Über die Autorinnen und Autoren

Sandra Glahn, ThM, is adjunct professor at Dallas Theological Seminary, her alma mater. She is the coauthor of eight books, including the CBA bestseller and Christy Award finalist, Lethal Harvest. She is also editor-in-chief of the award-winning magazine Kindred Spirit. Glahn is currently pursuing a PhD in aesthetic studies at the University of Texas at Dallas. She serves on the board of the Dallas Christian Medical/Dental Associations and the advisory board of Hannah's Prayer.

William R. Cutrer, M.D., is an OB/GYN and an ordained minister. He is the Gheens Professor of Christian Ministry and the director of the Gheens Center for Marriage and Family at the Southern Baptist Theological Seminary in Louisville, Kentucky. He serves as the medical director at A Woman's Choice Pregnancy Resource Center. He is the author of Choice Today: A Pregnancy Resource and Under the Fig Leaves, and coauthor of Sexual Intimacy in Marriage and The Infertility Companion. He has also coauthored the novels Lethal Harvest, Deadly Cure, and False Positive.

Von der hinteren Coverseite

Endorsed by the Christian Medical Association.

A Comprehensive Christian Guide to the Challenges of Infertility
• Medical • Ethical • Emotional • Marital • Spiritual • Biblical

Infertility changes everything, shattering dreams and breaking hearts. But hope is available--today more than ever.

The Infertility Companion draws on the Bible and on current medical knowledge, including the latest research, to shed light on such questions as:

•Can people of faith ethically use high-tech infertility treatments?
•How do we make moral, biblical decisions about medical treatment, third-party reproduction, stem cell research, and embryo adoption?
•Is God punishing me?
•Does God even care?
•Will adoption increase our chances of getting pregnant?
•How can we reduce the stress of infertility on our marriage relationship?
•How can we keep sex from becoming a chore?

These theologically trained authors have taught at a variety of conferences on infertility, pregnancy loss, and adoption, and they have helped thousands of couples to face the future through their message of encouragement.

The Infertility Companion includes discussion questions and a workbook suitable for individuals, couples, or small groups. Full of practical tips and true stories, this book will guide couples past the ethical pitfalls of assisted reproductive technologies as they travel the difficult road ahead.

An all-encompassing guide for the Christian infertility patient. Where other books fall short, this “companion” aids the patient not only with the physical and emotional aspects of this journey, but also helps answer the tough spiritual and ethical questions that arise in a couple's desire to conceive.--Julie Watson, Conceiving Concepts

Auszug. © Genehmigter Nachdruck. Alle Rechte vorbehalten.

The Infertility Companion

Hope and Help for Couples Facing InfertilityBy Sandra L. Glahn William R. Cutrer

Zondervan

Copyright © 2004 Zondervan
All right reserved.
ISBN: 0-310-24961-9

Contents

Acknowledgments..........................................................................................................91. Where We've Been: Your Companions in "the Ditch"......................................................................112. The Wedded Unmother: Myths and Facts..................................................................................233. Marital Dynamics: She Wants a Baby; He Wants His Wife Back............................................................354. Emotional Dynamics....................................................................................................475. Handling Well-Intentioned Advice......................................................................................596. Where Is God When It Hurts? The Biblical Infertility Stories..........................................................737. The Spiritual Struggle: Is Infertility a Curse?.......................................................................878. The Underlying Question: Why Did God Create Sex?......................................................................999. The Medical Workup: Collect the Clues.................................................................................10910. The Continuing Workup................................................................................................12111. The Doctor: The Third Party in a Couple's Love Life..................................................................13312. State of the ARTs: High-Tech Treatment...............................................................................14513. A Moral Minefield: We Can Do It, but Should We?......................................................................16114. Determining Right from Wrong: The Ethics Construct...................................................................17115. Three's Company: Third-Party Reproduction............................................................................18316. Aid in the Begetting: Donor Egg, Surrogacy, and Embryo Adoption......................................................19317. Using a Donor: What the Kids and the Research Tell Us................................................................20918. Loss upon Loss: Miscarriage, Failed IVF, and Failed Adoption.........................................................21919. Infertility Patient as Parent: Secondary Infertility, Pregnancy, and Parenting after Infertility.....................23120. Resolution: Adoption or Childfree Living.............................................................................24121. You Are Not Alone....................................................................................................253Appendix 1: Workbook: Exercises for Couples..............................................................................257Appendix 2: Christian Medical Association Statement on Reproductive Technology...........................................265Glossary.................................................................................................................269Resources................................................................................................................283Notes....................................................................................................................289Index....................................................................................................................305

