Today’s Couples Have a Number of Fertility OptionsNO ONE UNDERGOING fertility treatments expects to remain childless. Yet couples are often faced with this and many other options when nothing they do results in a baby. If this applies to you, it’s time to carefully examine your options. Talk with your partner about how you feel. If you’re determined to have a biological child and haven’t made a decision on an alternative solution, consult with a reproductive counselor or contact one of the resources on page 313.
When Your Dream Is Not Possible
We started out with the same expectations as everybody else. I went into it thinking it was going to happen for sure. Jodie and I tried for a good portion of two years. I remember feeling worse and worse each time because of the tremendous drain it had on us. I recall the shots and how frustrating that was getting for her. I have vivid memories of waiting by the phone for hours and hours to hear good news only to realize by 5:00 p.m. that it didn’t take.
—Brett, 39, marketing director
WHEN IS IT TIME TO STOP TRYING?
Each couple has to decide when enough is enough. Treatment can continue as long as you both have the desire and the pocketbook to make it work. But it’s not just financial cost that may drain you; it’s also the psychological and physical aspects of continuing treatment.
Some signs that may force you to reconsider what you’re doing will resemble stress (page 191) or burnout (page 193). Other signs may include asking questions like, “Why are we doing this?” or “How will we know that we’ve done enough?”
Today’s Couples Have a Number of Fertility Options
Reproductive medicine got a face-lift in the 1990s when third-party reproduction (use of donor sperm, eggs, embryos, and surrogacy) became a standard practice. Today it’s widely accepted in the United States.
Keep in mind that what works for some couples doesn’t work for others. Some modify their treatment early, choosing an alternative route to parenthood, while others may hang in for the long haul, pushing past many disappointments to reach success. Some couples may opt out after one, two, or three treatments, while others may have six, seven, or more. All you need to accomplish this is to have a desire to alter your course or push past limits you never knew existed.
Considering Other Alternatives
After our third cycle failed, Mike and I considered egg donation and adoption. We decided to forgo it because somehow I had this feeling that IVF would eventually work. The fact that I did get pregnant initially gave me hope. But what really drove me was the vivid dream I had of seeing our child gaze joyously at our Christmas tree.
—Jeanette, 36, sales representative
Ever wonder why ending fertility treatment is so difficult? If you’ve never had a problem making important decisions, walking away from treatment may leave you at a loss. Saying goodbye to anything you hold dear is hard. When your heart is set on having a child of your own, you want to know that you did everything in your power to make it happen. The key is to do everything within reason.
If continuing treatment is taking a tremendous toll on you, your spouse, your family, or your relationships, you should reevaluate what you’re doing. While having a baby with your bloodline is important, you need to make sure doing so doesn’t sabotage other areas of your life like your work, health, or your primary relationships. Remember, those elements were intact way before you began treatment, and you should do everything you can to keep it that way.
Another reason you may have a difficult time ending your treatment is because breakthroughs in reproductive medicine occur at a blinding pace. Medical reporters seem to announce advances daily. New treatments, often couched as controversial, become standard treatments within years. These solutions offer hope to couples who up until now may have exhausted all conventional methods of getting pregnant.
You’ll want to avoid developing an addiction to treatments the same way you might when trying your luck at blackjack or bunko or any other venture that involves chance. Any form of gambling has a payoff at the end. In your case the payoff is a baby. If you’re like most people, you may feel that in the end you’ll walk away a winner. This is when you need to know yourself and your partner and be clear on what your limits are emotionally, financially, and psychologically.
As you plunge ahead in your treatment plan, you might even find yourself addicted to a stealth drug: crisis. Your schedule is in a constant state of flux. Going for weekly ultrasounds only reminds you of what you can’t accomplish. All the while you have to stay on course by prepping your mind and body, overcoming disappointments, giving your partner pep talks, preparing responses when people ask the baby question, figuring out what to say when your boss asks where you went for hours, trying not to distance yourself from your partner, counting to ten when a family member says something irritating, psyching yourself up for the next cycle, consoling your partner if it fails, and huddling together to hammer out a winning strategy for your next round.
What the Stress of Repeat Treatments Can Do
I wanted to hole up. I wanted Natalie and me to be completely alone together and pretend things were the way they used to be. I felt saddened that things were different. I was aware of the loss we both knew. We now had sex as a chore. We made doctor appointments and invasive medical procedures routine, and we told our friends as little as possible. There were dark times. We kept telling one another that we are coming through this difficult time and that these sacrifices will make us closer, having survived the journey together. But secretly I worried that we would not survive it as a couple.
