Sitting as I do with one foot in the infertility world and one foot in the adoption world, a question I hear a lot from people is whether they have to stop infertility treatment before they can apply to adopt. I suspect adoption agencies and social workers don’t hear this question as much since most people aren’t comfortable asking them this question. Quite frankly, it is a bit of a sensitive hot topic in adoption circles.
Over the years (Gulp, that sure makes me sound old!), I have talked with many adoption experts and therapists about this question, and there is disagreement about the advisability of continuing to pursue infertility treatment and adoption at the same time. Some adoption agencies prohibit the practice, some discourage it, and some allow it.
It should be noted that even when prohibited, plenty of folks waiting to adopt are checking their ovulation, timing their sex, and perhaps taking an occasional Clomid. Some stay in full fertility treatment and just don’t mention it to the agency. I think it is helpful to think through whether staying in treatment or actively trying to get pregnant is in the best interest of you, your family, and especially your future child.
Arguments Against
Those that oppose pursuing both are concerned that on some level (perhaps unconsciously) you will consider adoption second best. They view continuing treatment as a red flag that you have not come to terms with your infertility losses and may have trouble bonding with your adopted child. The financial drain of pursuing both may also put undue stress on the family.
Arguments For
Others do not think pursuing infertility treatment and adoption are mutually exclusive and that it is possible to pursue both without lessening your commitment to either. They point out that adoptions are taking longer now, so it is unreasonable to prohibit trying to get pregnant during the long wait.
My Thoughts
I have mixed feelings.
While I see it as possible to pursue both in an emotionally healthy way, I also think that it’s harder than most people anticipate. Infertility treatment is all consuming—emotionally and financially. As long as you are in treatment, there is still hope, and as long as there is hope, you have not had to come to terms with all the losses that infertility presents.
Infertility is not just the loss of being a parent; it is also the loss of having a genetic connection to your child, the loss of being pregnant, the loss of the opportunity to breastfeed, the loss of seeing the “perfect” mixing of your and your spouse’s genes, and the loss of your dream about how your life would play out. Adoption only addresses the loss of being a parent, not all the other issues you need to grieve. It is not until you stop treatment that many of these losses hit you full force. Before that point, they are just theoretical. I’m here to tell you that there is a world of difference between a theoretical loss and a real loss.
From my experience, it takes time and commitment after fertility treatment stops to work through the various losses associated with infertility. It also takes time and commitment to pursue an adoption.
You owe it to yourself to work through your infertility grief, but mostly you owe it to your soon-to-be child to do this work. You also owe it to yourself and your child to not get pregnant right before or right after she comes home. In an ideal world every child deserves the limelight alone for a little while.
If you decide to pursue adoption while in infertility treatment, seriously consider talking with a therapist who specializes in infertility to make sure you are really ready to whole heartedly parent an adopted child. No child deserves to be anything but first in his parents’ eyes.
P.S. I strongly recommend the fabulous book Adopting: Sound Choices, Strong Families by Patricia Irwin Johnston. The first part of that book addresses the various losses of infertility and suggests a plan to help you work through your grief and decide if adoption is right for you.
Other Creating a Family resources you will enjoy:
- Transitioning from Infertility Treatment to Adoption (radio show)
- Owning the Right to be Sad When Moving to Adoption (article/blog)
- The Infertility Treatment vs. Adoption Wars!?! (article/blog)
- “Once You Adopt You’re Sure to Get Pregnant” (article/blog)
Image credit: girl_onthe_les
“In an ideal world every child deserves the limelight alone for a little while.” I get what you’re saying but that only happens for first children, not twins or second-born, etc.
Anna, true enough for twins, but by “limelight” I was referring to the time when a child first arrives. This is a time of intense adjustment for everyone and a time of awe. When a baby first arrives that new baby has the “limelight”.
I was looking through some adoption websites and found this interesting page from an organization called Adoption Network Law Center on dealing with infertility, and moving from infertility to adoption. I think it really hits the button on what this blog is discussing and thought some of you may be interested in reading it.
