from
the book How to Have a Baby: Overcoming Infertility
by Dr. Aniruddha Malpani, MD and Dr. Anjali Malpani,
MD.
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Alternative Medicine: Exploring Your Treatment Options
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How
can you be sure you are making the right decisions about
your treatment ?
What
are the issues which will affect your final decision
?
What
tools can you use to make better decisions about your
options ?
How
can you prepare yourself ?
How
can you be sure you are making the right decisions about
your treatment ?
Discovering that you have a fertility
problem can be a difficult process. In addition to the
emotional stress you now find yourselves faced with
making endless decisions about treatment. The word "decide"
comes from a Latin root meaning "to cut away from."
Thus decision making, by its very nature, involves loss,
giving up one or more options while grasping another.
Not deciding maintains the illusion that you can have
it both ways - that there is no loss, no risk. Unfortunately,
most infertile couples have not learnt to make their
own decisions - and not making decisions is one sense
the worst possible decision of all! You cannot allow
your doctor to make treatment decisions for you either
- this can be disastrous as well.
Most likely, your original goal was to have your own
biological child. However, because of your fertility
problem, you may be forced to examine your deepest feelings
about family, children, and parenting. You could find
that you have to re-evaluate your initial plans in order
to get the family that you want.
As you work to identify your goals and
examine your options, you'll discover that essentially,
there are four choices as regards treatment. Depending
on the cause and treatability of your infertility, you
may need to choose one of the following options:
- To pursue having a biological child
with infertility evaluation and treatment
- To try to have a child biologically
related to only one parent, either through donor insemination
or egg donation
- To adopt a biologically unrelated
child
- To decide to remain childless
You may want to rate each of the four
options as "desirable," "acceptable," or "unacceptable"
at the beginning of your evaluation and periodically
re-evaluate these choices.
For some infertile couples, trying to
have a biological child and childlessness ( child-free
living ) are the only options. For , the switch from
having a biologically related child to adopting or having
a child biologically related to only one parent may
be easier than having no children at all.
Many couples lose track of the fact
that their main goal is to be parents, even if they
can't be biological parents. Therefore, they may pursue
infertility treatment for several years and find themselves
above the age limit to adopt an infant through an agency.
Furthermore, since a woman's fertility decreases after
the age of 35, this also decreases the chances of successful
treatment. You and your physician should try to take
these possible consequences into account when evaluating
and choosing your options.
If you are relatively young, there may
be a good chance that you will achieve pregnancy without
expensive procedures. Therefore you may not wish to
explore these as yet. If you are older and have less
chances of conceiving , a more aggressive approach might
be called for, since time is at a premium.
The decision making process is different
for each couple and depends on individual situations
and personalities. For example, some couples may opt
for expensive high-tech treatments, while others in
the same situation will wait to see if they can become
pregnant without treatment.
Once you've discussed your infertility with your physician,
you'll find that there are a number of treatments available.
These include:
- Medication that may be prescribed
for either partner to improve fertility
- Surgery to correct an impediment
- In vitro fertilization ( Fertilisation
Video ) (IVF) or gamete intrafallopian transfer
(GIFT) for patients who require assisted reproductive
technologies
- Donor insemination , if male infertility
is the problem
- Egg donation , if the woman cannot
produce eggs
- Embryo adoption
- Surrogate parenting , if the woman
has no uterus
- Adoption
Your doctor may be able to make recommendations about
treatment - but there are a number of questions that
you should always ask your physician so that you can
make the best decision. Unlike other medical questions,
infertility recommendations are not always clear. You
need to evaluate whether and how well each treatment
option will help you reach your goals. Then you'll have
to determine which options you will pursue. The following
questions may help you build a foundation of medical
information to assist you in your decision making process.
- How much will this treatment improve
our chances of pregnancy?
- How much risk is involved and what
kind of risk is it?
- How long will we have to undergo
this treatment in order to give it a reasonable chance
to work?
- Will undertaking this treatment eliminate
other options?
- How much will the treatment cost?
- Are there other options if this treatment
fails?
Your physician can help you determine
how much time, physical discomfort, risk, and money
will be required for a particular treatment option.
You will have to decide how much money you are willing
to spend, and how much emotional stress you can take.
You need to design your own fertility
treatment plan. Not only will this help you maintain
control over your life as you proceed with treatment,
it will also help to ensure you get good quality medical
care.
