Addicted to Hope

The issue of stopping treatment is a concern for couples who are taking fertility drugs alone or in combination with an ART procedure. These treatments can become addictive unless you define when "enough is enough" before you start. Many couples report that the addiction lies in the hopefulness at the beginning of each new cycle. However, as each menstrual flow arrives, the despair gets deeper and deeper until you can't dig yourself out. Treatment is like being addicted to a miracle. "Just one more cycle and then we'll stop" can go on for longer than the recommended cycle-length of the fertility drugs, and in some cases, for longer than two years -- an eternity for fertility treatments.

Before you begin your treatment, you should set down your own financial and time limits. For example, some couples plan for three in vitro fertilization (IVF) cycles and one gamete intrafallopian transfer (GIFT) cycle. Some couples plan for three clomiphene citrate cycles and one IVF cycle. You should then discuss a fallback plan in case treatments don't work. This may include adoption, childfree living, or plans to continue to try to conceive naturally (as may be the case for unexplained infertility, irregular cycles, or borderline low sperm count).

One couple with unexplained infertility actually went on oral contraception after their treatment cycle because the hopefulness/despair merry-go-round at the beginning of each natural cycle, and the beginning of each period, was just too much for them to handle emotionally. For this couple, oral contraception was the only way they could get on with their lives.

The Issue of Failure

For some, stopping treatment is admitting defeat or failure. Yet in the general fertile population, few will sacrifice what you have to reproduce. Issues like child abuse, deadbeat parents, and unwanted children infuriate those of us who cannot conceive. Where's the fairness in denying so many committed parents-to-be of biological reproduction when, clearly, so many people who don't deserve to be parents can reproduce at the drop of a hat? There is no fairness.

For philosophers, the "problem of evil" is what has kept the question of deity in a fiery debate over the centuries (i.e., "If there is a God, why is there so much evil in the world?"). For infertile couples, the justice in who gets to reproduce and who doesn't is a philosophical and spiritual quandary. For many, it is the spiritual straw that may turn us away from religion, or draw us into it.

Stop Signs

For every person in treatment, there are different STOP signs that tell him or her that "enough is enough." The following is a list of signs compiled from other couples' experiences. If you're currently in treatment and you've seen one of the emotional and/or physical signs below, it may be time for you to stop.

1. The fertility drugs are causing painful or adverse symptoms, ranging from physical pain to severe mood swings.

2. You're already in debt and cannot afford another cycle.

3. You cannot stand to be around anyone but your partner and your doctor. You can't remember the last time you chatted with a friend.

4. You can't remember the last time you did anything for pleasure -- reading, sports, going to a movie -- that did not revolve around infertility.

5. You and/or your partner are incapable of becoming sexually aroused just for "fun."

6. You eat, drink, and sleep infertility. You're so obsessed about your infertility that it's interfering with your job, your sex life, your social network, and your relationship with your partner.

7. You're showing signs of depression: Apathy, loss of interest in formerly pleasurable activities, change in appetite (usually decreased), fatigue, guilt, self-loathing, suicidal thoughts, poor concentration and memory, sleeplessness (waking early and not going back to sleep), and anxiety.