“I just got stuck” reflects a common phenomenon fertility doctors see during patients’ fertility care; here’s how we can help them.
I saw a patient recently who I hadn’t seen for a couple of years. That’s a long time for an infertility patient. When going through infertility treatment, we’ll often see patients several times a week. She was sheepish when starting the conversation and said, “I just got stuck.”
She got me thinking about a common phenomenon we see as fertility doctors … getting stuck. What exactly do I mean when I say getting stuck? For this particular patient, she was stuck in a period of indecision.
For others, life happens, and things come up that make it difficult to continue the fertility treatment journey … a job change, a move, another health problem, a sick relative, a pet dies. Life happens, and sometimes people need to take a break from treatment, and sometimes, they get stuck feeling scared to restart the journey.
It is not unusual. The International Journal of Gynecology & Obstetrics reports that in a survey of infertile patients in 20 countries, overall 36% of patients discontinue treatments.
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Why her indecision about proceeding with fertility care surprised me
I asked her, “Do you know why you felt stuck?” She said she worried that she was wasting my time with her repeated visits because she couldn’t decide how they wanted to proceed with treatment.
This was eye-opening for me. I think most of my patients feel comfortable sharing some of the most intimate and painful parts of their lives with me. I think most would also say they feel they have the space and time to ask questions and we encourage shared decision making between the doctor and patient.
Previous patient experiences in healthcare can shape future encounters
But, most of us are shaped by our prior life experiences, and we don’t know what experiences people have had with the medical industry prior to starting fertility care at TRM. Some may have felt their concerns were not heard, some have felt dismissed, some weren’t actively involved in shared decision making, and while prior providers likely had no intention of making a patient feel unheard, the negative experiences can lead to genuine fear about future encounters.
For my patient, she became fearful of the fact that her not knowing how to proceed with treatment meant that the medical establishment would be frustrated in working with her. I took this visit as an opportunity to clarify how I view my interactions with patients.
Related Reading: After a Second IVF Failure, Would Hollie & Jared give Up?
What are some primary reasons why people stop fertility treatments?
Treatment postponement |
Patients need time to recover emotionally, physically, financially or to reassess their plans. |
Emotional/psychological burden |
Fertility treatment can result in anxiety, depression, treatment fatigue and negative emotional impact from failures. |
Physical burden of treatments |
Tests, ultrasounds, injections, medication side effects and procedures can become physically difficult to continue. |
Clinic or treatment related factors |
Scheduling, dissatisfaction with care, communication issues or frustration with the treatment process can cause discontinuation. |
Personal or relationship issues |
Relationship stress, differing opinions about continuing, life changes or other personal circumstances can cause patients to stop. |
Poor prognosis or repeated failure |
This happens after repeated unsuccessful treatments or when the fertility specialist advises that the chance of success is low. |
Financial concerns |
The costs of medications, testing, travel and time away from work can place significant financial strain on patients. |
From study in Human Reproduction Update on why patients stop fertility treatments.
My fertility medicine mission can help patients get unstuck during fertility care
My mission as your doctor is to help educate you about your health and how to build your family through fertility care.
- My goal is to listen to your questions and provide clear answers.
- My goal is to be honest with you when I don’t know the answer.
- My goal is not to push you into a specific treatment or make you feel that there’s anything wrong with feeling paralyzed with the fear of making a wrong decision about your healthcare.
I understand that life happens, and for whatever reason, patients sometimes have to take a break in their fertility care. But whenever they walk through my door, it’s a privilege to see them and I’m happy to help them get back on the journey to health or building a family, no matter how long it’s been that they’ve been on that journey.
Related Reading: Couples Counseling When Infertility Dashes Their Dreams
Some patients get stuck by not letting go of fertility treatments
On the opposite end of the spectrum, we sometimes have patients who feel that they get stuck in treatment and can’t let go of continuing to try when efforts are failing. It can be heartbreaking to help a patient through this part of the journey. I respect a patient’s right to choose to continue treatment, even when the likelihood of success is low.
My goal for them is to continue to provide safe care, realistic expectations for success, and offer alternatives to continuing so they have the best information to decide what is best for them. I imagine this phenomenon of getting stuck is not unique to infertility care, it’s probably true with a lot of other chronic health conditions and life situations.
It’s OK to get stuck, and I’m here when you’re ready to get unstuck.