Sunday, September 30, 2007

The Serenity Prayer for infertile couples

Counselling infertile couples after they have failed an IVF cycle can be very stressful. As a doctor, I am human too, and it's very depressing when they fail to conceive even after all the hard work and effort we have invested in the treatment. No matter how much you explain that the success rate is not 100% ; that it is often a matter of chance as to which patients' embryos which implant ; that Nature is not efficient at producing babies; and that our technology is not perfect as yet, and we cannot determine why embryos fail to implant, it still hurts when the HCG is negative. Sometimes I feel I have let the patient down by failing to get them pregnant - and this is especially true when patients are doing their "final IVF cycle" and we are the court of last resort.

At this time, the only thing I can give them is a shoulder to cry on - and a copy of the Serenity Prayer.

God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.

Living one day at a time;
Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this world
as it is, not as I would have it;
Trusting that He will make all things right
if I surrender to His Will;
That I may be reasonably happy in this life
and supremely happy with Him
Forever in the next.

--Reinhold Niebuhr

I try to explain the ABCs of Rational Emotive Therapy to them - that's it not the Action ( the negative HCG because of the failure of the embryos to implant) which causes the Consequence ( the depression and sadness); but rather their Belief about the event ( that they are "worthless " because they cannot produce a baby) which causes the problems. I need to remind them that they are far more than just "baby-makers".

It's always hard for humans to deal with failure. Many infertile couples are young and successful and used to having their life going the way they want it to. They are smart and hardworking - and they are used to topping in their exams; getting the jobs they desire; the spouse they pursue; and advancing rapidly up their career path. They earn more money; buy a new car; buy a new house - everything falls into place for them ! And when they find out they cannot have a baby, this is a rude shock. This is often the first time they are confronting failure - and the reason this is so scary is that it's often the first time in their lives they are being forced to come to terms with their own biological limitations - their own mortality ! This is not a comfortable feeling , and the fact that the outcome of what they do is not in their hands , and that they may never get what they so strongly desire, can be very difficult to accept for many of them.

Many make a bad situation worse by blaming themselves for the failure. They feel that God is now punishing them because they were " selfish " and pursued a career and postponed childbearing. Also, the social stresses add insult to injury when well-meaning fertile friends and relatives say hurtful things - without even realising the damage they cause !

Some patients become very bitter, angry and unhappy as a result of the failure. Others, who are more resilient, become kinder, nicer human beings - more empathetic and understanding, because they have been through the fire of adversity. This is one of the reasons I like treating entrepreneurs - because they are used to dealing with failure - and bouncing back ! They response is - " Fine, what did we learn from this ? And what do we do differently the next time ?"

The life lesson a failed IVF cycle often teaches is that it forces you to confront your own mortality - that life can be fickle and uncertain. This can be a major life changing event - and if you enjoy the learning , you will learn the truth behind the saying - What does not kill you, makes you stronger !

1 comment:

  1. Dear Doctor,

    With your article I would like to share this beautiful. I hope it provides courage to all. May god confer strenght:


    Sometimes we wonder, "What did I do to deserve this?" or "Why did God have to do this to me?" Here is a wonderful explanation!

    A daughter is telling her Mother how everything is going wrong, she's failing algebra and her best friend is moving away.

    Meanwhile, her Mother is baking a cake and asks her daughter if she would like a snack, and the daughter says, "Absolutely Mom, I love your cake."

    Here, have some cooking oil," her Mother offers. "Yuck" says her daughter.

    "How about a couple raw eggs?" "Gross, Mom!"

    "Would you like some flour then? Or maybe baking soda?" "Mom, those are all yucky!"

    To which the mother replies: "Yes, all those things seem bad all by themselves. But when they are put together in the right way, they make a wonderfully delicious cake!
    God works the same way. Many times we wonder why He would let us go through such bad and difficult times. But God knows that when He puts these things all in His order, they always work for good! We just have to trust Him and, eventually, they will all make something wonderful!

    God is crazy about you. He sends you flowers every spring and a sunrise every morning.

    Whenever you want to talk, He'll listen. He can live anywhere in the universe, and He chose your heart.

    Hope your day is a "piece of cake!"


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