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07/24/2004

Why we don't stop

Andrea wrote:

Many of the women who do pursue ART, whom I've known online through the forums and, more recently, blogs, are both forging on and being broken as I speak, as I read, as you read this. I am not losing empathy — I don't think that's possible — but I am beginning to lose my ability to understand how anyone could put herself through this, try after try, miscarriage after miscarriage, one grim prognosis after another...how can the body, how can the soul survive it?

I would never post it on anyone's blog, but I feel OK about posting it here, on my own turf: I wish you'd stop. Please don't do this to yourself anymore. You will be great parents; be parents already. Just stop trying to get pregnant.

I know: horribly rude. It is verboten, in Infertileland, to suggest that a fellow infertile ought to do anything other than hope and soldier on. But I can't help wishing it — I can't bear to watch any more. Maybe I'll just stop reading. Except I know I won't.

Whoa, whoa, whoa, friends — don't jump on Andrea, okay? She's endured infertility herself, and, with empathy and sincerity, asks what I consider to be a very pertinent question: why don't we just stop?

If we're honest, I suspect most of us will admit we've asked ourselves that, usually in the darkest hours after a negative, a cancellation, another miscarriage. I asked myself that a lot.

When Paul and I first weighed our options before attempting IVF, our calculations were fairly straightforward: given the cost of IVF in our area, we could do three cycles for the cost of an adoption. Given my age, my general health, and the overall success rates, it was reasonable for us to suppose that within those three cycles I would become pregnant.

It sounds so cut and dried. That's certainly how it felt.

What you probably don't know when you start treatment is just how infertile you truly might be. Oh, sure, you know there's something wrong — but how bad could it be when you're 31, ovulate regularly, and have a normal hormonal profile? I mean, there's that slight male factor to think about, but if the only obvious problem is getting sperm and egg to meet cute, it's not outrageous to assume that IVF will work for you within a relatively short time.

You go in thinking that it will work. I'm young, I'm strong, and I want this enough. But what you can't know then is just how unlucky you might be, and how quickly "just one try" can turn into more.

How do you stop once you've started? How do you give up when, at first, your chances go up with subsequent cycles? How do you say no when a new protocol holds promise? How do you cut your losses and walk away? Like any dangerous habit, it's easier never to start than it is to kick the fucking thing once it's taken hold.

In my case, the second cycle was a given: I'd gotten pregnant under adverse circumstances after our first IVF, and we thought we finally had a diagnosis. Although it ended sadly, I wasn't broken then. I was energized and hopeful. We knew we could make a good embryo, one that wanted to cling and grow. How could we stop then?

When the second cycle went haywire, I was deeply discouraged. In its immediate aftermath we had no firm plans for a third. That I got pregnant then still shocks me; that I lost it still makes me cry. We knew we could make a good embryo, and we knew one could grow in my uterus. We also knew the deep happiness of pregnancy, and the electrifying joy of seeing a beating heart. I knew how it felt to want that again. I couldn't stop then. I needed to try.

After the third cycle, we faced a difficult choice, and found ourselves at the most logical stopping point yet. My eggs were bad, said my doctor, who wrote on my chart, "Donor eggs. Closure?"

Many people do stop there, and we might have, but I had questions, big ones. With two pregnancies after three cycles, could my eggs be that bad? At 32, was my reproductive life over before it had even really begun? Was that heartbeat I saw just a fluke?

Could I move on, could I stop with a peaceful heart, leaving such questions hanging unanswered?

One more cycle for "closure." Which brings us to today.

The thought that kept me going was the knowledge I could get pregnant. I knew I couldn't stop until I'd truly hit bottom, and at every turn I saw I hadn't gotten there yet. I couldn't say "enough" until I'd truly had enough.

How other women do it, I don't really know; I can only assume that their reasons are as powerful and consuming as mine. I know, from speaking with women who've finally changed course, that when we hit that wall, we know it beyond doubt — when that happens, we can leave treatment behind, maybe not without regret but with relief and resolve. But probably not before.

To those of you still going, why don't you stop? What keeps you going? I do believe you should hope and soldier on if the need is still within you. If we're to be true to ourselves, I don't think we can do otherwise.

To Andrea, this will seem like a long and rambling attempt to justify a baffling kind of martyrdom. I think I understand where your frustration comes from, because I've felt it myself as I watch the women I love taking blow after blow without hollering "uncle." It's painful to watch people you care about — even friends inside the computer — struggle when it seems on its face unnecessary.

But to any of us still pursuing treament after disappointment, the struggle is necessary. Why don't we stop? Each of us has a different and complicated answer, I'm sure, but I suspect most would say, "I can't. Not yet."

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