Many parents find that they are unable to conceive without help from reproductive endocrinology (RE) and fertility experts. Sadly, even in this age of advanced reproductive technology and diagnosis, in-vitro (IVF) and intra-uterine insemination (IUI) pregnancies can also end prematurely and tragically. When this happens, the pain can feel insurmountable, as the journey to conceive has already been a rollercoaster full of hurdles to overcome and perhaps even earlier losses. As a result, some parents wonder if they should start fertility treatments again, or if they should stop altogether. Most do go on to try again, but sometimes trying to get pregnant once more does not happen immediately and the questions arise: “How long do we keep trying?”; Have we been aggressive enough?”; and “Maybe this wasn’t meant to be?”.
Every parent has the right to re-evaluate whether they want to continue fertility treatments, but sometimes it feels as though there is no “right” answer. Here are a few tips to help you walk the path of trying to figure out whether continuing trying to conceive with the help of RE is right for you:
Get your RE Team Involved Sooner Than Later
This first tip also applies to people who perhaps had an easier time getting pregnant in the past, but after loss are struggling. While some couples prefer to try naturally, others may find it increasingly hard if they don’t get pregnant immediately. It is common to feel as though your case isn’t “worth” the attention of an RE clinic, or that they will turn you away if you seek assistance. As a general rule, it is always worth getting an appointment, if only to gather information. Spare yourself the anxiety of trying to create the optimal conditions to conceive based on google and internet discussion forums, and trust the experts who do this for a living. Every case of infertility is so unique that it needs its own customized plan of action informed by the latest science and technology. There is no penalty for calling a clinic and asking to speak with a specialist about your situation and whether an appointment, basic bloodwork, or more invasive testing is needed. So many parents assume that they must wait a certain amount of time, often 3-6 months of unsuccessful attempts to conceive naturally, prior to enlisting the help of an RE. However, your own personal medical history will factor into whether this applies to you or not, so it’s worth a call.
Those who have already been through fertility treatments may feel embarrassed or even ashamed to ask for help once again. Please know that RE clinics are full of compassionate providers who will grieve your loss and want to help you conceive. They never judge or blame patients when losses happen, even if you (unjustifiably!) blame yourself. It is also important to give yourself permission to consult another clinic if you feel uncomfortable returning to the one you began with. Second opinions are common and, again, clinic staff and providers are not judgmental when clients ask for their files to be sent to other specialists. If you do look for a second opinion, be sure to ask yourself what you might do with the information you receive, as it can leads to “analysis paralysis”: this means that receiving different opinions about the path you traveled and alternative options can feel overwhelming and make you even more anxious. Go with the provider who feels like the most compassionate, but professional, “expert”. Remember, at the end of the day, you want to trust these specialists to use their experience and knowledge on your behalf.
Have Arbitrary "Final" Deadlines
If you’ve been through multiple IUIs, egg retrievals and IVF transfers, you may be dreading doing another one. It’s important to think about your mental and physical health when it comes to pursuing RE help again. Some parents feel they need to sacrifice their own health and comfort for the sake of having children, but it is important to know that the toll treatments can take on you are important, and you must give yourself permission to care for your body. This may mean taking a break, choosing less invasive options, or choosing to undergo them with additional help (for example: taking an anti-anxiety medication before a hysteroscopy). Then, you may want to try imagining what the future might look like if you set a deadline to be pregnant, or go through a certain amount of procedures. For some, even setting a deadline provides clarity, whether they follow up or not. Think about it: Does the idea of having an “end date” fill you with dread, or excitement? Your feelings about even an artificial ending can guide what you do in the future. You can also choose to be more or less invasive depending on the procedure and, of course, your RE’s recommendations. While you’re at it, you might:
Research other ways to Have a Family
It is important to know that when doors close, windows can open. So, you can choose to continue fertility treatments, or to end them, while also exploring other ways to become a parent. There are numerous options, from gestational surrogacy, donor egg/sperm, and fostering or adoption. Each path has its own requirements and stipulations, so it can be helpful to ask your RE about other biological methods while also searching for local adoption agencies or your Department of Human Services to consult with about requirements. It can be helpful to ask yourself (and your partner) some of the following questions:
- Is having a biological child important thing to me?
- Is carrying a pregnancy important to me?
- Am I interested in temporarily taking care of children as a foster parent if they don’t stay with me permanently?
- Would I be willing to raise a child whose biological history may be different from mine or even somewhat unknown?
- Would I be interested in raising an older child or do I want the experience of having and caring for a baby?
There are no right or wrong answers on this journey, and collecting information as well as self-reflecting about your desires is always a good thing. It can be helpful to designate and keep a special journal to track your thoughts about all of this, because it’s likely your ideas will evolve over time. No subsequent pregnancy or plan for having a family can replace the pregnancy you lost, but it can feel hopeful and helpful to aim for a new plan all the same.