Support For Fertility Challenges

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A recent survey from the nonprofit organization Healthy Women found that about half of those surveyed had friends or family members who had experienced fertility problems. That’s not surprising, since between 10 to 14 percent of couples will experience fertility problems at some point.

If your friend or family member is struggling with infertility, she needs your support and understanding now more than ever. Unfortunately, too many people get uncomfortable around this issue and say or do the wrong thing. That’s why we’ve provided this roadmap:

10 Things You Should Not Say to a Friend Experiencing Infertility

Pregnant yet?

If your friend is pregnant, she’ll tell you when she’s ready. Don’t keep asking her how it’s going. Let her tell you in her own time.

It could be worse.

To a couple who wants children, it really can’t be worse.

Haven’t you done enough?

It is up to your friend to determine when enough is enough.

Focus on the other parts of your life.

This is really tough for a woman with infertility problems to do. For some women, her desire for a child becomes her life.

Think of all the fun things you can do if you don’t have children.

If the couple didn’t want children, they would not be going to the trouble they are to have them.

How much is this costing you?

This is none of your business!

Are you sure you chose the best doctor?

Don’t question your friend’s medical choice unless she asks your opinion.

Just relax.

Infertility is a medical condition, not a psychological one.

You can always adopt.

The couple already knows this. They are going through the expense and trouble of infertility treatments because that is the path they have chosen. At some point they may consider adoption, but not now.

When my friend couldn’t get pregnant.

Your friend doesn’t need to hear what worked for other people. Her efforts to coneive are hers alone.

Sharing Your Infertility

At some point, you should share your infertility with the people who care about you. If you don’t, your friends and family may assume you’re childless by choice, leading to some hurtful comments and uncomfortable situations. Keeping it secret also enhances the stigma and shame some couples feel. You also may subject yourself to continually being asked when you’re going to get pregnant and to jokes about your sex life.

Studies find that couples who seek support from their social networks tend to cope better with their infertility than couples who hide it. Plus, if your family and friends know about your fertility issues, they will be more understanding when you beg off occasions that involve children.

When sharing:

  • Keep the details to a minimum. Your mother doesn’t need to know how often you have sex.
  • Warn them that the hormonal treatments can lead to major mood swings.
  • Ask for their support when you need a ride to doctor appointments or help managing your life during exhausting tests and treatments.
  • Tell them what you don’t want to hear (see “10 Things You Should Not Say to Your Infertile Friend”).
  • Give them information about infertility. The Web sites of the American Society for Reproductive Medicine (www.asrm.org) and RESOLVE (www.resolve.org) provide excellent information.
  • Explain that you may not be able to attend baby showers, christenings, children’s birthday parties and other such events for a while.
  • Consider setting up a blog or Web site your friends can visit for information so you aren’t barraged by questions.

Would you like me to go to your appointment with you?

If a partner is not available or your friend is becoming a single mother by choice, having a friend to accompany her to appointments can be welcome support.

May I take you out to dinner?

How about if we just sit here and you tell me how you feel?

If your friend isn’t comfortable talking to you, since you haven’t experienced infertility, offer to help her find a support group for women who are having similar experiences.

No, I don’t mind hearing about how hard this is!

Remind her that she’s always been there for you, and that you will be there for her. That’s what friends are for.

It is not your fault! It is no one’s fault. Sometimes these things just happen.

You will make a wonderful mother.

You look so beautiful!

(This is particularly important since many women begin to loathe their bodies during infertility treatment, viewing it as dysfunctional or inadequate. Some women gain weight from the treatments.)

I want you to come to my baby shower but I totally understand if it’s too much for you.

While some women find it too painful to be around young children and pregnant women, others are hurt if they’re left out.

I’d like to come over tomorrow and clean the house and make you dinner.

Infertility treatments can be exhausting, physically and emotionally. Your friend will appreciate the help.

I think you are amazing. I admire your commitment.

Support during fertility treatment

It’s common to feel stressed when undergoing fertility treatment. Some people find their feelings become more difficult, and they may experience depression or anxiety. Fertility clinics have to offer counselling to all patients and should offer it before, during and after treatment. “Couples and women shouldn’t be reserved about coming forward to see the counsellor,” says Brown. “Asking for the counsellor doesn’t mean you’re not coping. It’s perfectly normal to want a chance to talk, or seek information.”

If you’re dealing with fertility problems and are experiencing feelings that make it difficult to continue with your daily life, you can go to your GP or fertility clinic for help. Your GP can talk to you about the help available, which could include talking therapies, lifestyle changes or medicines. You can find out more about fertility tests.

Problems getting pregnant

If you have fertility problems, you may be struggling with many difficult feelings. Complex and often painful emotions are common for people with fertility problems, those who can’t have children and those having fertility treatment. “People can feel fear, anger and guilt,” says Clare Brown, chief executive of Infertility Network UK, an infertility support network. “They can feel as though they’ve failed. People talk about feeling less of a woman, or less of a man. Depression and anxiety are common. Fertility treatment can be an intensely stressful experience. Most of us never imagine experiencing problems with having a child. When it happens, it’s a terrible shock.”

For those whose fertility problems prevent them from having children, there can be a sense of loss or grief. Brown says: “It’s almost a kind of bereavement for the child that this person expected to have. We can build our future around a plan to have children, and suddenly it’s taken away.”  Not all people who experience fertility problems feel this way. The 1.5 million people affected by fertility problems have all kinds of responses, says Brown. But for those who find themselves tackling difficult emotions, there is help.

Recognize that a fertility problem is a crisis

A fertility problem may be one of the most difficult challenges you’ll ever face. Acknowledging this is a key to coping, says Kate Marosek, a licensed clinical social worker who has counseled people with fertility issues in the Washington, D.C., area for more than 20 years.”It’s normal to feel a monumental sense of loss, to feel stressed, sad, or overwhelmed,” says Marosek. “Don’t chastise yourself for feeling this way.” Facing and accepting your emotions can help you move through them.

