If you are on Twitter, or you follow some of the infertility blogs, you may be familiar with some of the abbreviations used by women who are trying to conceive and have a baby. One that frequently tears at my heart is BFN:( . It means “big fat nothing,” as in not pregnant this month. You examine and re-examine the dates on the calendar, plan your activities around the possibility that you might be pregnant by then, and spend money on pregnancy tests that you know are going to come out negative. You may also have experienced the elation of finding out you were pregnant and whispering it to the chosen few you trusted to support you through those intial, very secretive and exciting days, only to have to return to them weeks later and explain that the pregnancy was over.
How do you begin again?
After a miscarriage or failed IVF cycle, there is the inevitable question hanging in the air: Are we going to try again? It may be a given that you still want a baby, however the criteria for whether you are going to try to conceive and carry a pregnancy will have been affected by the recent lack of success with IVF, or the terrible end of your pregnancy. Whether you are on your own, or with a partner, the criteria you use to make your decisions may have changed and need to be looked at again. You must consider your current health, age, fitness, need for medical intervention, financial position, other commitments and your doctors advice. Assuming that you have decided that you do want to try to conceive again, naturally or with assisted reproduction techniques, the next set of decisions will be about when you begin trying.
When can I try again? is one of the first questions that will come up in a womans mind once she has determined to pursue another pregnancy. Opinion, even among medical professionals, varies. Some doctors will say that, all being well, 3 months is a good amount of time to wait after a miscarriage. Others will suggest that an otherwise healthy patient wait until after she has had one menstrual period before trying to conceive. I believe that readiness is a combination of having had a check-up by the doctor or nurse a few weeks after your miscarriage or IVF procedure, feeling well in yourself physically and determining that you and/or your partner are both emotionally prepared to take the risk again. Why do I use that word “risk?” While many women go on to achieve a healthy pregnancy after a miscarriage, and IVF can certainly be successful on a subsequent attempt, there is a risk that they will not be successful. Can both of you gather all your resources together and steel yourself against that possibility or do you feel painfully vulnerable?
Are you up to it?
Miscarriage and fertility treatment are both hard on the body and can cause you to feel physically depleted. This is exacerbated by the emotional toll that they take. It isnt unusual for a woman to feel that she wants to, or has to, jump right back in and try again and simultaneously think that going through this process again is the last thing in the world she wants to do at that moment. Have you ever felt torn in that way? The reason for this dichotomy can be that you have not recovered fully and need to build up your strength and stamina. It may be worth asking your GP for a once-over health check, paying attention to your appetite, sleep, energy levels and hormone levels.
Your emotional wellbeing
It could also be that you are putting on a front, trying to fool yourself and others about how you are really coping. What you say and what you truly feel must be congruent, or the result could be additional stress, sleepless nights and high emotion. There may be no doubt that you want a baby, but being pregnant may be another matter entirely. Do you feel resilient; as if you have been able to pick yourself up, put your disappointment aside and look forward to the future? Or, do you feel fearful or hopeless? Your thoughts will affect your behaviour and very possibly, your outcome.
If you are trying to conceive, while simultaneously thinking that it will never happen, or that it will end disastrously, you are draining your positive energy away from your goal. You are literally telling your body, that it will not function the way it is meant to do and reinforcing that message every time you let your mind obsess in this manner. Ovulation does not occur in a vacuum; it is dependent upon signals from your brain to your ovaries. Additionally, the stress caused by negativity has been known to interrupt reproductive function, which may affect your periods, ovulation, fertilisation and/or implantation of the embryo.
Your negative thoughts, sadness, anger and stress are all understandable responses to either a miscarriage or the disappointment of a failed IVF cycle. How quickly you move through various feelings or thought processes to a state of readiness is unique to your circumstances and how you respond. You may feel conflicting emotions and be confused as to whether you are ready to try to conceive again. If so, a fertility coach can help you isolate your feelings about your miscarriage or IVF experience. This can help you prevent or reverse the spill-over into your abilities, body, medical treatment, relationship and future.
Are you both ready?
It isnt unusual for two people in a relationship to have different ideas about whether they are ready to try to conceive again. On the one hand, the woman may (erroneously) believe that the previous attempt is her fault and feel the need to make up for it or prove herself. She may be itching to try immediately, in contrast to her partners more measured approach. Even if this self-blame is not present, she may feel there isnt any time to waste. Only she can truly know how strong and physically healthy she feels, so her partner is reliant upon the information she provides. A partner may be concerned about her health and want to ensure the safety of a subsequent attempt to conceive. On the other hand, I have had female clients whose partners want to sweep it all under the rug and move forward as if nothing has happened. She may be unready; lacking in self-confidence and feeling unsupported.
Marriages have broken down from the stress of trying to conceive. One party may feel less committed to the idea of having a child than the other, so that when the disappointments, difficulties and costs are tallied up, they decide that they don’t want to put everything into the attempt. The sacrifices necessary to divert money from other dreams to fertility treatment may be more than one is willing to make. To contemplate trying to conceive only for your partner’s sake, or while you are unsure, will only add to the stresses you will have to endure.
The best advice I can give any couple in this situation is to talk. Be open about how you feel, what the loss meant and how you want to proceed now. If either of you are unable to communicate effectively without someone teasing the words out of you, get someone to act as a facilitator. A good fertility coach will help the two of you say what you really think and feel; not imposing her own ideas or taking sides. Perhaps a joint visit to your GP or gynaecologist will help the two of you find mutual ground.
Just knowing when it’s right
As quickly as it came over, an emotional cloud can lift. A new day, an overheard inspiring word, reassurance from someone you trust or just some release inside of you; any of these can shift how you feel about beginning the process of conception over again. You may not be able to explain it to someone else, but you just know you are ready. If trying again feels right and you can maintain that feeling for a few calm days (no roller-coaster emotions and changing of mind), trust your instincts. Only you can know for sure.
Lisa Marsh is the owner of Your Great Life, a fertility coaching and advocacy business in Stanmore, North London. She also writes for her own blog; http://yourgreatlife.typepad.co.uk. You can follow her on Twitter @yourgreatlife. Contact Lisa for individual or couples fertility coaching, via phone or office visits, or to find out about educational workshops on fertility issues from menstruation to menopause: Tel #011-44 (0)20 8954 2897 or email email@example.com