When to Move On & When to Stop Fertility Treatments
When to Move On with IVF and Other Fertility Treatments?
When it comes to moving on to the next fertility treatment option, each treatment cycle should be viewed as an independent event. This means that if the first cycle fails, the next cycle has an equal chance of working. This cycle independence holds true for each type of treatment for at least three cycles of treatment. If you examine the clinical efficacy of a given treatment protocol, the cumulative pregnancy should be viewed as the likelihood of conception within a reasonable time frame, approximately three to four cycles, and NOT after only one attempt.
When deciding when to move from one treatment protocol to another, it is important to review what has been learned from the preceding treatments. Did the ovaries respond appropriately? Did the ejaculate tolerate the sperm wash? Did the endometrium reach a target thickness? Did the follicles release the eggs? Were the hormone levels correct? By examining the response to treatment the patient and physician can decide when it is appropriate to move from one treatment protocol to another.
By and large, if a treatment is going to work, it will be effective within three cycles. Since the majority of successes occur during the first three attempts, this presents a reasonable interval in which to schedule a reevaluation consultation with your physician. Before this visit, the patient must reevaluate her feelings and comfort zone about treatments. It is interesting to observe the changes in a couple's comfort zone as they experience successes and failures with differing treatments. A couple who first thought they would not possibly consider artificial insemination may move on to IVF after a few cycles of FSH injections.
When to Stop Fertility Treatments?
The decision to stop treating is probably one of the most difficult decisions faced by any couple who struggles with infertility. A sense of when to stop and when to continue can be reached if a couple has a firm grasp on their objectives. For instance, one couple may have as their goal to have a baby in their home and are willing to consider adoption or egg donation as a route to achieve this goal, whereas another couple may not be interested in this approach at all, deciding that if they cannot conceive using their own egg and sperm then they will not have children or they may opt for gestational surrogacy. These very personal choices differ from couple to couple.
Unfortunately, your fertility doctor may not be able to help much with this decision. Remember, it is the doctor's job to think of alternatives and choices for you to consider. It is your job to decide which choice is best for you. One couple may enthusiastically proceed with egg donation IVF whereas another stops short of laparoscopy to correct endometriosis.