read his biography.  A handful of friends had highly recommended RBA and another handful specifically referred Dr. Slayden, including our OB/GYN, Dr. Cline.  We had spent lots of time praying, researching, and talking with others.  We truly felt like God had led us to RBA, to Dr. Slayden.  And after spending over an hour in his office, we were certain of it.  Dr. Slayden has a good balance of bed-side manner and expertise in the field, both of which are extremely important to us.  He is sensitive and caring.  His knowledge of and experience with infertility and endocrinology is very apparent.  He took time to get to know us as people - not only our history, but our faith, our interests, our careers, where we liked to vacation.  There were tears and there was laughter.  He had reviewed our complete medical history prior to the appointment, an inch-thick stack of paper that sat in front of him, and after some questioning, shared his thoughts on diagnosis and treatment - both from a medical standpoint and personal standpoint, what he would do if he and his wife were in our shoes.  

Dr. Slayden gave me a probable diagnosis of hypothalamic ammenorrehea, with instructions to cut the intensity of my workouts "in half" (walking and yoga acceptable).  He also wanted me to gain a few pounds, with the hopes that these changes would help improve the function of my hypothalamus, regulating my irregular periods, and preparing my body to carry a baby.  We discussed and weighed the options of trying a few more rounds of clomid or going ahead with in vitro.  Since we had already experienced several losses, Dr. Slayden gave us information about PGD/PGS (pre-implantation genetic diagnosis/screening of embryos), if we choose the IVF route.  He was honest and straightforward, thorough, listened, and made sure our questions were answered.  We talked about what would come next: Good Start genetics carrier screening and panels of blood work for both Sam and I, a sonohysterogram, semen analysis, financial consult, genetic consult, nurse consult with injection teaching and protocol review, consent forms... 

As we winded down our appointment, the doctor received a text that one of his patients, a lady who had flown in from somewhere in Europe, was prepped and ready for embryo transfer.  Dr. Slayden said his goodbyes, and we watched him walk towards the opposite side of the office to the surgery center - off to help a woman make her dream of being a mom become a reality.  

In that moment and in the days, weeks, and months that have followed that first appointment, we have felt so incredibly blessed to be in such great care at RBA - who in recent years celebrated 30,000 babies in 30 years!!  The physicians, PAs, embryologist, nurses, ultrasound technicians, phlebotomists, genetic counselor, and business staff are top notch and have made an upsetting situation an even better experience than we could have imagined.  We thank the Lord every day for loving us and giving us strength on this journey.  We praise Him for peace and comfort, for assurance, for reminders that He remembers and He cares.  We have trusted/are trusting that He has a BIG plan.

We pray that by sharing our story - our experiences, struggles, battles, and the ways in which God is working in our lives - He is glorified.  His grace is sufficient for you and for me.  His power is made perfect in our weaknesses.

Thursday, February 19, 2015: Today we had a follow-up appointment with Dr. Slayden where we reviewed our blood work and test results.  We further discussed diagnosis.  Sam and I have spent the last month praying and giving lots of thought to treatment, how we should move forward.  We feel very strongly about in vitro and have chosen to take that route.  We talked with Dr. Slayden about our morals and ethics and what that looks like for us in regards to IVF.

It was fascinating to see my karyotype on paper.  I felt overwhelmed in a great way by the magnitude of our God.  How incredibly detailed He made each of us!  How unique and different and each of us are.  And the miracle of life - talk about chills!!  Our genetics carrier screening checked for twenty-something of the most common genetic disorders out of over 6,000 known genetic disorders.  Even without a known family history genetic disorders, if Sam and I both happened to be carriers of the same genetic disorder, it would affect our family.  Fortunately, our screenings came back clear.  Before we are cleared to begin IVF though, we will have a phone consult with RBA's genetic counselor to review our family history in more detail and see if she recommends any further specific genetic testing for us/our embryo(s).

In a normal pregnancy, the baby receives one set of 23 chromosomes from the mother and one set of 23 chromosomes from the father.  In a partial molar pregnancy, the baby receives two sets of chromosomes from the father, often because two sperm have fertilized the egg.  Since our first pregnancy resulted in a partial molar pregnancy, Dr. Slayden suggested that we use a process called ICSI as a reliable way to insert just one sperm into the egg(s) and decrease the chance of another partial molar pregnancy.