Thank you, Dawn and all of you for your moving, insightful personal stories and comments. As the former clinical director of RESOLVE, the national infertility association, the author of THE BABY DECISION, and a clinical social worker specializing in infertility and adoption, I believe it is possible to pursue fertility and adoption simultaneously. I have worked with many people who have done so quite happily and successfully. I have been speaking at RESOLVE conferences on this topic since 1982, and have gotten validation of my ideas from in-the-trenches people and from adoption workers. The determining factor, I believe, is that you must have grieved thoroughly enough about not having a biological child that you are ready love an adopted child for the unique person that she or he is, and not as a substitute for a biological child. For people who have conscientiously done this homework, usually with a psychotherapist specializing in infertility and adoption, the blended family typically works well.
You may wonder, how can you grieve over not having a biological child if you are still trying?
My response is that you are grieving over all the lost potential babies you missed out on in the months and years of getting your period or having pregnancy losses. Your mind is capable, especially when you are at the tail end of treatment (the time I think simultaneous trying is appropriate), of grieving these losses and the probability of not having a biological child. At this point, I believe, most of you are ready to welcome your adopted child and adapt to a biological child and love them equally.
While I agree that having a break from fertility and devoting yourself entirely to the adoption process is ideal in terms of getting the most out of your home study, this ideal is not practical for people who are older and hope to have at least one child, or under many of the circumstances faced by many of you wonderful commenters!
I want to offer you all my guidelines on simultaneous trying for adoption and fertility, an excerpt of my book, THE BABY DECISION, originally published in 1981, but which I have revised and updated to include my 35 years of experience with RESOLVE and in my workshops and clinical work. It will be available in June, so I would like to offer Creating a Family a sneak preview of these guidelines.
Dawn, I am sending you the excerpt in a separate document so that you can post it as you see fit.
Of course I reference CREATING A FAMILY multiple times in THE BABY DECISION and will add this most inspiring and value post for my readers’ benefit!
Thanks so much Merle for your wise words.
We didn’t plan to continue treatments once we started the adoption process. I firmly believed I had put that behind me. However after 2.5 years of waiting and a failed placement that completely devastated us, we decided to try IVF again with donor egg. I got pg but miscarried at 8 weeks, exactly 2 days before we met our now daughter through adoption. Our agency never knew we were pregnant, at the time we were not very happy with them and felt like it was none of their business. I was still very early and we were coming up on three years of waiting. We weren’t going to close any doors at that point! Sometimes you just don’t know where the journey will take you, sometimes it takes twists and turns you did NOT expect! BTW, I am now 7 weeks pregnant from another IVF/DE cycle. I never thought in a million years we would ever do IVF again, especially with donor eggs!
I see nothing wrong with it. When trying to build a family you don’t close a door unless there is no other choice. We always planned on having a mix of birth and adoptive children and now I have 3 adopted children and a birth child.
Ann and Mandy and everyone else, please also post your comments over on theblog itself so non FB folks can benefit from your wisdom as well.
@Ann – all children should be parented with the same love – absolutely! I think in our case – we'd gotten to the point with IF treatment where it was oocyte adoption and then they started to say that we'd need ICSI and then we had a failed cycle … but when you went back to the next assessment appointment rather than say STOP they'd say there's something else we can try…We took a year off (not deliberately) but just happened and then we thought we want the family more than the pregnancy…
I did assure them I would not actually accept a referral until my youngest was a certain age.
I am pregnant and in the process of adopting. (We started the adoption process about a year before this pregnancy). My husband and I chose to both to conceive another child and adopt (we have been fortunate enough not to have struggled with infertility). My agency does not have an issue with this, especially considering that the adoption process is projected to take us another 2 or 3 years. I am wondering whether the same agencies that frown on infertility treatments during the adoption process would also frown on our situation? I'm a bit confused.
@Ann. We came to the decision to adopt when we asked the question – did we want the pregnancy or did we want to be a family ? It did help that we'd been out of the IVF / oocyte loop for about 12 months by that time. Infertility clinics are great at *selling* the pregnancy dream.