Chapter One

Where We've Been

Your Companions in "the Ditch"

* * *

Sandi's Journey: Knots and Tangles

I am Sandra, daughter of Ann, daughter of Velma, daughter of Ella,all the way back to Eve. But the genes carried down through my ancestorswill stop with me.

When I was a little girl, I never dreamed that I might be unable tohave children. In my childhood home in Oregon's Willamette Valley, bymid-April the plum trees had sprouted purple blossoms and the wholeworld seemed to bloom with new life. Foals, calves, and lambs appearedin the fields. By Mother's Day, everything had either given birth or wascelebrating hope, and I assumed that I would someday join in thatprocess.

I was the fourth of five children. When I reached adolescence andstarted babysitting-which I loved-I became increasingly aware thatmany people have more children than they anticipate. I figured that, ifanything, I'd fall into that group.

Fast-forward to age twenty-seven. My adoration of spring turnedto dread as I felt out of sync with the rest of the world. While everythingaround me celebrated new life, I experienced spring more as an injury-almost as an indictment. With tear-stained cheeks, I watched birds buildnests and lay eggs in our trees and thought of how children describedme as "nobody's mommy." Mother's Day-that dreaded "M-Day"-came as the crowning insult.

My husband, Gary, and I had been married seven years, and he wasstarting his last year of seminary training (master's degree) in Dallas,Texas. In addition to our jobs-he at a law firm, I as a writer at an insurancecompany-and his studies, we served as part-time staff at ourchurch, ministering to college students. After working full-time to putmy husband through graduate school, I dreamed of quitting my job andstaying home to take care of our children. Friends and family were askingwhen we'd start having babies, and it was finally time to get an "allclear" from my physician.

Dr. Bill Cutrer, my medical doctor, was also a seminary student, andhe had a reputation for being a godly man with technical expertise. SoI made the new-patient appointment, and after our consultation, he toldme everything looked great. The next six months were wonderful.There's something magical about making love with the expectation thatyou'll produce something as marvelous as a child. The plans anddreams arrived in full force. I mentally picked out nursery colors. Forgraduation we got a car-a new station wagon big enough for the familywe were going to have. I told a few close friends we were trying. Wesaved up all we could for the day when I could quit work.

Nine months passed with no success. I had expected to get pregnantthe first month, but I told myself we'd been too busy. Then monthsturned into a year. But I wasn't too worried.

Another six months passed, though less quickly, and my sister confidedto me that she was going through fertility testing. A pang of concernstarted gnawing inside me. Mary recommended a book aboutinfertility, and I read it. Afterward I wrote in my journal, "The infertilityfear is getting greater. There's a lot of denial on my part. I'm finallyhaving to come to grips with the fact that there's a problem." I cried forthe first time when someone asked when we were going to start a family.Three days later I wrote, "I'm facing that we may not have kids. It'stough. But his mercies are there, too." A church in British Columbiainterviewed Gary by phone for a pastoral position. A week later I wrotein my journal, "My strong preference would be to stay in my currentjob until I know I can have kids. The Lord knows."

The job didn't pan out, and we both kept working. After eighteenmonths had passed, I returned to see Dr. Cutrer for what was supposedto be a belated annual checkup. All went fine until near the end, whenhe asked me a few questions.

"I think I just need to relax," I told him. "We've been trying to getpregnant, but we've probably been too busy to hit it right."

