Higher payment allowance for donor-assisted fertility treatment

 yourgreatlife lisa

Will a new, higher payment allowance have much impact on donor-assisted fertility treatment in the UK?

It’s all about the money, money, money when it comes to donor gametes, according to some in the fertility field.  Until now, the Human Fertilisation and Embryology Authority (HFEA) has limited compensation for egg and sperm donation to a maximum of £250, for reasonable expenses such as travel and loss of earnings, but has denied donors any other payment. However, a report to be published by the HFEA this week is expected to raise that maximum sum to £700.

The question of compensation for donor sperm and eggs has been hotly debated in the UK for years, from an ethical standpoint as well as a practical one. At one extreme, there are people who believe that payment for donor gametes amounts to the commercial trading of human flesh.  Others merely find the idea distasteful. The HFEA itself does not want to be seen to be creating a financial incentive to donate.  However, the other major consideration here is the one of supply and demand.  There has been a shortage of donor gametes in the UK, which many people believe is a result of the no-payment rules. This is not the case in countries like the USA, where payment is allowed.

The perspectives of both donor and recipient will, of course, be based upon more personal considerations. For those requiring donor gametes in order to have a baby the shortage of supply can be frustrating and the alternative route of going abroad for fertility treatment can be extremely expensive.  Donors must take into account the time, effort and discomfort involved in providing sperm or eggs.  Egg donation, in particular, involves the taking of hormone medication by injection for several weeks, and then an invasive procedure under general anaesthetic to retrieve the eggs. 

The change in HFEA regulations has the support of fertility industry groups, including the Nuffield Council on Bioethics and the British Fertility Society, according to an article in the Sunday Times. Nuffield Council on Bioethics likens donors to volunteers who test new medicines and suggests they be paid similarly. The British Fertility Society is more specific; suggesting fees of up to $1,000 for sperm donors and between £500 and £2,500 for egg donors in addition to a fixed amount of compensation for their discomfort and inconvenience.  It is unclear how much will actually be paid to donors of sperm or eggs, when the recipients are receiving free IVF through the NHS, and who will be responsible for that payment.

The proposed UK compensation scheme will almost certainly lead to an increase in the supply of donor gametes, if other countries’ models can be relied upon.  It means that someone who considers being a donor can weigh their reservations about the time and effort it will involve with the compensation they will receive.  No one is going to get wealthy on this scheme as the compensation isn’t overly generous and there are also regulations in place which limit the number of times a person can donate gametes.  The limited payments also means that people who must pursue private fertility treatment are not faced with enormous additional costs, but will probably benefit from a greater supply.  Look out for news of the changing HFEA regulations this week.

The Fertility Focus Telesummit is underway. but there is still time to join in!

The second interview of the Fertility Focus Telesummit was mine, on how “Creating an Effective Support Network Can Make All the Difference When Trying To Conceive.” I’m really excited by the response I have had, with many listeners emailing me afterward to thank me and/or tell me that what I shared really resonated with them. The Telesummit is completely free to listen to the live presentations, and the replays for 24 hours after each interview. If you didn’t know about it before, it’s not too late to get involved.

The 2nd Fertility Focus Telesummit, created and moderated by Sarah Holland, is running this week.  Twelve fertility experts from around the world, and 3 fertility bloggers, are speaking throughout the week on various aspects of fertility health and support.  Sarah started things off on Sunday, the 20th of March, with an introduction to the Telesummit and an explanation of how to get the most out of it.

Yesterday, Monday the 21st, saw the first two interviews; Dr Marion Glenville spoke on the nutritional aspect of fertility health, giving much of her hour-long presentation over to listeners’ questions and providing really comprehensive responses.  The second interview of the evening was mine, on how “Creating an Effective Support Network Can Make All the Difference When Trying To Conceive.”  I’m really excited by the response I have had, with many listeners emailing me afterward to thank me and/or tell me that what I shared really resonated with them.

The Telesummit is completely free to listen to the live presentations, and the replays for 24 hours after each interview. If you didn’t know about it before, it’s not too late to get involved.  Click here to register for the Fertility Focus Telesummit FREE!  You can listen live, and submit questions for each of the speakers, or listen at your leisure to the recordings afterward.  If you are really busy this week and know you won’t be able to listen in, OR you just want to have all 17 audio files to refer to over and over, Sarah provides the option of upgrading to a Golden Ticket so you can purchase the whole Telesummit’s talks, which will be emailed to you as an MP3 file afterward. This is an incredible value, this week only while the Telesummit is running, at US$67, including several bonuses. You can find all the information at the Telesummit website.

Because I’m a bit late in letting you know about the Telesummit and my own presentation on creating a support network, I’d like to share some of that information with you here.  Having been through several challenging years of recurrent miscarriage and secondary infertility myself, I have the benefit of hindsight telling me that I really could have coped far better if I had been more proactive about getting myself, and my husband, the right balance of emotional and practical support.  Infertility put a big strain on our marriage, and I felt very alone and fearful that I would not be able to have the children I had always dreamed of having.  We are fortunate to have come through those rough times, and to have our two children.  Using my training and experience as a fertility coach, I have developed a system to help each of my clients create a support network for their unique needs, thus easing their experience of infertility and efforts to conceive and helping them to feel less isolated and stressed.

During the call, I explained:

  • Why infertility support is so important;
  • The 5 most essential types of support every infertile person needs;
  • Why your partner is not always the best source of support;
  • How you actually create your personal support network;
  • What you can do is someone you expected to be supportive has turned out to be the opposite; and
  • How to maintain a really effective support network over a long period of time.

I’m also offering a Free Bonus to Callers from the Telesummit! I’ve created a comprehensive Worksheet that takes you through the process of creating your own infertility support network, step by step. So, if you haven’t already registered, don’t let this opportunity pass you by.

I’m listening to the other speakers throughout the week myself. I have to say, I’ve been very impressed so far. I’ve learned a lot already from both Dr Glenville and Andrew Loosely, Acupuncturist and Chinese Herbalist. Other expert speakers during the week include Sarah Holland on using EFT for conception, Kristin Hayward, Zita West, Gabriela Rosa, Toni Weschler, Sue Dumais, Nicola Smuts, Deirdre Morris and Cindy Bailey. Then, you can listen to talks from 3 prolific bloggers, including the authors of “From IF to When,” “Eggs and Sperm” and “Survive and Thrive.” I’m really looking forward to the rest of the week.

Information about possible birth defect risks from assisted reproductive techniques; scare tactics or essential disclosure?

There was a report in The Sunday Times yesterday that Prof Lisa Jardine, of the government’s regulatory body the Human Fertilisation and Embryology Authority (HFEA), is to recommend that fertility clinics warn prospective patients of the risk of birth defects associated with IVF, ICSI, twin pregnancies conceived using assisted reproduction and embryo screening. What does that mean for you, if you are in the midst of or have already availed yourself of one or more of these treatments?

We have heard this before – The first thing you should know is that this is not strictly new news. Eleven months ago, the Daily Mail carried an article stating that “IVF children have higher risk of infertility, obesity and diabetes.” In June of last year, it was reported by the HFEA that a study in France showed that there is a small increase in risks of congenital abnormalities in children born as a result of IVF or ICSI. More recently, The British Medical Journal has recently published information from a study that shows women who have one embryo transferred during IVF treatment are five times more likely to give birth to a healthy baby than those who receive two embryos.  This is not meant to frighten you further, but to show that there are reports in the news all the time and they need to be read carefully and validated.

Risks associated with assisted reproductive techniques – The next thing is to be aware that the HFEA is merely saying that there is a greater risk of health problems associated with assisted reproduction, but not definitively how much greater the risk is. Their intention is merely to be as open as possible with women about any risk before they give consent to starting an assisted reproductive procedure. I am absolutely in favour of that, as the process in which individual women, or couples, go through should be one of fully informed decision-making. What I want, however, is enough specificity to help people understand the results of the studies, as well as a user-friendly explanation of how likely it is that those conditions may affect the health of their child. The Sunday Times article only alludes to possible side effects of IVF and other fertility methods, but gives no statistics. The list of potential health problems in children born of assisted reproductive techniques (A.R.T.), including:

·        heart defects, cleft lip and neurological flaws;

·        low birth weight;

·        cerebral palsy;

·        cancer of the retina;

·        undescended testicles in boys born of IVF; and

·        Infertility in children born as a result of ICSI, a procedure in which a sperm is artificially inserted into an egg.

