news item: is it *ever* okay to tell a friend to stop trying?

This week’s article was submitted by PAIL blogger Chon at Life After Infertility.

In my world, IVF is the final frontier– that elusive “two cycles away” that I never got to because injectables and IUI got me pregnant on the first try after a few unsuccessful rounds with Clomid and IUI (among other things). I hold IVFers in a level of awe and esteem because they have been through something that I have only seen a piece of– the rigors of a very heavily medicated cycle, with all their bodies’ attempts at reproductive success halted and replaced by an entirely artificially created series of events. I have read about IVF and am dumbfounded by just how much it all is. Maybe it is just because I have my own medical intervention story to tell, but I think that having a piece of the puzzle (but not the whole puzzle) brings into sharp relief for me just how intense and heart-rending (not to mention physically strenuous) one single IVF cycle is. You IVF ladies are warriors.

So it, erm, raises the hairs on the back of my neck to read this article from Australian eZine Mama Mia entitled “IVF: How Much Is Too Much?“, subheading “When is it okay to tell a friend to stop?” This article itself references another article, written by a woman who watched her friend “Louisa” go through 9 unsuccessful rounds of IVF at age 46. From that article:

If Louisa were your friend, what would you say to her?

Would you back her to the hilt? Would you encourage her to try and try and try again; to keep fighting for what she wants so badly? Or do you break the news to this person who you love, that the pain she is putting herself through is no longer worth the ever-dwindling chance of success?

I understand caring for a friend’s well-being– any good friend would do the same. Infertility and ART have the potential to break even the strongest woman down, and it is very difficult to watch a beloved friend go through any sort of hard time. But a few nuances to the story of thinking in this article stand out to me:

1) ART is given a bit of a “you inflicted this on yourself” status. The article doesn’t speak to whether or not infertility is horribly unjust– certainly, I do not doubt the author would agree that it is– and it puts the onus on the infertile friend with the presumption that it would likely be best if she stop subjecting herself to repeated treatments. The issue is less “Is it true that your friend should stop?” and more “Should you tell your friend to stop or not?” This is especially evident in the discussion question provided at the end of the article: “At what point is it okay for you to stop being the supportive friend and start being the realistic one?”

The flip side of this is a friend telling someone who stopped after “just” one or two rounds of IVF, “Try again! You didn’t try enough times yet!”

2) There are some invisible people haunting this article like ghosts. Where are the partners? Not every woman who uses ART has a partner, but a majority do, both male and female. This article quietly omits those essential co-parents and their support and input.

3) Need I say it? We really do not need your input, well-intentioned friends and family. Unless you have been through it, you do not have a leg to stand on, and even if you do, it is not your decision. Offer support and someone to talk to, but that is all. This article talks around IFers– leaving us out of the conversation to ask our friends and family how they think we should be handled.

So tell us what you think here in the comments, or hash it out in your blog and leave us a link…

*****

How would you feel about a friend’s input on your ART attempts? Does it matter who the friend is or whether they have been through ART themselves?

Are there times when you think a friend or family member should intervene?

Has anyone ever told you “enough is enough”?

 *****

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Comments

  1. I am going to resist reading any of those, because I’m sure I’d just end up furious. I would back my friends, as long as they had hope, I’d be there for them.

    I have exactly one real life friend who reads my blog. But mostly, I blog so I don’t have to talk about it. My blog is my support, and right now, it’s enough for me. I have enough sense of belonging in the ALI community, and I’m really glad of that, since I don’t have a ton of physical interaction with other people. So I don’t get much input in real life, and that’s the way I like it.

    I do think that there is a point where intervention may be necessary, but only very rarely. And I probably only think that because I’ve had times, before IF, where I desperately needed outside intervention because of my depression. I don’t mean telling someone to just stop altogether, more a gentle nudge when someone is consumed by IF to the exclusion of everything else. That people still care about all of you, even when it seems like IF is all there is to you.

    I haven’t been told enough is enough, at least not by anyone who counts. It does sting from casual acquaintances or friends of friends, but it’s not the same as from someone who knows me and cares.