What
are the issues which will affect your final decision
?
Issues which affect your choice include:
Medical Factors:
- Diagnosis ( or lack of one)
- Quality and availability of medical care
- Success rate of treatment
- Level of technology required
Personal Factors:
- Age
- Time commitment needed for treatment
- Personal feelings - physical and emotional
- Partner's feelings
- Job and career
- Financial resources
- Ethical and religious concerns
- Family and friends
- Other obligations and commitments
- Willingness to change life-styleAggressive or
low-key approach to resolution
Each of us has a different personal
decision-making style. It is for you to choose which
one of the following best fits your own personal style
for making medical decisions:
- I prefer to make the final selection
of my treatment after seriously considering my doctor's
opinion.
- I prefer that my doctor make the
final decision with regard to which treatment should
be resorted to, after seriously considering my opinion.
- I prefer to make the final selection
about which treatment I will receive on my own.
- I prefer to leave all decisions regarding
my treatment to my doctor.
It is important to understand that there
are no right or wrong styles, and that your style may
change as you proceed through diagnosis and treatment.
It is imperative that you find a doctor who respects
and understands your personal decision-making style.
Just as there are no right or wrong
styles, remember that there are no right or wrong decisions
about your treatment, and as your options change with
time, you may also change your priorities. Counselling
may be helpful in setting your priorities - especially
if you and your partner disagree on the course of action.
As your options change with time, you may also change
your priorities . Try to be as realistic and open-minded
as possible. While the final outcome will always remain
unknown at the time of making decisions, if you take
the time and the trouble to make your own decisions,
at least you will have the satisfaction of knowing that
you tried your best!
In order to make infertility treatments
less stressful, you'll need to place time limits on
them. Doing this may help you define your goals more
clearly. Many couples are willing to accept only two
to three years of therapy, because continuing treatment
for long periods of time may cause excessive stress.
It is important that you do not lose
sight of your relationship with your spouse . Make sure
that each of you understands how the other feels about
each stage of treatment. Throughout treatment, both
of you may encounter times of ambivalence about having
children. This is a normal reaction, and you should
remember to have realistic expectations of one another.
If reasonable goals are maintained and
difficulties and limitations are kept in mind, stress
can be minimized. If this is not the case, then a break
from treatment, change in plans, or counseling for stress
and marital issues may be good idea.
What
tools can you use to make better decisions about your
options ?
Sometimes, recording information on
a worksheet can be helpful. Here is a sample worksheet
for making medical decisions about treatment:
| |
Option
1 |
Option
2 |
Option
3 |
Option
4 |
| Benefits
|
|
|
|
|
| Success |
|
|
|
|
| Risks |
|
|
|
|
| Costs |
|
|
|
|
| Time |
|
|
|
|
Decision (in the rank of choice)
You may want to take each of the options
your doctor has suggested, gather the information you
need, and go over the options in terms of :
- Time
- Physical and emotional risks
- Cost
- Chances of success, with and without
treatment
Also keep in mind how much money and
time is needed, what is available and how much you are
willing to invest. As you go through this decision-making
process, you will probably find that your answers change
with time.
If you do not conceive after pursuing
your initial plan of treatment for a set period of time,
you may need to re-evaluate your goals and options.
You may find that you want to discontinue medical intervention,
or you may want to seek a different kind of treatment.
Keep in mind that it is not at all unusual for partners
to have differing views and feelings about infertility
and its treatment . Open communication can help both
of you to make the best decision.
How
can you prepare yourself ?
An early step in the entire process is to try and prepare
yourself . Ask yourself if it is worth the risk of pursuing
treatment without a guarantee of success. Anticipating
difficult situations and emotions may help you deal
with them more easily.
Your doctor can provide you with information
and can refer you to further sources. You can take steps
to prepare yourself for what could be a long and frustrating
process. But you may also find that as you and your
partner work through the stages of infertility treatment,
your relationship grows stronger.
Your physician, support groups, other
couples who have made similar decisions, and counselors
can also provide support and guidance. Above all, remember
that with patience, a positive attitude, and the appropriate
treatment, most infertile couples can eventually become
parents.
Next page: How
to Find the Best Doctor
Previous page:
Alternative Medicine: Exploring Your Treatment Options
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|
