I'm going to attempt to make this post seem more important than it really is, by linking it to the National Infertility Awareness Week "Take Action" campaign happening over at Stirrup Queens and Sperm Palace Jesters. Don't let the linkage fool you - I'd love to think of this as a selfless act of "reaching out" to the infertile community, but in truth it's as much about y'all "reaching out" to me. So let's not go overboard and paint me saintly, or anything.

I've been thinking about coping strategies over the last twenty-four hours. I want to start a discussion. I'm going to try to stick to simple outlines today, and follow up later in the week once I have your responses and thoughts. Now, obviously, different things work for different people at different times. Which people? What times? Would you find these strategies helpful? Well, what have you found helpful, then?

Here are two strategies I'm thinking of trying out:

Coping Strategy One: A Firm Belief In My Own Mediocrity (aka "that stuff only happens to other people")

It's paranoid to believe I'll be one of those unfortunate patients who, without any sort of explanation, fails one transfer after another, or loses pregnancy after pregnancy. Isn't it? I mean, I know these are real concerns and real people (some of whom might be reading this post) have to face them. Is it naive to make myself believe that won't happen to me, or is it necessary? And if it's necessary, how do I do it?

Coping Strategy Two: The Creeping Finish Line (aka "just one more cycle")

The trouble with agreeing to do as much IVF as it takes, is realising it sometimes takes an awful lot. The thought of being prepared, if necessary, to go through years of IVF can be overwhelming. What about agreeing to a limit, subject to last-minute changes of heart? Or does the pressure of having a deadline do more harm than good?

Well? What do you think?


15 Comments

Meri-ann said...

No, it's not paranoid because it does happen- BUT, huuuuge BUT here- statistically speaking the odds are for a) healthy pregnancy & b) healthy birth. I don't think it's necessary for you to believe that it won't happen to you- but I think it's necessary for perspective. Which is that the most likely outcome is a good one. I LOVE statistics and to fall on the wrong side of statistics is unusual. I kind of cope with the 'Expect the worst and hope for the best' strategy, and somehow I'm still kicking along.
We decided early on that we wouldn't set ourselves a number of cycles, but rather that we'd trust ourselves just to 'know' when the time to stop was close. I think a deadline is probably a bit final, a bit 'now or never' when the question is always in the back of your mind of 'is the next cycle the one?'
Does any of this help?

Meri-ann
www.impatientpatient.wordpress.com

Bea said...

I guess I was saying it's paranoid to think that everything's going to go wrong.

I guess I'm trying to give myself permission to think positive, in fact. Not even babydust perkyturd positive, but just "I'm sure I'll be no worse than average" positive.

Because logically, it's still a reasonable assumption but more than that, I think it's a necessary coping mechanism.

I can't deal with the thought of doing twenty-five IVF cycles (or whatever) and I think I need to give myself permission not to. Because, damnit, I *probably* won't need to do that many. So why am I worried and overwhelmed by the thought?

Which brought me to the "deadline" theory. We've never set a deadline (although we have set points for review). But I'm wondering if that might help - to have a finish line in sight, no matter what the result? Or would that just cause grief and panic? Has anyone tried this? Did a deadline make you feel any better?

Am I making sense? Will anyone else join in?

Bea

Bea said...

Oh, and I was going to say you did help. As I said initially, it's horses for courses, and it's interesting to hear the deadline strategy wasn't for you.

I also liked your reassurance that things were probably going to turn out... well, the way they'll probably turn out. It's hard to grasp.

Bea

StellaNova said...

I think I'm sticking with ambivalence - it seems to be working OK this time. I think my strategy is 'just keep going but don't really think about it' or 'do it but pretend you're not'. I'm not sure how much longevity those ones have, but I can't do it any other way at the moment.

Bea said...

Oh (and I'm actually hogging my own comments here...) but I note the difference between "agreeing to do as much as it takes" and "agreeing to keep going until you know it's time to stop". The second one does seem less daunting.

So maybe "giving yourself permission to stop, and to move on" is an important coping strategy.

Ok - someone else.

Bea

Bea said...

Stella - posted at the same time as me!

This is like a "one step at a time" strategy, right?

Personally, this one falls in and out of favour with me. Planning the future is my natural state of being, and I find it stressful to sustain an "in the moment" mindset over long periods (even with the aid of Tai Chi!).

Is it because I haven't been pursuing other things in my life actively enough? If I did, would it make this coping strategy work better? Then I could let my other things go on, as planned, whilst IVF goes on one step at a time. What do you think?

Bea

Rachel Inbar said...

I guess I always saw myself going on until I succeeded. Fortunately I got pg on the 2nd try (after ~3 years of treatments).

For me, the whole process was an adventure of sorts. I was young (still 20, when I first started ttc) and all the medical fuss was exciting. Sounds sick, huh?

Bonnie in SoCal said...