Looking up with gentle eyes, he rolled closer. "How long have youbeen trying?"

"About eighteen months." I had believed the myth so many peoplehad told me: "Just relax and you'll get pregnant."

He spoke in a soothing tone. "No. Perhaps it's time to stop 'justrelaxing.' There are a few simple things we can try. The pace is up toyou." We could take it fast or slow, he told me, starting with the easiest,simplest test: a semenalysis on my husband.

Not a chance. We're not infertile! I thanked him politely and left foranother eighteen months.

Threads of Grief

The time passed with increasing emotional pain. It got harder todeny the reality. So I finally returned to the doctor. By that time, I hadheard a lot more about "Dr. Bill," as many of his patients called him:

"He stayed up with us all night rather than rush a C-section."

"He came in on the weekend to do our insemination."

"He prayed with us during our rough delivery."

Dr. Bill had a reputation for being a kind and compassionate manof God. I wish I could say we hit it off from the start, but at the time, Iresented what I perceived as "doctor worship" on the part of many ofhis patients, so I determined to be distant.

Gary and I decided to begin the testing process. Dr. Bill began bytesting Gary, who appeared to have no problem. Then Dr. Bill ran a lotof blood tests and did some studies to make sure I was ovulating. Afterthat, I had an endometrial biopsy. I began to read everything I couldfind on the subject of infertility because through knowledge I feltempowered.

My sister called to say she'd had a laparoscopy (the so-called Band-Aid surgery) and her doctor had found endometriosis. Because there issometimes a familial connection, Dr. Bill recommended that I, too, havea laparoscopy. But he also thought I might have a congenital structuralproblem. The day he told me that, I drove back to my office, shut thedoor, and sobbed my heart out. The shock of the news hit like a tsunami.I really might never have children.

I experienced a spiritual crisis. I had to face the fact that I had a mistakenperception of God. My life had gone fairly well up to that point,and I thought it might have something to do with my obedience. Isecretly believed that if I continued feeding my "quarters" of obedienceinto God's cosmic vending machine, I'd get what I wanted. When thatdidn't happen, I realized that either something was wrong with mybehavior or, the more helpless option, that God doesn't necessarily stickto such clear cause-and-effect arrangements. If the latter was the case, asI began to suspect it was, no amount of obedience would solve my fertilityproblem.

I wrote in my journal, "Waiting. Waiting. More waiting. I can hardlythink of anything else. It was easy not to think about it when I wasn'tfacing the doctor or my charts every day or week, but it's hard to get itoff my mind now that I'm constantly confronted with it."

When I stood around talking with other women, I felt somewhatlike an imposter. I was incomplete, not quite a part of them, havingfailed what I perceived as the true test of womanhood: the rite ofmotherhood.

Monthly we would watch my ovaries on the ultrasound screen tohelp us "time it right." And I began taking medication for a mild hormonalimbalance. We found ourselves paying for multiple medical bills,having quickly discovered that most insurance policies will cover thediagnosis of infertility but not its treatment.

Dr. Bill prescribed the low-tech ovulation inducer, clomiphene citrate(brand names: Clomid, Serophene, Milophene). Of all the medicationsI would take during treatment, Clomid made me the craziest. Oneafternoon when I went in for a sonogram, I sarcastically asked Dr. Bill,"Could you give me more Clomid? I'm only crying at mall openings."

He responded in the schooled "doctor voice" that he has sincelabeled "vocal anesthesia," "Being the rather sentimental soul that I am,I'd probably cry at mall openings, too."

"I don't mean grand openings," I snapped. "I mean every day at tenwhen they open the doors."

Gary and I dreamed up a board game called "In Futility," which wepatterned after Monopoly, except that instead of buying up real estate,the object was to get a child. We replaced the four railroads with rollercoasters. Free parking was reserved for teens who got pregnant the easyway. "Community Test" cards were responses to people who madetacky comments, like the man who asked, "How can you miss somethingyou never had?" We got to move ten spaces for quelling the urgeto answer with, "You mean like your brain?" A little lame humorhelped.

