Suggestions such as “relax,” “take a vacation,” or “just give it time and it will happen,” are commonly heard by patients struggling with infertility. Underlying these comments is the idea that somehow the person suffering from infertility has complete control over it. Unfortunately, many people can’t control it, not matter how they try, and these comments often increase the patient’s sense of frustration and potentially relentless self blame.
We cannot completely control infertility any more than we can control the tides of the ocean. However, we can control how we handle it… or how we surf. Infertility treatment can be exhausting, physically and emotionally. This is a well documented fact. But in order to get pregnant we need to tolerate it, so learning how to surf the waves can increase your chances of staying in treatment and ultimately getting pregnant.
Learning to manage treatment may also provide an added bonus. If we can be thoughtful about the way we manage our time and relationships we may find that we can even improve those important connections in our life. This is no small matter. Although treatment may feel like it will last forever, it won’t. Your friends and family, however, will be in your life years after the agony is gone.
Only Control the Things We Can Control
When I am working with patients, we frequently talk about their disappointment, sadness and fears. Patients tell me about the ways in which they feel a loss of control. They can choose an excellent practice and follow the medical team’s directions. Yet they are not able to create a pregnancy and sadly, they cannot, as they have always imagined, have a baby the old fashioned way. They are not able to make treatment move faster or produce a better outcome by applying more determination and focus.
Heartbreak and frustration often ensue and there seems to be no way out of the nightmare. Sometimes people blame their partners, their bodies, their careers, and of course, the biological clock. The disappointment feels like it needs to be placed somewhere and it is hard to realize that often it’s just bad luck. For many, it is the first time that the patient truly realizes that life is not fair.
Most people in treatment are young enough to have learned that by working hard they can usually meet their goals. As we age, we see more injustice in the world, but when we are young the world is still our oyster and we believe we are in control. It’s hard to accept that some things are out of our hands, but blame will not help. In fact, it can hurt us, as self blame can increase depressive feelings and it can ultimately hurt our relationships with our loved ones.
We Have Control Over our Choice of Providers
Taking action in the areas that we do have control over can help us feel more stable, less depressed, and can give us the opportunity to live without regret. Finding an excellent practice is first and foremost. This is a very practical matter. Statistics are posted in a report by the Society of Reproductive Technologies (SART). You can find this information on the websites of the American Society for Reproductive Medicine (ASRM) or the Centers for Disease Control.
The best fertility clinics see fertility treatments as a process, where the whole patient is considered. The waves are much smoother and easier to ride when your doctor understands. Patients also can connect with a good nutritionist and acupuncturist. RMACT has a wonderful team of acupuncturists and a nutritionist who works with patients individually. These treatments can help you feel better, and provide benefits that may improve your odds for success.
We have Control over our Support Network
Emotional support can be professionally provided in individual-, couples- or group-therapy. Support groups are very helpful in dealing with the isolation of treatment and can supply the patient with a support network. At RMACT, groups are free of charge and numerous. There are specific groups for third-party reproduction and general support. A peer support group also is available for people who would like to talk with others who have walked in their shoes.
It also is helpful for patients to find support for issues they may see as distinct. For example, single women who are pursuing motherhood, or gay and lesbian couples seeking a path to parenthood, may feel particularly isolated. The logistics of treatment also might be more complicated for these individuals. Treatment options could include donor gametes or gestational carriers; issues around these choices necessitate education and support.
We Have Control Over the ways we Manage our Day-to-Day Stress
It is natural for our bodies to have a fight-or-flight response when we feel threatened. Our bodies do not understand that it is the infertility that is threatening us. Like any animal, our bodies prepare to run or fight. Our hearts race, our pupils dilate, our blood pressure rises. If the stress is unrelenting, our depression can increase.
Chemotherapy Stress Levels
We have research that shows that infertility patients can experience the same level of depression as chemotherapy patients. Just knowing this can help normalize the experience. Seeking professional help for support and to learn stress management techniques can be beneficial. Yoga can also ease stress. RMACT offers yoga classes that are designed for infertility patients and are free of charge. If these methods are not helpful to you, find some that work. Finding time to read or take a hot bath, to take a walk in the country, or to get a massage could be just the thing you need to put your body in a calmer state.
Planning a pleasurable but goal-oriented activity also can be worthwhile. Since our bodies feel so out of control, planning an activity like taking a painting class or learning to knit can help us feel more control over our environment. It can be very stabilizing to put effort into something pleasurable (not work) and see the fruits of our labor. No task is meaningless. Just rearranging our furniture or painting a bedroom can be very centering.
We Have More Control Over our Relationships than We Know
Our partners may not understand what we are going through but it is important not to push them away. Our families and friends may say the wrong things or invite us to one-too-many baby showers, but they need us in their lives, and we need them. This doesn’t mean we need to go to every birthday party or answer everyone’s questions. It means that we can control the information we provide and set limits, while respecting and nurturing our relationships.
It is okay to tell people that we can’t come to every first baby birthday party but we will be there for the next twenty. It’s okay to tell our partners and friends that we do not want to discuss treatment when they ask, but that we will discuss it when we are ready. Treatment can be consuming but it is important to remember there are people who care for us and we should try to be available to them in the ways we can.
As with friends, partners may want to withdraw or may feel disconnected from the ways in which you are experiencing your treatment. It is important to respect that you may have a difference of opinion and that is okay. If you need to talk about it, keep it limited and keep some fun in your life. Even if you see a movie and only 20 minutes of it were pleasurable, that’s 20 minutes more distraction, or pleasure, than if you stayed home and crawled under the covers.
You Can make Infertility an Opportunity
When I work with patients I encourage them to make themselves the priority. Self nurturance and setting limits are essential, but caring for yourself also means to consider those around you. Being mindful of this will help you surf the waves of infertility and its treatment by helping you and your relationships feel more stable. It is not possible to control the diagnosis or the outcome but it is possible to find ways to manage your experience in treatment and your reactions to your friends and family. It may sound effortful, but the benefits can be numerous. Most immediately, these strategies can help you get through treatment so you can attend to your ultimate goal; being a parent.
Lisa Schuman, LCSW and Director of Mental Health Services at Reproductive Medicine Associates of Connecticut (RMACT), has worked with infertility patients for almost two decades. She also is the Chair of the Oocyte Cryopreservation Task Force for the Mental Health Group of the American Society for Reproductive Medicine’s (ASRM). Lisa has received several awards for research projects at the ASRM and the Pacific Coast Reproductive Society’s annual meetings; her most recent award was presented at the 2014 ASRM Annual Meeting for her contributions to clinical studies about elective oocyte cryopreservation, commonly referred to as egg freezing.