When is Enough Enough? Deciding When to Stop Treatment

When is Enough Enough? Deciding When to Stop Treatment is a workshop at the 21st Annual Conference that covers a consideration of the medical and emotional factors that help in deciding when to end infertility treatment and move on to other options. Here are some thoughts from the presenters on what to expect at their session.

Dr. Selwyn Oskowitz is a Reproductive Endocrinologist and one of the founders of Boston IVF.

The journey of infertility care is thwart with emotional pitfalls while always hoping you are the next menstrual cycle away form a success. The decision that this cycle is the last, is one of the toughest of choices. How much more emotional and financial capital do we have for this?

Merle Bombardieri has some powerful approaches and exercises that enable patients to move on while the medical findings can give credence to the importance of stopping. At the same time there always appears to be something new and alternative medically, that can be tried. Sometimes these simply confuse a healthy decision to stop. Friends, relatives and enticing advertising aggravate the problem by anecdotes of someone getting pregnant on “this and that.” There are no “new” things that will grant a quick success and most new research efforts, if ever successful, are often decades away from being effective.

It’s time to stop when our gametes and embryos are very poor, our responses to medications are low despite magical or massive doses and when uterine receptivity is overtly diseased such as with severe scarring.

This session will discuss many other tell-tale signs that may be begging patients to stop treatments and smell the roses.

Merle Bombardieri is a LICSW in private practice in Lexington, MA

I have found that my clients are better able to decide to stop treatment if they take the ten steps listed below. In the workshop that Dr. Selwyn Oskowitz and I will be giving on “When is Enough Enough?” at the RESOLVE conference, Dr Oskowitz provides a clear list of medical signs that you are approaching a time to stop treatment. His part of the talk will enable you have a useful talk to your medical team and to bring to a second opinion consult. My part of the workshop will guide you through the psychological steps of this decision. Handouts include checklists to assess your decision making and your progress in healing from the stress of infertility.

I would like to acknowledge and thank Diane Clapp, B.S, R.N., for many years RESOLVE’S medical information counselor, as the co-developer of the ten-step approach.

The Ten Steps

  1. Take Stock of your current situation. For instance, how optimistic are you that treatment will work? How many more cycles of treatment do you feel you have the energy for?
  2. Talk to your partner. Tell each other what you came up when you did step one on your own. Are you surprised by your own or your partner’s answer?
  3. Talk to your doctor. Ask for a special meeting to discuss the possibility of stopping and to talk about any treatments you haven’t tried yet.
  4. Get a second opinion.
  5. Set a deadline or time frame.
  6. Take a vacation from trying.
  7. Do your psychological homework
    • Finish grief work
    • Consider alternatives
    • Resolve couple disagreement
  8. Decide when to stop
  9. Decide if you will begin adoption before stopping, and if you do so, how to do that comfortably and responsibly.
  10. Make peace with the decision. Announce and explain it to family and friends.

To learn more about moving through these steps and making them work for you, please attend When is Enough Enough? Deciding When to Stop Treatment on November 8th at the 21st Annual Conference.

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