As I write this blogpost, I recognize that there are many people in the world trying to survive dire circumstances. And I suspect that many readers who are infertility patients might be experiencing twinges of related discomfort.
For example, the other day I read a Facebook post from someone expressing a sense of guilt over how good her life is compared to people in places like Japan and Libya. She revealed her true feelings: that she was having a hard time enjoying the excitement of an upcoming, hard-earned trip to Disney with her family, because she was so acutely aware of the world's distress.
As you might imagine, her friends responded with comments supportive of her desire to be happy. As one posted, "Nobody in Japan wants you to be unhappy!"
With infertility, the pain you feel is most often hidden from the world. You don't want to be the one who brings sadness into a baby shower. You'd rather friends not see the hurt on your face while they chat about their little one's latest antics. The very fact that you keep grief a secret can compound your sense of isolation, which makes a little pain feel overwhelming.
On the other hand, just as we realize how much worse things can be for others -- as in the case of so much recent news from abroad -- you don't begrudge your friends' pleasure at being new parents.
The bottom line is that we are all human, and we all have drives, the strongest of which is to have a baby. We cannot all feel direct empathy for everyone, but we can strive to understand and be sensitive toward each other. In truth, we really do want everyone else to be safe, happy, and have their hearts' desires.
As many of you are, I am praying for people around the world, for peace and restoration in their lives and communities. I also continue on my personal path toward making life better for myself and for those directly around me, including my patients, because that's where it all begins.
Friday, March 25, 2011
Friday, March 11, 2011
How Many IVF's Is Enough?
Yesterday I wrote about the importance of perseverance in fertility treatment. And in light of research that says "more IVF attempts equals greater chances of success" plus my concurring with Dr. Rosen's comment that likelihood of success per cycle decreases... here's my explanation of what sounds like conflicting stances:
There are so many facets that add up to IVF success or failure, we potentially learn something each time we use this technique for a patient. I use every tool I have -- the latest research findings, my years of experience in treating infertility, state-of-the-art equipment, highly skilled staff -- and still must approach each patient as a unique situation. Every body is different.
So any treatment cycle is an opportunity for us to find out more about how this body responds to various components of the IVF journey. When subsequent treatments are required, I take what we've learned, adjust the plan accordingly, and continue to observe the results carefully. Try again.
Decreasing success per cycle may not be related to the failure of the IVF technique itself, but to an organic sort of patient-screening dynamic.
For example, a patient chooses to undergo IVF. Her diagnostic workup reveals a potential reason for her infertility thus far, and we believe IVF can help resolve this issue. Her first IVF attempt does not result in a pregnancy, yet through that experience we learn something else about this patient's fertility factors. We decide on parts of the IVF process to change -- we may tweak the medication protocol, or use some additional technique or tool -- and we all try again. If we continue in this manner, the IVF process may wind up revealing even more causes of this patient's infertility with each treatment cycle. In most cases, after paying careful attention to a patient's IVF responses and adjusting the next cycle accordingly, success -- a healthy pregnancy -- is the outcome. For some, the result is coming to terms with the need to move forward, either with a different treatment technique or to adoption or to living child-free.
So in some situations, each procedure adjustment we make whittles away at the possible infertility causes until finally, we determine that IVF either is or is indeed not the answer for this patient. But there may have been no way to determine that fact if IVF had not been tried.
Of course, passing time is one of the biggest factors for decreasing success rates per cycle. Especially for women who are already in their 30's when they start fertility treatment, the natural biology of the female results in fewer chances for pregnancy as her body ages.
To some extent, medical treatment -- not just for infertility, but other conditions as well -- involves taking risks. My fellow practitioners and I always first balance the risk of harm to a patient versus the potential success of treatment. Each patient is different, not only in their body's responses to treatment, but in attitude and ability to move forward. Some are naturally more at ease taking risks, while others are more comfortable risking little. Helping patients make those choices is part of my job.
~ Sonja Kristiansen M.D.
