The right attitude to infertility treatment can make a different between success and failure. Here are some common mistakes made by infertile couples and how to avoid them.
Mrs. Radhika Desai was my last appointment of the day, and she had a thick medical file which described all the medical tests and treatments she had been through. She had consulted doctors in 3 continents, and was now seeking another medical opinion for her problem of unexplained infertility. She had had over 4 laparoscopies, performed by various doctors in different parts of the world - and had had been through 6 insemination treatment cycles. She now wanted me to do another insemination for her. When I advised her that it was time to consider IVF, she got upset. " Why do I need IVF when all my test results are normal, doctor? Can't we just do another IUI cycle please? "
This is typical of many patients I see. They change multiple doctors -but each new doctor ends up doing exactly the same thing the previous doctor did. When I ask why they give permission for their third laparoscopy, the typical answer is " My new doctor did not trust the previous doctor's reports and needed to see for himself. " Hope springs eternal in the human breast - but patients get so fed up and frustrated going through the same cycle month after month that by the time they come to my clinic, they are ready to give up.
As an infertility specialist, I find the saddest stories are those of patients who failed to get pregnant because they did not get the right medical care. Being infertile is bad enough - but having a problem which is not treated correctly is even worse. Instead of wasting her time and money on repeated laparoscopies and IUI, it would have been much more cost effective for her to have moved on to IVF.
What can you do make sure you don't get suboptimal care? Here are the common mistakes I have seen infertile patients often make, and you need to learn to guard against these.
Since infertility is never an urgent problem, many couples keep on putting off seeking medical attention. There is always something more pressing, and who likes going to a doctor anyway? Many will refuse to go, because they'd rather not acknowledge there may be a fertility problem.
This is a common mind block, especially amongst men. Many of them believe that treatment is "unnatural" or artificial, and they would rather have a baby who was conceived in the bedroom. It's better to be aware of all your options up front, and to explore these systematically, rather than try a hit and miss approach.
Infertility is likely to be one of the first major life crisis you will encounter, when you have to confront your biological frailty. More over, it's a problem which will not go away by throwing money at it, since the technology is still not perfect. How well you cope with this adversity will depend to a large extent on your "adversity quotient" - and you need to develop coping skills. Joining a support group can be a very valuable source of emotional strength.
The most important tool in your armamentarium is information. Knowledge is power - and this is especially true for infertility treatment which is potentially open ended, expensive and has an uncertain outcome. Don't minimize the problem or take an ostrich in the sand attitude and hope that it will go away. If you are well-informed, you will be able to make your own decision for yourself, to suit your own lifeplan and personality. There are no right answers in this field - only what's right for you Trust your own heart.
While it's an excellent idea to trust your doctor, this should not be blind faith. It's always worthwhile to get a second opinion from an infertility specialist, to make sure you are on the right track. It's even better to get an opinion from a specialist who is not going to be treating you - this is much more likely to free of bias.
Patients who have unrealistic expectations from their treatment go through highs and lows which they find difficult to cope with. You need to have a plan of action, in which you hope for the best, but prepare for the worst. Don't think of any treatment on a single cycle basis - you have to learn to accept that nature is not very efficient at making babies!
Some patients want to try every new wrinkle every time they read a report in the newspaper. Remember that newspaper reports are deceptive and often give a one-sided view which emphasises the successes - it's hard to trust media hype. Don't act as a guinea pig - let the technology mature. If it's really good, it will be even better in another 2 years. Many fads come and go, and not all of them are truly helpful for patients ( though they often help some doctors rake in quick bucks because it's the latest thing to be doing!)
As a rule of thumb, if a treatment has not worked in 4 cycles, you have reached the point of diminishing returns, and the treatment is now likely to be right for you. It's possible that the next stage of treatment may be more expensive, but just because the right treatment is expensive is no reason to do the wrong treatment just because it is cheap!
Do these mistakes sound familiar? Have you made one of them? Don't kick yourself - put it down to a learning experience ( you are now wiser!) and move on! Everyone is allowed to make one mistake once - don't repeat it twice!
"Of all sad words of tongue or pen, The saddest are these: 'It might have been!'" While the final outcome of treatment is always unpredictable , you should have peace of mind that you did your best. Take the path of least regret.
Dr Aniruddha Malpani, MD
I first wrote this for the ezine published by Conceiving Concepts. Check out their website at www.conceivingconcepts.com if you'd like to subscribe to it - it's packed with useful information!