Risks associated with embryo screening – Additionally, the HFEA wants patients who choose to have their embryos screened for genetic defects before implantation, to be informed of “potential high risk of neurodegenerative disorders,” or brain disorders in their children.  Apparently, embryo screening which uses one cell rather than two cells is of less danger.  It’s important to note that “before issuing new guidelines, the HFEA is to carry out a further review of scientific papers on the health outcomes of assisted reproductive technology children.” That means that no guidelines have been issued yet and that fertility clinics are not yet required to provide this type of information.  Most people who have IVF will not feel the need for embryo screening as a matter of course. I assume that a fertility specialist would recommend the procedure only in such cases as when a genetic condition has already been identified as a possibile outcome. Consequently, the risk of the screening may be offset by the risk of the suspected defect which could already present. Still, I believe that this information should be included with all of the factors relevant to the patient’s decision-making, as it may make a difference to the type of screening undertaken.

What should you do? By all means, you should feel free to ask your medical practitioner for an explanation of these risks. It is worth mentioning that even if the risks of birth defects are somewhat higher in assisted reproductive births than in naturally conceived births, the incidence will still be relatively low. A good analogy might be the risk associated with amniocentesis. There may be a higher risk of miscarriage in pregnancies in which amniocentesis is performed, however, the risk is still less only about 1% of pregnancies in which the miscarriage will actually occur as a result of the procedure. The patient and her partner are the only ones who can decide whether the risk is a reasonable and acceptable one, given the context in which they are operating.

Weighing and balancing – If you cannot conceive naturally, you must decide whether a greater risk of birth defects in A.R.T. births is acceptable to you, relative to your desire to have a baby by any means. Weigh it against the chance that no birth defect will occur, but make sure to discuss how you would feel about having child with a condition like the ones listed above. I don’t have any overall statistics for you because they have not been issued yet, and may never be; you would have to take each study separately. The best way to make any sense of them is to restrict your exploration to those relating to the specific procedure  you will undergo.

Doing your own research – In order to fully explore these issues, you may want to do some of your own research, starting with the HFEA website, which has an excellent section for patient information. Then, if the information you discover leads to questions that you and your partner find difficult to resolve, you may want to talk to a fertility coach who can help you explore your values and priorities specific to your proposed fertility treatment. Just remember, the HFEA seeks to hold the fertility industry accountable, in line with public policy and to the patients that use it, for the protection of all concerned. While the media reports the findings of studies and government reviews of those studies in a way that sometimes makes them seem of greater or more immediate importance than they actually are, it is better to have that information available to us than to be kept in the dark.

Blog http://yourgreatlife.typepad.com   Follow me on Twitter.com/yourgreatlife

How do you begin again after a miscarriage or failed IVF cycle?

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.

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 doctor’s 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.

Your timing

“When can I try again?” is one of the first questions that will come up in a woman’s 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 isn’t 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 isn’t 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 partner’s more measured approach. Even if this self-blame is not present, she may feel there isn’t 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 lisa@yourgreatlife.co.uk

Select the sources of your information about infertility carefully to avoid overwhelm

We now seem flooded with so many references to infertility that many of the information and resources currently available are being overlooked. Infertility and IVF have almost become ubiquitous topics in the health sections of major newspapers and monthly magazines, like weight loss, skin care and cosmetic surgery. Infertility support websites, forums and blogs abound, but even if an infertile person belongs to dozens of them, how many can they actually read and appreciate? I check out as many as 10 new infertility resources a day, and I can tell you that there is a wide range of depth and quality of the information available.

Is there too much information about infertility available now?

My first instinct would be to say “no, absolutely not!” There are women and men out there who don’t know nearly enough about the road ahead of them as they begin to wonder why they haven’t conceived yet.

Anyone who has been diagnosed as infertile and doesn’t know what to do next, where to get support or the pros and cons of treatment, has a steep learning curve. There’s also the potential of vital time being wasted as overwhelm sets in and incapacitates infertile people who need to research, reflect and agree. On top of these first-hand needs, there’s the need to promote public awareness about the physical, emotional and financial aspects of infertility; to promote sensitivity, encourage medical science, motivate regulatory change and improve access to treatment.

However, we now seem flooded with so many references to infertility that many of the information and resources currently available are being overlooked. Courses, conferences and symposiums are going begging for attendance; whether aimed at professionals or the prospective patient. Infertility and IVF have almost become ubiquitous topics in the health sections of major newspapers and monthly magazines, like weight loss, skin care and cosmetic surgery. Infertility support websites, forums and blogs abound, but even if an infertile person belongs to dozens of them, how many can they actually read and appreciate?

I check out as many as 10 new infertility resources a day, and I can tell you that there is a wide range of depth and quality of the information available. It can be incredibly confusing for the newly diagnosed or freshly motivated infertile person to encounter. How do you know who to follow, what to attend or how much validity to give to a particular expert, whether professional or from personal experience?

Ten tips for fighting infertility information overload

  1. Browse – Whether on the internet, at an event or looking through the back of a magazine, take the time to investigate all of the groups putting out information about infertility.
  2. Ask for information – One fantastic aspect of social media is being able to pose a question to the universe and get an answer. It’s like Google info + opinion in one.
  3. Go by recommendations – If you see something you like posted on Twitter or Facebook by people you respect and like, chances are that you will like the sites they like.
  4. Categorize – Balance is everything when your mind is focused on one subject: infertility. So gather and categorize resources. Ex. medical information, emotional support, infertility news, beautiful writing, humour, etc.
  5. Find the right site for your personality – If you want to share your test results down to the nth degree of detail with others who understand the numbers, find the right site for that. Others may just want to share feelings.
  6. Look at an event’s content before registering – Some of the biggest events are more about selling you treatment and travel options rather than giving you substantive information. It’s great to know about providers and get a chance to talk with them, but you don’t just want to go home with loads of brochures for the bin. Are there seminars offered at the event? Is there a Question & Answer period?
  7. Don’t join everything – One of the greatest causes of overwhelm can be too many email newsletters flooding your inbox. Instead, try bookmarking or Favourite the blogs and websites you find and go to them occasionally, until you decide how useful they are.
  8. Leave comments where asked – Give feedback after articles, on blogs, on forums and at events telling how useful, enjoyable and accessible you found them, or where they missed the mark.
  9. Support the infertility resources you do value: When you have found an excellent resource, help keep it afloat by paying the membership price, buying the entry ticket, book or magazine, nominating the blog for an award, Tweeting the link, or donating to the charity.
  10. De-clutter – If you look back a month and see repeated, unopened emails from infertility groups or blogs, take the pressure off yourself by clicking on “Unsubscribe.” You can always visit those sites and blogs if and when you find extra time.

Fight the overabundance of information and overwhelm by singling out the good resources by quality and deleting or ignoring the rest.  Likewise, if you think a particular health journalist is doing a great job, champion their efforts by replying when appropriate and posting links to their work on Twitter and Facebook. Don’t be afraid to make a comment rating the value of what’s out there on infertility. It’s worth showing a bit of loyalty to a particular source too: It’s a win-win situation.  You can develop a rewarding rapport with a blogger or a group of contributors to a forum. You may also qualify for special deals on publications and events. Your membership, visits and purchases help their stats, which raises their profile and/or brings in revenue.

Readership is everything, so if you aren’t supporting the less-than-helpful information providers, they will get the point eventually. Remember, it’s not about how much information you can take in; it’s about the quality and usefulness of that information.

Lisa Marsh is the owner of Your Great Life, which provides one-to-one and couples’ fertility coaching, educational seminars, support groups and advocacy for matters related to women’s health, infertility and family-building. Contact Lisa by email lisa@yourgreatlife.co.uk or by following her on Twitter @yourgreatlife.

TLC For TTC

When we use the acronym TLC for tender loving care, we generally mean one person to another. However, I believe that it’s also to spend some time and effort on your own behalf.  I promote self-care in all areas of an infertile person’s life, both for emotional wellbeing and to maximize the chance of conception.  It’s not as easy as saying we will make changes.  It requires a positive attitude, a desire to change and taking action. I have to work at it too. This is part my own ongoing self-development, and being aware of it helps me understand a client’s efforts and difficulties. Success requires:

  • Self-awareness;
  • Honesty;
  • Motivation; and
  • Follow-through

The self-awareness that is required in order to improve lifestyle choices is:  1) knowing your own habitual way of operating, and 2) identifying the areas in your life which have a potential to be neglected, as a result. Even if others perceive a decline regarding your health, and tell you, it won’t make much difference until you can admit it to yourself. This realization may not be triggered until the connection is made between your choices (healthy sleep, eating, alcohol, exercise, hygiene, nutrition and/or medication) and the delay or absence of conception.   

