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Welcome!

This blog addresses various emotional aspects of experiencing infertility. It is written by a clinical psychologist who specializes in infertility counseling. Thank you for reading, and best of luck with your journey!

Wednesday, October 20, 2010

The end of the line? The decision to end infertility treatment

A reader asked me to address the issue of how you can tell if you should stop infertility treatment. This is a very important question, and one that is perhaps impossible to answer. However, I am going to try my best to share my thoughts on this subject, for whatever they are worth.

Sometimes the decision to end treatment is basically made for you. A biological event occurs, like being diagnosed with a serious illness, that makes continuing in treatment unwise. In other cases, diagnostic information comes to light that makes the possibility of success so unlikely that continuing in treatment is pointless. Also, financial or practical considerations may arise that make it simply impossible to continue in treatment. However, in most cases, the situation is not so clear cut, and it becomes a judgment call as to whether or not you should continue.

The way I think about the decision to terminate infertility treatment is centered on one of my fundamental beliefs--that we should try whenever possible to anticipate what our future selves will think about our decisions, in order to minimize future regrets. Having children (or not having them) is a very important, life changing decision. Thus, I feel it is extremely necessary to really think about how you will feel about your choices ten, twenty, or thirty years in the future. As an example of what can happen when you do not take your future self into consideration, I would like to tell the story of a lovely woman that I know from my hair salon. She is now in her late 80's and is suffering from some cognitive dementia, so although she has met me several times, she does not explicitly remember talking to me before. Despite this, she always sits down with me and tells me her story, each time with more nuance and detail. In a nutshell, she and her husband had a baby when she was in her early twenties, but sadly, he was stillborn. She wanted to try to have another baby, but her husband was insistent that they should not. He felt if God wanted them to have a baby, he would have let their first baby live. As time went on, she still wanted to have a child, and suggested that they adopt. Again, her husband was adamantly against this--to him, God obviously did not want them to have a child, and besides, he was not interested in raising "someone else's children". She loved her husband and wanted to stay with him, so she put her dreams aside, and stayed with him through thick and thin. Every time she told me this story, she stated that although she is very sad about not having a child, she feels she must come to peace with it. But it seems to me if you are telling this (and only this) story sixty years later to a relative stranger at the hair salon, you may never come to peace with the decision. Although she has led a rich and full life, and has wonderful extended family that make sure all of her needs are met now (including making sure her hair looks fabulous), I am pretty sure that remaining childless was not the right choice for her. And the deep regret that she expresses is the kind of thing I think we all want to avoid.

If it's over, you'll know

So given that you want to make sure that in the future, you do not have profound regrets, how do you tell when it's time to call it quits with infertility treatment? My personal and clinical experience has taught me this: when it's time to quit you will know it. You will feel it, almost as a physical sensation--something like, "I can't do this anymore, it's bad for me." Your self-protective mechanism will kick in, and saving yourself will become the most important goal. I vividly remember the moment of my decision to quit infertility treatment. I had a break at work, and was pacing back in forth in my office when I realized that although I didn't want to stop trying IVF, I had run out of treatment options. If I kept going, it would be sort of like gambling--the odds were stacked against me. I had the profound sense that I would be really hurting myself if I continued, and to no good end. I acknowledged that I was really bad at getting pregnant--but maybe there was something else at which I was good, and it made more sense to put my energy toward that. We turned to adoption, and so far I have never regretted that decision.

But the heart wants what it wants...

However, if you feel in your heart of hearts that you would like to continue, but that maybe you shouldn't because it is expensive, time-consuming, or other practical concerns--then it is a different story. In this case, I think that if you could logistically make it happen, you should probably continue in treatment. Infertility treatment has a time-stamp on it, so you don't want to be looking back 10 or 20 years down the line, when you don't have the option anymore, and wishing you tried when you had the chance. The heart wants what it wants, and if continuing is what is in your heart, I think it is important to try to honor that. Whether or not it results in a baby, at least you will have the closure of knowing you tried everything you could to achieve your goal.

I know that this way of thinking comes at a price, usually financial. I personally hate the fact that money can be such a primary factor when it comes to decision making about creating a family. But money can usually be earned or borrowed, although admittedly not without significant sacrifice. However, having a child is such an important part of life that it may be worth taking on more financial risk or burden in order to maximize your chances.

As for the time, logistical difficulties, and other inconveniences involved with infertility treatment, I would urge you to remember that although it may be difficult in the near-term future, if you avoid these things now, you may be feeling regret later for many years.

As in so many things in life, we must balance our short-term needs with our long-term goals. It is never easy, but I think you should keep in mind that this is one of the most important decisions you will ever have to make. This will help give you the necessary perspective--and courage--to do what you need to do to protect your future happiness.

17 comments:

  1. Thank You Lisa. Thanks for your support and help. I wish we lived closer!!
    Your post has cleared my thoughts. I need to look into the future and make sure I don´t regret anything I do now. For now, we are moving forward with another IVF. Check out my blog for updates if you want.

