Knowing When to Draw the Line on Fertility Treatment
The lowest point of my life happened, somewhat fittingly, on a toilet. It was about a week into my first miscarriage, and I’d finally peeled myself off the couch (where I’d been curled up with cramps for days) to take my dog on a short walk and get some fresh air. Upon coming back inside, I headed to the bathroom to pee, but when I sat down, I felt a sharp sting on my inner thigh. There it was: a large bee. It had snuck inside my pants during the brief time I’d been outside and was now taking up residence in my underwear.
Later at the urgent care (thanks to a minor allergic reaction), I had the distinct feeling that I couldn’t sink any lower than I felt in that moment. The low point had begun about a week earlier, when I’d learned that my baby’s heartbeat had stopped at nine weeks; since then, I’d been in a lot of pain processing the bad news and trying to pass the pregnancy naturally with no luck. (I ended up having a dilation and curettage procedure.) It had been my first pregnancy, achieved via IVF after four other failed fertility treatments. My husband and I were heartbroken — we’d already named her Faith and started planning for the future.
Losing the pregnancy was absolutely devastating, but almost worse was the immense feeling of dread at having to get back on the seemingly endless hamster wheel of trying to conceive against all odds. During the two years that my husband and I had been trying, I’d gone down a rabbit hole of sorts, where my infertility had completely taken over my life. First it had been trying to get a diagnosis and figure out why I couldn’t get pregnant. Once I finally learned that I had diminished ovarian reserve, then the obsession became about how to surmount that obstacle and somehow trick my body into producing viable eggs.
As my husband and I started an ongoing series of fertility treatments, I became utterly consumed — trying everything from acupuncture to meditation to a 40-pill-a-day supplemental regimen. I also made a bevy of lifestyle changes, such as quitting alcohol and Diet Coke, removing all endocrine disruptors from our household, getting regular vitamin D injections and going on a dedicated fertility diet. As a compulsive researcher (it’s the journalist in me), I spent almost all of my free time lurking on message boards and devouring the latest medical developments.
The deepest parts of the rabbit hole, though, were the intense feelings of isolation, sadness and being in limbo that intensified with each passing day. Going to Resolve meetings and seeing a therapist helped, but it became increasingly difficult to think about anything but my inability to get pregnant.
For all of these reasons, I was perilously close to my point of “enough” after the miscarriage, but my husband felt strongly that we should soldier on and try another IVF cycle. (Unlike me, he’d always been optimistic about our prospects and felt that there was still hope.) I didn’t want to give up either, but felt mentally, physically and emotionally exhausted. However, it didn’t feel right to stop there since we’d finally had some degree of success, so I managed to talk myself into doing a third IVF cycle just a few months later. My one caveat? That if it didn’t work, I was done.
Miraculously, that third cycle did work, and I ended up giving birth to twins. (I initially got pregnant with triplets, but lost one of the babies in the first trimester.) In retrospect, every step of the journey was so worth it, and knowing what I know now, I would do it all over again 100 times. But how would things have been different had that final cycle not worked? Would I have summoned the strength to keep going, or would I have honored my desire to stop fertility treatments and get off that proverbial hamster wheel?
That’s the question I ask myself now as an advocate and friend to women still navigating infertility. At what point does the pain of infertility outweigh the pursuit of motherhood? The answer is different for everyone. For me, three years and six treatments felt like the limit, while I’m amazed by women like my friend Melinda* (who withstood 18 fertility treatments in order to have her two children) and actress Jaime King (who underwent 26 IUI treatments and five IVF cycles before conceiving naturally).
LA-based entrepreneur Jen Dede Kelly and her husband recently decided to turn to adoption after seven long years of trying — spanning 10 IUIs and four IVF cycles. Though the couple has neared this crossroads before (“usually after a big treatment that left us feeling devastated, drained and hopeless,” says Kelly), they experienced a more significant mental shift last year after several canceled IVF cycles.
“While we were grateful that our doctor always made an ethical decision about what was worth putting my body through, it was extremely tough on me,” shares Kelly.
When her husband landed a temporary acting job in Chicago, the couple jumped at the chance to take a much-needed reprieve, but “what was supposed to be a few months turned into almost a year of giving our minds and my body a break,” says Kelly. “There was a lot of grief along with healing and a feeling in my gut that perhaps the treatments were doing more harm than good. I was at my breaking point.”
For Sarah Chamberlin, who writes the blog Infertility Honesty, it took four years, $77,000 and a host of treatments and interventions before she and her husband made the painful decision to live “child-free, but not by choice.” Having transferred 24 embryos unsuccessfully, Chamberlin felt she simply couldn’t continue. “When you have to work so hard to make a child, your love isn’t going into that child initially; it’s going into the creation of those embryos,” she explains. “It was as if I’d lost my children [when the treatments didn’t work]. We didn’t have the financial resources to pursue parenthood any further — and we were depleted on every level.”
To avoid hitting that point of total depletion, fertility coach Rosanne Austin believes it’s important to have a “finish line” in mind — whatever that means to you. Her motto? “A finish line isn’t failure, it’s freedom.” She suggests keeping the following three criteria in mind when deciding whether to halt treatment.
Money. It’s hard to think of many other situations in which one could possibly spend thousands of dollars and not receive any return for their investment (other than heartache). Though there are programs to offset the cost of fertility treatment, it’s helpful to have a ceiling in mind for what you’re ultimately willing to spend and stick to it.
Time. Austin suggests taking your age into account and being realistic about exactly how much time you’ll devote to pursuing fertility treatments before exploring other options for achieving parenthood. As she puts it, “fertility treatment limbo should just be a stop on your journey, not the destination.”
Emotional bandwidth. According to literature from Resolve, studies have shown that the psychological stress of infertility is on par with that of having cancer, so it’s vital not to discount the heavy emotional burden that can accompany infertility. For Chamberlin, it was about reclaiming her life. “I felt a certain numbness in everything I did, which was preventing me from enjoying even the most basic things,” she says. “Baby-making debacle aside, we knew we had good things in our lives — somewhere — and we wanted to get back to enjoying them.”
Some of the key questions that helped Kelly were: "How much more do I want to put my body through? Is this harming me more than helping? What does life look like childless? What alternative family-building options are we open to? We then tried to detach emotionally and take the pressure off feeling like we had to make any decisions — it helped us to think of it as an adventure of exploration. It shifted our perspective from scary to liberating.”
When you’re steeped in the thick of fertility treatments, it’s easy for the pursuit of pregnancy to become almost like an addiction. (It definitely did for me.) Though it can be a slippery slope deciding when enough is enough, it can also be empowering to know and honor your limits — even when the desired outcome still hasn’t materialized.
“It had been especially hard because we were always waiting for our doctor to say, ‘It’s time to go another direction,’” says Kelly, “but in our case, we needed to make that call ourselves. We’ve started to realize there is an end of the road, but that doesn’t mean it has to be the end of our dream to create our family.”
* Names have been changed.