Tuesday, October 13, 2009

Adoption versus IVF

Should I adopt ? Or should I do another cycle of IVF ? This is one of the commonest quandaries infertile patients find themselves in. It's also one of the hardest to resolve, because there are so many conflicting opinions

While IVF gives you the best chance of having your own biological baby, its also an expensive option - and the outcome is always uncertain, so it can be quite difficult going through a treatment cycle - especially when the first one has failed.

However, while adoption does offer a 100% success rate, many couples are worried whether they will be able to love the child as much as other couples love their own children.

Others feel guilty when they don't want to adopt. They feel that their insistence on IVF treatment means they are being shallow - after all, why can't they open their hearts and love a baby who is already here , and give her a good home ? As one patient put it - " Am I being selfish to insist on wanting a baby who shares my own genes ? " Unfortunately, the heart does not listen to the brain in such matters, and this sort of debate can be endless, leading to a lot of heartbreak and sleepless nights !

Also, IVF doctors sometimes make it harder for patients to go down the adoption route. They will often egg patients on to do another cycle; and since most patients build a good rapport with their doctor, and they feel they are letting him down by choosing to adopt a baby rather than do another IVF cycle.

Since adoption involves the entire family, you also have to deal with unhappy parents and disapproving relatives if you want to adopt a baby. The family pressure to have your own child is enormous - and to adopt, most parents will try to get buy-in from the extended family, because they want the child to be loved and accepted.

The decision is even harder when your husband and you don't see eye to eye on such a touchy topic - and many marriages will break down when they reach this impasse. Let's suppose your wife wants to do IVF and you'd rather adopt. You feel that she has started obsessing about her infertility and that she is no longer the person you married. You want to protect her, and because the chances of success are poor , you cannot bear to see her go through the heartbreak of handling another failure. She would rather do IVF and feels she is strong enough to deal with the process. She is not comfortable about adoption because she wants to experience the joy of pregnancy; and feels you are being overprotecting and paternalistic by depriving her of a chance of having her own baby by stopping her from doing IVF, even if the chances of success are slim. One possible solution would be to agree prospectively that you will do 3 IVF cycles; and if these fail, then you will adopt a baby. This is crafting a win-win solution, where both partners are happy. Your wife is happy that she's given IVF her best shot; and you are happy that you have put an outer limit to what she will need to put herself through, so that you can achieve emotional closure and move in with your lives.

I feel adoption and IVF are not competitive options, but are complementary, and I encourage my patients to explore both in parallel rather than in sequence. After all, why waste time ? If you get pregnant, you can always take your name off the list - and another infertile couple will be very happy that you have chosen to do so , as they get to move up the list, thanks to you !

And if the IVF fails, then at least your waiting time on the adoption wait list will have been cut down a lot !

Another major benefit is that exploring both processes will give you clarity as to how you want to achieve resolution. After all, until you explore both, you never really know what's actually involved in both - and no amount of reading can ever prepare you for the reality of adoption or IVF, both of which can be gruelling, time consuming processes, which can suck up a lot of time, money and energy.

Some social workers frown on this , and they will refuse to put infertile couples who are trying IVF on the adoption wait list. They feel these couples still have unresolved issues, and therefore may not make good adoptive parents.

Finally, the bitter truth is that adoption has become much harder these days. There simply aren't that many unwanted babies anymore ! As Indian women become better informed, most unmarried girls will terminate unwanted pregnancies, rather than unwittingly carry the baby for 9 months ( out of ignorance) and then hand this baby over to an adoption agency.

The good news is that there is now an alternative option available , which does not depend upon women abandoning their newborns. This is called embryo adoption, and has become an increasingly popular method of family building.

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