The stress related to infertility can be unhealthy in itself, but in some ways, stress can actually provoke necessary action. If your fertility clinic delays your IVF cycle until you lose weight, stop smoking or bring down your blood pressure, it will force self-awareness, require honesty and provide motivation.  Honesty is an admission of the state you are in and your responsibility for it. It’s most important to be honest with yourself.  However, honesty with someone else about your difficulty in giving up a bad habit can be rewarded with support and helpful suggestions.  Choose the person who is likely to support your efforts the most, rather than a person who will express disapproval, criticize you and say I told you so

Motivation is what propels you forward. If becoming pregnant and having your own baby is the paramount issue in your life, then you have a motivator that is easy to visualize. You have probably thought and talked of little else lately, so it’s fresh.  Write down everything about pregnancy and motherhood that you daydream about, starting with the line on the pregnancy-test stick, to going to the playground with a group of friendly mothers, all with your babies in strollers. Your list may include:

  • Joy of telling my husband “we are pregnant;”
  • Feeling the physical signs of pregnancy;
  • Having a pregnant belly;
  • Picking baby names;
  • Shopping for cute baby clothes…and so on.

Next to each point, put a check mark if it is motivational or an X for something that won’t motivate you to work a bit harder on self-care.  If having a baby is your most important aim right now, use these motivators when reaching for a pint of ice cream, a cigarette, or a gin and tonic.

Just talking about making changes is not enough; it means nothing without follow-through. It’s one thing to identify what you need to do, another to honestly assess where you are falling short and still another to finding that which will prompt action on your part. The last piece of the puzzle is taking action, or following through on your commitment. This is where most people begin to feel like it’s all too much work. 

With infertility, you could be on this self-improvement course for months or years without yet achieving your ultimate goal: the baby.  Having only a long-term reward in sight, no matter how important, can’t always keep you going, especially when you may also be experiencing other challenges in your personal, social and work life.  Several short and medium-term rewards will work better to motivate you; so build them in to your scheme every few weeks.  Focus on one area for a while, to the point that you are satisfied that you have embedded a new habit. Reap a reward, and then add the next goal.

Ask for help. Do not just nominate a person to support you, putting the responsibility for action elsewhere, rather than on yourself. No one wants to be put in the position of nagging you and earning your resentment.  If you feel unable to do it on your own, consider partnering up with another woman who is also trying to conceive.  Alternatively, if there is an area of self-care that you and your partner both need to work on; such as weight loss, or giving up caffeine, you could have it easier if you both tackle it at the same time.  Agreeing to hold each other accountable for your commitments is a good way of keeping honest.

With the amount of hard work it takes to improve our habits and increase our self-care, it would be a shame not to sustain the positive results. In coaching clients, I have seen people who think that once they have heard something, they are capable of putting it into action.  However, hearing and learning are two distinctly different things.  You need to understand why you weren’t taking care of yourself before.  You must be equipped with the tools to counteract temptation and subconscious habits. You need to develop trust – a belief that you are deserving of TLC. This takes time to embed.

Every once in a while take a stock-check of your emotional and physical health, taking care to note where they may have declined. Go back to the beginning by reflecting on your attitude, behaviour and effort.  You will have already learned the methods needed for improvement, so a reminder will set you back on a healthy path. Use positive affirmations such as EFT techniques to embed the new learning. Why? Because you’re worth it.

Lisa Marsh is a fertility coach, working with individuals and couples to enhance their chances of conception, reduce stress and carry a healthy pregnancy among other things.  She has a fertility blog http://yourgreatlife.typepad.com, coaches in person in North London, and by phone in the UK and internationally.  You can contact Lisa for coaching on lisa@yourgreatlife.co.uk .  You can follow Lisa on Twitter @yourgreatlife to get great Fertility Support and Miscarriage Support tips, as well as links to news, her articles and connect with others in the IF community.

Finding Support for Your Infertility

How do you find the support you need for your infertility?  Regardless of how you came to be infertile or what your goal, it can be a challenge to find someone who not only empathizes with your situation, but also is prepared to be there for you on either an emotional or practical level. You may wonder why, for something so fundamental to your happiness, someone wouldn’t want to be counted in your support network. 

Why You May Not Be Getting the Support You Need from Logical Sources

  1. They believe that you must be responsible for your infertility somehow.
  2. Your partner is ambivalent about becoming a father or mother.
  3. You want to be a single parent.
  4. You are not married to your partner.
  5. You are in a gay relationship and they believe every child needs a father
  6. They are infertile also and worry they will lose you to a baby and mom-friends.
  7. It’s your boss. Doctor appointments and maternity leave will inconvenience them.
  8. People think you should be grateful that you already have one child.
  9. They are jealous of the attention and sympathy you get for your infertility.
  10. They are too wrapped up in their own life to realize you need them.

Those people may not realize they are being unsupportive. What is obvious to you may not occur to them.  An example:  your mother phoning you daily with details of her friend’s daughter’s pregnancy.  “What do you mean? I thought you would be happy for her.” Or, someone may think if you needed them you would ask and you haven’t.

They may be judgmental.  “Well if she hadn’t (pick one) a) taken such a stressful job, b) had that abortion years ago, c) waited so long or d) gained so much weight, she wouldn’t be in this situation now.” In fact, almost the entire list comes from people judging you and your condition by their own values, rather than stepping into your shoes to think what it must be like to be you.  However, you may be able to turn their attitude around.

First, look at your own responsibility for the situation and take ownership of it.  In that way, you will be less likely to assign blame, feel resentment and put other people on the defensive.

  1. Have you failed to let people know about your infertility? (Most can’t read minds.)
  2. Have you made it so much a part of your identity that you sound like a broken record?
  3. Have you not been there for them when they needed your support?
  4. Have you isolated yourself from all your friends who have children?
  5. Have you held back on congratulations toward a sister-in-law, cousin or colleague who has had a baby?
  6. Did you previously fail to show empathy toward someone else who was infertile?
  7. Do you whine too much?
  8. Have you lost your perspective?
  9. Have you made sex seem like a chore, obliterating the romance and passion in the bedroom?

If you don’t keep up your work, friendships, social or sport activities, you may become “out of sight, out of mind.” If you no longer accept invitations, people may assume you no longer want or need their company.  Though it may seem logical to you and very unfair to compare the situations, a friend who has had a difficult pregnancy or birth, postnatal depression, has a colicky baby or has had a miscarriage, may feel that you have not supported her when she needed you.  It isn’t your friend’s fault that you haven’t yet had a baby of your own.  Messages can be misconstrued and feelings hurt on both sides.  All relationships need to be nurtured in order to thrive, so give to get.

How to Find The Right Kind of Support

The trick to getting support is to first list the type of support you need, and then identify who can provide it.  For example:

  • Someone who will listen and keep it confidential
  • Go with me to the doctor
  • Someone who’s also infertile and knows what it’s like
  • Friends I can go out with, to forget my problems
  • Cover my workload when I need time off
  • Friend(s) who won’t need an explanation or take it personally when I opt out of get-togethers and baby showers
  • Give me my injections  
  • Pass the word so that I don’t have to get into it 10 times a day
  • Friend who will rescue me from upsetting conversations
  • Help me with my food and fitness plans

Now, split your list of needs into two, under the headings: emotional support and practical support. Connect the tasks with the names of people you know. Then ask yourself a very important question: “Is it reasonable for me to expect this person to provide this support.”  Consider:

1.     your relationship

2.     their nature (sensitivity, generosity, etc…)

3.     their availability

4.     their reliability

Next, look at acquaintances in an outer layer of your life.  A colleague at work may also be trying to conceive.  You may click with a nurse at the clinic.  That other woman you always see in the RE’s waiting room may be happy to go for a coffee. A friend of a friend may have had the treatment you are considering and be happy to answer your questions. Reach out when you feel strong enough or the need is big enough. Infertility seems like a personal or sensitive subject that people may wait for you to bring up the conversation. So go for it; you have nothing to lose and everything to gain.