—Mark, 40, professor
Still, you might let an uninvited guest influence your decision to continue treatment even when you feel otherwise. Often this is guilt. This emotion is much easier to spot if someone else is giving in to it. Many people let guilt become a joint decision maker in their lives. You might not even know you’re doing this. Have you ever had a girlfriend who wanted to bolt from her own wedding but felt she was too invested in it? Maybe she walked down the aisle because she didn’t want to let her guests down? Or maybe you know a guy in the same situation who couldn’t bear the idea of disappointing his pastor, priest, or rabbi?
Getting infertility treatments can be the same as planning a lavish wedding. There are a lot of people anticipating everything will go as planned. The phrase “be fruitful and multiply” has never felt as weighty as it does when you’re trying to live up to others’ expectations. But like the friend who has serious reservations about going through with her own wedding, couples may feel like they’re walking down a gangplank when it comes to infertility.
The expensive appointments, medications, and treatments can be just as stressful as finding the ideal venue, booking the reception, and springing for a honeymoon in paradise with someone you’re not 100 percent sure about.
Like for a wedding, couples scrimp, save, borrow, and even gamble their life savings to have a baby. Just as brides and grooms announce their upcoming union to loved ones, couples going through fertility treatments often tell people they can count on. Many times family and friends pray or send positive thoughts to couples in both situations. If you’re lucky, you might get a few well-wishes, a smattering of prayers, and a couple of sentimental family members who wear pink or blue in the hope that it makes a difference. But let’s not forget about your doctor and his staff, who spend many, many hours treating you. With all this riding on the chance to hold a baby in your arms nine months later, who wouldn’t feel guilt over abandoning treatment?
If you’re unsure about how (or when) to end your treatment and feel angry, understand that this is a secondary emotion. What lies beneath your anger is a layer of sorrow. You’ll need to address your grief before moving forward. (Many experts believe that illnesses ranging from anxiety to cancer stem from the body’s inability to process stress.)
If you feel guilt or shame but have no idea how to end your treatment, pat yourself on the back for acknowledging your feelings. Believe it or not, you’re one step closer to ridding yourself of these crippling emotions. Then realize that guilt or shame will never get you anywhere. These emotions are counterproductive, and what you need right now is to be productive.
To get started, make a list of risks and benefits, and share this list with your partner and your doctor. If you have more risks than benefits, consider ending your treatment and discuss alternatives. Then set a timeline for discontinuing your treatment. This could be your next birthday, anniversary, or maybe even a holiday of your choosing. The idea is to help you visualize getting closer to your goal. If you need to modify your timeline and you’re feeling positive about your treatment, by all means do so.
If you’re still confused about ending your treatment, take a vacation from the whole process. Once you’re feeling like yourself again, then set a timeline. Jot down the steps you need to take to achieve your goal. Then write a Plan B next to your goal in case your timeline arrives before you both are ready to change courses. For instance, you might set a goal that you want to be pregnant within eight months. Eight months later you can stop what you’re doing and go to Plan B, or you can continue your current treatment.
Closing the door on fertility treatments doesn’t mean closing the door on parenting. As Yogi Berra once said, “When you come to a fork in the road, take it.” But which path?
Chances are if you stopped your treatment and you’re feeling worse than you did before, you’ll consider trying again. Having regret (or guilt) is like having an ulcer. In time it will eat away at you. But if you feel a sense of relief after ending your treatment, chances are you made the right choice. At this point you can feel comfortable considering other possibilities.
Whatever you do, you need to make this decision with your partner. If you’re in a situation where you want to continue treatment but your partner doesn’t, come to an agreement before proceeding. It takes large doses of fortitude and finances to continue pursuing treatment, so you both need to be on the same page. If you feel that you’ve had enough, tell your doctor. He may want to discuss parenting alternatives with you, including egg or sperm donation, surrogacy, and adoption (see chapter 9).
Walking away from the chance to conceive can seem like burying the child you never had. But once you allow yourself to move past your loss, you may find that adoption is the right fit. You don’t need a birth canal, potent sperm, or 23 chromosomes to be a parent. All it takes is a willingness to love a child with everything you have. Once you hear the words “Mama” or “Dada,” your heartache will melt.
Hope . . . When All Hope Was Gone
A good friend of ours knew a young woman who was having a baby, and she wasn’t sure if she could keep him. Mark and I didn’t get our hopes up…basically we had given up hope. But my girlfriend was persistent! She said, “Natalie, I don’t know why, but I know this is your baby.” It sent chills down my spine. Now we have a son, and life couldn’t get any better.