Then finally it happened. After three years of trying, I had a positivepregnancy test. But then I lost the pregnancy several days later.Soon after that, I had a difficult conversation with Dr. Bill. He told mehe wanted to refer me to an endocrinologist. While I appreciated hisdesire that we find answers to my infertility, I had developed friendshipswith him and his staff, and I was actually starting to be nice tohim. I had grown comfortable. Now I had to start over.

Threads of Patience

We called the endocrinologist and had to wait three months to getin. I became even more aware of how much of life is spent waiting.

I crossed off each calendar day leading up to my appointment. I wrotein my journal, "More opportunities for hope and despair ahead." Whenmy brother-in-law told me I'd make a great mom, I wept. I realized thenthat I'd been wondering if the Lord was keeping me from being a motherbecause I'd be a failure at it.

During that time, our church asked us to start a support group forinfertility patients, so Gary and I organized one. At the same time, I alsoserved on the national board of a secular support organization forpatients and providers. Their local chapter, on whose board I'd served,had been a lifeline. The group asked me to chair a medical symposiumfor patients, bringing together the state's top doctors and therapists. Isaid I would.

I had been told that infertility patients are second only to cancerpatients in terms of what they will endure for a cure, and I found themto have a pretty high level of sophistication. I asked Dr. Bill to lectureon infertility and spirituality. He wondered if anyone would attend hisworkshop, but it ended up having the highest attendance of anythingwe offered.

Then I got pregnant again. Then lost the baby. Then again. Anotherloss. Pregnant. Loss. Pregnant. Loss. We experienced seven early pregnancylosses. Tests told us nothing. It was a mystery.

After seven years of trying to conceive, we watched as the odometeron our station wagon turned 100,000 miles. We'd stayed in Dallas tocontinue treatment. But we were getting to the point where it hurt moreto go on than to quit. We were tired of it all. Then new tests suggested Ihad a rare immunological problem for which little could be done. So wetook a year off to explore the possibility of never having children anddevoting ourselves full time to ministry. Among other pursuits, we wentwith Dr. Bill and his wife, Jane, to Russia on a medical mission trip.

When we returned, I asked Dr. Bill to prescribe birth control pills. Iwanted to stop mentally keeping track of my "cycle days," and I'd hadenough pregnancy losses to know that my womb was not a safe placefor a developing embryo. I needed to avoid conceiving.

At the end of that year, Gary and I learned that my immunologicalproblem might be corrected with blood thinner and baby aspirin. So wepursued treatment again. It required giving myself daily shots in mythighs or stomach, and soon I was covered with bruises. Then I developedbleeding complications.

I finally reached my limit.

The next few weeks were filled with both mourning and resolution.I wrote: "Part of me wants to party and celebrate that we're through.But I will also grieve as the realization hits me. I feel unmotivated towork and tired from it all. But grief is a friend. I've learned to trust it totake me to the other side of emotional health."

I enrolled in some seminary classes to further my writing ministry.And we checked out U.S. adoption agencies. After the miscarriages, ourinfertility was pretty much public knowledge. We worked that to ouradvantage and recruited people to help us find a birth mother.

During the three years that followed, three birth mothers agreed toplace their children with us and then changed their minds-either rightbefore or on the day of birth.

How long, O Lord, how long? (Ps. 6:3).

Threads of Hope

"Don't send us any more birth mothers," we told our friends. "Wedon't think we could handle it." I wondered if I'd ever stop being suspiciousthat every piece of good news would turn into a disaster. I questionedwhether my heart could ever freely love a child now.

Not long after that, I met with a book publisher about a fiction project.In the course of the conversation, I expressed my disappointment inhow little helpful information I'd found in the Christian market aboutinfertility-especially on the ethics of high-tech treatment-and he toldme to send him a book proposal. I was stunned. I was a magazinewriter; it had never crossed my mind to write a book.