An AMH blood test determines a woman's fertility reserve (number of eggs she has left).  My results came back higher than average for my age, which was good news to my ears, but the AMH test only determines quantity, not quality, and both are important factors.  Dr. Slayden expressed his concern for OHSS (hyperstimulation), a condition where ovaries enlarge and fluid builds up in the abdomen following controlled ovarian stimulation in IVF.  He felt I was at risk for hyperstimulating and recommended fertilizing, growing, and freezing embryo(s) following egg retrieval instead of doing a fresh IVF cycle (where an embryo/embryos are transferred three or five days after retrieval).  Though it's a longer process, freezing the embryo(s) would give my body time to "settle down" after injections/retrieval and avoid major pain and a hospital stay.

IVF is the plan with a FET (frozen embryo transfer) a couple of months following egg retrieval!  I feel like I'm learning so much more than I ever thought I needed to know about biology and fertility. ;)  I'm extremely grateful for the wisdom and talents God gives the doctors (of all kinds!) who care for and treat us!

Tuesday, March 10, 2015: Today we turned in our notarized consent forms and met with Nurse Tracey.  She reviewed our protocol, which begins on the first day of my next cycle.  On the morning of "Day 2," I will go in for a screening ultrasound (follicle count and cysts check) and for blood work (to get a baseline estradiol number).  The screening and blood work will determine if I may begin stimulation.  Starting on "Day 5," I'll go in pretty much every morning to monitor follicles and check estradiol level (blood work) up until egg retrieval.  Tracey will call me each afternoon (once my blood work comes back and Dr. Slayden reviews the results from both my follicle count and estradiol reading) to give results and let me know if I need to make any changes to my medication that night (keep same, up, or lower injection dosage depending on how I am responding to drugs). Tracey taught us how to mix Menopur for injections today since it comes in a powder form.  Sam got to practice "administering shots" to a squishy ball!  My medicines will be arriving in the mail in about a week so that we'll be set to begin when the time comes.  My IVF cycle should begin between March 22th and March 26th. We're getting close!

Thursday, March 19, 2015: First batch of meds arrived - this is getting so real!  Expecting to begin injections within the next SEVEN days!

"Spirit lead me where my trust is without borders, let me walk upon the waters, wherever You would call me.  Take me deeper than my feet could ever wander, and my faith will be made stronger, in the presence of my Savior."

-Hillsong United, Oceans

Sunday, April 5, 2015: Surprisingly, we were able to make the three hour trip down to Fitzgerald to spend Easter Sunday at my hometown church and with family.  We weren't sure we would be able to do this because technically, I "should" have already begun my protocol, which requires daily monitoring and would not allow me to be too far from the Atlanta area.  But because I had not begun as of 4:30 yesterday, Sam and I were able to head South last night.

Guess what - today is "Day 1!" (There really isn't an eloquent way to say, 'I started my period,' is there!?).  Emotions are all over the place!  Excited.  A bit nervous.  A bit anxious.  Above all, thankful.  It has been 41 days since the start of my last cycle.  To say the least, being "late" is frustrating - and it has been especially frustrating this month since my IVF cycle depended upon it.  But today, I am grateful for a delayed start.  I got to spend Easter with my grandfather who was diagnosed with cancer earlier this year.  He is declining.  For much of the day Papa has been surrounded by family, but I got a quiet moment with him and he said these words, "We need a half dozen little Sarahs.  And I know it will happen.  Joyce used to always say, 'Sarah will make a good little mama.'  And you will."

Be still my heart!  What a happy day!  We celebrate a risen Savior!  Today marks the start of a new path on our journey.  Time with family.  Those words that came out of my Papa's mouth.  Have I mentioned my hormones yet!?  Yep.  The tears are flowing.  "Because He lives, I can face tomorrow."

Monday, April 6, 2015: This morning we went in for an ultrasound screening.  The ultrasound tech counted each itty bity follicle on the left and right sides.  In a typical cycle (without medication), one follicle becomes dominate and a single egg is released from that follicle at ovulation.  The fertility medications I will be taking will encourage growth of {hopefully} many of those follicles which will {hopefully} allow many eggs to be retrieved.  Before leaving the clinic, I also gave blood for my baseline estradiol level.

Late this afternoon, Nurse Tracey called with instructions to being my injections sometime between 6:00 and 11:00 p.m. (we have to pick a time to stick with for the remainder of my IVF cycle).  My sweet friend Brighton, who is an ER nurse, was working tonight, but offered to FaceTime us for support.  Sam gave my first shot like a pro (though I think - I hope - he was nervous to stick his wife ;))!

