I vote no. I know from my experience that had I needed IVF, I would not have qualified due to my high FHS levels and diminished reserve plus severe endometriosis at 33, but would have liked to have tried anyway. Its hard to let go if you have not tried every avenue. As it turns out I still managed to conceive without IVF regardless of my health issues.
I voted no based on my own experience. I had a doctor tell me after 3 failed IVF's that he didn't see the point in my continuing with my own eggs. The clinic was far too concerned with their stats, and although I had heard this I didn't expect to be turned away after 3 failed cycles at the age of 33. The eternal optimist in me couldn't give up. I went on to do 4 more cycles before finally accepting that I had to move on to donor eggs. (Best decision of my life by the way) However I was no where near close to being able to accept it back then. I was furious with the doctor for turning me away. I even asked him "If I'm fully aware of the odds, and willing to spend the time and money, why are you not willing to help me?" He just answered with "I just don't see the point." Charming!
So here's the thing. Women are autonymous and adults. Given the full truth from a doctor, it is up to her to make the decision. You give ANYONE the right to control what goes on in a woman's uterus, then the slippery slope starts and the next thing you know, the government is right back in there saying THEY have the right to decide. A woman's body is her eminent domain and NO ONE else should EVER have the right to tell her what she can and cannot do with it.
Now, having said that, I think if she goes to several different doctors and they all tell her that they cannot in good conscience take her money for a procedure that they know will not work, she'll eventually understand that it's time to move on. And I say this from experience. After 7 years of trying everything including donor eggs in my dustbowl of a ute, I have just signed the contract with a surrogate and egg donor. It was the most painful decision I've ever made. But it took me 7 years and 5 clinics all trying a round or 2 or 3 with me, then telling me they'd done all they could before I could face the facts that it was time to move on. Still - that decision was MINE and mine alone to make (well, my better half had some say in it too but you know what I'm sayin!)
I voted yes. Like several other people commented, the doctor must adhere to professional ethics. If in this doctor's opinion, it's just too low a chance to try, then he should deny treatment. It's quite possible that another doctor would have a slightly different (honest) opinion of her chances, and would be willing to give it a shot. That being said, I'm a DE mom after 8 cycles with my own eggs (mostly IUIs because I didn't produce enough to be worth retrieving). I wasn't ready to go the DE route until I had exhausted the hope that we could find that one golden egg. Now, had my doctor been more forceful about DE (like, denying me treatment), would I have gotten there sooner? Interesting question. Maybe, but maybe not... Interesting topic!
I don't believe the doctor has a professional obligation to supply services, for an elective procedure, against medical advice, to anyone who requests them. Your friend has every right to want what she wants, but that doesn't mean the doctor will or must change their protocol to suit her. (Unless there are laws governing this I'm not familiar with, and that's entirely possible.)
Also, with that low a risk of success, can't you look at all the possible side effects of the drugs and crummy outcomes of the procedures (perforation, sepsis, unknown??) as carrying such a comparatively great risk to her life that they outweigh the miniscule chance of success? I mean, if you were a doctor, the first rule is do no harm. If your chances of doing harm outweigh your assessment of doing good, aren't you obligated to withhold the harmful treatment?
I think it depends on the woman's insurance and ability to pay. If she can afford it, and it's her dime (or her insurance policy), then she has every right to insist on the IVF. The doctor must tell her the honest truth about her chances, and then should say "But it's up to you."
(Caveat- we just had a woman in the U.S. who gave birth to octuplets, after already having six young kids already. She says she did IVF and transferred six embryos (two split). She's only 33. That doctor was totally guilty of malpractice, in my opinion. NO WAY should any doctor transfer that many embryos in a young woman, regardless of what she thinks she wants.)
I don't blame her for wanting to try and wouldn't blame her for wanting a second opinion or doc-shopping, but I do feel that the doctor is well within his rights to refuse an elective procedure, whatever the reason.
He is within his professional right to refuse service. This sounds like someone with integrity. And, even if she went to someone else who would do the IVF with her eggs and she failed, I bet the origianl doctor's refusal will start to carry more weight and ultimately get her to use DE faster.
Not that I don't blame her for going to someone else. I would, too.
While I do see both points of view and certainly understand the conflict, at the end of the day I feel that provided the patient and her significant other know EXACTLY what they are up against (this could include counselling of some kind??) it should be her right to choose.
Her body, her money, and her right to believe in miracles.
I voted No. I was 37 when I did my first IVF using my own eggs, even though our embryos didn't look good, I got pregnant and miscarried. Tried it again even though it was likely that my eggs weren't great. Had not very good embryos again and did not get pregnant. Finally moved to donor eggs and first cycle ended up with a baby girl. Getting to donor eggs was an iterative process for me, don't think I would have jumped to it straight out of the gate so I totally understand your friend's inclination to use her own eggs. If the doctor counsels your friend about the real numbers and likelihood of getting pregnant with her own eggs and she wants to move forward then the doctor should treat her. People make medical decisions with a small likelihood of success every day. Is it ok for a doctor to refuse a cancer patient a treatment because the likelihood it will work is very low? Doctors know a lot but they don't know everything. They aren't always right. And we all have to be advocates on our own behalf.
Professionals have a duty to abide by their professional ethics. As a lawyer: sometimes I have to say "No" to my clients because if I did what they wanted I would, in my opinion, be abusing my license to practice law. Even if they can find another lawyer who is willing to do what they want, and even if that other lawyer gets away with it without incurring any sanctions, still, I must exercise my judgment and abide by my profession's ethical guidelines, to the best of my ability. Doctors also have to exercise their judgment, and abide by medical ethics, in the same way, even if that means they sometimes refuse to perform elective procedures on their patients.
I voted no because of my own personal experience. After 3 failed IVF attempts I was told by my doctor to consider Donor Eggs. (I was only 32 at the time though). Anyway, we went ahead with the next treatment using my eggs and were successful. I would have been devastated if the doctor refused to treat me because he thought my eggs were no good. Like Tertia said, I think you have to keep going until you're ready to face it. A doctor telling you there is very little hope isn't going to change your mind. You have to come to that decision yourself. I would have found a new doctor if I had been refused treatment.
I voted yes, because I don't think the doctor should be forced to go against his/her best judgment when treating a patient. However, I have certainly gone doctor shopping to find one who agrees with my choices and I think your friend has a right to pursue treatment in the way that is right for her and her family.
And, personally I think doctors who make decisions based only on statistics are idiots. Each body is different, each family is different, and everyone should be treated as an individual. Any doctor who refuses to treat a patient because they might fail is an idiot. Would you refuse to treat a cancer patient who has little chance of survival, just because it might hurt your success rate? That to me is obscene.
I see the point of view, from the desire to have a family, and a family that is your own genetically. Sometimes honest answer are the best, and from where I sit 1% is not a chance.
I believe once you know (whether you like the answer or not), then you can move on, and try option “B”. The second, three and maybe even forth choices are not necessarily be mainstream, there are choices none the less. Not saying it is easy.
Voting YES. The doctor base his decisions and suggestions on years of study, personal experience, journal reading and generally keeping up to date
("CONTINUED PROFESSIONAL DEVELOPMENT"-CPD) with the latest protocols and thinking in his field. That's why you go to him/her.
Doctors work under a regulatory body which demands strict adherens to ethical codes that act to protect the profession and the public.
A decision to treat or not is never taken hastily or lightly.
The patient is always welcome to have a 2'nd or 3'rd opinion.
I voted yes. If McDonald's can refuse to serve you a hamburger if you don't have shoes and a shirt then why can't a doctor say no? While I certainly feel for your friend I don't think the doc is to blame.