When No One Close at Hand Will Do – Infertility forums are wonderful resources for information, camaraderie and supportive conversations.  They all have a “personality” of their own, so cruise them for a few days to figure out which one is a good fit for you.  There are also hundreds of blogs written by infertile women (and a few by men) to which you can subscribe.  Again, cruise the blogs until you find an appropriate few, keeping in mind that they are the product of someone else’s personal experiences, attitude and knowledge level.  After a little while, if you keep reading and commenting on the forum(s) or blog(s) of your choice, you will feel a part of that community.  Be careful though not to take someone else’s experience or opinion as valid medical advice unless they are medically qualified.  Always check with the doctor treating you before trying anything that may interfere with or delay your chances of treatment.

Professional Support – Last, but not least, there is an advantage in having a specialist fertility coach if you are not coping well with your infertility.  The criteria to look for in a coach include training, rapport between the two of you and their ability to teach and motivate you to achieve the positive changes you are after. While coaches don’t absolutely need to have personal experience with a client’s issues to be effective, I believe that it is a genuine advantage in the area of fertility coaching. A fertility coach who has herself had difficulty conceiving, will have an authentic understanding of the emotional, physical, financial and social aspects of the fertility rollercoaster ride.

There is plenty of evidence that your state of mind can affect your fertility.  If you are overly stressed, feeling negative, comfort-eating, arguing with your partner or not sleeping, you are not creating the best possible state of wellbeing for conception, pregnancy and childbirth.  A fertility coach will look at the whole person to determine which small changes in your attitudes, actions and lifestyle will make a difference to your overall wellbeing.  From that better place, you will work together to find the best way to create and build your family. By aligning your goals with your value system, your coach may also be able to help you determine whether to undergo or continue fertility treatment, if and when to stop trying to conceive, end fertility treatment or consider an alternative path to parenting, such as egg or sperm donation, surrogacy or adoption.

In the end, it’s your choice of how open or private you will be about your infertility and that will directly affect what kind of support you receive.  Just remember support comes in many forms and from many places and sometimes must be earned. Be understanding; over time, supporters can be more or less active in your life as their own circumstances change.  Giving support is not a job description; it’s a gift.

Lisa Marsh is the fertility coach  and owner of Your Great Life in Stanmore, North London.  For more information about her, go to http://yourgreatlife.co.uk. Subscribe to her blog at http://yourgreatlife.typepad.com or to arrange a coaching session, in person or via telephone, please contact her at 020 8954 2897 or lisa@yourgreatlife.co.uk

You can also follow Lisa at http://twitter.com/yourgreatlife for helpful Fertility and Miscarriage Support Tips, as well as other information about news in the field of women’s reproductive health.

Your Weight Could Be a Fertility Issue

Have you considered your weight as one of the possible obstacles to your dreams of having a baby? This isn’t about being fat or skinny; no judgment about your appearance is being made. Your weight can play a significant part in the ability of your body to ovulate, produce quality eggs and maintain a healthy pregnancy, especially if you are extremely underweight or overweight.

You may already have some idea about your weight’s impact on your reproductive system if you have had irregular menstrual periods, the onset of a thyroid condition or polycystic ovary syndrome (PCOS) or vitamin deficiencies.  What you may not know is that very overweight or underweight women have a much lower chance of conceiving, even with fertility treatment. As a result, many fertility specialists won’t take on a patient who wouldn’t benefit as much from their help and/or whose unsuccessful treatment would affect their success ratings.

Many clinics will use your weight, or Body Mass Index (BMI), as criteria for accepting you as a patient.  There is no hard and fast rule on this because one athletic woman with developed musculature can weigh more and carry less fat than another woman of similar age and height.  BMI of 19 – 24 is considered normal and 25 – 29 overweight. If either your weight or BMI falls under 19 or above 29, you may encounter a delay in being accepted for treatment, with instructions to lose or gain weight before coming back.  Whether you are still trying to become pregnant naturally, or if fertility treatment is your next step and your weight is a possible issue, here are some steps that you can follow to move forward with your family plan.

Your Attempts to Conceive Keep notes, not only of your weight, but also how often you have a period and how often and when you have sexual intercourse without the use of contraceptive devices. There are books available that provide a structure for tracking essential information for fertility, but any journal or notebook will do.

Identify Your Obstacles See your doctor to identify whether your current weight is a possible obstacle to conception. You must be forthcoming about your pattern of weight gain and loss, your eating habits and any extreme dieting or exercising you have done, even if you find these topics embarrassing.  You may be tested for high or low blood pressure, thyroid function, diabetes, vitamin and mineral deficiencies and the level of oestrogen you are producing.

Eating Disorders Serious eating disorders such as anorexia, bulimia, and extreme compulsive overeating require medical supervision, structured programs and counselling over a lengthy period to ensure and support recovery. Anorexia and obesity can both affect ovarian function adversely and bulimia is linked to PCOS, so pregnancy is unlikely, though not impossible. If you do conceive while battling an eating disorder, it could impact negatively upon the baby’s ability to thrive as well as your own health. Think about everything you eat and drink passing to the baby in your womb, though in a slightly different form. Not only nutrients are taken in by the baby, but also the high calorie/ high sugar and high fat content of your less nutritious food.

Recovery from an eating disorder can be a long and difficult process; it’s not only about what you eat, but also why you eat it that needs to be determined.  The destructive cycle of thought and behaviour has to be broken and relearned in a positive way.  The baby will be dependant upon you and require a fully present parent.

Eating disorders actually require an enormous amount of mental energy, planning the next binge, the next purge (self-induced vomiting) or how to avoid eating without anyone else noticing.  These disorders are nearly always accompanied by some degree of self-hatred. Dissatisfaction with the sufferer’s appearance, social relationships and/or self-belief fuels the fire and that brings on more irrational and dangerous behaviour.

If you think, or know, that you have an undiagnosed eating disorder, don’t waste a minute before you consult a doctor.  I am not minimizing the difficulty in admitting it to oneself; it will take courage and commitment.

Your GP can probably refer you to a specialist medical unit where counselling  and other practical assistance is offered.  There are also many groups where you can meet with people who have experienced similar disorders and receive confidential support.

Lifestyle Changes for Self-CareYour health is vital before, during and after you conceive, carry and deliver your baby.  You can’t breathe a sigh of relief upon conceiving and then let yourself go to pot.  Bad habits don’t disappear overnight, so get working on them immediately.

If your current weight is due to poor diet, lack of exercise, smoking or over-consumption of alcohol, a nutritionist and an experienced personal trainer can advise on necessary changes in your lifestyle.  This is no time for a crash diet or the use of over-the-counter weight-loss or weight-gain drugs or powdered drink mixes. Don’t put all of yourself into a weight-loss or weight-gain scheme just to win the approval of your RE, only to let it all go back the way it had been afterward.  Careless indulgence in bad habits means that you aren’t prioritizing self-care.

How fit you are will also determine how you carry a pregnancy.  Over the nine months, you may be carrying anywhere between 18 and 45 extra pounds, putting extra pressure on your skin, muscles, veins, spine, breasts and joints.  Stretch marks only mar the surface of your body, but varicose veins can result from carrying too much weight and excess blood flow during pregnancy and knee trouble is quite common in obese women.  That’s just during pregnancy.

Then comes the aftermath: life with baby.  Think about how often mothers  have to bend over, crouch down on the floor, get in and out of the car or bus, lift car seats and play cots and balance a baby on one hip.   If you were quite overweight before conceiving, and continue your poor habits, you could easily find yourself 75 to 100 pounds above your optimal weight before you give birth.

Trading One Habit for Another Keep in mind that what you ingest (not just food) during pregnancy and breastfeeding, your baby will too. Do not consider turning to cigarettes, alcohol or caffeinated, artificially sweetened soft drinks to help you avoid eating.  Nicotine and damaged lung tissue stay in your system for a very long time.  Smoking itself can cause low birth weight and nicotine addiction in newborns.  Alcohol could result in your baby being born with Foetal Alcohol Syndrome, which could cause low birth weight, developmental problems or epilepsy among other symptoms that could affect him for life. The soft drinks will just fill you up, make you gassy and add no nutrition relative to the volume you consume.  Since you need extra nutrients for optimal health at conception, don’t waste space on junk drinks.

Your Motivation Finding the motivation to change your behaviour should be simple because you already have a goal in mind. You want to become pregnant and give birth to a healthy baby. Use that goal as motivation to change your attitudes and behaviour.  Think of yourself as a healthy vessel for conceiving, carrying and then caring for your child. When you are on the verge of bingeing, skipping a meal or eating junk food, consider how that would impact upon your weight and health and ultimately upon your attempts to conceive.