Identify and share your feelings

If you’re always putting up a brave front, others won’t understand what you’re going through, and you’ll feel even more alone. It can be helpful to sort out your thoughts and feelings by writing them down in a journal first, and then sharing whatever feels comfortable with trusted friends or family.

Don’t blame yourself

Resist the temptation to get angry with yourself or listen to the little voice in your head that says negative things like, “I shouldn’t have waited. I’m being punished for terminating that pregnancy. I should have lost more weight or taken better care of my health. I shouldn’t have assumed that I could have children whenever I wanted.” “People can get caught in negative thinking patterns that only make matters worse,” says Yakov Epstein, a psychologist at Rutgers University.

“Instead of berating yourself, look forward to how you are going to manage the situation.”When you start feeling like you “should have” or “could have,” remind yourself that your fertility problem is not your fault. Even if you could have made different decisions in the past, they’re behind you. Focus on the present.

Work with your partner as a team

If you have a spouse or partner, help each other through this time (and don’t blame each other for your difficulty getting pregnant). This doesn’t mean you need to feel the same thing at the same time expecting to have the same emotional experience or ways of coping is one of the most common pitfalls for couples facing fertility problems. It does mean paying attention to what your partner’s going through. “If you’re taking care of each other emotionally, you can unite to fight the problem,” says Marosek.

Work together to find practical ways to share the burden. If you’re undergoing treatment, your partner can take care of the insurance paperwork. If one of you needs injected therapy, the other can administer the shots.

Educate yourself

Find out as much as you can about your fertility issue. Ask your doctor questions and talk to other people in your situation. Staying educated is especially important when you’re dealing with a fertility problem because the technologies behind the treatments are complicated and change quickly. “You’ve got to understand what’s happening medically,” says Epstein, “or you won’t be able to make informed choices.” Explore our fertility problems section to learn the basics, and see our resource guide for a list of helpful books, websites, and organizations.

Set a limit on how long you’re willing to try

Some people decide from the get-go that they won’t go to extreme measures to have a baby. Others spend years and thousands of dollars exhausting all their treatment options. It’s your decision when to stop trying to conceive, but you’ll feel more in control of your life if you start thinking in advance about how far you’re willing to go to get pregnant.

Start by discussing your medical odds of getting pregnant, which treatments you’re not willing to try, and your end goal. (For more help with this choice, read about making the decision to end fertility treatment.)

Decide how much you’re willing to pay

In vitro fertilization (IVF) averages $12,400 a cycle – and you may need to have more than one before becoming pregnant.

To cope with the anxiety caused by the high costs of treatment, sit down and develop a financial plan. Start with your insurance: Find out exactly what it does and doesn’t cover. If your plan covers some or all of your treatments, decide how you’re going to monitor the paperwork and negotiate with the insurance company.

Then review your assets and determine how much you can spend and on which treatments. “You should always have a plan B,” says Alice Domar, a psychologist and associate professor of obstetrics, gynecology, and reproductive biology at Harvard University Medical School who specializes in helping people with fertility problems. “Because nothing, especially with fertility treatments, is certain.”

Get support from professionals and other people with fertility problems

Society often fails to recognize the grief caused by infertility, so people struggling to conceive tend to hide their sorrow, which only increases feelings of shame and isolation.

“Finding other people who are going through the same thing can help you see that fertility problems are widespread and your disappointment is understandable,” says Linda Klempner, a clinical psychologist at Women’s Health Counseling in Teaneck, New Jersey.

Share stories and advice about fertility problems with others in the BabyCenter Community or find a support group in your area.

If you’d like to talk to a therapist, look for one who understands reproductive medicine. “Fertility problems are very complex, and if a therapist does not understand the medical issues, he or she won’t be able to help,” says Epstein. Look for a referral through Resolve: The National Infertility Association or the American Society for Reproductive Medicine.

Help others help you

Find articles and books about infertility to pass on to close friends and family, so they can better understand what you’re going through and how they can be supportive.

Just say no to baby-focused activities

If certain situations are too painful for you – if all your siblings had babies in the last two years, or you keep getting invited to baby showers – give yourself permission to skip family get-togethers and other social events or at least to have a good cry afterward.

To avoid hurt feelings, send a gift but order children’s books online or email a gift certificate to save yourself an upsetting trip to the toy store or baby boutique.

Balance optimism and realism

“You need to be optimistic to go through a procedure,” says Epstein, “but if you’re too hopeful – if your hope is unrealistic – you’ll be setting yourself up for a huge fall.” By keeping current on the technology and your diagnosis, you can have a good understanding of your chances of success with each treatment.

The variety of medical technologies available today leads many patients to keep trying month after month, year after year. But about a third of women treated for fertility problems will be unsuccessful in having a biological child, and often must make peace with that before they can move on with their lives. Staying realistic can help you make smart choices as you work your way through the emotional minefield of treatment.

Take care of yourself by pursuing other interests

Being treated for a fertility problem can feel like a full- or at least part-time job, so it’s important to keep up with some of the activities or hobbies that you enjoy. “It won’t be easy,” says Marosek, “especially if you’re doing something like going in for a blood test every other day, but look for ways to take care of yourself.” She recommends that people get a massage, exercise – anything that can offer relief from the focus on fertility treatment.

If your old activities are painful – maybe all your friends are parents now – look for new diversions. If hiking sounds appealing, do that. Or take a class in painting, dance, or something else that’s always interested you.And remember, laughter really is the best medicine. See a funny movie, head out to a comedy club, or reread your favorite funny novel.

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