Thursday, September 2, 2010

When your problems have problems--experiencing setbacks in infertility treatment

Experiencing setbacks, disappointments, and other obstacles is very common when undergoing infertility treatment. In an emotionally charged environment, such occurrences can cause a great deal of distress. Many times I have seen clients, who are already upset about their situation, become very overwhelmed and anxious when a roadblock inevitably appears. Sometimes, their emotional responses have the potential to derail their treatment plans and chances for success, unless they can quickly recover and respond. As I myself have been no stranger to such bumps in the road, I have found it helpful to have a system of classifying the types of problems that can arise, because each type of problem requires a different type of emotional response and plan of action.

In my mind, I think the most important thing you can do when you get some bad news or a problem arises, is to stop, take a deep breath, and ask yourself, “What type of problem is this? Is it one that it is theoretically possible to fix-a “practical problem? Or is it one that has no practical or known solution?”

Practical Problems

These types of problems usually require solutions involving time, money, hard work, and patience. So if you think you have a practical problem, my advice is:

· Try to calm down
· Don’t get caught up in your feelings just yet (there’s time for that later); and
· Get to work on figuring out a solution, and then implementing it.

As a psychologist, you may find it odd that I’m advising you to put your upset feelings to the side for the moment. But it may be necessary to do that temporarily so that you have the mental and physical resources you need to get your process back on track. Then when things are settled, you can revisit and process these feelings.

An example of this type of setback occurred to a client of mine when her insurance company rejected her IVF claim for thousands of dollars, causing immediate (and understandable) panic! She immediately became quite overwhelmed and felt convinced she would no longer be able to afford her IVF treatment. After she was able to calm down, she could then see that this development, while unwelcome, wasn’t a deal-killer. Through many unpleasant phone calls and much determination, she was able to resolve the billing issues and continue with her treatment.

Another common example is when a treatment cycle gets delayed for a medical reason, such as an ovarian cyst, or other similar unavoidable factors. Usually, infertility treatment is so unpleasant, and people want a baby so much, that the idea of waiting even another month can be extraordinarily unsettling. However, in the long-term scheme of things, it probably isn’t going to be that big of a deal if Junior is born next March instead of next January.

My fundamental point here is that if your setback or problem can be fixed with money, time, or effort, than you are actually pretty lucky. When motivated, we are all capable of putting our full efforts into an endeavor; can all do; we can make time for the things that are most important to us; and if we put our minds to it, we can often even find creative solutions for accessing more money. It may not be fun or easy to fix these problems, but it is possible, and if we are motivated, we can do almost anything.


Problems you can’t solve

Notice that I said that we can do “almost” anything. Because there are other types of setbacks and problems that, no matter how much you may want to, you cannot control or fix. Sadly, this type of problem makes you long for a practical problem like the ones listed above. One common example involves being diagnosed with something that makes it impossible for you to achieve your current definition of successful treatment, such as finding out you have very diminished ovarian reserve, uterine problems, genetic and chromosomal issues, etc. For these types of problems, my suggestion is:

· Work through your feelings of anger and loss, and then;
· Figure out the “workaround”.

If you’ve just gotten some devastating news, and there isn’t anything that you can do to fix it, the most important thing you can do is to acknowledge to yourself that you are in a crisis, and start taking as good of care of yourself as you possibly can. Trying to put your feelings aside it this point is not helpful, and anyway, it is probably impossible. Talking to your partner, friends, family, or even a therapist will be beneficial and possibly necessary. If you don’t deal with these feelings, you probably won’t be able to make a good decision about what you are going to do next.

The workaround

If you’ve learned that you can’t achieve your goal, then you have two choices—either give up on your current goal, and select a new, entirely different one—or alter your definition of success. In the infertility treatment world, this may involve parenting children with whom you do not share a genetic relationship, whether through adoption or the use of donor gametes. The vast majority of those who go this route find that they feel very happy with their choice, and state they can’t imagine having any children other than their own. Of course, restarting the adoption or treatment process will inevitably bring up its own new set of problems— but hopefully “just” practical ones.

So if you are experiencing a setback, remember to stay calm, and try to think about what type of problem it is. If it is a practical problem, you will usually be able to fix it if you try. If it is a problem you can’t solve, you will first need to grieve the losses associated with this, and then decide on what alternative method you will use to build your family.

7 comments:

  1. I'm really enjoying your blog. Your rational advice is helping me as I start my first IVF. I like the idea of thinking about minor setbacks as being just that and fixable with time, money, work and patience. I am not great at the last one which is my first problem.

    I have accepted there will be setbacks and we need to work at this. I think it is the fear of long term failure that haunts me. What if we try IVF many times for a few years and still nothing? Our answer is adoption but that will take even more time. I know with hard work we will get a child one way or another but they idea that I could face failure after failure and have to come up with "work arounds" and disappointment for years before success is daunting.

    I think I'll be OK if the 1st IVF fails. Then I just need to face the next one but the idea of trying for so long scares me.

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  2. @Anonymous,

    I just wanted to say that I hope you do not get discouraged by my blog! Although some of us in the IF community do experience multiple setbacks, most people do not-so don't worry. You hopefully will not have to deal with this. My main point was that even if you do, you can still have a wonderful parenting experience and life. Best of luck to you in your IVF, and thanks for your comments!

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