When Is Enough, Enough? Does Fertility Treatment Have an End?
Some things are really hard to hear. Whether it is as simple as how your hair looks or how you look in that dress to how to treat an aggressive medical condition, the truth can really hurt. And oftentimes, accepting the truth can be nearly impossible. However, there are only so many times that you can hold your hands to your ears and play deaf. There are only so many times that you can ignore the flashing red lights in front of you. Ultimately, if you don’t change lanes you will find yourself at a roadblock that you can’t overcome or pass. However, knowing when it’s time to get out of the lane can be the hardest part. That’s what we are here for.
As fertility doctors, our job is to guide you, to support you, to educate you, and ultimately to help you achieve your dreams of becoming a parent. We take the information provided to us by blood tests, ultrasounds, medical history, semen analyses, and family histories and with it try to see what is off, which pieces in this puzzle are not fitting together and how can we put the pieces back together.
However, our job goes way beyond diagnosis. We are also there to implement and design treatment plans. Some plans you may like, and others, you may not. Some may seem too aggressive; others, too lax. Some may seem too involved, and others, too casual. Whatever it may be, you have to take the information and options presented to you, process them, and then proceed.
But we cannot simply stand on the sidelines and watch you run into a 320-pound linebacker without a helmet. While your fertility doctor should be frank with you throughout your entire treatment course, this is particularly true when deciding on the best treatment strategy.
At some point, the seesaw of pros versus cons is no longer even close to even. The American Society of Reproductive Medicine defines this tipping point as futile treatment (≤1% chance of achieving a live birth) and very poor prognosis treatment (>1% to ≤ 5% per cycle). Allowing a patient to continue to try when the odds are so incredibly low and not sharing such information is, in our opinion, criminal. Honesty is imperative in any doctor-patient relationship, but it is especially essential in fertility medicine.
While we want to help you achieve your dream, we must be honest with you about the likelihood of achieving these dreams. Sometimes, dreams must be modified (donor eggs rather than your own eggs, a gestational carrier rather than your own uterus) in order to end happily.
Closing the chapter on any stage of life can be difficult. It is wrought with confusion and anxiety. We are here to help you through this process, to help you move through the pages, and to reach the ending that will make you feel the most complete and the most content. Telling you what you want to hear may make you feel better, but it will likely not make you a baby. And although hearing what we have to say may sting, it may be the bite that leads you to parenthood. And in our line of work, parenthood is paramount.