Your Plan Bad habits take a long time to embed, so they are not going to change over night. If you and your doctor believe that you can make positive weight changes yourself, formulate your own structured plan. Write down your:

  • specific weight,
  • a realistic time frame,
  • a list of quality foods in moderate quantities and
  • the exercise you will do to boost your health and strength
  • other healthy strategies to achieving your goal weight.

Keep track of your efforts and your achievements as you move toward your goal. While there may be other obstacles to conceiving a healthy pregnancy, if you persevere, you will have eliminated weight as one of them.

Lisa Marsh is a qualified life coach in
London, UK, specializing in Fertility and Miscarriage Support. She is dedicated to educating and supporting men and women concerned with reproductive health, infertility, fertility treatment and all forms of family building.

To find out more about Lisa and her work as a fertility coach, visit her blog at  She can be contacted at lisa@yourgreatlife.co.uk  for coaching, article writing or speaking engagements.

Facing Many Crossroads, Together

Part 3:  Turning to Others for Help

You are at another crossroads in your fertility journey and neither of you wants to take a risk, so you stand still.  These decisions are difficult, but in order to progress, they must be made.  At any point on which you and your partner feel stuck, bring in additional troops. 

If you don’t feel like your discussions are going anywhere, wasting time, or you feel unsupported, you both may need help from a third party. In this case, that third party should be someone who doesn’t have a stake in the outcome and/or has not been the confidante of one of them. (Tip:  Never, never say “My parents think that you…” In-law relations may never recover.) The other half of a couple does not need to stress out about their support network taking sides. 

 Perhaps each of you will need a separate support system.

 ·         If you need more firsthand information about infertility or treatment options, one of the dedicated internet fertility forums may help. They provide a quick, constantly updated and supportive response from someone who is or was also infertile; just make sure that you don’t take medical advice from a non-medical member.

·         A support network can be created from family, friends, colleagues, other patients at your clinic, a support group that meets in your area, or anyone who truly wants you to succeed in your efforts and have a baby of your own.

·         If you think you are depressed, (look at your sleep pattern, eating too much or too little, moods and lack of self-care) ask your doctor to refer you to a psychologist or counsellor who has professional experience with issues relating to infertility. 

 ·         If your difficulties are more strategic (accepting your current situation, what you want to do, how to do it, how to restore self-esteem, control and decision-making, how to communicate, etc.), a fertility coach can help you sort things out and move forward with more motivation, hope and self-belief.

If you and your partner are honestly sharing and accepting each other’s thoughts, feelings and needs, you will have an excellent chance of making it through the ups and downs of fertility treatment with your relationship intact. If, however, you are experiencing differences bubbling under the surface, this may place you at a more fundamental crossroads.

Fertility coaching for couples is a good way to bring unsaid (or poorly said) thoughts, attitudes or behaviour to light and/or resolution. 

For example, no one wants to let down their partner in such a fundamental area as family-building, but anxiety, fear, insecurity, pressure or exhaustion can affect their commitment. 

If someone is feeling trapped in a long, stressful process, it is useful to re-examine choices, goals, timetables, and cost and re-align them with their values. 

You need to face these crossroads together in order to safeguard your relationship. 

Be willing to ask for help with feelings and communication. 

Remember: if you are doing things completely on your own and it’s getting you nowhere, you have everything to gain by trying something different.

Lisa Marsh is a Fertility Coach working with people on all aspects of fertility, including female and male infertility, pregnancy loss, assisted conception, alternative means of family-building and menopause.  Visit her blog http://yourgreatlife.typepad.com or her website http://yourgreatlife.co.uk for more information.  For coaching, email lisa@yourgreatlife.co.uk

Facing Many Crossroads, Together

Part Two: Coming upon a Crossroads, What You Need To Make Your Decisions

The first crossroads is likely to be when you decide to see the doctor because, despite your efforts, you have not conceived.   It isn’t everyone’s cup of tea, or culture, to expose their intimate life to the scrutiny of doctors or undergo blood tests and scans, checking for something “wrong.”  Some uninformed men may be unwilling to provide a semen sample, for fear of what the results may suggest about his manliness.

Both the woman and man may feel some anxiety about whose family line may be to “blame” for their inability to become pregnant.  If this pertains to you or your partner, you must cast these outdated stigmas aside and take some relatively simple tests to discover the cause of your infertility.  If having a baby is your ultimate goal, your value system may have to adapt to accept the help that modern medicine and technology offer.

The second crossroads is deciding whether to pursue more invasive medical investigations and/or treatment.  With a clear diagnosis and readily available treatment, it is easier to decide what to do because the options are more clearly set out.  Your personal life may present the deciding factor: your relationship, finances, career, religion or emotional wellbeing may all be taken into consideration.  Many couples have to contend with unexplained infertility, where early test results were ambiguous.  If you (or your doctor) are operating in the dark, it won’t do much for your confidence.  In this case, the dilemma about which treatment to pursue may be decided by not knowing what else to do. 

Whatever your decision, the most important factor is agreement between the partners, not only because cooperation, understanding and support are vital to keeping stress levels down, but also because it could mean the difference between having a genetic child or not.  From the point that you choose assisted conception you enter a different world; one where your daily life centres on the fertility clinic. For working men, the clinical, inconvenient scheduling, financial and sexual aspects of trying to conceive while being treated, put them into unfamiliar territory and cause stress.  Women will physically experience all of that, and possibly, mood swings, pain, invasive procedures and fear that time is running out as well. 

The decision-making shifts to:

  • Are you happy with the doctor/clinic you started with?
  • Should you try less invasive treatment first, or go straight to IVF?
  • Should we try complementary therapies before, or alongside, traditional medical treatment?
  • How will you pay for your treatment?
  • When should you begin treatment?
  • Can this be managed around your work and/or other obligations?
  • How many embryos do you want to implant? 
  • How many times will you undergo treatment?

These questions may have the two of you at a new crossroads every week. While some people may sail through and others agonize, it’s more likely that some decisions will bring up unexpected issues.  Pay really close attention how you are both functioning.  Your emotional state is important: Do either of you feel stressed, resentful, guilty, desperate, depressed, or hopeless?  Is one of you leaning one way and the other in another direction?  Are you fighting? That is where mutual respect, communication and agreement come into play.

Lisa Marsh is a Fertility Coach working with people on all aspects of fertility, including female and male infertility, pregnancy loss, assisted conception, alternative means of family-building and menopause.  Visit her blog http://yourgreatlife.typepad.com or her website http://yourgreatlife.co.uk for more information.  For coaching, email lisa@yourgreatlife.co.uk

Facing Many Crossroads, Together

Part One: How Do You Function as a Couple? 

Infertility is no picnic. There are months or even years of suspecting a problem, opening up about it, asking for help, educating yourselves about issues, medical terms, finding acceptance and making decisions about how to proceed.  It’s not entirely straightforward for most couples.  How can it be, unless you are incredibly agreeable, immediately find the right doctor and receive an unequivocal diagnosis and solution?  Often, I get annoyed by the over-used term “fertility journey,” but it fits here too perfectly to cast aside, as I describe various crossroads you may reach on the way to creating your family.  A crossroads, in this context, is one of those times when you have to stop and deliberate a big decision that will affect the way you pursue parenting and its success.  You may have a possible diagnosis, a medical opinion, and/or the opinions of family, friends and forum members to contend with, fighting for attention in your head.  You have to pay attention to what your body is telling you as well.  Primarily, if you are in a relationship, you must come to an agreement with your partner at each of several crossroads. 

How will you get through these rather large bumps in the road? For the most part, that will depend upon how your relationship already works.

For a couple whose communication skills are quite healthy, facing these decisions may not be too difficult. Secure in their relationship, they may sit down together and have private, peaceful conversations every step of the way.  They will lay out the pros and cons very efficiently, really listening to each other and reading the subtext (that which is not actually spoken) to arrive at a decision that both find acceptable.

The couple who do not talk about much may just launch into medical investigations and treatment without much forethought.  That may seem unbelievable, considering the physical, emotional and financial costs, but it works for some.  This is the couple that knows they want children, want their “problem fixed” and allow their doctor to run the show. “It seems like everyone is having fertility treatment these days,” so why shouldn’t they? One concern is that if they don’t talk about huge issues like fertility treatment, they may not know when they need to be supportive of each other.

