Fertility Problems
Making the decision to end fertility treatment
 

Some couples decide from the get-go that they won't go to extreme measures to have a baby by, say, trying in vitro fertilization (IVF) Others spend years and thousands of dollars trying out all their treatment options. No one can tell you when to stop trying to conceive that's a decision you need to make with your partner and doctor but you may feel more in control of your life if you start thinking now about how far you're willing to go to get pregnant. To help make this decision, ask yourself the following questions:

 
What are the medical odds that you'll get pregnant?
At some point you have to evaluate the medical odds of continuing treatment. Some doctors and clinics will tell you that as long as you keep trying, you have a chance. And while philosophically that may be true, statistically it may not be. For instance, a couple who is considering their sixth IVF cycle needs to carefully look at their chances of success, which drop below 15 percent after five tries.

For help in weighing your options, talk to a social worker or psychologist who's well versed in the emotional and medical aspects of fertility problems, suggests Lara Deveraux, a clinical social worker in St. Louis, Missouri, and co-author of Infertility and Identity: "Be an educated consumer. The fertility business is an industry. There are doctors who care, but not everyone is out for your best interests." The  American Society of Reproductive Medicine and the national fertility problem support organization RESOLVE may be able to help you find a therapist in your area.

Which treatments won't you try?

Talk to your partner about which procedures you're willing to try to get pregnant and where you draw the line. You might agree to try everything possible to have a child, or discover that you want to skip the more invasive procedures (such as surgery or assisted reproductive technology (ART) treatments) and adopt a child if fertility drugs don't work out.

How's your health -- mentally and physically?
You may feel that ending fertility treatment is the same as giving up. But how are you holding up mentally and physically? Are you developing other conditions such as fatigue and depression as a result of your treatment? Have you had multiple miscarraiges? Can you take any more disappointments?

"Sometimes I think couples who find out right away that they can't be the genetic parents of their child are best off," says Alice Domar, a psychologist at the Mind/Body Center for Women's Health at the Mind/Body Medical Institute at Harvard University Medical School, and the author of Healing Mind, Healthy Woman. "They are hit with the terrible news, they grieve, and then they can make plans for moving on they don't spend years going from one disappointment to the next."

How's your relationship with your partner?
Undergoing months or years of fertility treatment will take its toll on your relationship no matter how strong it was when you started. You and your partner may have feelings of resentment, guilt, anger, or disappointment, and you may find it hard to communicate with each other.

One warning sign to be aware of is sexual anxiety. "Many couples who repeatedly fail to conceive begin associating sex with false hope and disappointments," says Deveraux. "Sex is no longer a spontaneous activity to express feelings and that's particularly bad if they aren't able to talk to each other, either." While a certain amount of sexual anxiety is normal when you're coping with a fertility problem, you may need a break from treatment if it's leading to feelings of isolation.

What's your end goal?
Many couples are so focused on getting pregnant spending years trying every treatment option available that they forget to ask themselves some crucial questions. Do you want to be a parent no matter whose child it is? Or will you be happy only if you have a genetic child? If that's the case, ask yourself where these thoughts come from. Is continuing with fertility treatments going to cost you more valuable parenting years?

Many couples end up realizing that they just want to be parents, but they don't feel like adoption is for them. "Don't push yourself it's an idea many couples have to get used to," says Domar. "Don't file adoption papers the day treatment doesn't work. Give yourself time to grieve you have to think about the child who is being adopted." And no matter what, ultimately, you have to feel good about the choices you make. Some couples find peace with the idea that they won't have children of their own and become deeply involved in the lives of children in other ways.

Can you afford to continue?
No one wants to put a price tag on a baby, but the reality is that you have to. "It isn't fair," says Domar. "It is very hard for couples to accept the fact that money could play a role in having a baby procreation is a fundamental right of humankind. But you always have to save some resources for plan B." Even if you can stomach mortgaging your home and draining your retirement savings to have a child, it's not practical. You may want to do some financial planning and consider the cost of adoption, surrogacy, or other options that guarantee parenthood before you go for broke on chancy and costly fertility treatments such as in vitro fertilization (IVF).