Dear Kris, I started this infertility “journey” with a clear plan (in my head). I thought if it didn’t work, I’d be able to move on knowing I tried. So far I’ve had two chemical pregnancies. I know that even these failed cycles give information so the next cycle can be adjusted to increase my odds. I really want a baby. How do I know when it’s time to stop trying? – Need to Know.

Dear Need to Know,

You went into your infertility journey with what felt like a clear picture of your goal, and when you knew you would have done your best.  That was a very rational approach.   And then you had those two chemical pregnancies that gave you hope.

Questions, questions, questions……  Why me?  Why us?

Sometimes the diagnosis is clear, sometimes there are no clear-cut answers.   When is it time to move to another plan and why would another plan perhaps give you a better chance at a successful pregnancy? What aspect of trying to conceive takes up most of your mental energy?

Are you afraid of some aspects you heard about infertility treatment on the internet?  Chat rooms can be filled with misinformation about what works and what causes problems.  If that’s the case, limit your online presence as a way of taking care of yourself.

Are your family genes the most important part of having a baby?  For some families the powerful idea of being from a unique heritage causes introducing donor sperm or eggs into the family to remain secret or parenthood foregone.

Is your desire to experience a pregnancy the most important aspect?  If chemical pregnancies may be related to age or genetic factors, donor eggs or sperm can help create a pregnancy.

Or is the most important aspect of your fertility journey to experience the joys of parenting a child and creating a family?  For some families their joy eventually comes through adoption, fostering, or a broader way of sharing their love of nurturing.

Do you feel heard?  Bring your partner or a friend to your medical visits.   Let your partner take notes and ask questions so you aren’t filtering out the details you’d rather not hear. Be kind to yourself, don’t expect yourself to have all the answers.

When is it time to stop trying (or at least take a break from treatment)?

Is your strong desire for a baby getting in the way of your relationship?  Is fertility stuff all you talk about or think about?  Are you feeling physically defective as a partner, as a woman, as a fully competent man?  Are you depressed?  If yes, therapy can help you sort this out.

Is all this trying to conceive radically affecting your future financial security?  Second mortgage to cover treatment costs?  Draining your IRA or 401(K)?  You have years of living after you’ve given fertility treatment your best effort, you’ll need money to enjoy the rest of your life without the “would’ve, should’ve” haunting you.

Have you got lottery brain?  Just one more try and you are 100%, absolutely, positively sure it will work this time.  Ask your doctor what the chances really are.  Statistics can be your dose of reality. Is a 5% chance of pregnancy good enough for you, or could donor eggs or donor sperm radically increase your chances of pregnancy?  Is another treatment cycle a way to fend off an overpowering feeling of loss?  Have that conversation with your doctor. Talk with your partner about it.  Cry.

There are lots of things to consider:  The most likely influences of success are your age, your follicle count, and your lab values.  Your doctor can give you a reality check, hope, and suggest alternatives to create your own parenthood.  If you need to, give yourself time to adjust to a new way of thinking about parenthood to increase your options.