@Ann – all children should be parented with the same love – absolutely! I think in our case – we'd gotten to the point with IF treatment where it was oocyte adoption and then they started to say that we'd need ICSI and then we had a failed cycle … but when you went back to the next assessment appointment rather than say STOP they'd say there's something else we can try…We took a year off (not deliberately) but just happened and then we thought we want the family more than the pregnancy…
I think that heart grown children and womb grown children all deserve to be equally wanted children. I know folks who parent period, and the heart grown kids need to feel cherishable and wanted just like womb grown kids.
I did assure them I would not actually accept a referral until my youngest was a certain age.
Jennifer, I don't think any of the 3 we used would have frowned on you at all b/c your adoption is projected to take so long. I'm guessing whatever type of adoption it is, your agency knew it would take that long. Part of the stmt we signed was to stop treatment and to take 'precaution' not to conceive. In that respect, then yes they would have frowned on it. But, that's why it's good to make sure you're on the same page as your agency when you begin the adoption process…and sounds like you did 🙂
I am pregnant and in the process of adopting. (We started the adoption process about a year before this pregnancy). My husband and I chose to both to conceive another child and adopt (we have been fortunate enough not to have struggled with infertility). My agency does not have an issue with this, especially considering that the adoption process is projected to take us another 2 or 3 years. I am wondering whether the same agencies that frown on infertility treatments during the adoption process would also frown on our situation? I'm a bit confused.
Just a reminder to you all to please please post your comments over on the blog as well as here. https://creatingafamily.org/blog/ Pat, I'm glad you chimed in since you "wrote the book" literally and figuratively on the losses of IF. I cited it in the blog, but feel free to repeat it in your comment.
Well said, Ann: adoption is NOT second best, only another road to a family. And I was never highly attached to my genes, either. I love that (might have to plagiarize that wording, lol) I was more than ready to begin the adoption process and cease any infert. rx. I believe I emotionally and psychologically dealt with it long before we physically closed that door.Mandy: Our decision was largely financial as well: it was more feasible for us to attempt infertility rx in the beginning, so that's what we did. We did not exhaust our efforts financially b/c we quickly learned that we were wasting precious time. We just wanted to be parents and we did not care how that child came to us…so we took the financial plunge and applied for our homestudy. That said, I can also understand agencies' hesitancy in accepting clients unless they sign the infertility stmt. They want the child you're adopting to have your full attention, right? And any issues one might have about infertility to be dealt with properly and resolved before pursuing adoption. I definitely understand that as well. My fert. specialist seemed to be very genuine and honest, and I appreciated that. I can only speak from our experience, but it's terrible to think that there are some out there 'selling' a pregnancy dream (altho I'm sure it happens every day).Interesting topic, Dawn!
I think almost the whole adoption world knows how I feel about this. Trying to deal with both processes, which are completely different, makes it nearly impossible to move into the early attachment process which is part of both physical and emotional "expectancy." Additionally, the risk of artificial twinning is too great, and is certainly not in children's best interests.
I think some docs and clinics are more supportive than selling. My first plan was to adopt and tried to get pregnant (with donor sperm), so I was never highly attached to my genes running around. It was very easy to return to an adoption route to parenthood when I found out I could not tolerate the increase in progesterone a pregnancy would entail. Adoption is not second best, it is just another road, and a child should never have to feel a hint of being second best and I have known people who really could not come to terms with adoption being just another road, and adopted any way. OUCH!
@Ann. We came to the decision to adopt when we asked the question – did we want the pregnancy or did we want to be a family ? It did help that we'd been out of the IVF / oocyte loop for about 12 months by that time. Infertility clinics are great at *selling* the pregnancy dream.
I have no personal experience in this situation, but my concerns are financial, because both infertility treatment and adoption, and on the emotional/psychosocial realm when people think that adoption is second best instead of simply another road to parenthood. If adoption is second best, with or without ceasing infertility treatment, adoption is not for your family. My two cents worth.
Most of the agencies I've seen ask you to sign a stmt that you have or will be stopping any infertility treatment. We've worked with 1 homestudy agency and 3 int'l agencies…and all have similar stmts.