Thursday, April 9, 2015: Wednesday after school, I packed my bags and headed to Atlanta, where I will be until egg retrieval.  Sam stayed in Madison for work, so I administered my own shot for the first time last night!  I can take shots in any subcutaneous spot, but the tummy seems to be the best place for me.  Hurts(!), but have learned ice immediately after helps.  Most every day from now until we trigger, I will be going in daily for follicle monitoring and an estradiol check.  Since we live an hour outside of Atlanta (also an hour from Dr. Slayden's satellite office in Lawrenceville) and my mother-in-law is three miles from RBA (talk about a God-thing!), my boss has graciously approved for me to take the next week and a half off so I won't have to drive back and forth.  I'll miss my sweet kiddos, but know that they are in good hands with my co-teacher, Christina, and Mrs. Angie, who is subbing for me.

This afternoon I received news that my estradiol level is only at 56.  Women who are not on fertility drugs can have an estradiol read up to 50.  After three days of Menopur, my estradiol level has not moved much from the baseline level we got Monday (25).  Dr. Slayden has me upping my Menopur dosage from 150 iu to 225 iu.  We will not go in for a check tomorrow, but pray that the upped dosage brings good news Saturday so this cycle is not canceled.  Headaches, nausea, and hot flashes are in full swing!  Glad I have a little retreat at my mother-in-law's and a good book!  Cannot wait for Sam to be here tomorrow!

Saturday, April 11, 2015: Today we have 5 "measurable" follicles (1 cm or larger).  Follicles 1.4 cm or greater have potential to house a mature egg.  I am beginning a second shot today, Ganirelix, to keep me from ovulating.  Estradiol level is at 339, which nurse says is a good place to be on "Day 7."  Praise the Lord!  I read somewhere that the estradiol level needs to be like Goldilocks's porridge - not too low and not too high - there's a good range in the middle.  Yes, I teach PreK.  I'm feeling yucky, but keep reminding myself that it's going to be worth it!!

Thursday, April 16, 2015: Tuesday we had a "sit down" appointment with Dr. Slayden to finalize plans for egg retrieval day and embryo making.  It really hit me during the appointment that these follicles we've been watching grow contain the egg that will one day become our baby - maybe even all of our future children.  It's amazing and overwhelming all at the same time!

Tuesday we had 19 "measurable" follicles (1 cm or larger) and an estradiol level of 1196.  Yesterday: 25 "measurable" follicles, estradiol level 1809.  Today: 27 "measurable" follicles, estradiol level 2883.  That's like a year and a half worth of ovulation in two weeks!

Tonight at 9:00 pm, we'll administer two shots (HCG and Lupron) to trigger eggs so they are ready to be collected exactly 36 hours later.

Saturday, April 25, 2015: It's egg retrieval day!  Dr. Toledo is on call and will be retrieving my eggs.  I am to arrive at the surgery center at 7:30 a.m. to prep for retrieval at 9:00.  Sam and I have both been on Doxycycline for since Thursday evening, and I have also been on Cabergoline to help with hyperstimulation - as well as a high protein diet.

The surgical nurses were fabulous!  Sam was such a trooper!  We love Dr. Toledo!  He wore a Florida Gator scrub cap, but I waited until after surgery to let him know I'd be buying him a Georgia Bulldog one. ;)  No complications with the anesthesia and the pain medicine I took following the procedure kept my pain at bay.  Sam brought me home and my parents came up to help out.  Dr. Toledo retrieved 24 eggs and we learned the following day that the majority of them were mature.

 Friday, April 24, 2015: This morning, the world lost one of its finest.  Cancer is a miserable disease, but never quenched the spirit and love for life, the Lord, and people my grandfather had.  He played on the Vanderbilt freshman football team, graduated from Georgia Tech, served in the US Navy, was a successful contractor and banker, a loving and devoted husband, father, grandfather, great grandfather, son, brother, uncle, and friend. He did a lot of good for others and was one of those people who made everybody feel like a somebody. He cherished the outdoors and told the greatest stories. And oh don't get me started on his smile!

Marion Howard Massee, III was called "Brother" by most - but I was blessed to know him as my "Papa." I will forever hold dear to my heart how lucky I was to grow up right down the road from my grandparents - Sunday mornings on the second row pew at Central, frequent family gatherings on the screened-in porch (where the Doxology was always sung after Papa prayed), bonfires at the "Dickson Place," and one of my fondest memories that we shared one last time this Easter: sitting right next to Papa in his big blue chair, where he listened and laughed and shared wisdom.  My heart is heavy over the loss of my grandfather.  But I rejoice that he is alive and well in heaven!

The recovery process post egg retrieval has been more difficult than I thought with bloating and discomfort.  I've also been extremely tired.  It has been the worst part of my IVF cycle.  Luckily I'm on spring break this week and have been able to rest at home.  I'm very glad Dr. Slayden opted for a frozen transfer in a few months since I ended up responding well to the protocol and produced a large number of eggs.  I cannot imagine how miserable (and scared!) I would be if I had severe hyperstimulation.  

