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Finding a way out of the infertility maze
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Dr. Aniruddha Malpani
Renowned infertility specialist. He runs an infertility clinic in Mumbai and has written many books.
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Dr. Margarete Sandelowski, Professor at University of North Carolina at Chapel Hill, has done some very exciting work in exploring how couples cope with their infertility.
She observed that infertile couples often find that they are trapped in a maze; and they exhibit six patterns of pursuit in their quest to exit the maze.
These are:
- Sequential tracking
- Backtracking
- Getting stuck
- Paralleling
- Taking a break and
- Drawing the line
This research describes the behaviour of infertile couples so well, that it's a shame mazing has not receive more exposure in the infertility literature. In this article, I have summarised her findings, which she has described in greater detail in her very well-written book, With child in mind: Studies of the personal encounter with infertility. (1993) Philadelphia, PA: University of Pennsylvania Press.
Sequential tracking
The "sequential tracking" pattern occurs when couples exhaust one option before they start another, such as trying a variety of treatment options in sequence for a number of cycles. When pursuing medical treatment, couples move from simpler, less intrusive, and less high-tech procedures to more technically complex ones. For example, some will do 4 cycles of IUI, before moving on to the next step, which is IVF. Importantly, there is no one sequential tracking scenario. Some couples found out quickly what their fertility problem was, some couples moved quickly to more complex diagnostic or therapeutic techniques, and other couples moved slowly as problems were found that turned out to be "minor", "insignificant", "borderline", or unresponsive to initial treatment efforts. What distinguishes tracking is the orderly step-by-step move from one previously untried procedure to the next.
Backtracking
A second pattern of pursuit is "backtracking", in which couples restart a diagnostic or treatment plan when they changed their doctor; or return to a previously attempted treatment or adoption option. Couples also backtrack when their physicians felt that a procedure had been improperly done or when their physicians did not have the results of a previously conducted test, or when a factor that can change over time, such as sperm quality and quantity, mandated that it be evaluated again. In all these variations of back tracking, couples moved over ground previously travelled.
Getting stuck
A third pattern of pursuit is "getting stuck". Seeing, believing, or being encouraged by their physicians that persistence paid off, couples who got struck in a treatment groove attempted the same regimen over and over and over again - though they have often crossed the point of diminishing returns. This is sometimes because they cannot afford more aggressive treatment options, and are not willing to consider other alternatives. These couples are often optimistic about succeeding the "next" time.
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