Hi Bea-- I normally lurk but thought I would join in here . . .
I agree with Meri-Ann in the "continue until you know it's right to stop" course. When DH & I started down this road there was no way we could decide on a specific number of IVF's to do before we stopped-- that seemed too final. At the same time, (in the beginning) I could not think about doing 10+ IVF's and continuing on if it didn't work. I think trusting that you will know when it is right to stop is giving yourself the benefit of the doubt.
About getting through the cycle at hand (I am on #6 right now), my basic strategy is to hope for the best. I have already experienced the worst so I know it can happen to me. If I constantly expected that I couldn't continue. Of course, when I say "hope", I DO NOT mean constantly chearful/babydust craziness. That would be unnatural. I just give myself permission to feel hopeful, which can take many forms (like reading success stories). I haven't found that lack of hope in a cycle (which I have had plenty of) has helped when the BFN or chemical happens, so now I just give myself permission to feel hope when I need to.
I hope that helped you. Sorry I rambled a bit!

Thalia said...

I don't think I've ever seen anyone post this much in their own comments!

I am a fan of "you'll know when you're done when you get there." Tertia defined it as the point when the pain of going on is worse than the pain of stopping. I'm not there yet.

I think that's more humane than setting an absolute deadline.

no reason not to be optimistic. I don't think it makes a difference to outcome, but whatever it takes to get through this is ok by me.

steph said...

We set a deadline. But honestly, it had a lot to do with finances. Paying out of pocket hits you below the belt when it fails, so we had to save up for a year to try IVF #2. So money + time = plan. Of course, when IVF #2 when to shit hubby said he would support me if I wanted to save up and try again in another year, but really, we're both sick of the waiting.
Now if insurance was covering, we'd be on cycle 15 or so by now!! If we hadn't had to wait a year to start (saving $) then another year after that, I would have been willing to do them back to back to back. But we still would have set some kind of deadline so we don't spin our wheels. Especially since now I know it was unlikely to get anywhere anyway. But that's a whole nother story ~~~

Meri-ann said...

Definitely a 'one step at a time' strategy. Look no further than you HAVE to- which for a type A like me is so difficult because I feel the need to have control over every aspect of my life!

Also, I think it's essential to give yourself permission to hope (obviously in that non-perkyturd babydust way)-because if there was zero hope none of us would even be doing this in the first place. So the existence of hope should give us that permission- but we need to insulate ourselves against that very same hope because sometimes she's just a bitch.....

Hope I'm making sense- but I think it's about perspective and taking things one day at a time; and hopefully your worst case scenario turns itself into the best case scenario...

Hopeful Mother said...

I agree with several of the posters here:

money + time (+ prognosis) = plan
(prognosis should come from a trusted medical professional familiar with your case and history)

I think "stopping/decision points" are a great idea, but always having permission to review earlier as you feel the need. I think this is slightly different than the Creeping Finish Line idea.

But you are right, Bea, you should expect yourself to fall on the good side of statistics unless you have a reason to believe otherwise.

I felt better when playing the "let's flip a coin" game. Put 10 coins out and flip each one - call heads or tails - and record the results. I know that science should be more, umm, scientific than this, but in reality ART is very much luck...

serenity said...

For us - we know that adoption is a viable option. In that way, we have a long term plan - that if we don't get pregnant through IVF, we'll adopt.

So our plan now is this: with every BFN we get, we take a break for a cycle and assess whether it's time to move on to that option, or continue trying IVF.

It's kind of a hybrid "one cycle at a time" with a long term plan of stopping - like Meri-ann said, when we "know" that it's time to stop.

And I think there's something too to her comment that Coping Strategy #1 is a good one because you just can't be on the wrong side of the statistics forever. It IS rare that it happens.

Not sure how much this helped, but hey - trying to do my part. :)

The Town Criers said...

I think anyone who engages in cycle after cycle after cycle IS playing the odds, therefore, it seems fitting to go with the attitude of statistics are on your side. IVF does work. Maybe not the first time and maybe not for everyone, but statistically, it has a high success rate.

I think it's a great idea to set limits, but I'm not great about sticking to them so I can't really say that I've ever done it successfully. I think treatments are as addictive as gambling. You always think, "maybe this will be the cycle where I win."

And I hope you do win. Quickly.

Bea said...

Rachel - I've come, over the last few cycles, to see myself as keeping on until we suceeded, but I've found this is not always a good way to cope (for me). Sometimes I look around and see people who have done enormous amounts of IVF - and many have eventually been sucessful - but the thought of having to go through all that overwhelms me.

Mentally, I guess I could cope with "as much as it takes" when I secretly believed it would "all be over by Christmas". Well, it won't be, and I now feel overwhelmed by the thought of what I might be demanding of myself. Twelve cycles? Twenty-three? Who can do it?

I don't think I've discarded the "as much as it takes" strategy, but it now comes with the back door "until you can't do any more". This is much less daunting to me.

Bonnie - ramble on, you sound like you have it sorted.

Thalia - yeah, well, I wanted to see if I could hit some insanely high and magical comment number. No, really I just had more of a discussion than a post-and-comments thing in mind. Like it?

Steph - I'm so sorry money had to be part of your decision. I'm thankful all the time I was born in Australia. I really think IVF should be covered in much the same way as any other child-bearing concern (obstetrics, etc).

Hopeful Mother - that's a great game. I can tell I'm going to be playing that a bit in the future. I had a little lightbulb moment there when I read your comment.

Serenity - like the "which plan should I choose this cycle" idea.

Mel/Town Crier - this is the "in the right place, at the right time, doing the right thing" theory. You have to put yourself in a position to let luck happen.

And I think you're right about addiction - there's no need to brace myself for twenty-three theoretical cycles, same way no-one ever sat down expecting to lose their life saving's at the crap table.

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