IVF: When is it Time to Stop Treatment and Try Something Else
Growing your family through IVF can be an emotional, physical and financial investment. With each cycle there can be anxiety, stress and hope.. Unfortunately there can also sometimes be failure.
Women – and their partners – who face infertility are resilient, determined and strong. They put their bodies and emotional well-being through a tremendous amount in hopes of success.
But for those who are unable to achieve success through IVF, is there a time when it’s “right” to stop treatment?
Circle Surrogacy & Egg Donation and CCRM Fertility in Boston work closely with intended parents undergoing IVF as a means to build their family. Together, we answered some difficult questions women and couples face during IVF treatment:
I’ve experienced several rounds of IVF that didn’t result in a pregnancy. Why isn’t it working for us?
The IVF journey can be scary and complex, so it’s important to keep patients informed every step of the way. Typically, a fertility physician will review the results of a patient’s or couple’s prior IVF cycles to identify if there is a specific factor that may contribute to the cause of their unsuccessful cycles (such as the treatment protocol, quality of egg and/or sperm or embryos, receptivity of the uterus). If a factor(s) is/are identified, then the team may recommend additional treatment options with a different treatment protocol or donor egg, donor sperm, and/or gestational carrier, if medically indicated. Our care team will check in with the patient/couple to evaluate how they are coping emotionally and provide additional support and/or a referral to a therapist with expertise in fertility to assist in their support.
Is there a point medically when I shouldn’t try another IVF cycle? How do I know when to start thinking about alternative options to conceive?
This is a hard question to answer, as each patient and their treatment is unique. At CCRM, we partner with each individual patient to develop custom-tailored analyses and treatments to help ensure the best outcome possible and to advise on these situations. In general terms, when an additional IVF cycle will not provide a benefit compared to trying to conceive naturally, additional IVF cycles may not be recommended. However, the experience and success rates of a patient’s fertility clinic will influence medical advice in this circumstance.
The threshold limits for IVF differ for each patient; therefore, it’s difficult to recommend alternative options based on specific thresholds/limits for age, prior number of attempts, number of eggs, ovarian reserve testing, or embryos created. To generalize, if the chance of conceiving and delivering a live born child with IVF is less than 5%, the IVF physician will discuss whether IVF is still a feasible option to pursue.
How do you support women in their acceptance of not using their own eggs? Or carrying their own baby?
Learning you can’t use your own eggs, or carry your own baby, can be hard news to hear…and accept. If an egg donor or a gestational carrier (surrogate) is recommended, the team will first review how a patient and their partner are feeling about these options. Based upon preliminary discussions, patients will work with our therapists and third-party reproduction team to provide information about the process. We also review potential social issues that may arise with conceiving and raising a future child with donor egg IVF and/or with a gestational carrier. Throughout the process, CCRM physicians frequently check in with the patient and all other care team members (e.g. therapist, egg donor or gestational carrier agency) to ensure that there is optimal communication and support for the patient/couple.
Egg Donation and Surrogacy agencies such as Circle Surrogacy & Egg Donation also offer intended parents access to social workers, as well as parent support groups that allow them to connect with others in a similar situation.
Would you ever turn away a couple who wanted to do another round of IVF if you didn’t think they should? How do you approach that conversation?
At CCRM, we’re committed to the advancement of research and development to fight infertility—and to ultimately succeeding, even with the most complex cases. With elective treatments such as IVF, the respective risks and success rates need to be completely evaluated by the medical team. If the chance of success is less than the risks of the treatment, then an additional IVF may not be recommended. The preferred approach for this circumstance is to be honest about the very low chance of success while being sensitive and compassionate about a patient’s/couple’s frustration with prior unsuccessful treatments.
Is there any advice you tell women/couples who have gone through multiple failed IVF attempts?
We know that fertility issues—even as the 3rd largest global epidemic—aren’t often talked about. We want to shift the cultural narrative around fertility and family planning, because it is critical to understanding and overcoming infertility. Our advice for those who have gone through multiple failed IVF attempts is to be as open as possible about their emotions and to feel empowered to ask for support. We also recommend that patients consider a second opinion at another clinic if they are not experiencing the success that they anticipated.
Only you know what’s best for you as an intended parent if you are trying to grow your family. And while there are options beyond IVF – such as egg donation, surrogacy and adoption – you must be comfortable with pursuing another avenue to build your family. It might be an easy decision, or it might take some time to get there; or, in some cases, you might not get there at all. And just know that’s okay.
If you’re interested in learning more about CCRM, or in scheduling an appointment, please contact us here.
If you’d like to speak to someone at Circle Surrogacy & Egg Donation about your options after IVF, you can reach us here.
This post was originally published in 2019 and has been updated in 2023.