Where one person in the relationship is clearly dominant, the person who is in the power seat makes most of the decisions and their partner follows the lead.  When it comes to fertility issues, I would lay a bet down that the woman is making the decisions. This is actually more effective than you might think, in that traditional relationships assign matters of health, wellbeing and family planning to the woman. Her man goes off to work, doesn’t accompany her to the doctor’s office and understands the need for scheduling tests, scans, injections, sex and, well, life.  She only has to tell him where and when to show up to fulfil his parts of the equation. 

 Finally, there are the couples who discuss EVERYTHING in minute detail, who I divide into two camps:1)  The couple who talk about everything with each other and everyone else. Copious research, note-taking, question-asking, Google-obsessing, and forum-hopping is normal for them, but they do finally come to a decision and eventually take a step forward and 2) The couple that goes round and round the issues in circles, saying “What do you think? No, you say what you want first. Please just tell me what you want to do. Maybe we should discuss it more.”  This couple is in danger of losing valuable time in getting their treatment started or moving on to the next available spot with the clinic.

This is Part One of a Series. Please look for the next Part: Coming upon a Crossroads, What You Need To Make Your Decisions.

Lisa Marsh is a Fertility Coach working with people on all aspects of fertility, including female and male infertility, pregnancy loss, assisted conception, alternative means of family-building and menopause.  Visit her blog http://yourgreatlife.typepad.com or her website http://yourgreatlife.co.uk for more information.  For coaching, email lisa@yourgreatlife.co.uk

Going in Circles With Infertility and Stress – Part Two

Take a Time-Out to Control Your Stress 

Liken the accumulation of stress from infertility to a traffic accident in which the first car stops suddenly. No one has been injured and the damage from the two-car accident is contained, but neither of the parties has put out flares signalling danger.  As a result, each successive car behind them piles up, multiplying the level of damage.  Similarly, small signs of stress like nail-biting or cranky behaviour, may seem harmless, but you don’t have to be falling apart to internalize damage.  If your ultimate goal is to become pregnant, your initial, short term goal must be to lower your level of stress, clearing a space for the work to begin.  Then, keep it clear throughout your attempt to conceive.  

If you are aware of areas of your life in which stress shows up, the next step is to acknowledge the stressor and change your response to it. When you feel your personal signs of stress creeping up, you can deal with them on the spot by practicing this short visualization technique I call a time-out. 

Time-Out – I call this visualization a time-out because all it takes is excusing yourself for a few minutes. When you become practiced at it, it feels like you have had a mini-holiday. It is useful in a few ways.  

  • Replacement – By focusing on an image in your “mind’s eye,” you block out the image corresponding to your stressor.
  • Relief – Placing yourself within the positive image/scenario you have chosen, and imagining its sights, sounds, smells and tastes, helps to break the emotional connection you felt in response to the stressor.
  • Rapid – It’s a quick fix, free of cost and no prescription needed.
  • Restorative – It is very empowering. Mastering the visualization allows you to re-gain control of your stress and restore calm.    

Take Two – A 2-minute visualization exercise can be slipped into your daily life without attracting attention.  Whether you are working, busy with your family, at a party or involved in a project, it is easy to slip away for two minutes at a time.   Any Time, Anywhere – Privacy and safety are the two required elements, in order to allow you to break the connection with your current environment. Be creative; you can find privacy in the busiest places: empty offices, walk-in closets, the loo or even sitting in the car on your own driveway. In order to reach that quiet space inside, it may take four or five minutes at first, but with some practice, you will be able to reduce the time it takes to regain control to about two minutes. Please use caution and do not practice it while driving.  Pull the car over to the side of the road if necessary.  Define Your Image – Close your eyes. Isolate a specific image, real or fantasy, which evokes a 100% positive feeling. If an image of your last beach vacation, however lovely, brings up the nagging feeling that you didn’t look great in your bikini, it isn’t the right image for this exercise. Your image can be a frozen moment in time, such as the kiss at your wedding ceremony, or a conjured image of a beautiful place you will go in the future. Let your mind play on this image, vivid detail and colour, sharpening the detail. Imagine that you can smell the air, hear the sounds and even taste something that is evocative of the memory or fantasy of your choice. This image should make you smile. The emotions evoked by your image might be peace, happiness, confidence, contentment, hope or a mixture of other positive feelings.   Write Your Story – Silently, describe the scene to yourself as if narrating a script. For example: “I am dressed in white, on the silvery-grey, wooden deck of my house. I am looking down at miles of virtually empty beach. The ocean is deep blue and turquoise; the sky melts into the horizon. The late afternoon sun is making millions of white, jewelled ribbons dance on the water.  I see a few people walking or sitting and enjoying the peaceful day.”  Now you know mine; it’s your turn. Make it as real in your mind as you can. Are your feet bare? What is the surface under your feet? Is your skin cool, warm or hot? What do you hear, smell and taste?  Are you alone, or with others?  

A Good Place

To Begin Every Day – Use your Time-Out to start each day until it becomes habit and you can fit the exercise into two minutes. This works well for clearing any non-specific stress; you know, the feeling that you want to crawl back under the duvet rather than face the day.  A good place for this is in your morning shower, because it’s private, you feel the pleasant sensation of the water and it blocks out most noise.  

Step by step:

  • Relax – Close your eyes and breathe fully and slowly several times. Concentrate on your breathing for as long as it takes to empty your mind enough to begin the visualization. Invite your positive image into your mind, filling out “the frame” with the context that envelops that beautiful image.
  • Drop yourself in to your visualization. If you are a fan of Star Trek, you can imagine “beaming down to the planet.” I prefer to use a different technique:  It feels as if an artist suddenly changed a 2-dimensional picture into a 3-dimensional environment that you can enter.  Imagine that image slip like a liquid over your head and down your body until you see yourself clothed and positioned as you were during the first Time-Out.
  • Become One with your image – Focus on and isolate each part of your body and “feel” them connect with the physicality of air, earth or water in the place you imagine yourself to be. Direct your mind to travel up your body, recognizing the sensations you feel, from toes to shoulders, and then out to each hand, up your neck and to your head.
  • Emotionally connect to your image – allow yourself to recognize the feelings conjured by your visualization. This is like “getting into character” for your own dramatic performance. Are you: euphorically in love? Flush with success?  Comforted by an embrace? Peaceful and still? Dazzled by beauty? Exhilarated by speed?
  • Lock it all in – Bring your arms up and wrap them around yourself. First you were part of a positive image; now draw that positivity into you and lock it in with a hug. I find that the physical embrace centres and comforts me. Try it, especially if you have been feeling tired, lonely, fearful or shaky. If you are not in a private enough space, you may feel it is enough to just clasp your two hands together in a firm grip.
  • Acknowledge that you will have challenges during the day and that you are strong enough to embrace them without fear of over-reacting. Then, shake your arms out and slowly open your eyes.
  • Repeat your visualization however often you feel the need. 

If ever you can’t relax enough to bring up your Time-Out image, use props and your other senses to give you a prompt:

  • When you open your eyes, write down what you saw in your mind’s eye, in a very descriptive way. This is one place that the gratitude journal really comes in handy. Knowing that you are doing something positive for yourself is very empowering. The physicality of writing and seeing your description on paper will further anchor the image and your positive response to it, and you will have it to look back at if need be. 
  • Practice your visualization while holding a talisman in your hand.  Then whenever you feel stress rising, hold and rub it between your fingers. I use a tiny silver ball with the faint, twinkling sound of chimes, to trigger both visual and auditory memories of my happy place.

I would be very interested to hear from you about your use of the Time-Out exercise; what your image is and how well it works as a stress reliever. 

My blog is http://yourgreatlife.typepad.comMy website is http://yourgreatlife.co.uk Contact information:  020 8954 2897 or lisa@yourgreatlife.co.uk

Going in Circles With Infertility and Stress – Part One

Moderate stress is part of the human condition, however, one serious stressor such as infertility, can truly disrupt our lives and make the difference between a good year (substitute “decade,” if applicable) and a bad one.  The irony is that stress is often cited as a serious factor in infertility.  It’s the old chicken and egg question…which of these came first. You may never answer that question, because you could initially have felt stressed by such common factors as the rigors of your job, difficulties in your relationship, financial insecurity, moving house or simply that you are a worrier.  Whichever it is, if you are struggling with uncertainty about whether you will ever have a child and want to give yourself every chance of success you must look at the symptoms of your stress and find ways to lessen them.  

