Monday, July 18, 2016

Bouncing back after a failed IVF cycle.

While being an IVF specialist is a lot of fun because we're helping people to have deeply loved babies, the one part of my job which I hate is having to tell patients their hCG is negative and the cycle has failed. This is specially true when the cycle was perfect, we got good quality blasts, the transfer went well, the endometrium was perfect. Because no matter how much we explain to patients that an embryo is not a baby and that IVF doesn't have a 100% pregnancy rate, when the cycle fails their heart breaks. Quite frankly, mine does too. I'd be very happy if we could give them a baby , so that they could move on with their lives, and send lots of their friends to us !

    It's very difficult to counsel these patients sometimes, because they're emotionally very upset, and even if their brain understands that we've given them good quality care, their heart still hurts. Often, they don't know how to cope with this. They either end up blaming themselves, or they blame God, or they blame the doctor. I tell them, "For heaven's sake, don't blame yourself. This is a biological process which no one can control, and you need to learn to be kind to yourself." Blaming the victim is a destructive way of coping with IVF failure.

    Blaming God doesn't help either. I believe in a kind God who wants good things for us. I think it's helpful to have faith in a higher power who we feel is looking out for us. Whether you're religious or not, this belief can help you cope with dark times, even when you cannot make sense of his actions.

    As far as blaming the doctor goes, I don't like being blamed of course, specially when  we have put in a lot of effort , and given patients the best possible medical care. We spend a lot of time counselling patients, and explaining to them what we're doing and why, so they know exactly what's happening. However, I'd much rather that they blame me , rather than themselves, because I have a clear conscience, and I know we've done a good job. Since I know no one could have done anything more, blaming me does not hurt me, and if using me as a punching bag helps to relieve my patient's distress, than I am happy for them to do this . I can deal with that blame, because I know it is mis-directed. I feel that giving them a target to get angry with helps them to vent their anger , so they can move on.

When an IVF cycle fails, the predominant emotions are one of depression and sadness, and this can be hard to deal with. When you feel sorry for yourself , you feel powerless and alone, and get paralysed into inactivity. Compared to this, anger is a better emotion, because you can channel it into doing something else - and I believe this is better than not doing anything at all.

    I tell patients that they need to find the strength to cope with this blow within themselves. While growing up, all of us have dealt with disappointments in our life, and we have sources of solace we can tap into. This could be a spouse; family members; friends; relatives, or a spiritual authority , such as a guru. While I can help them analyze what went right in the cycle and what went wrong , there are still lots of grey areas we can't figure out - what we call the unknown unknowns, because IVF is still not an exact science.  However, no amount of analysis can provide comfort when the cycle fails, and healing finally has to come from their heart.

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