04/01/2010 by yourgreatlife.

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.

Posted in fertility coach, Life Coaching, Fertility & stress, Fertility Blogger, Support for infertility, Fertility Experts, Guest blogger, Infertility, Fertility, Friendship & support, lifestyle and fertility, Fertility Advice | 4 Comments »

25/11/2009 by yourgreatlife.

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 http://yourgreatlife.typepad.com/.  She can be contacted at 020 8954 2897 or lisa@yourgreatlife.co.uk  for coaching, article writing or speaking engagements. You can also follow her on Twitter for Fertility and Miscarriage Support Tips at http://twitter.com/yourgreatlife .

Posted in Weight loss, fertility coach, Fertility & weight, female fertility, PCOS, Fertility, Polycystic Ovarian Syndrome, Fertility Advice | 2 Comments »

23/11/2009 by Anya Sizer.

As I sit at my kitchen table and write this blog I am incredibly aware of just what a lot has happened over these last few years . And how , for all the noise , tantrums and lack of sleep I will never cease to be amazed that I have finally got here .That I can finally be a mum .I guess thats one of the only advantages to having had such a fight to get my family . I will never take it for granted .Change the scene to about 8 years ago and the situation was very different and in a sense  where our  journey began  . 

I had met my husband at university and always had a strong friendship as well as romantic hope for him . So it was with little suprise that we finally told family and friends that we were getting married in 1997 . We were very much in love and talked from early on about how great it would be to be parents .The summer before we officially started trying I remember being on holiday and writing a list together of our top girls and boys names for the family which lay just within our reach . There was such optimism and such hope . It was to be over so soon .We tried for a family for about 9 months before I could take it no longer and assumed there was something wrong .

I was never known for my patience and thus nearly everyone told me to calm down , stop trying so hard etc etc ….the usual . But deep down I really just wanted reassurance . And so I persuaded a doctor to do some initial tests on both of us . Fully expecting the results to match the helpful comments of friends and family . That we would be fine and to just relax more .However the results for my husband were utterly devestating . He was Azoospermic , there was no sperm whatsoever  present . The ” kindly ” doctor pronounced we would never have chidren and we were sent on our way .

And just like that our world crumbled and a new chapter began .We then went through every test we could do , choosing to use my savings rather than wait ..again that old impatience . I found out information about my inner workings that I never thought I would know . And certainly more about my husband than is common in most marriages !Finally we saw one of the top specialists in the country and were told in no uncertain terms that ours was one of the worst situations a couple could find themselves in .” If I were you mr Sizer i wouldnt put my wife through IVF but would look at Donor or adoption . You have a 1 in 125,000 chance of this ever working “To say my husband was crushed would be an understatement . And I grieved that day as Much for what it was doing to him as  for the loss of our dreams .

Over the next few weeks we re emerged from the duvet and began to talk . ..and talk ..and pray and talk . Until finally , and for no good practical reason we chose to give that 1 in 125,000 chance a go . Not good betting odds but I guess we needed to close the door before moving on .And so we started IVF number one at the lister clinic , a wonderful warm enviroment who supported us all the way , even when they felt it was a run to nothing .The cycle went badly to begin with and then got worse with the realisation that I was what they called a “poor responder ” ( how I hate that phrase !) and probably early menopausal ..just to add to the tension !!Finally however 4 eggs were obtained , my husband had a very painful op to remove the few sperm he did have and the wonderful world of science miraculously made 4 embryos .Just 3 days later 2 little bundles of potential were lit up on a screen and shown going into my womb …and so began the dreaded 2 week wait .Again we were so low on hope that I almost didnt do a test on the set date . But eventually we did . And amazingly 1 little ball had made it .I was pregnant !! 9 months of  elation and anxiety ensued until finally on April 26th 2003 our first miracle was born and Hope Sizer came into the world .We were literally over the moon to become parents and loved those early days with our new daughter .

And yet our dreams of a family had always been of two or more children .And though family and friends pretty much begged us not to keep going we entered the wonderful world of ART once again when Hope was just over a year old . The abridged version of what happened next was that amazingly , our odds actually seemed to get worse ! I was diagnosed with High FSH , and an over active immune system as well as the initial poor responder bit !  We went through 3 more cycles and two miscarriages before our final attempt at the ARGC clinic .This was to be it . Enough of the battering .And so a new regime was started ,new protocol and an immune suppresant drug for a mere £2000 extra .Two embryos put back in and …..well lets just say Barnaby sizer is a very meant little boy !

We finally felt like a family.I have done many things in my life that I am proud of and many things make me grateful . none of them howehver come close to the pride I feel personally and as a couple, in fighting for our family .It was without doubt the hardest thing I have ever done , possibly ever will do  , and amazingly it was worth it .During my time going through IVF I retrained from a counselling background , into Life coaching and began to specialise in supporting encouraging and resourcing couples through Infertility .

To come up with specific coping tools  through this most emotional of times .One of the key things I always say to people is to never belittle what you are facing . Infertility has recently been given a stress point reading akin to Cancer and Bereavement and as such a person dealing with fertility issues needs support . A new chapter has again then started for me through this work . A new chance to help support and encourage other people facing the difficulties of Infertility . Whether it is running the support group , running workshops or speaking to the media I remain passionate that people facing Infertility should be as best looked after as possible .

Best of luck to everyone reading this 

Anya Sizer

www.thefertilitycoach.co.uk     

Posted in Fertility Blog, Infertility & Stress, Fertility Blogger, ART, fertility coach, Male Infertility, Infertility, IVF, Assisted reproduction, Male Fertility, Male Fertility Issues | 1 Comment »

09/11/2009 by yourgreatlife.

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

Posted in Fertility Blogger, fertility coach | No Comments »

03/11/2009 by yourgreatlife.

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

Posted in doing things differently, female fertility, Fertility Treatment, Assisted reproduction, Life Coaching, infertility investigations, Asking for help, fertility coach, Marriage, Getting Pregnant, Trying to Conceive, Fertility Tests, Male Fertility Issues, Pregnancy, Infertility, Alternative Therapies & Fertility, IVF, Fertility, Uncategorized | 2 Comments »

01/11/2009 by yourgreatlife.

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

Posted in Guest blogger, Assisted reproduction, Male Infertility, fertility coach, infertility investigations, Asking for help, Fertility Treatment, Male Fertility Test, Infertility, Trying to Conceive, Fertility, IVF, Getting Pregnant, Fertility Tests | No Comments »

16/09/2009 by yourgreatlife.

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.

Posted in Fertility & stress, fertility coach, Guest blogger, doing things differently, female fertility | 2 Comments »

28/07/2009 by yourgreatlife.

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 .

Posted in Self Coaching, fertility coach, Pregnancy after miscarriage, TTc after miscarriage, Miscarriage | No Comments »