Making Your Fertility Treatment Plan: Finding Your Happy Ending

"Without children, life would be meaningless."
"I don't have anything in common with my friends who have children. Being different makes me uncomfortable."
"A baby will make our marriage happier and more stable."
"Fitting meetings, graduate school, and business trips into feedings, diapers, and baby-sitters would stifle me."
"Pregnant women glow with their femininity."

I have heard all of these statements and more from patients and friends— normal men and women with normal feelings and concerns. I find, however, that many of my fertility patients are afraid to explore or discuss their feelings, both positive and negative, about having children. They are so intent on resolving their fertility problems—on creating a pregnancy—that they lose sight that what they are really trying to do is make a baby. They seldom stop to ask themselves, "Why?" and, "How is this baby going to change our relationship and lives?" and, "Do I welcome those changes—or most of them—wholeheartedly?"

A fertility treatment plan should lead to results that will satisfy your basic needs. Since the happy ending that's right for you may be different from the one that another may choose, it is vital at the outset that you both identify how having a baby will meet your needs. Will the baby carry on your family name and genes? Will having the baby make you feel like a complete person? Will the baby be your companion—someone to nurture and love?

The answers to these and other questions will greatly influence your treatment options. If like Steven and Kathy you want a baby to carry on the family name and genes, donor artificial insemination will not be a happy ending for you. If like Debbie you want to carry a pregnancy to make your life experience complete, then adoption won't be a happy ending. But if you just want a baby to nurture and love, as Richard and Margaret did, you won't be as concerned with how you get your baby as with just getting one.

To help you identify your happy ending, I have developed an evaluation test for you and your spouse. I use it with my patients before we sit down to work out a fertility plan. Discussing your responses with one another will help you understand your motives, concerns, interests, attitudes, and feelings. You will both gain insight into why your fertility problems cause you pain and frustration. And you will be able to identify which happy ending will resolve your fertility problem.

Even my patients who have been receiving fertility treatment for a year or more enjoy and benefit from taking this test. "When we discussed our answers to the test, it was the first time we'd talked about our problem when we weren't in the middle of a crisis," Shelley T. reported. "It was very refreshing."

I recommend that my patients retake the evaluation every six months or so. This renews their dialogue and identifies significant changes in their attitudes. People like Michael and Shelley who at first completely rule out adoption, for example, will often find that it becomes more attractive after years of unsuccessful treatment.

It's okay to change your mind. If you don't achieve your first goal, you may wish to reexamine your needs and select another. You probably didn't succeed at getting a date with your first love either, but that didn't stop you from trying again or finding an alternative. Besides, you may not have had all of the facts when you made your initial decisions. Once you have discussed your answers together, you will be better prepared to find medical and professional services that will meet your needs.

Since you may wish to use the evaluation test several times throughout your fertility treatment, I suggest that you write your answers on a separate piece of paper. Number the sheet from 1 to 70 for your responses. By placing your completed answer sheet beside your spouse's, you can easily identify points of agreement and conflict. You may wish to save your answers and discuss them from time to time and compare them with future scores.

When you respond to the statements, do not ponder too long on any one issue. I find that an initial response is often more accurate than one analyzed to death. You should be able to complete the test in just a few minutes. After that, I will tell you how to interpret your answers and what they mean to you, to your spouse, and to your fertility treatment.

Examining each of these areas will help you understand how internal and external forces influence your reaction to infertility. By tuning in to these forces you can learn to accept your emotional responses, choose to accept or ignore the needs of others, discover your spouse's needs, and together control your future.

Continued