Infertililty treatment: How long should you persevere?

I feel ashamed. I love spending time with our friends' adorable children, but today I can't cope with their visit. I've felt the panic rising since yesterday, but have been trying to ignore it. I've been running and re-running scenarios in my head: I could start cooking when they arrive, so that I'm in the kitchen for the most part, and then occupied with eating and clearing away. Even better, I could send parents, children and my husband, Bruce, out walking with our dogs, so that I have space to deal with how I'm feeling.

Since making the decision to stop our fertility treatment and accept the unsuccessful outcome, being with kids is generally OK, but without warning my distress at not being able to have Bruce's child jumps up and bites me on the behind. I'm having a wobble, and I don't know what to do.

I snap my head around to look at the kitchen clock: noon. They're due any minute. If I really can't cope, I need to leave, but Bruce is out, so he'll wonder where I've gone. If they arrive and I'm alone, I'm going to burst into tears as soon as I see them. Our friends will feel awkward, and I'll be too embarrassed to explain.

I leap up the stairs, my heart racing. I grab a coat and fold it around me, trying to find a hug of reassurance in the material. I wonder how to explain to Bruce how I'm feeling or where I've gone. I decide to text him once I'm out the door, but he arrives home, "springing" me, bag slung over my coat, car keys in hand.

"Hi, honey, where are you off to? Forgotten something for lunch?" He smiles at me, so trustingly that I feel my eyes fill with tears, plus a pang of guilt. "I can't do it. I'm sorry. I can't be here."

As I close the door behind me, I start to feel calm.

Deciding to end fertility treatment was the hardest decision we've ever had to make. How do you begin to make the decision to give up on trying to have a child of your own? After four failed cycles, my health was deteriorating and our relationship was suffering as I became more and more obsessed with achieving what I'd set out to do. But the decider was when my consultant told me that my chances of conceiving were slim without more intensive IVF, and even then they were only about 2 to 5 per cent.

From the beginning, Bruce's diagnosis was conclusive. "It doesn't make you any less of a man, you know," were the comforting words of our former GP shortly after she had told us that all of Bruce's three sperm tests were negative. We didn't know that a zero sperm count was possible. Azoospermia, the condition where the male reproductive organs produce no sperm, can be caused by a missing section of Y chromosome. Despite recent advances with stem cells, it represents the Black Hole of infertility treatment and donor sperm was our only option. I was unwilling to try this at the outset, because I love Bruce and found the idea of allowing a stranger's child to grow in my womb abhorrent. I overcame my resistance because I wanted not only to give birth and be a mum, but also to give Bruce the opportunity to be a dad.

Initially, we hoped that there might be another explanation for the absence of sperm: a blockage, for example. Bruce endured an exploratory procedure called a Testicular Sperm Extraction (Tese). We went private because the NHS waiting lists were long and I was already 38 years old. The Tese involved removing 15 tissue samples with a needle under local anaesthetic, searching them for sperm suitable for use in fertilising one of my eggs with ICSI (Intracytoplasmic Sperm Injection). I wimped out of accompanying Bruce into the operating theatre, but boy, did he earn my respect and prove his manhood on that day! Sadly, no sperm were found, and we even received a £250 refund on our £1,100 bill because there was nothing to freeze for future use.

After three failed cycles and the loss of my career as a live event producer, my self-confidence was in tatters and our relationship under threat, due to my obsession with getting pregnant. I needed professional help. Bruce chose not to take advantage of the counselling offered by our clinic, so I went alone. Bruce dreaded coming home on the evenings I had been with the counsellor, because my mood was usually sombre. To his credit, no matter how little he wanted to talk about it, he always had the conversations.

With insight, I slowly and painfully decided that my failure to get pregnant could be protection for our relationship - probably for the best. I certainly couldn't face putting myself through another cycle. We stopped treatment, after two years of trying. But faced with the reality that you are never going to have your own child, how do you make the decision stick?

After an 11-month break away from the clinic, desperately trying to regain the fun of our former lifestyle, we had the courage to admit to each other that we hadn't quite finished. We told no one about my fourth attempt. However, listening to a radio phone-in one morning, Bruce was incensed by the ignorance of the callers who were commenting on sperm donation: only lesbian couples have a use for them, and people who can't have children should be made to adopt. He went on-air declaring our circumstances to the whole of London; much to my embarrassment as I was at the clinic at the time, waiting for a scan. Our last cycle was also unsuccessful, despite excellent prospects, so that was that.

"Why not adopt?" is the question I'm asked when I say that we have stopped trying to have a baby of our own. Well, to be honest, my husband is the love of my life, and I wanted his child; every other option, including adoption, seemed too many steps away from what we wanted to do in our hearts. I firmly believe that any child has the right to be loved for who they are, and that adoption is something you both have to feel passionately committed to; that doesn't make me particularly proud of myself - but it's the truth.

Twelve months after stopping, I was still feeling the persistent shadow of a maternal longing. I knew it was only hormones, but how to subdue it? During my counselling sessions, one of the most helpful things said to me by the counsellor was: "You are a woman of 40, and you want a baby. It's a biological imperative, I don't think you really need analyse it any more than that." If adoption wasn't the natural next step for us, how else could I find an outlet for my desire to nurture? Well, our dog Barney helped me through the worst of the depression and ill health I suffered during the insemination cycles. He gave me a reason to get up in the morning - I had to go walking everyday, and found daily support from our friends and fellow dog-owners. As a vote of thanks in a way, and to find a companion for our faithful friend, we decided to apply to Battersea and re-home another dog. Our names were placed on a waiting list.

Three months later, we introduced eight-week-old Guz to our home. This terrier cross-breed had been abandoned, together with two other litter-mates, at one week old, in a back garden. So I rescued Guz and he rescued me.

Where I am now on my journey? I would like to leave a door open to the thought that I would give fertility treatment another try before it's too late - but when I imagine picking up the phone to make a new appointment with the clinic, I don't think I could, and actually, I know that I won't. I'm happy to let time do the rest of the healing.

Caroline Gallup is the author of Making Babies the Hard Way, available from Jessica Kingsley Publishers, www.jkp.com

When should you stop treatment?

* Is your treatment pushing you apart as a couple?

* It's a biological imperative - your body is urging you on, but you don't have to keep obeying the order.

* Are you regarding all of your life as a failure, just because you are not being successful in this one respect?

* Are you doing this for each other, or are you doing it for your your partner? Keep talking and checking with each other. My husband kept "giving me permission" to stop, but I didn't believe him.

* Are you satisfied that you've left no stone unturned and that 40 years down the line, you will feel you did everything you could while you had the opportunity? Write a letter to yourself, imaging how your life will be, just the two of you, or you on your own.

* Talk about what attracted you to each other in the beginning. Can you re-discover any of the pastimes you have lost as a result of the rigours of treatment? What will you be able to do if you stop treatment, which you would not have been able to do if you'd continued?

* Keep talking, no matter how difficult it becomes. Bruce hated coming home on the nights I'd had counselling, because he didn't want to keep going over and over the same ground about whether or not we should continue - but he always had the conversations.