In the UK continuation is a big no no. The agency we used (local authority) would refuse to consider you even for training / assessment if you were still undergoing IF treatment. I think you had to be stopped for about 12 months if I recall correctly…
Please don’t slam me if you disagree, it was hard to put what I wanted to say down in writing and how I phrased something below may not be the “best” way.
We continued to pursue the tail end of our infertility treatments as we did the paperwork for our adoption. Basically, after IVF #4 failed, we kind of gave up on infertility treatments and we started the 6 months of paperwork to adopt internationally.
But, because of some insurance changes, our only opportunity to use up some frozen embryos was just as our dossier went out. Well, surprisingly the FET worked. While we were pregnant, we delayed the adoption 8 months (the country we adopted from was just reviewing our paperwork during that time anyway) and then reinitiated it when our biokids were 7 months old. We almost immediately were assigned our daughter and went to get her 2 months later. She is 5 months older than our biokids. They get along great and are in the same class in school.
If we had waited until the biokids were 12 months old as many suggest, then all our Immigration paperwork would have expired and we would have basically had to start that all over. Not something I could have contemplated when we had babies to take care of.
For us, there is really not a difference in how we feel about our kids…they are all just our kids. Obviously, since our daughter through adoption is of another race and thus was obviously adopted, we do have to deal with overly curious people when we go out and we have to direct time and resources to giving her and her sisters experiences related to her country of origin. The only thing that we really missed by adopting, is not having been with our daughter from her birth; she was already walking and babbling when we met her. We miss that early time, but that is not really an option when you adopt internationally.
Personally, in reflection, as both the survivor of 4 years of infertility treatment and an adoptive mom, it would have been easier emotionally to have started the adoption process earlier, before as the previous poster mentioned, that was the “only” option. Maybe not so it would have been a “choice” but so that you can leave it up to fate/luck which way would work first to bring you your child. Kind of like fertiles might have a preference for either a boy or girl, but are happy with whichever fate gives them.
Also, maybe you would not be as desparate when you had setbacks in one or the other path. Regrettably, both methods have LOTS of “hurry up and then wait” periods, so you can do both. During an IVF cycle, you are intense for 3-4 weeks, but then if it fails, you have to wait 2 months to start over. During our adoption, I was running around frantically getting paperwork done, then spending weeks on end waiting for our social worker or Immigration to do their parts.
In our case, we had already faced the issues related to what particular aspects of becoming a parent mattered to us and for us it wasn’t really biology so much as having a healthy child from a young age. I did want the opportunity to experience pregnancy though and with the way it happened, I did.
By the way, the agency we dealt with did not make us sign a “no more fertilty treatments” pledge…one reason we chose them. They said that they usually have at least one couple on each adoption trip that is either pregnant or has recently had a child. For us, finally succeeding at pregnancy did not remove our desire to adopt. And I think that by the time many people have suffered from infertility for several years, they are open to the idea of a blended family because many infertility “treatments” require one of both parents to not have a biological connection anyway.
There is another local couple that used our agency. They had “unexplained” infertility. After starting the adoption process, they unexpectedly got pregnant without any medical assistance. They also continued with their adoption and have 2 daughters very close in age.
Great post. My wife and I talked about this issue when we went through infertility and decided it was best to focus our energies in only one place at a time, and to do that area with everything we had. Your point in the second to last paragraph about letting a new child have the limelight is an important one too. Thanks for these great thoughts!
We pursued both adoption and fertility treatments at once precisely because I never wanted to feel like adopting was our last resort, our second choice after exhausting all other options. I wanted to choose adoption while it was still a choice, while conceiving was still a possibility. Now we have adopted and couldn’t be more thrilled that our little boy has made us parents, and continuing with fertility treatments now is not nearly as painful as it was before we had him since our ability to become parents is no longer on the line–just whether or not we’ll pass on our genes (a big thing in itself, of course, but not as huge as fearing I’d never be a mom).
We have been thinking about doing exactly this. We want to have a baby one way or the other. I think I would be able to do both, but after reading your thoughtful points, I’m not sure. I really don’t know if my husband is ready. I made him read your post on You know you’re ready to adopt when…. He flunked it. Thank you for giving me something to think about. From what the other people have said, no adoption agency would consider it anyway. Infertility is so HARD!