—Natalie, 38, real estate investor and stay-at-home mom
Just because adoption isn’t your first choice doesn’t make it any less rewarding than biological parenting. Many couples choose adoption over natural childbirth even when infertility isn’t an issue. But with adoption come issues that you’ll need to find creative ways to deal with. For instance, nearly every child of adoption experiences some form of separation loss. This loss is usually a wound of abandonment. Contrary to popular belief, the fact that you chose that child doesn’t compensate for it.
Even though you may be able to name a number of reasons why your child’s life is better, like she’s no longer living in poverty, subjected to an alcoholic parent, or in close proximity to drug dealers, this is all logical, cognitive information. None of this information, no matter how spectacular, will change her psychological scar. The fact remains that one or both biological parents gave her away (or did something to cause an authority to take her away). This is something that no amount of love can erase. Sharing the story about how she came into your life with her is a great way to let her know that it’s okay to talk to you about her feelings of loss. As she gets older, you’ll want to add details about her genetic background and medical history. This is assuming you talk openly about your decision to adopt (see chapter 15).
Many couples face serious doubts about whether they should pursue adoption. It’s not uncommon to ask questions like
• Can we love our adopted child the same as our own?
• Will telling our child about his or her conception change the way he or she feels about us?
• Will our child leave us for his or her birth mother?
• What if our child has adjustment issues?
• Will our families accept our child? Will they love him or her like our own?
• What will our friends say? Will they support our decision?
• What if we change our minds?
Once you decide to adopt, you may find that you replace questions like this with an entirely new set. Now your concerns center on proactive issues like interviewing agencies, choosing a reputable agency, completing the application (and securing solid references), and preparing for interviews (individual and joint). Other concerns that you’ll address before you proceed include the following:
• What age child do we want?
• Do we prefer one gender over the other?
• Will we legally change our child’s name?
• Do we want a child who resembles us?
• Do we want an open or closed adoption?
• Are there any particular traits we want like musical talent, high IQ, or athletic ability?
• How much will this adoption cost? Where will we find the money?
When the agency you select accepts your application, a social worker will arrange an interview with you at the agency’s office and at your home. They may conduct a background check on you and contact a number of your references, including family, colleagues, and friends. Once the agency has identified you as a candidate for adoption, your social worker will work with you to meet your requirements. Matching parent to child is just as important for you as it is for the child. Your social worker will do everything possible to make sure the placement is a good fit. She’ll try to match all the preferences you indicated, including age, gender and traits.
These days, all adoptions are considered open, which allows you to have contact with the birth mother. This means that you can stay in contact with the birth family every month or limit it to landmark occasions like birthdays and holidays. With open adoptions contact depends on what you arrange in advance with the birth mother (see chapter 9).
Closed adoptions are no longer in use but are exactly what they say they are. Both parties have complete anonymity. There is no contact between the adopting family and the birth family at any time for any reason. Usually in cases like this you may know about your child’s genetic and medical background and their traits, but you don’t know the birth mother or have any way of contacting her.
Adoption is right for people in many situations. But if you have persistent doubts that you might be making the wrong choice, listen to your instincts. Adopting a child means taking on the same lifetime commitments (emotional, psychological, and financial) that biological parents face when they conceive. To make sure adoption is the right choice for you and your family, ask yourself the following questions.
• Do you feel that you’re under tremendous stress to adopt?
• Are you following suggestions of friends and family, who are tired of hearing you talk about wanting a baby?
• Are you in denial, or do you still feel profound disappointment about your infertility?
• Do you have ongoing daydreams about how life would be different with a child of your own?
• Are your family and friends disappointed that you’re not having a baby?
• Do you have strong feelings of guilt and shame that you can’t have a baby on your own?
• Do you want to keep your adoption a secret?
If you answered yes to any of these questions, adoption is not the right decision for you at this time. Give yourself more time to heal before committing to anything.
If you’re not ready to adopt but you’re interested in trying parenthood, foster parenting may be the right choice for you. Becoming a foster parent means you need to be willing to provide a nurturing environment for many children over time. Most can return to their birth families eventually and need only temporary placement with you. What this also means is that you’ll have dual responsibilities: (1) providing a safe and loving environment for children placed in your home and (2) working as part of goal-oriented team with the agency social worker and birth family to reunite the family. If for some reason the family is unable to reunite, you may have the opportunity to adopt the child placed in your home.