Loss of identity – With infertility, women are confronted with two serious blows to their identity. The first is the endangerment to their life plan, including hopes and expectations of having a child or children of their own. The second blow is to their image as a woman, which includes the perception that their body is letting them down by not functioning as it should. This in turn affects their sense of femininity and sense of purpose.  Who am I, if not a mother?  Who am I, if my body won’t do what it is supposed to do?   

Lack of control – Infertility propels women into a world of blood tests, unfamiliar medical jargon, drug therapy and/or surgery.  Not only can they be devastated by their diagnosis, but also by their measurement against a Rate of Success chart.  You are no longer you; now, you are geriatric (40 & over?), obese, poly-cystic, have unhealthy eggs, anti-cardio whatever and/or “unexplained” infertility. While weight, nutrition and bad habits can be improved, we can’t turn back the hands of time or produce another supply of eggs. To any woman who has even the slightest tendency toward perfectionism, this categorization, entry into the mind-boggling medical system and the inability to control her own reproductive function can be dehumanizing.  Even the strongest woman can find herself feeling helpless, isolated and dependent, all of which are incredibly stressful.  

Where stress shows up – Stress, from any source, is cumulative and can affect other psychological and/or physiological areas of your system.  Just as stress from your job can turn around and bite you from behind, lessening your efficiency at the workplace, stress from infertility can affect your reproductive health.  Common areas that show symptoms of serious stress are: 

  • Appetite and weight – either losing or gaining them substantially
  • Sleep – not having enough of it
  • Concentration and organization – the loss of which can affect productivity and safety
  • Emotional stability (neediness, wide-ranging emotions, desire to isolate yourself, jealousy, self-esteem, guilt, anger, etc…)
  • Headaches
  • Digestive system
  • Blood pressure
  • Menstrual cycle – you must ovulate properly and on schedule to achieve best chance of conceiving
  • Personality – a rollercoaster of emotions; acting out
  • Relationships – arguing, feeling unsupported, worrying about the future together
  • Reliance upon unhealthy habits to calm you – smoking, drinking alcohol, etc…
  • Temperament – whether low, disinterested and negative or self-centred, volatile, even bitchy 

Both the stress and its symptoms are real and can cause temporary or long-lasting damage, so don’t brush them off.  If you can identify with any of the symptoms above, it’s time to find your way out of this maze. 

Acknowledging Stress – Since your ultimate goal is to become pregnant, your primary, short term goal must be to acknowledge and then lower your level of stress.  Look at how you are performing in your job, your relationship and friendships. Have you been in denial about how well you are coping with the strain of infertility? Perhaps you can remember uncharacteristic emotional outbursts, sudden tearfulness, and snappish responses. A little of this is normal and quite understandable, until it begins to impact upon the very things you need to safeguard: your health and your support network.  If you notice that people are walking on eggshells around you, it’s a pretty good clue that you are not coping well with stress. Be careful. Patience may run out if you start to indulge in primadonna behaviour, expecting special treatment all the time.  You need all the support you can get, so don’t alienate those who are standing by to offer it. 

There are several things you can do to help yourself if you are suffering from stress due to infertility.  How do you know for sure if this pertains to you? Self-awareness is essential, but if you are not particularly good at it, ask someone you like and trust to be honest with you.  

  1. Begin a gratitude journal. A truly miserable person will find this difficult at first, however, even if (or especially if) you fit that description; the focus on the positives will also have a cumulative effect. Record the simplest or mundane events in your day if you must, such as “the sun is shining, my bus was on time and I haven’t gotten my period yet.”  Eventually, you may find gratitude for enough things in your life and even those connected to your infertility, like “met a new friend in the doctor’s waiting room.”
  2. Try acupuncture, making sure to find a practitioner who has knowledge of your condition.
  3. If you are in fertility treatment, schedule the scans and blood tests for early morning to get them out of the way, leaving you with the rest of the day to live your regular routine.
  4. Talk about it. See a fertility coach or counsellor with whom you can release your pent-up stress.  Their objectivity, confidentiality and support make sessions a safe place to talk about your thoughts and feelings and work out your options. It gives your partner and friends a break too.

In Part Two, I show you how a visualization exercise I call a time-out can be a quick, easy and independent way to lower your stress level.

My blog is  http://yourgreatlife.typepad.com/

and my website is  http://yourgreatlife.co.uk/

Contact information is 020 8954 2897.

Pregnancy after Miscarriage – Anxiety, Expectations and Hope

So, you’re pregnant again after a miscarriage.  You may have let nature take its course, or gone through another cycle of assisted conception.  Either way, you have achieved your goal, and it was supposed to feel like a triumph, worthy of celebration.  But, now that you are there, how do you really feel about it?

 Start at the beginning – Women, who are trying to become pregnant after having experienced one or more miscarriages, often express desperation to become pregnant again and then experience a huge range of emotions about this next pregnancy, including everything from hopeful but mildly worried, to terrified. Because I often work with women who are still feeling the emotional, and even the physical, effects of their loss, we tend to focus on making sense of facts and recognizing feelings: shock, grief, guilt, blame, loss of hope and confidence. I like to go back and work through her expectations around that previous pregnancy. Then, it is easier to understand the reason for, and the depth of, her feelings about her miscarriage and gain some degree of closure. 

 Shattered dreams, plans and self-esteem – For example, especially if it was a woman’s first pregnancy, the pictures in her mind of how that pregnancy would unfold will have shattered.  She may have spent considerable time, even in the short period of a first trimester pregnancy, falling in love with her baby.  If it was an unexpected pregnancy, she may have had to come around to the idea and begun making mental adjustments to the unfamiliar territory of motherhood. Perhaps she focused on romantic daydreams of herself and her partner experiencing a new, intimate connection with each other over her swelling, pregnant belly.  So, on top of her grief over the baby she will never know, she could also be missing the specialness of that imagined, future time in her relationship.  He may or may not be aware of that aspect of her emotional response to the miscarriage. She may also have expected the pregnancy and her child’s birth to transform her in some way: to give her more significance: mother, mother of his baby, mother of someone’s grandchild, part of the “club” of friends who are mothers, or on the same level as her sisters who have children. Not only could miscarriage mean she had failed in her own eyes, she could perceive that she is a failure in the eyes of others, even when it isn’t true.

Walking on Eggshells – What happens to this couple when they are fortunate to conceive again? In my experience, no matter how often a woman reads or hears that many couples go on to have a healthy, full-term baby after experiencing miscarriage, there is a lot of walking on eggshells in a subsequent pregnancy.  If she excitedly discussed her previous pregnancy with family, friends and colleagues, she may not even tell anyone she is pregnant again. To some extent, it is impossible to suspend fear entirely because we have the negative memories of having placed our trust in God, medicine or both and it resulting in enormous pain.  In the new pregnancy, that trust is somewhat reduced in all except those who have absolute, blind faith that a Higher Power will deliver what is meant to be. The need to exert control over something that is largely out of our control is all so understandable, and at the same time, such a shame because it means that she will experience less unreserved joy.

Achieving a Deeper Level of Understanding – In trying to support a woman through this next pregnancy, I believe that the best route is to go back to the basics: her identity, her values, what she wants out of life, her level of satisfaction with all aspects of herself and her lifestyle, sorting out her wants from her needs, and measuring her competing interests. To each of these areas, I would ask her to reflect upon how any of them was changed by her experience of miscarriage and finally, to anticipate how they will be changed by having the child she now carries.  The progression of the coaching process will reveal, layer by layer, how deeply she believes in herself, where her strength lies and how she will use it, no matter what lies ahead.  Those are the qualities that will make her a good mother and provide them both with a great life. 

Self-Coaching – If you want to do this for yourself, I suggest that you buy a journal with lined paper and set it up for a self-coaching process by putting each of the categories (previous pregnancy, miscarriage, subsequent pregnancy) above at the top of separate pages, with several pages in between each, headed by the sub-categories (ex. Who am I? My values, my aspirations, what I need to be happy, my satisfaction level at the particular time, my strengths, my frustrations, my expectations, how any of this has changed, etc…) Then, write on them at your own pace; whenever a flash of insight occurs, or in purposeful sessions. Don’t worry about your language or whether you are “making sense.” This is just for you. It is not about gaining an explanation for your miscarriage; it is about understanding yourself and what you want, accepting that there are no guarantees in life and opening the door to what is to come.

