When enough is enough

I got a very kind comment on one of my older posts from someone who is going through one of several failed IVF/ICSI cycles, and thinking about whether to go on or what to do next.  This is a very difficult scenario, and one that we encounter in life many times:  the question of when to stop, compounded with its sister question of what to do next.

Hmmm...  I know.  Give me a call and for a small fee I will tell you what to do :)

But I don't want to be held responsible for the outcome.

Sorry, I am just trying to make light of a very heavy, very serious topic.  I have a couple of thoughts on this topic and I am just going to type them as they come to mind.  Life seems to come to points in the road where you can swear that you have met a fork:  a place where you must make a decision, to go left or to go right, and once you have made this decision, there is no turning back.  However, I think that when it comes to IVF, this isn't necessarily so.  You might decide to stop now, but unless you continue to decide that same thing every day for the rest of your fertile life (and even later, if you are open to gamete donation/embryo adoption), this stop might just be temporary.  Yes, it would be quite a change of heart, and you will need to talk your partner into it again, but say you have decided to stop, and in a few months you feel that you must give it one more try, or ten more tries, who's to say you can't change your mind?  Be flexible.  It's not now or never.

In the same vein, if you absolutely have no clue what to do and have the luxury of time, do nothing for a few months.  Wait.  When you are burned out by depression and hormonal imbalances and unfairness and financial stress (all of which come with failed IVF's), you might go through a stage when you feel NOTHING.  I did.  I felt nothing, including no idea what I wanted to do next.  I go by feel, so if I feel nothing, I am blind.  If that happens, you have two choices:  one is to wait if you can, and realize that eventually you will get a feeling for what you want to do next.  The second one is to try and remember what your old (now comatose) self would have wanted, and to act accordingly.  Presumably you remember some of your old values, and so you could make a decision for yourself the same way you would for a comatose spouse, according to what he/she would have liked to do.

This might sound strange, but when I did not know what to do because I had no feeling for the future, no feeling for the present, and truth be told I really felt nothing at all, I remembered that I am the kind of person that would go on until I die or there is nothing left to try.  Hence, as long as the clinic would continue to treat me, I would keep on going.  So I would just go on in a state of haze and numbness, until either they told me to stop, or I got pregnant and had a baby, or I got the very sharp realization that I can no longer do IVF/ICSI, and that I want to stop.  I never got that though.  I did go through a comatose 10 IUI's until I decided all of a sudden that I wanted to move on to IVF, and at that point I stopped in the middle of a medicated IUI cycle, just suddenly stopped injecting the medications, and made an appointment with the IVF clinic.  Just like that.  Up until then, I had been deathly afraid of IVF (something about the dildocam with the long needle in the wrong place...).  At that point, it was suddenly IVF or nothing else.  Go figure.

If it is time to stop, you will know it.  There will be a voice (either a real one, like that of several doctors telling you so, or an inside voice of your own) telling you in no uncertain terms that the chances of success are too small to be worth the time, money and emotional investment, or that you would rather move your resources to pursue other avenues.  These other avenues are suddenly going to feel like relief, or maybe they will suddenly start to seem more and more appealing.  I remember thinking of surrogacy with great relief at one point, when I thought my incompetent cervix would make it impossible to carry a pregnancy to term.  Before that point, the though of surrogacy felt like a personal failure and loss.  At that point, suddenly surrogacy seemed almost ... chic, if not the greatest invention on earth.  Listen and watch for this change in nuance, it is your brain sending you clues of what it wants you to do next.

So, to sum it up:
1.  realize it is a difficult situation and allow yourself some time to think
2.  most decisions don't have to be final.
3.  it's ok to change your mind
4.  decide based on what you feel that you want to do
5.  if you don't feel anything, decide based on what you think you would have felt if you could feel something
6.  watch for a sudden change of heart towards an alternative (like embryo adoption, gamete donation, surrogacy, adoption, living child free) that you previously thought unacceptable.
7.  if you still don't know what to do, send me a cheque and I'll tell you :)  But I might have to read your energy field first, and visit with your ancestors.
8.  if you have to chose between doing too much or regretting not doing something, always chose doing too much.  Regret is the shittiest thing to live with.