BENEFITS OF BECOMING A FOSTER PARENT
• knowing that you helped keep a child safe
• providing a loving and nurturing environment to a child in need
• helping a child have a brighter future
• teaching a child to be a “giver” and not a “taker”
• helping reunite a troubled family by opening your home and your heart
• rewarding positive behavior and actions
• imparting your skills and wisdom on a young mind
• coaching a child to have respect for others and the environment
• realizing that you made a difference
• enriching a life that could have become stagnant
• showing your child how to communicate effectively
• instructing your child on how to resolve conflicts in a nonthreatening way
What if you’re concerned about forming a significant attachment to your foster child only to give him up when his birth family reconciles? Maybe you’re afraid that giving up a child like this would bring back the heartache of infertility all over again. If you see this as a deterrent, then you may want to check into fost-adopt programs. Here are the key considerations regarding fost-adopt programs:
• As a foster parent, your key responsibility is to act as a parent or guardian for a child in place of the child’s natural parents without an obligation to legally adopt (though many do once a court terminates the child’s natural parents’ parental rights).
• Placement begins before the child’s biological parents’ parental rights have terminated.
• Efforts at reconciling the family may continue, or biological parents may be in the process of appealing an earlier court decision terminating their parental rights.
• Children in these programs are less likely to return to their biological parents.
• Participants must undergo special fost-adopt training.
These are programs designed to bridge the gap between a child’s temporary need for care and long-term need for a permanent home. One reason this option is so popular is because a vast number of placements in fost-adopt families are young children or infants. To learn more about fost-adopt programs in your state, contact your state adoption specialist or state foster care manager.
RISKS OF BECOMING A FOSTER PARENT
• coping with frustration and anger once you realize your lack of influence
• dealing with feelings of insecurity when your child fails to grasp concepts
• finding creative ways to diffuse anger directed at you
• managing situations in which your child might disrespect or disappoint you
• having your reputation compromised when your child is caught stealing or has other trouble with the law
• having personal belongings tampered with, stolen, or damaged by the child
• disapproving family or friends
• giving up a child whom you have a significant bond with
What does it take to be a foster parent? Besides being 21 years old or older, you must prove that you’re a responsible adult. Once you complete your application, a social worker will ask to speak with you about yourself and your reasons for wanting to be a foster parent. She’ll inquire about your experience with children, past residences, medical and psychological history, condition of your home, where your foster child will sleep, education level, job history, personal references, and much more. After a lengthy conversation she’ll determine whether a placement in your home makes sense for everyone involved.
If you’re single, you may wonder whether an agency will still consider you for placement. The answer is yes. Foster parents mirror the general public in that they’re single or married, own homes or rent, and work inside or outside their home. Don’t fret about qualifying with a certain income. Foster parents don’t have an income requirement. All you need to show is that you can provide for your family.
Don’t let the list of risks discourage you. The idea is not to convince you to give up but rather to give you some idea of what you’re getting into. Every parent has to deal with these risks at one time or another. Keep in mind that one of the greatest gifts you can give is to open your home and heart to a child in need. If you can give a child a chance at one day living a healthy, independent life, wouldn’t you want to?
If you’re unsure about any of these paths to parenting and are still grappling with your inability to have a child of your own, then child-free living might be for you. Before you can make this leap successfully, you’ll need to reconcile feelings you have about losing your dream of becoming a parent.
Making peace with your infertility means saying good-bye to your dream of having a biological child. Doing so will require you to grieve the child you expected but never got. This process could take weeks, months, or even years, depending on how you go about it. Many people find that once they put an end to the stress and uncertainty that comes with infertility, they’re relieved. This feeling can infuse new vitality into your life.
Imagine never worrying again about tests results, about whether a treatment worked or whether a new treatment will be available in time to help you get pregnant. Ending daily uncertainty might help you reach new heights in your own life. Many people rediscover long-hidden talents like painting or playing the piano. Doors may open to you that once seemed airtight. Realizing that you no longer have to concern yourself with what could have been an 18-plus emotional and financial commitment may leave you feeling giddy. This sensation may leave you with more energy than you ever had before. You no longer have to worry about shots, appointments, and procedures. You can shift your energy to career, investments, travel, recreation, hobbies, and living happily single or as a couple.
But don’t get confused about this lifestyle. Living child-free doesn’t mean a life without children. You don’t have to be a parent to enjoy the rewards that children bring. Here are several activities that allow you to connect with kids (and the kid inside you).
• Take your niece or nephew to the park, lunch, movies, and so forth.
