Mia never imagined she would go through in vitro fertilization (IVF). She used to think, “We’ll try for six months, and then if it doesn’t work, we’ll stop. I don’t want to have my first baby after I’m 35,” she said. But now, at 39, she and her husband, Chris, have undergone countless IVF cycles, facing the challenges of infertility for three long years.
What started as a brief attempt to conceive turned into an extended and emotional journey. Initially, Mia was reluctant to pursue IVF, but after one failed attempt, her medical team suggested modifying her medication protocol, making her hesitant but willing to try again. IVF patients often find themselves in uncharted territory, with no clear timeline or guarantee of success. For Mia and Chris, the possibility of success with each cycle kept their hopes alive. “Take it one day at a time,” Chris said. “Maybe this first thing will work. OK, maybe the next one will work!”
Mia and Chris’s experience reflects the reality of many IVF patients. They initially thought they’d only undergo one cycle, but the process quickly expanded as the failures mounted. For those pursuing IVF, the question isn’t necessarily whether they’ll stop, but how long they’re willing to keep trying. Despite the challenges, patients often find it difficult to know when to stop, as doctors rarely suggest discontinuing treatment.
Hakan Cakmak, a reproductive endocrinologist at UCSF Center for Reproductive Health, published a paper in 2022 discussing the challenging question of when to stop IVF treatment, especially for “poor responders.” For women over 45, success rates with their own eggs are close to zero. But for many others, the decision is far from clear. The question of when to stop IVF is one of the most difficult decisions in fertility care.
Fertility treatments are costly and often emotionally draining. Even though insurance coverage for IVF is expanding, many still face significant out-of-pocket expenses. Despite advancements in success rates over the years, such as the increase in live birth rates for women under 35, the chances of success are still far from certain. For Mia and Chris, like many couples in similar situations, the question remains: How far are they willing to go for the possibility of having biological children, and at what point do they draw the line? The emotional and financial toll of IVF can be overwhelming, but for some, the hope of parenthood keeps them moving forward, one step at a time.
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