Supporting Her – This way of going back to the beginning, before the trauma of the loss, can, work for those closest to her as well; encouraging her to talk about her first pregnancy, this one and what makes her to want to become a mother. It is important to pay attention to her signals of being willing, ready and able to talk.  However, you can communicate a state of openness, verbally or through body language.  Looking directly into her eyes will show emotional availability and not expressing any criticism about how she is acting will go a long way toward building trust. Please, don’t ever try to stifle her by saying “Forget about it. Surely it won’t happen again.” You can’t give her any guarantees and may provoke resentment, anger or being misunderstood. She is not looking for you to solve her problems; she may just need you to listen and give sincere comfort.Instead of shutting off those dreams and memories that existed in her with the previous pregnancy, I would encourage them to flow. They are the reason that she is risking her body, heart and mind again.  By remembering and talking about her positive reasons for conceiving and carrying the first baby, she can reach a level of acceptance and underlying strength to move forward into the new pregnancy with renewed courage.  She deserves to embrace and enjoy carrying this child who is, at no other time, more a part of her than right now.

Lisa Marsh is a fertility coach, supporting those who are trying to conceive, experiencing loss, secondary infertility, assisted conception, alternative parenting and loss of fertility through illness, medical treatment and menopause. You can find out more about Lisa’s work by visiting her blog: http://yourgreatlife.typepad.com or contact her directly at lisa@yourgreatlife.co.uk .

An essential of fertility treatment

An Essential Of Fertility Treatment Is Choosing The Right Doctor For You 

A key ingredient to a positive experience with fertility treatment is a good relationship with your doctor and his/her medical team from your GP to your RE.  Perhaps more than any other medical treatment, fertility treatment delves into the most intimate areas of your life.  From your first enquiry about difficulty conceiving, you step into a different relationship with them than when you were in for general health checks.  The focus may be on your reproductive health; however, to varying degrees you are inviting them to be part of your hopes and dreams.  As time goes on, you will entrust them, from the receptionist up to the specialist, with details of your values, spiritual beliefs, the strength of your relationship, your views on and knowledge of sex, birth control, procreation, parenthood, and so much more.  You will be phoning frequently for appointments, lab tests, scans, results, advice and simply to ensure that they don’t forget your life has turned upside down. 

Depending upon your age (+/- 35) and medical history, the question of your fertility may have been completely unexpected.  Even if you are a positive sort, the threat to such a fundamental part of your being, your images of the future and your relationship may lead to thoughts such as “What’s wrong with me?”  “What did I do wrong?” or “Why us?” Hopefully, your doctor has enough experience and sensitivity to anticipate this and will explain the next set of investigations or results in a way that turns your panic into measured concern.  Actually, I might as well say it right now:  you must step forward and meet the doctor more than halfway. Leave embarrassment, shame, guilt and anxiety at the door as they will do you no good and the stress they cause may actually harm your chances of becoming pregnant. 

Infertility takes conception, which should be a natural function, out of your control. For many women, that loss of control is deeply uncomfortable, and even frightening.  I have seven years’ experience of ups and downs in this area, with a combination of recurrent miscarriage and periods of infertility.  I’ll admit to periods of pure numbness, and then heartache, followed later by many glass-half-empty tears.  My GP seemed wholly indifferent to my plight. I wasn’t offered further medical investigations, treatment or counselling.  Why didn’t I change doctors?  Somehow, while I was adventurous and outspoken in other parts of my life, I lost my voice when it was a question of my fertility. I can only conclude that, with infertility looming like a big, dark cloud above me, I felt too vulnerable to assert my needs.  

My response, as an American used to private healthcare, was to ask women friends for a recommendation, then dig deep in my pockets to pay for the services of a Harley Street consultant.  I realise that not everyone would be willing or able to cough up all their holiday, Christmas and rainy-day funds, however, if it matters enough for you to know more about your condition, overcome it and to become pregnant, do anything you can to find the right doctor for you, whether NHS or private.  A sad truth of our fertility and physical stamina is that time will eventually run out and you don’t want to have regrets that you didn’t do everything you could have to create your family.  (Yes, I am aware that a 66 year old woman has just had her first child, but seriously, do you want that to be you?). With today’s search engines, researching each fertility doctor and clinic you are considering for success rates, good standing with their professional association and the number of times they have performed certain procedures is so easy now. If you make an informed choice and use your instincts, you will be paid back with peace of mind and trust. 

So, you have reached a point where you need medical assistance to conceive.  Maybe, you have a short-list of fertility specialists and clinics within a reasonable distance (Or not. I went abroad for my IVF.)  Here are a few tips to help you choose a medical team and achieve and maintain a good relationship with them.   

  • Look everywhere (your doctor, insurance company, friends of friends, internet fertility forums, etc…) for recommendations of a good reproductive endocrinologist (RE) and clinic.
  • Think about whether you and your partner respond better to male or female doctors. This may affect your ability to talk openly and honestly, endure frequent physical examinations or trust their opinions.
  • Ask if you will always see your preferred doctor.  If not, ask to meet the other doctors before agreeing anything.  Burning with resentment at an appointment will interfere with your sense of well-being and your relationship to the staff.
  • Educating yourself about your condition makes “hearing” your doctor that much easier and takes the edge off your anxiety.  However, don’t trip over the doctor’s toes with unqualified self-diagnosis.
  • Do not be afraid to go for a second opinion. An experienced, confident doctor will understand that you have difficult decisions to make.
  • Try to identify each person as friend or foe (for instance, the dragon lady who answers the phone or guards the appointments schedule; it’s her job) and find ways to get them in your corner.  Be conscious about your demeanour; pleasant, patient and worried goes a lot further than impatient, aggressive or hysterical.
  • Be bold. In the waiting room, ask other patients if they have been happy with the medical practice and if they have any tips for you.
  • Whether you choose the most sought-after doctor in the field or someone out of the public eye, you should expect his full attention and compassion during your appointment, but understand that he may not have extra time for chatting and hand-holding.
  • The medical and non-medical staff at the RE’s office may display a professional demeanour that masks real caring. They can’t get emotionally involved with each couple. Be content with friendliness and patience when you have questions or a few tears.
  • If the fertility clinic offers counselling or coaching for your emotional well-being, take advantage of it! This may very well provide the empathy, attention and support to balance out the doctor’s more scientific approach.
  • If, after you have begun with one doctor, you are not comfortable with anything from his bedside manner to the distance from your home or workplace, find someone else.  Don’t stress out.
  • The best thanks you could give your doctor is a recommendation to other couples. Those baby photos in his office, with joyful commentary from grateful parents, are better marketing material than he could buy.  You may need your RE’s services again someday, so if you recommend him to someone else, ask them to mention it when they meet him.
  • The nurses are often there at unreasonably early hours 6 or 7 days a week to allow for patients who have to get to work. A word of appreciation or a bag of croissants won’t go amiss there either.

It is easy to be swept up in the flood of instructions, procedures, an artificially induced cycle, frequent trips to the pharmacy, lessons on self-injecting, an endless list of incomprehensible medical terms and rules of a fertility clinic.  It’s all made more difficult by the high level of emotion that accompanies infertility.  It quickly strips the “trying for a baby” of romantic ideals.  Work on feeling positive, hopeful and supported (perhaps the topic for my next blog).  Central to your fertility plan and within your control, is your choice of doctor’s practice, including his practice manager, receptionist, nurses, and professional support for your emotional well-being.  You should be absolutely convinced that you are all on the same team, wanting the same result and doing everything that can be done to achieve it.  You deserve it.

This post was posted by Lisa Marsh

To find out more about Lisa Marsh of Your Great Life click on the link below

http://yourgreatlife.typepad.com

Another guest blogger saying hello

Hi, I am Lisa Marsh, of Your Great Life, saying my own hello as a guest blogger. I will be writing from the perspective of someone who has experienced both recurrent miscarriage and secondary infertility in the past. I have been incredibly fortunate to have two healthy children within the seven years of TTC and am not planning to have any more children. I hope that my experience will be inspiring to some of you.

As a direct result of my personal experiences in this area, I went on to train as a life coach and as a miscarriage helpline volunteer. I run a miscarriage support group and find that issues of infertility are entwined with miscarriage, such as PCOS, in the members’ reproductive health. I am now devoting my entire professional practice to fertility clients, starting with TTC and continuing into the loss of fertility due to ageing (menopause), disease and chemotherapy.

I am really looking forward to being a part of this forum. Please give me some feedback on my blogs and let me know what you want to hear about.