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You may be starting fertility treatment with great hopes. You hope to conceive on the first attempt of whatever type of treatment you started. Unfortunately, that is not always the case. Or you may be well into a relationship with your doctors, nurses, and clinic. Fertility treatment can become an obsession that can challenge your health, emotional well-being, energy, relationships, and finances.  Deciding your fertility treatment options and limits can help you to feel more in control of your treatment options, your schedule, and your life. Here are some suggestions for deciding when to proceed with treatment and when to step away.

Make some decisions up front
It is important to know what you and your partner can or will not do about particular treatment options.  Negotiate what makes sense to you and your partner.  Some people will stop after one round of inseminations and some will stop after ten IVF cycles. It is common that one partner is willing to pursue many options but the other partner is less comfortable. Express every fear and thought you have out loud.  It is the unspoken stuff that gets you in trouble later.

Some of your choices will be determined by finances.  Will you go as far as IVF (in-vitro fertilization)? Will you consider donor eggs, donor sperm, or donor embryos?  It is unwise to pursue treatment to the point of bankrupting yourself and your future, or harming your health.  A baby at any cost will be harmful to you and your relationship in the long run. Sometimes fertility treatment options bring moral or religious concerns. Discuss your concerns with your partner and a religious leader, if necessary, to know how far you wish to pursue treatment.  There is a caveat to early decision-making:  often the finish line moves.  For example, IVF does not work and you find yourself open to using donor eggs. Restart your negotiations with your partner.  You don’t need to know exactly where your line is right now.  It will come to you in some way, maybe in a way that surprises you.

Set a timeline for family building
Trying to have a child or adding to your family can take months or years. Know how long you wish to pursue family building and by which means (i.e., medication with timed intercourse, inseminations, IVF, donor eggs or sperm, surrogacy, or adoption).  I hear often from my clients that they will continue with treatment until their birthday, the New Year or another 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 for all of us. Put some time limits around your efforts.

Feeling traumatized and running out of energy
It is not unusual that one of my beautiful clients will say something like, ““I miss my happiness” or “I’ve lost who I am.”  If you are tired of your life being on hold, cannot stand driving near the fertility clinic, cannot take one more injection, you feel beat up, or feel 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. Get some therapy for yourself and your partner.  It is also 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.

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. Clomid is notorious for making women feel jacked up in perpetual PMS.  It is also just fine to say out loud that you don’t want any more medications at all.

Trust your intuition
It is very important to pay attention to your intuition about continuing or ending your family building efforts. You may not trust your body but you can trust your intuition.  If you can keep going and shift to more of the same or different treatment, I support you wholeheartedly.  If that is not the case, though, listen to what it is going on inside.  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 loud “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.”  You do not need to stay with more and more treatment because you fear disappointing your partner or your families. But please think it through.  Don’t be reactionary with a “Dammit, I want to stop right now.”  You can.  And then what?

People continue fertility treatment long beyond their breaking point because they want to avoid regrets.   If you have done everything that you can do, let yourself find some peace.  Know that you have fought the good fight and you have done everything that you could do to get what you want and need.  Perspective matters.  If you stop, what does that look and feel like?  Grief, relief, acceptance, and reevaluation of life without children can be okay. Think and feel your way to the right decisions for you.