, , ,


How do you decide when to stop infertility treatments?

I got an email from my IVF nurse coordinator saying that it is good that I’ll be talking about my options with my RE on the 9th, but she also indicated that my RE is leaning toward recommending we do a frozen embryo transfer (FET) with my PGS “abnormal” embryo that we still have on ice. Since we didn’t do Next Generation Sequencing, we have no way to know whether this embryo is mosaic or not. It has one small issue that would either result in a failure to implant, early miscarriage, or self-correct and turn into a healthy baby. There’s just no way to know. It won’t result in a live birth of a baby with a chromosome-related disorder. In my mind, I’ve been saving this option in my back pocket for our last ditch effort before discontinuing treatment. It is a long shot after all, but still a possibility. So I don’t want to leave this one embryo behind, but I’m not expecting it to work. Honestly, I really thought my RE would recommend one last egg retrieval and fresh transfer before going with this long shot FET.

I know it’s my choice. My body, my money, my choice. So I think I could talk my RE into one more IVF try. That’s what my husband wants to do, but he is open to hearing what the RE’s rationale is. But if my RE ends up recommending transferring the PGS “abnormal” embryo rather than another IVF fresh transfer, then he is basically saying that  I’m at the end of my road with my own eggs. He’s saying that the chances for success with my eggs is so low that it’s not worth going through another cycle.

But it’s still my choice. So how does one make that choice?

It’s a heart heavy equation. You weigh your dream against your finances, the physical impact of the medications and procedures, the emotional toll this takes on you, the effect on your relationships, and you try to figure out just how much more you can take. Or how much you want to take. I think I can take much more, but honestly, I don’t know that I want to. Many women won’t have to make this decision because IVF will work before they reach their limit. But some of us do have to make the decision.

People tell you, “don’t give up.” Never give up. But I think that is naive advice at best, and potentially harmful advice as it can make you feel like a failure or guilty if you stop. Not everyone can afford endless rounds of IVF. I’m lucky to have insurance coverage or I would have had to stop due to finances long ago. But that still doesn’t mean I should never give up. I’m fighting an uphill battle against age. I could do this 10 more times and have less chance of success each time as I get older and my egg quality decreases. But honestly, the factor that is weighing heavily on my heart is quality of life. I’m tired of my life revolving around IVF cycles. I’ve missed conferences and trips. I’ve missed time with my family. Often, I feel like I’m missing life. Every decision I make revolves around my fertility – what I drink and eat, when and how I can exercise, when I can go out of town, what I read, the appointments I fit into my schedule, how emotionally connected and present I feel with those around me. Some days, many days, during IVF I don’t even feel like myself anymore. The hormonal fluctuations are real and they change how I feel and perceive things. It changes how happy I am in life.

At the end of all of this, whether it works or not, I will still have my life to live. And my life is filled with so many blessings. Not the least of which is my daughter from my first IVF years ago. And I want to enjoy all of the blessings in my life, and sometimes that’s hard to do when I’m so deep in IVF hell.

So I have to weigh out all the factors in my equation and decide when it’s time to stop. After this last cycle failed I found myself feeling really good about the idea of doing one more egg retrieval and fresh transfer, then the last FET with the PGS “abnormal” embryo. If I did those 2 cycles, I felt that I would be satisfied knowing that I didn’t “leave anything on the table”. I would have given it my best shot without sacrificing myself.  Doing more cycles beyond that tipped the scales too much and didn’t feel worth it. But am I ready to go straight to the FET with the PGS “abnormal” embryo? Can I forgo one more retrieval and fresh transfer and still feel okay about my decision if I end up not pregnant? I’m not sure. That ending almost feels too abrupt. But I won’t lie – there is a part of me that feels relieved at the thought of not having to go through another whole IVF cycle. I want to be realistic about my chances.

I’ve done 6 IVF cycles in total. I know some women do many more than that. If I didn’t already have my daughter then I know I would be willing to do more. But part of me feels like I’m missing out on fully enjoying my daughter’s life because I’m so caught up in infertility treatments and the hormonal emotional roller coaster that goes along with this. But I want to give her a sibling so much, and we want to expand our family. However, the truth is she may very well be my only child – how much do I want to miss out on? I could say that I’m not really missing out on anything with her, and maybe that’s true for some women. But it’s not true for me. The medications and the emotional ups and downs do impact me, and negatively affect my relationships and my ability to really enjoy life. IVF is hard. It gets depressing. It becomes all consuming. If can even feel addictive.  And I’m tired of paying that price.

It is okay to stop. That doesn’t mean that you are giving up or are a quitter. It means you are carefully weighing all the factors, which are unique to you, and making a smart, healthy decision. That stop point is going to look very different for different women. And that’s okay.

I suppose I’ll wait to hear what my RE ultimately ends up recommending and what his rationale is before I make my decision. I feel like I’ll have to make a quick decision after our meeting since I’m already on birth control pills to get ready for my next cycle – whether that be another IVF or the FET – and I don’t want to drag out being on those pills. Will I feel like I’m done if I do only the FET? Will I regret not doing one more IVF? Do I want to do another IVF even if the chances for success are so low? Those are the questions I have to weigh.