    • Julie Anita says:

      I definitely use my blog to sometimes say something I don’t feel like talking about. Not often, but I’ve put it in as a disclaimer before– “if I know you in person and you’re reading this, please don’t mention it to me later when I see you, and please don’t call me to talk about it because I don’t want to. Leave a comment and I’ll know you read it, if you want, but that’s all.” I have a lot of IRLs who read, so sometimes it’s a mixed blessing– there are things I won’t write about because I don’t want to share it with everyone I know, you know?

      I can understand the theory of what you call the “point where intervention might be necessary;” I just wonder if I could ever find the person who I think would have the right to say anything. Maybe my cousin who’s like a sister to me, maybe just my husband… probably no one else. I don’t know. That’s part of the problem– sure, there is probably a time for some women and couples when continuing to try becomes so disabling and emotionally devastating, for whatever reasons, that people decide it’s in their best interest to stop, but when could you trust that someone else would ever know you well enough to recognize that happening *before you do* and tell you? I bet few people have such relationships.

      • I don’t think it’s that they necessarily notice before you do. When I was so depressed I wasn’t going to work or eating or answering the phone, I knew I needed outside help, but I didn’t have the will to spare to ask for it. That’s when I needed someone to not just ask if they could do anything, but actually tell me ‘this is what we’re going to do until you can make decisions for yourself again.’ Yeah, right now, with infertility, I have my husband to do that, but what if we go another six years with no good news?

        And even if you know that’s what you need, that doesn’t mean you’d welcome it at the time. I think my real issue with the question is the word ‘ever.’ It’s hard for me to answer no, because ALL possibilities and scenarios are included in that ‘ever,’ including the many that none of us would think of. There’s going to be an exception to the rule in such a broad collection of experience.

  2. No. Not ever. And chances are that LONG before you seriously consider being “such a good person” as to do the “tough love” BS of dashing someone’s hopes and dreams and taking a dump on them…. chances are if you’re considering saying anything like that to a friend… they already know that you are not their real friend. You’ve probably already hinted around it, said horribly insensitive things, rolled your eyes at heart felt pain, and basically told us already without having to say it. Anyone who is wondering if they should say it out loud IS ALREADY someone that we know we can’t rely on, someone we can’t trust with our hearts, someone we avoid when our pain is too great. If they want to put another nail in that coffin and get direct about their disapproval, then I think I’d get direct about the fact that they are not really my friend anyway… I think what I’d say would start with “F” and end with “you.”

    • Julie Anita says:

      That’s a really good point. Like how long before my mother told me I should move my girls out of our bed into their cribs she’d ask how long we were planning to have them in our bed, and I’d say “Until we’re all ready to move them out” and she’d have “that look” on her face. Hmph.

  3. When I read this on the internet the first time the thing that really struck me was that the friend was of the same age (both women were in the mid 40’s) and she was child free by choice not by circumstance. Therefore she clearly didn’t have that same desire to have children as her friend did. This was clearly summed up where she says

    “But I have a deeply felt opinion that children are not a given in life – they are a gift. And that sadly, despite how much a child is desired, it is simply not every woman’s lot or luck in life to reproduce.”

    See this is where I differ. I believe that we all have the right to be parents. Why do people who have no right at all (you know the crack ho’s I am talking about) pop them out like no tomorrow and then good people struggle. And parenting can come in different forms. You can adopt, you can use a surrogate, you can parent or you can use ART and have the opportunity to have one for yourself.

    Her friend was in her mid 40’s and had gone through 9 IVF’s in one year. I can tell you that is a lot – especially if they are full cycles. The most full cycles I did in one year was two and that was spaced out between Feb and Sept there was also a FET thrown in that resulted in a m/c – last year was not a good year. However I am 34 (well 33 last year) so if someone had told me it was time to stop when I am still biologically capable of reproducing then I would have probably told them to take a long walk of a short pier. But if I was in my mid 40’s still determined to use my own eggs would my thought process be different? It would be interesting to hear from older IVF’s warriors (and Julie – damn straight we are warriors!) what they think.

