Wednesday, 14 May 2008

When is enough, enough?

At what point do you decide that enough is enough? When do you accept that it is time to let go, to move on?

Over the past couple of weeks, I've found myself inexplicably drawn to the IF message boards. I spend hours scrolling down through the animated emoticons and the liberal sprinklings of baby dust searching for women in a similar position to myself. What I suppose I'm really looking for is hope: hope that our one embryo may emerge from the freezer unscathed and then implant, hope that I may yet have a better response on a different protocol. I read about wheatgrass, DHEA supplementation and oestrogen priming protocols. I torture myself with stories about those who had repeated cancelled cycles, and who then went on to conceive naturally after a course of acupuncture. The boundaries of what is possible with ART are constantly being pushed forward, and the temptation is to assume that there must be something else out there - a different clinic, an experimental new protocol, or some kind of complementary therapy - that may make the difference for us.

A few months ago, several British newspapers reported the story of a couple who had eventually conceived after fifteen attempts at IVF. Over a ten year period, they had spent nearly £65,000 on fertility treatment. They had twice remortgaged their home, and had each worked two jobs to cover the cost of those repeated cycles. They finally brought their baby daughter home from the hospital in January of this year. Implicit within this story was the assumption that, if you want it badly enough, and if you just keep going, you'll get pregnant in the end.

It's an assumption which, it seems to me, also haunts the infertility community. I've recently read a couple of posts written by other IF bloggers wondering whether or not to put themselves through another cycle. In these posts, I could not help but detect a certain note of guilt and anxiety lest they should be perceived by others still in the trenches as having 'given up' too soon.

There is no set number of treatments you should have to go through before you decide that enough is enough; each of us has our own individual limits. Given my poor response on these first two cycles, the chances are that I will be prescribed high doses of FSH on any future cycles. I remain concerned about the possible long-term effects of those drugs. If I choose not to put myself through repeated high-dose stimulations, then it doesn't mean that I want a baby any less than someone who is willing to undergo multiple cycles of IVF. Stopping treatment does not in any way deaden the aching desire to become a mother; in many ways, it brings it into even sharper relief.

I'm not ready to let go just yet: while we still have that one embryo on ice, there is still hope. But I think that I am beginning to move towards an ending, and to acknowledge that that ending might not necessarily be the one that I'd hoped for.


Lisa said...

I hear everything you're saying. The best way I've described it to people is that, in a way, it feels like gambling. It's hard to walk away from the poker table or the slot machine because the next hand, or the next pull, might be the big one. Feels the same with IVF. Maybe the next cycle will be the one that succeeds? How can I stop when it might just be one more cycle I have to go through?

People have asked me since my first cycle when I'll stop and, each time, I tell them that I can't answer that right now. I think, or all of us, we just know when we know, you know?

I hope that your frozen baby is the one that is it for you!

Malloryn said...

I know exactly what you mean. I'll admit to feeling anxiety when I think about moving on the other options after just two IUIs. It's hard not to compare yourself to other people. I want to be a mother so badly, and yet I'm not convinced that my body can pull it off. Every day I ask myself if it's time to cut my losses (Lisa's gambling metaphor is apt!) and look into other possibilities. Yet there's that little voice inside that says, 'What if the next IUI is the one that gets you pregnant?'. *sigh*

I'll be crossing my fingers and toes for your little embryo!

luna said...

I feel like I just wrote this! as you know everyone's got their own limits, whether they are financial, physical, emotional, logistical.

how do you give it everything you have and still have something left for you? that's what I want to know.

wishing you all the best for your hope on ice. I feel you though, it's a very tough question.

(many thanks for the birthday wishes!)

jp said...

I go through this with myself every single month.
There are many reasons I would be getting ready to stop, right after this month if it doesn't work or if I don't get to IVF after a poor response.
It is a very difficult decision.
Initially I said I'd do three rounds of IVF (that was two years ago) and I've not yet gotten there. I never imagined two full years would be gone and I'd still be doing this.
I am so glad for you that you have your frozen embryo.

annacyclopedia said...

Although in some ways I'm just entering the trenches, at the same time I really relate to this post. I had to make a choice between DI and trying to do IVF/ICSI after sperm retrieval, and I chose DI. From time to time, I am haunted by that decision and I do wonder if I gave up too easily. But you are absolutely right that we all have our own limits and they may be wildly different. The answer to where the limit is for each of us can only be found in our own hearts and our own guts.

I'm so proud of you for asking these questions. It really takes so much courage to start looking at this stuff - for me, it's about taking responsibility in a new way when we honour our own limits instead of pushing past them. You will find a path out of here, and although it may not be what you wanted, it will still be your own path. And who knows? It might bring you happiness or benefits that you never imagined, in spite of the sadness.

You are in my thoughts and prayers as you work through these very difficult questions. Wishing you much peace and clarity in the midst of it all.

kate said...

I'm at a place where I haven't even begun real treatments and I've already decided that enough is enough. I just don't have the finances and the emotional wherewithall to go through an expensive failure. My body has failed me enough. I would be crushed if my first IUI or IVF failed because then it would all seem more real to me.

Maybe I'll eventually get over myself and step up to the plate, etc., but for now, I'm forcing myself to focus on other areas of my life, and telling myself that I actually DON'T want to get knocked up right now. It's all very weird, but I guess what I mean is that your post prompted some interesting thoughts for me.

Shinejil said...

I think it's natural to look for a possible solution through research--that's what folks like us do every day, right?

But you'll know in your heart when it's time to back off. You'll feel it in your body, too. Most non-IF people make odd assumptions about a process they don't bother to understand, and we have to use our own internal guidance to make the call.

Kymberli said...

I followed you through from my blog. I just wanted to let you know that I am thinking of you.

TABI said...

Thanks for this post. I got a lot of support when I was struggling with whether to stop at 3 IVFs and 3 PG losses. It's so seductive to try again with thoughts of, "This time it will work." Even though I am about 95% sure we want to move on to other options, I still sometimes think we should try another IVF. It's so hard to know when to stop because you feel like each time is a new prospect for success. But as I was told and comforted by from everyone that we all have our limits and you just have to stay true to them.

BB and MTB said...

It's such a hard decision to know what and when is enough. No one can tell us, and there may always be some tinge of doubt no matter what we decide. That's why is such a personal journey for each of us. I think that may be one more reason why these things are so hard to talk about in real life and so easy here with the anonymity of the internet. It's harder to judge and feel judged here. Good luck in whatever comes next for you.

Pamela Jeanne said...

There is nothing quite so daunting as answering this question. We each have an innate sense of what is right and yet there's another part of us that can't bear to hear the answer. Thank you for this post...

Phoebe said...

You may never know the answer to this question, or it might take a long time to feel resolved about it. I wish I could just say no to more medical treatments, as it seems to bring more heartache than it's worth.