It is impossible for those of us who have been able to have children at the drop of a hat to put ourselves in the position of couples who so yearn to become parents that they are willing to risk depleting themselves emotionally, spiritually, physically and financially in the process.

I’ve often asked myself what drives infertile couples to be willing to sacrifice so much in an attempt to achieve parenthood. The conclusion that I have come to is that while for many, having a child is the ultimate consummation of a loving relationship, the basic driving force behind procreation is the fact that that we as humans all yearn to leave some tangible evidence of our existence behind when we depart this world. We can’t take our possessions with us, and our fame and personal achievements rapidly fade from memory when we are gone. All that remains as proof that we were here is the genetic thumbprint we leave behind in the form of our offspring. I believe that is the fear of being denied the opportunity to gain some degree of immortality through our progeny that motivates infertile couples to go to virtually any length to have children.

Wouldn’t it be wonderful if we as physicians could help every infertile couples achieve their goal. But alas, the truth is that no matter how good we are at providing reproductive medical services, this is not possible. There will always be some couples who, in spite of availing themselves of all infertility treatment options and state of the art therapies, will remain childless. For these couples, adoption is an excellent option because it solves both infertility and a social problem at the same time.

When it comes to fertility treatment it is as well to remember that while doctors can improve circumstances that favor fertility, we are unable to create life. That is way above our pay grade. When we understand that the “creation of life” requires a divine spark, it makes it much easier to understand why best effort is not always rewarded with a successful outcome. The realization of this sobering reality will help ground us and inject much needed humility in the way we treat human beings who entrust us with their care. It is about having the right intent, the proper application of tried and tested methodologies, coupled with the realization that ultimate success comes through the grace of a supreme being that ultimately provides all parties (i.e., patients, physicians, families and society) with the best possible medical service.

I firmly believe that to be both successful and rewarding at all levels, the treatment of infertility mandates that from the very get-go, patients and medical providers interact at the basic human level – one person to the other – and thereby establish a clear understanding of one another’s motivations and intent before proceeding to the intricacies of therapy. It is only through dialogue at such a grass roots level that patients and physicians can come to recognize each other as human beings that, while they might differ with regard to their areas of expertise, share a common humanity. Only once this has been established, and suspicion of intent has been cast aside, can medical care be optimized and the relationship between physician and patient become fulfilling. Any physician who has avoided the indignity of patient-driven litigation will tell you that it was because they interacted with their patients, keeping them informed at all times, and did so with deference and respect.

So, it is as well for consumers of IVF care and physicians to understand that failure to achieve a pregnancy does not mean failure of treatment, provided that such treatment was medically appropriate and administered in a spirit of good intent and humility.