    ReplyDelete
    Replies
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  2. I find the advice of thinking about our future selves a very good one in terms of decision making. After our failed fertility treatments, a friend offered us eggs. It was hard to contemplate risking the kind of loss we had gone through in the past and it took some time to decide whether we could accept her gift and go ahead with the egg donation. What finally did it for me was that I knew I would regret it deeply if I didn't at least try. That's what finally helped me confront my fear of nurturing hope and be able to go ahead with a new attempt at motherhood.

    Thanks for your blog, Lisa.

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  3. just found your blog through ICLW: thank you for writing what you do. We can all vent and tell our stories, but you're reaching out in such a needed way!
    Thank you.

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  4. Thanks for the wonderful comments! I think both LaLoca and Augusta have highlighted how hard it can be to move forward with treatment when it seems so emotionally risky in the short term--but how important it is to do so in the long term. I hope it worked/works out for everyone!

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  5. Well said Lisa. It is such a tough decision. It often helps to start getting educated on your other options for creating a family. This "education" can help in making the decision to try another cycle or may help you come to peace with another way.

    Dawn Davenport
    Host of Creating a Family: Talk about Infertility and Adoption
    Creating a Family, a non-profit providing education and resources for Infertility and Adoption
    www.CreatingaFamily.org

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  6. We had said 2 cycles and then we'd stop. In my IRL IF group, I have seen many couples say that and are on their 5th and 9th cycles. I don't know if we would have been similar but we did start researching other options very early on in order to prepare for any eventuality.

    ICLW
    http://daega99-arewethereyet.blogspot.com/

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  7. I've often wondered, in our 4 years of TTC, if I would ever feel like it was time to stop. This post does a great job of explaining what that realization would feel like, and I know that I'm not there yet. We adopted last year, which I too am much better at than at getting pregnant! For me, the experience of being a mother wad the one thing I could not imagine my life without. That realization led us to adoption,and I couldn't be happier with that choice. But I continue to have a deep longing for pregnancy, and so I am proceeding with donor eggs courtesy of my best friend so I can at least carry my husband's child. If that doesn't work, I want to pursue embryo adoption, though we plan to go the regular adoption route as well. Thank you for this insightful, thought-provoking.

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  8. Thankyou Lisa. Our TCM practitioner asked hubby & I to think about this the other day - what would our life be like if we decided to stop and live a childless life? It really made us think about when we would stop - and your post has some great advice :) ICWL

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  9. Thank you! This was such a wonderful article! I will definitely link to this! Thanks for stopping by my blog! Happy ICLW! (#72 & 106)

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  10. This was such a well-written piece, laying out both the pragmatic and the emotional repercussions of the decisions that have to be made about continuing or ending fertility treatment. I have subscribed to your posts and will surely be bringing some of them, and specifically this one, to the attention of my fertility coaching clients, as appropriate.

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  11. oh! i like that thought - try to envision what our future selves would think about our decisions. that's fantastic advice. we just did our 3rd IVF cycle and the response was not good. we only had 2 4cell embryos to transfer on day 3. it was a slap in the face after 2 beautiful cycles last year, both BFN. now we're left with trying to decide where to go next if this fails. this piece of info will be a great discussion point for me and my dh.... and i agree with you. i will know when its over. and i don't know that yet... thanks for this post. stopping over from ICLW (#31)

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  12. This is a simply wonderful post. Thank you so much for sharing... your words "that we should try whenever possible to anticipate what our future selves will think about our decisions, in order to minimize future regrets" really resonated within me. While I'm not considering stopping treatment, I'm considering starting it at all. We had planned to move straight to adoption, but as you said so beautifully "the heart wants what it wants" - it's in the best interest of my future self to get that second opinion. Thank you for solidifying that decision for me.

    Happy ICLW and I look forward to reading more!
    ~Keiko, Hannah Wept, Sarah Laughed (ICLW #142)

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  13. Great article. What I do not see here is what to do when you and your husband do not agree on when to stop?

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  14. , I have no words to express my gratitude, Eka the great priest of Eka kingdom...I have fought with infertility issues for more than a decade. My Gyn told a year ago that one of my tubes was blocked, and had insisted that IVF was the only option left for me. I was desperate and terrified due to my relatively advanced age (I was 38 a year ago) and the 2 ovarian cysts that were giving me hell, that I would be childless. My husband and I decided we will keep on fighting as I have read many awful stories about the side effects, the low success rates and pain involved with the IVF procedure so we kept looking for a way out to have a child of our own. We almost gave up and then I found the email of priest Eka (dreka14demons@gmail.com) and I emailed he for help and he told me all what I will do for him to cast me a pregnancy and pregnancy protection spell. And kindly I immediately ordered him to do all the needful for me to get pregnant and I did everything Eka said along with my husband who had poor sperm motility. After two months of trying I got pregnant with my first baby boy. With one blocked tube and 2 ovarian cysts, I think this is nothing short of a miracle! I will thank Eka for everything, Contact him (dreka14demons@gmail.com)

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