• Babysit for friends or neighbors.
• Buy toys, clothes, and food for kids in shelters.
• Volunteer with Big Brothers and Big Sisters.
• Coach t-ball, soccer, or little league for tots.
• Volunteer in a hospital nursery or pediatric ward.
• Sponsor a kid in need.
• Volunteer at a children’s art or recreation class.
• Teach infants or toddlers early play and socialization skills through Gymboree.
• Help a kid achieve his/her dream by donating a scholarship.
• Volunteer with Girl Scouts or Boy Scouts, Indian Princesses or Indian Guides.
• Teach inner-city kids skills to get them off the streets.
• Volunteer at a YMCA children’s program.
• Teach a children’s religious study class.
• Become a licensed counselor and help institutionalized kids deal with their problems.
• Volunteer at a day care, preschool, or elementary school.
Whatever you decide, remember that the choice is yours. Living child-free gives you the freedom to do what your heart desires and stay as connected as you want to nieces, nephews, and children in your community. This choice also allows you to see children when you feel like it and leave them when you want to. Consider yourself more like an aunt or uncle. You can create a strong bond with children, delight in their wonder and discoveries, but have no obligation to discipline poor behaviors, wash soiled clothes, or help them with their homework.
No matter how much time you plan to spend around children, remember to enjoy every minute of it. Infertility, like any other major life stressor, can take a toll on you. The stress that comes with it often brings depression that outsiders rarely understand. Some people may view your decision to stay child-free as selfish, when it’s actually a medical condition that no one wishes upon themselves.
Numerous psychosocial studies have found that child-free couples are as content as those with children. Many of these couples volunteer or spend their days with children in helping roles like teachers, social workers, nannies, guidance counselors, coaches, child therapists, psychologists or pediatric coordinators, or nurses. Remember that many people have children for selfish reasons, like they want to pass on their family name, they want their kids to succeed in a sport they love, or they want someone to look after them when they’re old. Accepting your reproductive reality is anything but selfish.
Once you’re able to accept that you can’t have children of your own, make a list of goals that you want to achieve. Ask your partner to do the same, and plan a quiet time when you can sit down and share your ideas for the future. This will help you decide how to put your maternal and paternal energies to use. While you’re making plans to do liberating activities with, near, or outside of children, always make time to nurture yourself.
Keep in mind that if your desire to become a parent reappears, you should talk to your partner and enlist joint advice from a counselor. Only you know whether and when to pursue parenthood again is the right decision for you. To avoid future heartache, make sure everyone is on board before investing your heart and soul (and pocketbook) in various parenting options.
WHAT QUESTIONS SHOULD YOU ASK?
Important decisions need careful consideration. Besides becoming a foster parent, options like third-party reproduction, fost-adopt programs, or adoption are permanent. If you have any misgivings, make sure you’re completely committed before making a decision. Don’t fall prey to options you believe may please your partner, loved ones, or save your marriage. Decisions made under these circumstances reek of resentment and regret and almost never work.
Ask yourself the following questions. If you answer yes to most, then you may be ready to move on.
• Do you spend a lot of time thinking about ending your treatment?
• Do you feel a sense of relief after ending your treatment?
• Do you feel physically, emotionally, and financially drained?
• Is your treatment putting your health or your relationships at risk?
• Is being a parent more important to you than having your own biological child?
• Have you grieved the fact that you may not be able to have a child of your own?
• Have you and your partner seen a therapist to discuss parenting alternatives?
• Do your family and friends support your decision?
• Is guilt a factor in your decision making?
• Saying good-bye to treatment is hard on a number of levels. The key for you is to do everything within reason.
• Getting fertility treatments can be the same as planning a lavish wedding. Don’t let guilt of disappointing others influence your decision to continue treatment when your gut tells you to stop.
• Understand that anger is a secondary emotion. You’ll need to grieve before moving forward.
• Talk to friends, colleagues, or neighbors who have contemplated parenting alternatives, or ask your doctor to recommend a reproductive counselor.
• If you’re still confused about ending your treatment, take a vacation from it. Once you’re feeling like yourself again, devise a game plan.
• Make a plan with pen and paper, show it to your partner, then write the steps needed to reach your plan. Make a plan B.
• If you’re unsure about pursuing other parenting options, you might consider volunteering with children. You don’t have to be a parent to enjoy the rewards children bring.
• It’s okay to reconsider pursuing a parenting option. To avoid heartache, make sure everyone is on board before investing your heart and soul (and pocketbook) into various parenting alternatives.