I clearly see now what a blessing it was that my cycle started so late.  I will always treasure being able to spend Easter with my grandfather one last time.  God's timing is perfect!

Wednesday, June 3, 2015: Today has been one of the greatest days of my life.  Today we transferred a precious little embryo.  My transfer protocol began several weeks ago with birth control followed by Lupron injections, Estrace (estrogen), Doxycline, Baby Aspirin, Crinone (progesterone), and Medrol.  Last Wednesday I had my uterine lining checked to be sure it was thickening as it should, to be sure the medicines were doing their job.  I was cleared for transfer.  We've been waiting for this day for quite some time- we were overjoyed with the thought of receiving our little embryo, our baby.

Following retrieval in April, the tiny egg that made this embryo was fertilized and monitored as it grew to a day 5 blastocyst (we got this news the same morning my Papa went to Heaven!).  It was graded an "A" based on its appearance (tight cells) and after genetic testing showed no chromosomal abnormalities.  Once the nurses prepped me for transfer they called for Dr. Slayden to come down and then she put our baby's picture up on a large television.  Magical!  Tears.  Happiness.  Love.  Adornment.  I was in awe.  I sat amazed at the sight of God's beautiful creation.

In vitro is hard.  It's emotionally and physically and financially a lot to handle.  But seeing that picture of our tiny love made my heart just about burst!  So worth it.  The embryologist said it "thawed beautifully" for transfer day.  Dr. Slayden replied, "Of course it did, it's Sam and Sarah's baby." <3  He walked us through each step of the transfer (which takes places via a catheter) as we watched on the ultrasound monitor.  It was incredible.  The rest of the day we couldn't stop smiling.  Couldn't stop singing praises to our Lord.

"Every good and perfect gift is from above." -James 1:17

Friday, June 12, 2015: It has been nine days since transfer.  This morning we went in for a blood test to check my hCG level.  A little after 2:00 this afternoon the phone rang and it was RBA.  Dr. Slayden said he had some very concerning news - I had gotten a positive pregnancy test, but my hCG level was extremely, extremely low.  Likely an implantation problem.  None of us were expecting this.  Dr. Slayden said over and over how sorry he was for us.  He asked that I take an at home test tomorrow morning.  If it comes back negative, I'm to stop medications.

"I don't want to face this valley, I don't want to walk alone. You say that You'll leave to find me, well I am begging You now to come. 
Don't think I can face the morning. Heaviness is on my chest. You say that You'll lift the burden, well I am begging You to bring me rest.
Come and find me in the darkest night of my soul. In the shadow of the valley, I am dying for You to make me whole. For You to make me whole.
-Ellie Holcomb, The Valley

All weekend I have been writing.  Various hours in the day and at night.  It's therapeutic for me.  It's healing.  It helps me to reflect and process.  Helps me to remember the highs and navigate through the lows.  Though our hearts are heavy and we just can't seem to wrap our minds around what went wrong, why we are having to grieve another loss, we have not lost hope.  Psalm 37:4 says, "Take delight in the Lord, and He will give you the desires of your heart."  God knows the desires of our hearts.  He knows how we long to be parents.  He hears our prayers.  We began trying nearly 23 months ago.  We are not giving up.  We are trusting and believing in God's plan.  We can do hard things.  We can do hard things because the Lord never leaves or forsakes us (Deuteronomy 31:6).

Most importantly, I desire to be strong and steadfast in my faith.  It is my hope that by sharing my testimony, I will point others struggling with infertility, those going through treatments, or who are trying to swallow bad news, towards Him.  "The pain that you've been feeling can't compare to the joy that's coming!"

"I was sure by now, God You would have reached down, and wiped our tears away.  Stepped in and saved the day.  But once again, I say 'Amen," and it's still raining. 

As the thunder rolls, I barely hear Your whisper through the rain, 'I'm with you.' And as your Mercy falls, I raise my hands and praise the God who gives.  And takes away.

And I'll praise You in this storm.  And I will lift my hands, for You are who You are, no matter where I am.  And every tear I've cried, You hold in Your hand.  You never left my side.  And though my heart is torn, I will praise you in this storm."

-Casting Crowns, Praise You in this Storm

We have been blessed with the most wonderful group of praying family and friends.  Family and friends near and far that lift us even though they don't know all the specifics.  And have been doing so for months and years.  We feel those prayers and are so, so thankful.  There are also family and friends walking through the trenches this weekend with us.  Listening through the tears.  Hugging and holding us tight.  Feeding us and checking in.  We are grateful for each of you.

"I want to be a woman who trusts that God has a plan, even when I don't understand." -Renee Swope

Aiming to trust in Him,
Sarah