After giving it some thought, I contacted Dr. Bill. It seemed that abook about infertility and pregnancy loss would have more credibilitywith a combination of perspectives. He agreed to work on the projectwith me. As he put it, a team of the two of us could be "doctor-patient,male-female, sane-insane." So we began to write.

The book gave me a constructive channel for my grief. When theodometer turned to 200,000 miles, Gary and I traded in the first stationwagon for another. I pursued finishing my master's degree in theology,choosing to focus much of my research on infertility as a spiritual crisis.And finally, more than a year after we'd started, Dr. Bill and I finishedthe manuscript.

These activities opened doors to a writing and speaking ministry forme and for us as a team.

I know now that I will never give birth. You'll read snippets ofGary's and my story and our path to resolution throughout the book,though the whole picture of what was medically wrong and all of God'sreasons for allowing it will remain mysteries to us.

Yet when I look back on where I have been and what the Lord hasdone, I can't help but think of a tapestry. For so long, the individualpainful situations made no sense. I shook my head as I tried to figure outwhat God was doing with my life and wondered why he had allowedso much death-whether of embryos or dreams.

Continues...

Excerpted from The Infertility Companionby Sandra L. Glahn William R. Cutrer Copyright © 2004 by Zondervan. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

The Infertility Companion Copyright 2004 by Sandra L. Glahn and William R. CutrerRequests for information should be addressed to:Zondervan, Grand Rapids, Michigan 49530Library of Congress Cataloging-in-Publication Data Glahn, Sandra, 1958-- The infertility companion : hope and help for couples facing infertility / Sandra L. Gahn and William R. Cutrer. p. cm. Includes bibliographical references and index. ISBN 0-310-24961-9 (softcover) 1. Infertility---Religious aspects---Christianity. 2. Infertility---Psychological aspects. I. Cutrer, William, 1951--. II. Title. RC889.G536 2004 248.8'6196692---dc22 2004004099All Scripture quotations, unless otherwise indicated, are taken from the Holy Bible: New International Version. NIV. Copyright 1973, 1978, 1984 by International Bible Society. Used by permission of Zondervan. All rights reserved.Scripture quotations marked KJV are taken from the King James version of the Bible.Scripture quotations marked NASB are taken from the NEW AMERICAN STANDARD BIBLE , Copyright The Lockman Foundation 1960, 1962, 1963, 1968, 1971, 1972, 1973, 1975, 1977, 1995. Used by permission.Scripture quotations marked NKJV are taken from the New King James Version. Copyright 1979, 1980, 1982 by Thomas Nelson, Inc. Used by permission. All rights reserved.The website addresses recommended throughout this book are offered as a resource to you. These websites are not intended in any way to be or imply an endorsement on the part of Zondervan, nor do we vouch for their content for the life of this book.All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means---electronic, mechanical, photocopy, recording, or any other---except for brief quotations in printed reviews, without the prior permission of the publisher.Interior design by Michelle EspinozaPrinted in the United States of America04 05 06 07 08 09 10 /.DC/ 10 9 8 7 6 5 4 3 2 1WHEREWE'VE BEEN Your Companions in 'the Ditch'Sandi's Journey: Knots and TanglesI am Sandra, daughter of Ann, daughter of Velma, daughter of Ella, all the way back to Eve. But the genes carried down through my ancestors will stop with me.When I was a little girl, I never dreamed that I might be unable to have children. In my childhood home in Oregon's Willamette Valley, by mid-April the plum trees had sprouted purple blossoms and the whole world seemed to bloom with new life. Foals, calves, and lambs appeared in the fields. By Mother's Day, everything had either given birth or was celebrating hope, and I assumed that I would someday join in that process.I was the fourth of five children. When I reached adolescence and started babysitting---which I loved---I became increasingly aware that many people have more children than they anticipate. I figured that, if anything, I'd fall into that group.Fast-forward to age twenty-seven. My adoration of spring turned to dread as I