    I know, that for me, I was never going to stop until I got pregnant. I knew that if my last IVF failed then I needed a break to regroup mentally and physically but I would not be able to stop. However, I had started investigating adoption and had been booked in to a session to start the process so come hell or high water I was going to be a mum. But I wanted this feeling I have now, I wanted to feel life inside of me and that was my destiny – regardless of what others may think.

    In summary – should have written my own post – I don’t think anyone can ever tell you when it is time to stop it needs to be a decision between you and your partner when you feel like you have exhausted all other options. However a friend can and should be able to talk to you about anything. If they are genuinely concerned for your emotional well being – and I believe this writer was – then broaching a “maybe it is time to stop discussion” doesn’t make her a bad person. It should not end the friendship but perhaps it can open up the dialogue further and allow the IVF friend the opportunity to have her emotional well being monitored but a friend needs to be there regardless of whether they agree or disagree with your decision to keep trying because at the end of the day it is our choice, our bodies, our money and our life.

    • Julie Anita says:

      I didn’t even notice the women’s ages or the “child-free by choice” thing– thanks for pointing that out because it’s definitely a factor here.

      I was wide-eyed when I saw 9 IVF cycles in one year. That is pretty extreme, and I don’t mean that in a “she shouldn’t have made that choice” sort of way. I mean that IVF requires a whole lot of pieces to fall into place, and she would need 9 cycles to happen within that year with probably no m/cs (I know the article said she never actually got pregnant from the treatments) to even have the opportunity for that many cycles to FIT into a year. That’s a VERY strenuous physical, emotional and spiritual load to take on, so I can see why the author used it as her example here. I also think it’s misleading because most people who use IVF don’t come CLOSE to 9 cycles, so it’s like she’s saying “Do you have a friend who burned her finger once? Here’s how to handle people who have suffered burns, and I’ll use the example of my friend who was in a terrible house fire as an example– just imagine I’m talking about your friend and let my example apply to your life.” I’m not trying to set up anyone who’s been through IVF in any sort of “oppression olympics” because any IVF is “too much” IVF for your soul; it’s a lot to go through. I just think this piece of the article is meant to be intentionally sensationalized.

      I have to ask– you started looking into adoption and then you got pregnant? So how many people have said something to you akin to “once you started considering adoption, you stopped stressing about TTC and then it happened!” ?

      • We did but not seriously as in our state you have to have given up all ART treatment for a minimum six months and because we didn’t know what was going to happen we thought we should at least get on the registry. So I got

        • * pregnant through ivf but I was starting the process to cover my bases. It would have been much nicer to have the miracle pregnancy

  4. I was very fortunate to have a friend going through IVF at the same time as us. We would NEVER have told the other one to stop trying. NEVER. It really isn’t anyone’s business what lengths I’m willing to go to to have a baby, but people sure do make it their business.

    I had one friend ask me why I wasn’t stopping. I was complaining to her about the whole thing, that I thought that maybe we were the patients that the doctor would have to tell one day, “it should have worked for you, but it didn’t. We have no idea why.” I was telling her that I was so over it and just wanted to be done. She took me head-on, very agressively, and asked why I wasn’t stopping. She said that if I really felt this way, that I should just stop. This was all coming from a friend who had done IVF herself (not the one I mentioned in paragraph 1). The difference was that it worked the first time for her. 6 months TTC naturally, no clomid, no IUI – just one IVF and pregnant. Good for her, but she had NO idea how it felt to fail miserably at making a baby (1 year TTC naturally, 2 IUI’s, 1 fresh IVF, 1 FET – all before the second fresh IVF worked). Our friendship has never been the same. She made me cry that day when I was already down, and then told me that it was what I needed to hear.

    So no – it is NEVER OK to tell your friend to stop – unless they ASK you. If my friend would ask if I thought they should quit, I would be honest (I’ve never thought they should quit, but I worried it would never work. It did!). But only if she asked.