There are so many facets that add up to IVF success or failure, we potentially learn something each time we use this technique for a patient. I use every tool I have -- the latest research findings, my years of experience in treating infertility, state-of-the-art equipment, highly skilled staff -- and still must approach each patient as a unique situation. Every body is different.
So any treatment cycle is an opportunity for us to find out more about how this body responds to various components of the IVF journey. When subsequent treatments are required, I take what we've learned, adjust the plan accordingly, and continue to observe the results carefully. Try again.
Decreasing success per cycle may not be related to the failure of the IVF technique itself, but to an organic sort of patient-screening dynamic.
For example, a patient chooses to undergo IVF. Her diagnostic workup reveals a potential reason for her infertility thus far, and we believe IVF can help resolve this issue. Her first IVF attempt does not result in a pregnancy, yet through that experience we learn something else about this patient's fertility factors. We decide on parts of the IVF process to change -- we may tweak the medication protocol, or use some additional technique or tool -- and we all try again. If we continue in this manner, the IVF process may wind up revealing even more causes of this patient's infertility with each treatment cycle. In most cases, after paying careful attention to a patient's IVF responses and adjusting the next cycle accordingly, success -- a healthy pregnancy -- is the outcome. For some, the result is coming to terms with the need to move forward, either with a different treatment technique or to adoption or to living child-free.
So in some situations, each procedure adjustment we make whittles away at the possible infertility causes until finally, we determine that IVF either is or is indeed not the answer for this patient. But there may have been no way to determine that fact if IVF had not been tried.
Of course, passing time is one of the biggest factors for decreasing success rates per cycle. Especially for women who are already in their 30's when they start fertility treatment, the natural biology of the female results in fewer chances for pregnancy as her body ages.
To some extent, medical treatment -- not just for infertility, but other conditions as well -- involves taking risks. My fellow practitioners and I always first balance the risk of harm to a patient versus the potential success of treatment. Each patient is different, not only in their body's responses to treatment, but in attitude and ability to move forward. Some are naturally more at ease taking risks, while others are more comfortable risking little. Helping patients make those choices is part of my job.
~ Sonja Kristiansen M.D.
Thursday, March 10, 2011
Try, Try Again
"If at first you don't succeed, try, try again."
I can nearly hear your sighs. One of the hardest parts about infertility and its treatment is the need for perseverance. Many of my patients who are now parents will tell you that even more than peaceful patience, going through infertility treatment and keeping your sanity requires maintaining a heavy dose of "hang in there".
Recently, Australian researchers concluded that the likelihood of IVF success increases with each cycle. This is especially true for mothers-to-be who are older than 35, but even for younger women, going through an average of three IVF cycles boosts success rates up to 58 percent.
Granted, this makes common sense in a way -- the more you try something, the greater the odds you'll succeed eventually. But this isn't the first bit of research that hints at something more: the treatment learning curve and the artful practice of medicine.
of course, as Dr. Rosen points out at the end of the article in BioNews, the likelihood of success per cycle decreases, and eventually an end to treatment attempts may need to be considered for some patients. I'll discuss that seemingly paradoxical point in a future blogpost.
For now, I'll leave you to consider the reality that, yes, for many fertility patients who choose IVF, it takes more than one treatment cycle to get pregnant. As I mentioned in my last blogpost, coming to grips with treatment realities is a kind of loss. Perseverance is a good trait to muster. And when you run out of your own, borrow some from a loved one or friend. Keep trying.
More to come...
~ Sonja Kristiansen
I can nearly hear your sighs. One of the hardest parts about infertility and its treatment is the need for perseverance. Many of my patients who are now parents will tell you that even more than peaceful patience, going through infertility treatment and keeping your sanity requires maintaining a heavy dose of "hang in there".
Recently, Australian researchers concluded that the likelihood of IVF success increases with each cycle. This is especially true for mothers-to-be who are older than 35, but even for younger women, going through an average of three IVF cycles boosts success rates up to 58 percent.
Granted, this makes common sense in a way -- the more you try something, the greater the odds you'll succeed eventually. But this isn't the first bit of research that hints at something more: the treatment learning curve and the artful practice of medicine.
of course, as Dr. Rosen points out at the end of the article in BioNews, the likelihood of success per cycle decreases, and eventually an end to treatment attempts may need to be considered for some patients. I'll discuss that seemingly paradoxical point in a future blogpost.