felt out of sync with the rest of the world. While everything around me celebrated new life, I experienced spring more as an injury--- almost as an indictment. With tear-stained cheeks, I watched birds build nests and lay eggs in our trees and thought of how children described me as 'nobody's mommy.' Mother's Day---that dreaded 'M-Day'--- came as the crowning insult.My husband, Gary, and I had been married seven years, and he was starting his last year of seminary training (master's degree) in Dallas, Texas. In addition to our jobs---he at a law firm, I as a writer at an insurance company---and his studies, we served as part-time staff at our church, ministering to college students. After working full-time to put my husband through graduate school, I dreamed of quitting my job and staying home to take care of our children. Friends and family were asking when we'd start having babies, and it was finally time to get an 'all clear' from my physician.Dr. Bill Cutrer, my medical doctor, was also a seminary student, and he had a reputation for being a godly man with technical expertise. So I made the new-patient appointment, and after our consultation, he told me everything looked great. The next six months were wonderful. There's something magical about making love with the expectation that you'll produce something as marvelous as a child. The plans and dreams arrived in full force. I mentally picked out nursery colors. For graduation we got a car---a new station wagon big enough for the family we were going to have. I told a few close friends we were trying. We saved up all we could for the day when I could quit work.Nine months passed with no success. I had expected to get pregnant the first month, but I told myself we'd been too busy. Then months turned into a year. But I wasn't too worried.Another six months passed, though less quickly, and my sister confided to me that she was going through fertility testing. Apang of concern started gnawing inside me. Mary recommended a book about infertility, and I read it. Afterward I wrote in my journal, 'The infertility fear is getting greater. There's a lot of denial on my part. I'm finally having to come to grips with the fact that there's a problem.' I cried for the first time when someone asked when we were going to start a family. Three days later I wrote, 'I'm facing that we may not have kids. It's tough. But his mercies are there, too.' A church in British Columbia interviewed Gary by phone for a pastoral position. Aweek later I wrote in my journal, 'My strong preference would be to stay in my current job until I know I can have kids. The Lord knows.'The job didn't pan out, and we both kept working. After eighteen months had passed, I returned to see Dr. Cutrer for what was supposed to be a belated annual checkup. All went fine until near the end, when he asked me a few questions.'I think I just need to relax,' I told him. 'We've been trying to get pregnant, but we've probably been too busy to hit it right.' Looking up with gentle eyes, he rolled closer. 'How long have you been trying?''About eighteen months.' I had believed the myth so many people had told me: 'Just relax and you'll get pregnant.'He spoke in a soothing tone. 'No. Perhaps it's time to stop 'just relaxing.' There are a few simple things we can try. The pace is up to you.' We could take it fast or slow, he told me, starting with the easiest, simplest test: a semenalysis on my husband.Not a chance. We're not infertile! I thanked him politely and left for another eighteen months.Threads of GriefThe time passed with increasing emotional pain. It got harder to deny the reality. So I finally returned to the doctor. By that time, I had heard a lot more about 'Dr. Bill,' as many of his patients called him:'He stayed up with us all night rather than rush a C-section.''He came in on the weekend to do our insemination.''He prayed with us during our rough delivery.'Dr. Bill had a reputation for being a kind and compassionate man of God. I wish I could say we hit it off from the start, but at the time, I resented what I perceived as 'doctor worship' on the part of many of his patients, so I determined to be distant.Gary and I decided to begin the testing process. Dr. Bill began by testing Gary, who appeared to have no problem. Then Dr. Bill ran a lot of blood tests and did some studies to make sure I was ovulating. After

