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You have started fertility treatment with great hopes. You hope to conceive on the first attempt of whatever type of treatment you begin. Unfortunately, that is not always the case. Fertility treatment can become an obsession that can challenge your health and emotional well-being. Knowing your limits can help you to feel more in control of your treatment options and schedule. Yes, there are choices to make along the way, even if they feel like forced choices. Here are 8 suggestions for when you choose to continue or to stop infertility treatment.

1) Make some decisions up front—It is important to know what you and your partner can and cannot do about treatment options. Some of this will be determined by finances. It is unwise to pursue treatment to the point of bankrupting yourself and your future. A baby at any cost can be harmful to you in the long run. Negotiate what makes sense to you and your partner. It is common that one partner is willing to pursue many options but the other partner is less comfortable. Sometimes treatment options bring moral or religious concerns. Discuss such concerns with your partner and your clergy, if necessary, to know how far you wish to pursue treatment. There is a caveat to early decision-making: the finish line often moves. For example, inseminations do not work and you find yourself open to using IVF or donors eggs. Start over and renegotiate with your partner.

2) Set a timeline for family building—Trying to have your first child or adding to your family can take years. Know how long you wish to pursue a parenting plan and by which means (i.e., inseminations, IVF, donor eggs or sperm, surrogacy, adoption). I hear often from my clients that they will continue with treatment until their birthday, a chosen date, or an anniversary of their first treatment attempt. Age can be an important issue when pursuing fertility treatment or adoption. I often hear “I don’t want to get my Social Security card when my child graduates from high school.” Know that time is passing in life for all of us. Put some time limits around your efforts.

3) Measure your level of hope—Having some level of hope is huge in making decisions about fertility treatment. You still have gas in the can. You feel resilient. You and your partner have enough energy for another try or for trying something different to build your family. You are both on the same page. If you can muster the finances to keep going—without wrecking your financial life, your sense of yourself, or your relationship—keep going. If hope is waning or out of gas, consider other options or stopping.

4) Accurately assess your chance of success—If your doctor is willing to keep going and there is a reasonable chance of bringing home a baby, keep going. However, if you have done many, many cycles of treatment and hormone levels show poor prognosis, we must take that into account. Hope is good. Denial is not.

5) Are you giving it your best shot—You don’t want to have regrets. In fact, avoiding regret is one of the strongest factors in undergoing treatment. Often people have a strong need to have the chance to try some sort of fertility treatment, even if test results aren’t too good. What’s interesting is what the range of “trying” means. For some, this may mean three cycles of timed intercourse with Clomid. For others, this may mean going from inseminations, to multiple IVF cycles, to donor eggs, or adoption. You have to balance the need to try with the need to be realistic. You have to be real about what can you afford. You have to be real about the effect of “trying” on your mood and your relationship. Is this just a bump in the road or one too many potholes that you can’t recover from? Give it your best shot, whatever you choose to do.

6) Are you feeling worn out by medication and injections—Hormones are difficult for many women. You may have gained weight or feel uncomfortable lumps on your rump from intramuscular injections. Your mood may have gone to new and uncomfortable places while on these medications. It is fine to tell your doctor that you no longer want a particular medication. It is also just fine to say that you don’t want any more medications at all.

7) Have you have lost the reason that you are trying to building a family—You may feel that you have to keep going because you started and the project is not complete. Many people continue treatment for fear of disappointing their families or their partner. With secondary infertility, people will continue beyond a breaking point because of guilt that there will not be a sibling for the living child. Staying with it because of fear of disappointing others, guilt, or shame are not reasons to continue fertility treatment. Losing yourself is a problem in and of itself.

8) If you are feeling traumatized and running out of energy—You are really, really tired. Of EVERYTHING. You feel defeated. Your spirit is deflated. If you cannot stand driving near the fertility clinic, cannot take one more injection, you feel beat up, or that you have lost yourself and the life you used to know, these may be signs that you feel traumatized and are running out of energy to continue with your family building efforts. Consider how many more disappointments you can take. If you have had one or more miscarriages, hope for a good outcome can wane. Determine how much hope you still have. It is a-okay just to say “I’m done.” You may notice a lot of unexpected relief. The idea of never going back to the clinic may have great appeal. Your partner’s got no more gas in the can. This is a time to pack up and find peace over time.

Pay attention and trust your intuition about when to continue and when to stop infertility treatment.

Sometimes the answer comes to you in an unexpected way. A client told me a story about the day that she unexpectedly ended her fertility treatment efforts. She stepped up to the receptionist desk and spoke warmly with the receptionist whom she had known for several years. When the very large chart was placed on the desk, it made a “whummp” sound. That sound was symbolic of years of trying and “That was it,“ said my client. “I was done and I was relieved to know that I was done.”

There are choices to be made. You can make them. Perspective matters. You can be reactionary and say, “Dammit, I want to stop right now!” You can. And then what? If you stop, what does that look and feel like? Grief? Bitterness? Relief? Acceptance? Do what you can to say that you fought the good fight and that you have done everything you could to get what you want and need. Then give yourself time to find closure. Closure takes however long it takes. There is no set amount of time to heal. Finding acceptance and peace is a choice. You will know when you are there. And truly, you will be okay at some point. I promise.

How did you decide to continue or stop infertility treatment?