Chasing a miracle: why infertile women continue to stay in treatment.

Abstract: This article discusses the reasons infertile couples continue to remain in infertility treatment. Through a qualitative research approach, using eight openended questions, the author interviewed a convenience sample of fourteen women in a large Midwestern academic health center reproductive endrocrinology group practice, to identify reasons that influenced their decision to stay in treatment. The desire to have one's own children was the motivating force which helped sustain a sense of hope in these women fueled by the advanced technology advocated by their physicians. Support for these women were mostly from spouses and family members with friends with children not being very supportive. The lack of patient education was seen as a very negative influence by most of the participants. Key Words: Infertility, Infertile Couples, Treatment for Infertility, Infertile Women, Fertility, Advanced Technology Approximately eight percent of married couples in the United States and more than one million new patients sought infertility treatment during the past decade (Mosher & Pratt, 1991). Advanced technology created more options, and therefore, gave a sense of hope to many infertile couples that they might have biological children. Gaze (1990) found that deciding to give up this treatment was the greatest difficulty faced by these couples because it meant that they had to come to terms with a childless future even when the proliferation of techniques continues to increase the available options. In today's society, to be female is to be identified with biological reproduction as the most essential female function (Calloway, 1978). The diagnosis of infertility is thought by many to be a personal failure in terms of achieving a developmental milestone (Lindell & Dinen, 1986). These couples must come to terms with their problem, face reality and decide how they will proceed with their lives recognizing that the new technology offers temptations and attracts them to seek and engage in continuing treatment. The purpose of this study is to explore the reasons why the infertile woman continues to remain in infertility treatment. IMPORTANCE OF STUDY This study will assist in the development of an intervention strategy to assist women in making informed choices regarding infertility treatment. The importance of exploring factors which influence women's choices to stay in treatment will assist the infertility care provider to plan care that will include completion of the grieving process and in assisting couples to maintain a sense of control in their lives. The increased knowledge will increase the scientific basis upon which nurses practice and would assist infertile couples in making knowledgeable choices. REVIEW OF THE LITERATURE After a comprehensive review of the literature, it was found that a number of factors entered into the choice of infertility care. Choices patients make regarding fertility treatment are influenced by the ways in which data are presented to them (Mazur & Hickman, 1990). These factors have been organized to conceptualize the multidimensionality of women's choices regarding infertility care. Characteristics of the infertile woman is the first factor. For example, numerous studies have shown that 89 percent of these patients are Caucasian with an average age of 31 to 34 years, have a college degree and are engaged in a professional occupation (Blenner, 1992; Frank, 1990; Olshansky, 1987). Characteristics of the infertile care provider is another factor which must be considered when reviewing patient infertility decisions. For example, patients viewed the reproductive endrocrinologist as competent if they used all the technology at hand and assumed the role of "miracle worker" creating high hopes and expectations of success (Wind, 1986). The prevalent mode of physician interaction was paternalism, wherein the physician assumed the role of expert or someone who knows best and makes the decision for the patient (Taylor et al. …