For now, I'll leave you to consider the reality that, yes, for many fertility patients who choose IVF, it takes more than one treatment cycle to get pregnant. As I mentioned in my last blogpost, coming to grips with treatment realities is a kind of loss. Perseverance is a good trait to muster. And when you run out of your own, borrow some from a loved one or friend. Keep trying.
More to come...
~ Sonja Kristiansen
Monday, March 7, 2011
Infertility's Grief: Unwelcome, Yet Present
We typically think of grief as related to traumatic events in our lives, and mostly, in terms of death. It's not a word that anyone wants to apply to their present or future, and even thinking about grieving in the past is tough.
But grief is often a big part of infertility for most patients.
Even for patients who are quite pro-active and forward-thinking about treatment, where infertility is, so is loss. And with loss, necessarily comes grieving.
The first loss that comes hand-in-hand with infertility is the dream of how you thought getting pregnant and having a baby would be. That's a loss that virtually every infertility patient must grieve. From there, variations in grieving depend on many things, including how individuals cope with whatever life throws their way.
I've had patients come to me and say, "Dr. Kristiansen, I'm finding it hard to stay positive about our fertility treatment."
To make it through the losses and grief of infertility, the first important step to take is simply acknowledging they are there. Doing so -- looking loss and sadness matter-of-factly -- does not mean you're being pessimistic. Optimistic thinking based on unreality is not helpful for anyone. Optimism that starts from a solid foothold of understanding where you are is the kind of thinking that allows you to put one foot in front of the other toward resolution.
No need to wallow in it, but if you find yourself doing so, be forgiving. Seek help. It's here.
The staff of Houston Fertility Center can refer you to resources that can support you through your grief.
Here are a couple of related items online:
Writer Ryan Jacobson succinctly described the grief of infertility from a personal perspective in this article, "Infertility: I Wish Someone Would Have Told Me"
He also gives very direct advice to friends and loved ones of those struggling through infertility.
While "how-to's" can sometimes oversimplify complex emotional processes, they can also be helpful for breaking down tough stuff into do-able chunks. This is one filled with meaningful steps:
How to Grieve Infertility Losses
By FaithAllen on eHow
Wherever you are in your journey, I and my staff are prepared to meet you.
~Sonja Kristiansen
But grief is often a big part of infertility for most patients.
Even for patients who are quite pro-active and forward-thinking about treatment, where infertility is, so is loss. And with loss, necessarily comes grieving.
The first loss that comes hand-in-hand with infertility is the dream of how you thought getting pregnant and having a baby would be. That's a loss that virtually every infertility patient must grieve. From there, variations in grieving depend on many things, including how individuals cope with whatever life throws their way.
I've had patients come to me and say, "Dr. Kristiansen, I'm finding it hard to stay positive about our fertility treatment."
To make it through the losses and grief of infertility, the first important step to take is simply acknowledging they are there. Doing so -- looking loss and sadness matter-of-factly -- does not mean you're being pessimistic. Optimistic thinking based on unreality is not helpful for anyone. Optimism that starts from a solid foothold of understanding where you are is the kind of thinking that allows you to put one foot in front of the other toward resolution.
No need to wallow in it, but if you find yourself doing so, be forgiving. Seek help. It's here.
The staff of Houston Fertility Center can refer you to resources that can support you through your grief.
Here are a couple of related items online:
Writer Ryan Jacobson succinctly described the grief of infertility from a personal perspective in this article, "Infertility: I Wish Someone Would Have Told Me"
He also gives very direct advice to friends and loved ones of those struggling through infertility.
While "how-to's" can sometimes oversimplify complex emotional processes, they can also be helpful for breaking down tough stuff into do-able chunks. This is one filled with meaningful steps:
How to Grieve Infertility Losses
By FaithAllen on eHow
Wherever you are in your journey, I and my staff are prepared to meet you.
~Sonja Kristiansen
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