    • Julie Anita says:

      I’m sorry your friend was so insensitive 😦 I get very wary of comparing war stories in any sort of “measuring each other up” way (not saying you’re doing that here, just that I know I’d probably phrase it wrong and make it sound like I was if I tried going into detail on that topic!) but I definitely look at people who had less treatment than myself as my equals, and people who had more treatment than I did as people who endured a lot more. I found injections and IUI to be fairly invasive, even though it wasn’t physically painful like I was expecting most of the time, but I know what people who do IVF go through and I just always assume it’s harder than what I had to do… so if I was your friend, I’d have extended you that same courtesy. Better to assume the person took on more than to assume they took on less.

      I also hate the “tough love” approach most of the time. It CAN be what some people need to hear in some circumstances, but generally speaking, I think anyone who’s overly willing to lay it on you like that is probably not as focused on your emotional well-being as they say they are.

  5. I think this is a very interesting topic. We were never at a point in our treatment where our doctor wasn’t completely optimistic that we would have success eventually, and didn’t talk to enough people IRL for there to be someone to tell us to stop. But, I will admit, that in a year of attending a RESOLVE peer group, there were people that I thought should stop. And every once in awhile, the leader would try to guide them to that conclusion on their own. There was a woman who was over 45, had moved on to donor eggs and donor sperm (husband was over 50) and her lining wouldn’t build, It was so sad to sit there and listen to her. But mostly what I thought was I would hope that I would have moved on to the concept of adoption long before I ended in the same boat as her. And there was a young girl who had chromosome issues, and multiple miscarriages under her belt, both from natural cycles and two IVFs. In that situation, I felt like she was just getting bad medical advice about the potential success rate of continuing to try using her own eggs. But how do you tell her that? I do understand that a determined infertile woman cannot be reasoned with. I was one, and the one time my husband actually said out loud “wouldn’t it be ok if it was just us…?” I literally felt a vice grip around my chest and lost all ability to speak.

    Another thing I grapple with in the blog world sometimes, is seeing people following behind me on a similar path, and wishing they would make the decision to move onto IVF much sooner, rather than spend so much time on IUIs. We attempted 6 (one was cancelled) without so much as a chemical. But as soon as we did IVF/ICSI, we got a chemical, and finally a BFP. We had a second opinion before the third, and successful IVF who determined that sperm might have been more of an issue than was previously thought, and therefore concluded that the IUIs were essentially useless. That was a really frustrating discovery. We’d already arrived at IVF/ICSI so there was nothing to change at that point. I know I needed to do a few of IUIs to be able to move through the emotional process to arrive at IVF. But 2 move with injectables after the first didn’t work (after three clomid IUIs already failed) just turned out to be a waste of time. I see a few bloggers here and there with known sperm issues following down that path, and I just don’t know how to encourage them to move on from it, and just go for ICSI. Every so often, I’ve written about it on my own blog, in hopes that maybe they will read it. But I just can’t bring myself to say in a comment…”I’m afraid you are wasting your time!” (and money in many cases…a few IUIs adds up to one IVF that gives you much better odds).

    And, I have definitely encouraged bloggers who have only experienced one failed IVF not to give up yet given that it took three times to get it right for me, I definitely learned that IVF is diagnostic. I want them to know that unless their doctor is flat our guiding them in a different direction, it would be really great to give that doctor a chance to learn from that first cycle and try something new. It’s a fine line, because there is such a wealth of knowledge in this community, but every journey moves at it’s own rate, and people take their own time to process the emotions. It’s hard to come up with the right way to share that experience without offending. I’m not sure I would be comfortable encouraging people to keep trying if not for my own experience.

  6. Im Australian and I cringe every time I see Mia, she has said some extremely self centred, involved in her little world comments sometimes. Which is fine, in that everyone is entitled to their opinion but unfortunately her ‘opinion’ is asked quite a bit here – all I can say to her is your personal experience and the fact you are a Mum does not make you an expert on all things women/pregnancy/birth/parenting/IVF/loss etc.
    Having never gone through fertility treatment myself, I do know what it is to lose babies and the desperate need to carry a child to term and be a Mum. I would never tell a friend to stop trying. I would support her (and family) how ever I could, there is much you can do for someone with out saying straight out – you have to stop this!

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