ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, January 16, 1996 TAG: 9601160023
SECTION: EXTRA PAGE: 1 EDITION: METRO
COLUMN: Personal Health
SOURCE: JANE E. BRODY
When Julie Miller began trying to have a baby through in- vitro fertilization, she had a plan. She would give it a year - four tries. If that did not result in a successful pregnancy, she and her husband, Jesse, would seek to adopt a child.
``I needed to have something in the wings if IVF didn't work,'' she recalled.
The Millers, who live in Brooklyn, N.Y.knew they wanted to have a child one way or another, so they approached an adoption lawyer even before Miller began her last in-vitro cycle. She recommends that others who are going through treatments for infertility start out with a plan for the treatment and its aftermath.
There are no hard-and-fast rules as to when a couple should abandon efforts to have a biological child.
The chances of success depend on many factors, including the cause of the infertility (which cannot always be determined), the woman's age, the competence of the clinic and the development of new techniques.
However, Miller maintains: ``You can't just go along month after month, year after year, hoping you'll get pregnant. You need to know when enough is enough. You should have a clear idea at the start of how much time, money and emotional energy you are willing to invest in trying to get pregnant.
``It's too easy to become obsessed with getting pregnant. IVF is such an emotional roller coaster. You can get addicted to the high you experience when starting a new cycle. It's such a letdown when you fail to get pregnant that you can't wait to start another cycle and re-experience the high, the hope, that this time it will work.''
Miller did not pick four cycles out of a hat. Before she and her husband even started, the counselor at the fertility clinic had told them that their chances of a successful pregnancy would not improve after four in-vitro efforts.
More important than the dwindling prospects of a pregnancy or the soaring costs of treatment was her state of mind.
Between the mood-altering effects of hormone treatments and the ups and downs of expectations and disappointments, there was just so much of the experience she could take and still function effectively.
``I had to stop working during the last cycle,'' she recalled. ``...After nine months on a roller coaster of hope and despair, I was emotionally worn out.''
A year after their last failed IVF effort, the Millers adopted a baby, but even that process was marred by a cycle of hope and despair. Their first try at adoption fell through.
The agony is now gone, though not forgotten; the Millers delight in their daughter, Molly, 6, now a first-grader.
Pamela Madsen, president of the New York City chapter of Resolve, a national organization that helps people deal with infertility problems, said that each woman had to ``decide how much you can take, how much your marriage can take.''
Madsen said that ``some couples adopt a child and continue on with infertility treatments; others say, `I'm getting out of the ovarian Olympics, I don't need to have a child,' and they go on to have wonderful lives without children.''
Amy Schaffer, a New York psychotherapist who decided to abandon the idea of having a baby after four miscarriages in her 40s, said that couples going through infertility treatments need support from people ``who don't have a vested interest in the outcome.''
The pressures can be unbearable - for example, from the couple's parents who want to have a grandchild; from friends who say ``enough already, forget it.''
There are also contradictory pressures from within. As Schaffer put it: ``It can feel very courageous, empowering, to keep on trying. It fends off feelings of helplessness and feeling like a victim. There can be a strong sense of failure associated with giving up. But at the same time, keeping on trying can become self-defeating.''
Participation in support groups, like those run by Resolve, can be helpful.
For those who can afford it, couples' therapy can help to ward off problems that typically arise when a couple faces the stress of dealing with infertility.
``Both spouses can become so stressed out, so needy, so depressed,'' Miller said. ``They may start attacking each other for not being emotionally available.''
Madsen reminds couples: ``As crummy as you feel at the moment, it won't last forever. The bad feelings will resolve.''
Resolve is a national nonprofit organization that serves people dealing with problems of infertility. To join the organization or to locate a nearby support group, call the national help line, (617) 623-0744, or write to Resolve, 1310 Broadway, Somerville, Mass. 02144-1731. The New York City chapter can be reached by calling (212) 764-0802.
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