WHEREWE'VE BEEN Your Companions in 'the Ditch'Sandi's Journey: Knots and TanglesI am Sandra, daughter of Ann, daughter of Velma, daughter of Ella, all the way back to Eve. But the genes carried down through my ancestors will stop with me.When I was a little girl, I never dreamed that I might be unable to have children. In my childhood home in Oregon's Willamette Valley, by mid-April the plum trees had sprouted purple blossoms and the whole world seemed to bloom with new life. Foals, calves, and lambs appeared in the fields. By Mother's Day, everything had either given birth or was celebrating hope, and I assumed that I would someday join in that process.I was the fourth of five children. When I reached adolescence and started babysitting---which I loved---I became increasingly aware that many people have more children than they anticipate. I figured that, if anything, I'd fall into that group.Fast-forward to age twenty-seven. My adoration of spring turned to dread as I felt out of sync with the rest of the world. While everything around me celebrated new life, I experienced spring more as an injury--- almost as an indictment. With tear-stained cheeks, I watched birds build nests and lay eggs in our trees and thought of how children described me as 'nobody's mommy.' Mother's Day---that dreaded 'M-Day'--- came as the crowning insult.My husband, Gary, and I had been married seven years, and he was starting his last year of seminary training (master's degree) in Dallas, Texas. In addition to our jobs---he at a law firm, I as a writer at an insurance company---and his studies, we served as part-time staff at our church, ministering to college students. After working full-time to put my husband through graduate school, I dreamed of quitting my job and staying home to take care of our children. Friends and family were asking when we'd start having babies, and it was finally time to get an 'all clear' from my physician.Dr. Bill Cutrer, my medical doctor, was also a seminary student, and he had a reputation for being a godly man with technical expertise. So I made the new-patient appointment, and after our consultation, he told me everything looked great. The next six months were wonderful. There's something magical about making love with the expectation that you'll produce something as marvelous as a child. The plans and dreams arrived in full force. I mentally picked out nursery colors. For graduation we got a car---a new station wagon big enough for the family we were going to have. I told a few close friends we were trying. We saved up all we could for the day when I could quit work.Nine months passed with no success. I had expected to get pregnant the first month, but I told myself we'd been too busy. Then months turned into a year. But I wasn't too worried.Another six months passed, though less quickly, and my sister confided to me that she was going through fertility testing. Apang of concern started gnawing inside me. Mary recommended a book about infertility, and I read it. Afterward I wrote in my journal, 'The infertility fear is getting greater. There's a lot of denial on my part. I'm finally having to come to grips with the fact that there's a problem.' I cried for the first time when someone asked when we were going to start a family. Three days later I wrote, 'I'm facing that we may not have kids. It's tough. But his mercies are there, too.' A church in British Columbia interviewed Gary by phone for a pastoral position. Aweek later I wrote in my journal, 'My strong preference would be to stay in my current job until I know I can have kids. The Lord knows.'The job didn't pan out, and we both kept working. After eighteen months had passed, I returned to see Dr. Cutrer for what was supposed to be a belated annual checkup. All went fine until near the end, when he asked me a few questions.'I think I just need to relax,' I told him. 'We've been trying to get pregnant, but we've probably been too busy to hit it right.' Looking up with gentle eyes, he rolled closer. 'How long have you been trying?''About eighteen months.' I had believed the myth so many people had told me: 'Just relax and you'll get pregnant.'He spoke in a soothing tone. 'No. Perhaps it's time to stop 'just relaxing.' There are a few simple things we can try. The pace is up to you.' We could take it fast or slow, he told me, starting with the easiest, simplest test: a semenalysis on my husband.Not a chance. We're not infertile! I thanked him politely and left for another eighteen months.Threads of GriefThe time passed with increasing emotional pain. It got harder to deny the reality. So I finally returned to the doctor. By that time, I had heard a lot more about 'Dr. Bill,' as many of his patients called him:'He stayed up with us all night rather than rush a C-section.''He came in on the weekend to do our insemination.''He prayed with us during our rough delivery.'Dr. Bill had a reputation for being a kind and compassionate man of God. I wish I could say we hit it off from the start, but at the time, I resented what I perceived as 'doctor worship' on the part of many of his patients, so I determined to be distant.Gary and I decided to begin the testing process. Dr. Bill began by testing Gary, who appeared to have no problem. Then Dr. Bill ran a lot of blood tests and did some studies to make sure I was ovulating. After