Great post. It presents a very balanced and informed view on the pluses and problems of pursuing both family building options at once.
~ICLW
Three years ago we tried to adopt through foster care but I always knew I wanted bio kids too. That fell threw and we would NEVER do it again but I really think it would be an emotional nightmare to try to pursue both at once.
I wholeheartedly agree. Though we are not yet on the path to adoption, and, in fact, don’t know if that would be the next step in our journey, I think about it a lot. We could do it in tandem with treatment, but I wouldn’t be wholly invested in it and that isn’t fair to anyone. If we opt to pursue adoption (or fostering), we want to do so with a completely open and willing heart. We can’t do that until we’ve wrapped up treatments and fully accepted that path isn’t right for us.
Thank you for sharing your perspective.
My agency let’s you know in no uncertain terms that you need to be done with fertility treatments and if you become pregnant while you are in the process, the adoption stops. I briefly considered trying again because I can’t really say I’m infertile. I don’t have a partner so I tried ART twice and it didn’t work.
I only decided not to do it again because of my age and the statistics about children of mothers in their 40’s. But it’s fine. I do think that you need to really need to make sure that you can live with a blended family and your capable of making no distinction between adopted and bio kids. Some people can’t do that (neither can extended family), and it’s is to the detriment of their adopted children.
Dawn,
I agree with you. As founder and director of a licensed adoption agency for nearly 30 yrs, I did in fact hear this question a lot and like you, had mixed feelings because I care about people and know the pain and difficulty they go through in grappling with infertility. Still, the focus of adoption agencies must ultimately be the best interests of the children they are placing or helping to place. As an adoptive parent, I also believe that this is the focus of the majority of us as well. All adopted kids, even placed as infants, experience loss in order to join their forever families. They deserve the right to be totally focused on, adored, nurtured and to come into a family that wants them beyond their ability to describe it in words. I think, then, for the sake of the child first, and then for the family that needs to be at a place of complete commitment and readiness to parent by adoption, there must be some time first to put the fertility treatments behind them.
Our agency always felt that we could not create happy, successful families without caring about the needs of all of the parties involved, so there are always individual variations and needs and we had to be sensitive to that and not make global decisions. As our agency winds down operations now, and I expand my practice as a Certified Family and Relationship Coach, including private coaching and groups for prospective and adoptive parents, I continue to feel that there are no absolute rules though, and each family knows in its heart what is best for themselves and the children they hope to have.
Here in Australia (where all adoptions go through the state departments and not private agencies) you are not allowed to do both. In fact you have to sign a statement saying that you are not pursuing fertility treatment before they’ll even start the assessment. It frustrates a lot of people because it can take a year sometimes just to do the assessment, and then all the countries that Australia has adoption programs with have a waiting list of a minimum of 3 years…
But I think your point about grieving the loss of a biological connection, pregnancy, breastfeeding, etc is a good one, and here I think it’s also done to encourage people to really think about the backgrounds of the children up for adoption and to learn more about attachment issues and child trauma… Fertility treatment and adoption are really not interchangeable and I think it’s good to have a break from one before embarking on the other. (Of course, I can say that from here because I only ever wanted to adopt! LOL)
I really think this divide comes down to how people view blending adopted and biological children. People who think it’s good to have blended families think pursuing both at the same time works. For example, many Christians adopt as a mission, not due to infertility, so you see virtual twinning. While people who have a bias against blended families come out against pursuing pregnancy and adoption concurrently.
And, just because I’m commenting, I NEED to say that adopting doesn’t mean giving up the dream of breastfeeding. Many many adoptive mothers successfully breastfeed. Dawn, I would love to see you give this subject more attention – on your blog and radio show. But at the least, you could avoid spreading the misconception that adoptive breastfeeding doesn’t exist or won’t work.
Oh Mama K, I knew when I decided to not mention adoptive breastfeeding that someone would point it out. Thanks for doing so. From a focus standpoint, I decided not to include it in the blog. We have addressed it on the radio show before, but I do take your suggestion that we could address it more often. 🙂