I was flicking through the online excerpt of The Infertility Cure last week after it was recommended to me by gracie (who didn't leave a contact/url - but thanks gracie!), when I read that the average couple goes through seven cycles of ART before they conceive or give up. Seven. That number keeps coming up.

  • Mananabanana conceived on their seventh (and last) cycle.
  • A woman at one of my transfers said she was on her sixth (and second last) transfer.
  • A message board discussion (at Essential Baby) some months ago indicated a wide consensus that seven transfers was enough.
  • Let's not even start on biblical sevens.

"How many cycles have we done?" Mr Bea asked.

"Well, that depends how you divide it up," I answered. "Because it's only been four transfers and you can't really count..."

"How many ART cycles?"


It's interesting. As a species, we seem to have an inbuilt quit-point. You can imagine how it went, back in the prehistoric days. Two cavemen have heard a rumour you can make fire by banging two rocks together. "Here," says one, handing the other two clods of earth. "Try it. Huh. Ok, try again. No? Try again - it must be true, I heard it from a friend of a friend of mine. And again. Again. Again. One more time. Tell you what - why don't we try flint?"

We've invented this myth of human progress as based on persistence, determination, perseverance in the face of great odds. But the real story of human progress is one of giving up. Without that, we're just apes in a cave, banging clods of earth together, getting nowhere as we watch them crumble apart.

More thoughts on quitting by our Stirrup Queen and Serenity.

Disclaimer - average means, of course, that some people will do more and some people will do less. I'm sure no-one's taking me literally here, but I thought I'd mention it. We're all faced with different circumstances - diagnosis, response to treatment, external factors... I just saw the number seven come up a surprising number of times in all sorts of different situations and it got me wondering whether there was some sort of evolutionary principle involved. I was not, in any way, trying to say that doing more or less than seven cycles is wrong, not least because our individual decisions on where to draw the ART line are based on a complex array of factors and what I would still like to think of as a sophisticated knowledge of human biology. My main point is that quitting is an essential part of the success story of the human species. Ok, I think we're all clear.


noela said...

Very interesting post, Bea.

I find myself feeling like a Veteran most of the time, although I have not done NEARLY as many cycles as so many have....

But, I've thought about this a lot, and feel that my "veteran" feelings stem all the way back to when I had Ovarian cancer at 18 -- because for a good ten years, I have known that my fertility was threatened. So, because I had "advanced warning" I feel like I have been thinking about, and dealing with fertility struggles since the day I got diagnosed in 1996!

In actuality, I have done one fresh cycle, and two FET's, about to embark on our third FET -- well, I am not anywhere near the "giving up" point.

Not because I at all long for a biological child, that is something of inconsequence to my husband and I -- but just that suddenly, over the last couple of years, it became incredibly important to experience at least ONE successful pregnancy in my life. We are totally open to adoption, but unfortunately, here, adoption costs FOUR TIMES the amount an IVF cycle costs, so that doesn't make much sense, does it!?

So, we soldier on with these FET's...until I either get knocked up successfully, or we run out of embryos (which will happen very soon) -- and then, I would do another fresh cycle. Have no idea where the money would come from, but I told my husband I would be willing to sell our new house and "downgrade" if it came to needing the money to finance a new cycle.

We shall see -- everyday I pray to G-d, or whoever, that we DON'T need to go down that road! All I'm asking for is ONE baby right now, from this batch of embryos, and then I will be willing to look at ANY and ALL options in the future!

Anyway, sorry this is so long!! Thanks for the thought-provoking post. :)


Baby Blues said...

I know what you mean. "When do you know when to give up?" I still have a long way to go but I know that someday I may have to face it. Sometimes I think I'd rather know so I could just go on with life. Because there's just so much more to life than having a baby. Life goes on...

Thalia said...

Not sure when we will quit, but 7 sounds about right -3/4 more from now, yes, I think we will be done.

SOunds like you're not ready to quit, either.

Serenity said...

Interesting. We've done two cycles Clomid and 4 transfers. That makes 6 cycles ART. And we our current plan we'll do one more fresh cycle, then move on to adoption if that doesn't work. That makes 7 as our quit-point.

Course, that's the way I feel today. Trying to figure out when to quit and pursue something else is hard- particularly when you know, intellectually speaking, that it could happen on the 17th or 27th cycle.

It's a little like gambling, really. How many times will I go back for that dose of hope - because it's the NEXT cycle that could work?

I want to explore this some more. Thanks for giving me something to think on, Bea.

Josie said...

When I am not going through a cycle I think I could do this until we get results and we have the money. When I am in the middle of an IVF I want to quit as soon as I get bad news.

I guess I did 7 clomid cycles before we moved on to something else....

Jules said...

That lucky number 7.

Do they mean 7 cycles collectively or 7 stims?

Well collectively, I have 5 (not including the 2 canc. FETs).

Is it just a numbers game, or is it a question, that they don't know the answer to?

Giving up... I think it's harder, than starting ART. Giving up to me, means the end, the finale, it's over, no more.

Although I am becoming mentally, physically & emotionally tired of all this, giving up is still a distance away.

TeamWinks said...

I think I'm falling under the less category. Hubby and I discussed adoption before we even started treatment (about a year before we did.) However, the quitting point is an interesting one. When do we quit and why?

ColourYourWorld said...

Well my next FET will be my 7th attempt at trying to concieve. I know I will be nowhere near ready to give up. If I don't count my IUI's which in hindsight I think were a waste of precious time, then I am really only up to number 3.
So 7 attempts at ivf are probably closer to be correct.
Sooner would be wonderful :)

Anonymous said...

That's interesting. In this context, does ART apply only to IVF cycles, or would any meds or IUI count? (I usually consider IUI as ART, but not meds with timed intercourse.) But I've done 7 medicated cycles -- 4 with IUI -- and yeah, we're done.

I wonder if there is a difference among average ART attempts in the U.S. versus other countries with better health insurance. Not having insurance for even 1 IVF cycle, I'm rather envious of those with multiple-cycle coverage.

Bea said...

As to the question (which has come up a couple of times) as to what "counts" as an ART cycle, I've taken it to mean anything "assisted" counts, and any "cycle" counts.

So medicated cycles with sex, IUIs, IVFs, even those which turn out to give no chance of pregnancy (eg cycles that don't result in a transfer or IUIs which are later demonstrated to be useless, because you find another piece of the puzzle and realise you never had a chance before you solved *that* problem) all count.

However, in real life people are very good at dividing these things up. So if you've done seven rounds of clomid and moved on to IVF, it's like you've started a new "set".

I certainly found I needed a break after our "seventh" cycle, but because I only really consider it our fourth (fourth transfer, fourth that may have resulted in a pregnancy) my sense is that we can do a few more before it starts getting too hard.

And then, if we change something - say we move to PGD - perhaps we can do another seven, who knows? Or perhaps not. We'll see.

Also, I think the point about insurance coverage is a good one. I do have a sense, from reading blogs, that Australians are more likely to do more cycles than, say, those in the US. But I think that's a combination of having good coverage for IVF cycles using your own, or known donor gametes, and having restricted choices when it comes to other family building options (anonymous donor, surrogacy, adoption).


Carol said...

Well this next one will be number 6 for us. But I'm hoping we don't have to get to 7.

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