Hello Again!

Back to blogging after a long absence!

I don't know exactly where all the time went between my last post and this one!  Actually, to be honest, I do know.  Things got really busy with clinical practice, and at the same time, things became somewhat challenging personally as well.   For a long time, the act or writing seemed to require more emotional energy than I had to spare.  And of course, there is the classic snowball effect.  The longer you let something go, the more difficult it is to get back to it.  So the months turned into years...and here we are.

Although I'd stopped writing about infertility and it's discontents, I certainly haven't stopped thinking about it, and there are so many times that I've had moments that I wanted to share in this blog.  But to begin with, I want to relate this clinical vignette that recently occurred, which I feel best exemplifies my experiences in the meantime:

I was having a session with a client who does not have a history of infertility.   What she does have is a long history of anxiety.  She has lived her life constantly afraid; afraid of natural disasters, afraid of storms, afraid of criminals, afraid of car accidents, afraid of an airplane crashing on her head, etc., etc.  We were discussing the recent changes in her situation, which of course have her feeling unsafe, when it occurred to me: she has the fantasy that there will be a time in which none of these threats exist, in which she will feel safe.  Thus, she keeps trying to do whatever she can to make this possible.

Being the killjoy that I am, I waited for a pause, and then stated that I thought that there had never been a time in human history when things were safe, or went well.  In fact, right now might just be the safest time, ever.  And she was right, it wasn't too safe--but that perhaps complete safety was impossible.

After a pause, she asked me, "So what you are basically saying is, life is unsafe and it sucks.  And there's nothing I can do about it."  I replied, "Yes, that is what I am basically saying.  And I'm also saying that you probably need to get used to it like that, because it's not going to change."

My client, who was gracious enough to have another session with me after this display of my charm, told me that although she found my words quite upsetting, she also found them liberating.  With the possibility of achieving a safe world off the table, she had more energy to put into enjoying her unsafe world.

I think the same principle holds true for dealing with infertility; for so many of us, the loss of the fantasy of the easily-conceived baby and the the easy, adorable pregnancy is one of the most painful aspects of infertility.  Only by allowing that fantasy to diminish in intensity can we experience any amount of relief.  If there is one thing that infertility reveals to us, it's that our world isn't perfect, and it's never going to be.   

I hope to be writing more regularly in the future, and as always, appreciate your comments, thoughts, and suggestions.

Decisions, decisions: a few thoughts about deciding how many embryos to transfer

One of the difficult parts of an IVF cycle comes near the end when the decision about how many embryos to transfer back must be made.  From a medical standpoint, this decision can be difficult because there are no hard and fast rules; every individual situation is different and involves multiple factors such as embryo quality, maternal age, prior treatment history, etc.

From a psychological standpoint, the decision about the number of embryos to transfer can be tricky as. Well.  Usually, these decisions need to be made quickly because the information about the embryos is only available right before the transfer. Further, by this point in the cycle, emotions and hormone levels as running high, making clear and rational thought a challenge.

Perhaps most importantly, however, is the fact that by the time a person is usually facing their IVF transfer, they have been dealing with infertility for a while.  Thus, they are naturally desperate for the whole thing to be over and done with as soon as possible.  The idea that putting another embryo or two back might increase their chances of success, meaning they could be on their way to parenthood very soon, is quite seductive.  If financial issues are a concern, an increased chance of success in fewer cycles is also a strong motivation.

I hear many clients tell me that their ideal outcome of an IVF cycle would be twins.  "Two for the price of one," and "buy one, get one free," are common refrains.  I totally understand that sentiment.  I think I may even have said those things regarding my own treatment at one point or another.  However, part my practice involves working with people who have experienced perinatal loss and/or who have given birth prematurely and whose children have spent an extended time in the neonatal intensive care unit.  Many of these people began their path to parenthood via IVF, and transferred multiple embryos.  There experiences in the NICU are often extemely difficult, traumatic, and of extended duration.  All of them have expressed a wish that someone had really helped them understand the risks associated with multiple pregnancies before their IVF transfer.

In addition, even if things work out medically, my work with the parents of multiples has taught me that having twins or triplets can sometimes be hard on a relationship as well, especially if there are other life stressors occurring simultaneously.

I don't mean to be full of doom and gloom here, as I know many healthy and happy families with twins and triplets.  But I do urge people to really educate themselves about the medical and psychological risks associated with multiple pregnancies before they get to transfer day, so they are prepared.  The good news is that with today's improvements in embryo freezing technology, single embryo transfer is a more viable option with a greater chance of success.

Sometimes the decision about how many embryos to transfer is made for you by the situation; you may only have one viable embryo, or the quality of the embryos may suggest transferring multiple embryos.  If you do end up with a choice, then you need to weigh the risks of multiple pregnancy against the emotional and physical wear and tear of doing another frozen embryo transfer.  After seeing the problems that can arise with multiple pregnancies, I find myself recommending single embryo transfer more often these days.

Of course, the decision about how many embryos to transfer back is a personal one, and can only be made by you and your partner.  Just be sure that you have all the facts, so you can make the choice that is best for your situation.

The aftermath: The effects of infertility once the dust settles

I often hear from clients in the midst of a battle with infertility that they can't wait for their children to come so they can "just put this thing behind" them.  I suppose some people, perhaps who are more skilled at this denial than myself, may be able to do so--but the majority of us find that our infertility is something that we simply can't leave behind.  Even if our infertility is eventually resolved in a manner we feel good about, it still has long-reaching effects in our lives.

As an experiment, this week I tried to keep track of the different ways my own personal infertility came up even though our family is (finally!) complete.  Here's what I discovered:

1.  Having to tell the nurse at our pediatrician's office (again) that I don't know my adopted daughter's birth family's medical history.
2.  Fending off questions from a neighbor about whether I had used infertility treatments and/or donor eggs in the procurement of our youngest child, who is one year old, due to my elderly age.
3.  Having to justify to the school principal and school administration officials why my middle daughter should be "grandfathered" in and not have to lottery in to gain admission to her older sister's school, as they are "too far" apart in age.  Luckily, the school officials didn't really want to deal with my argument that because of my medical problems, I couldn't control the age spacing of my children, and they agreed to let her in the school.
4.  Listening with incredulity to the story of a woman who managed to get pregnant twice while faithfully taking birth control pills.

To me, I think that's a pretty typical week.  Even if I wanted to "put it behind" me, the world has a way of bringing it right back around to the forefront.

I don't think my experiences in this regard are atypical, either.  I am frequently struck by women telling me, that despite the many traumas they may have experienced, their infertility is the problems that still continues to haunt them.

Thus, although wanting to put infertility into the past is an understandable wish, it may not be a realistic expectation.  My personal recommendation is that it may be better off to expect that infertility will continue to be an issue, although hopefully in a less urgent and intense manner.  That way, when you get the insensitive questions or difficult situations, at least you won't be surprised, disappointed, or filled with self-blame.

"Fertility envy", infertility and friendships

I came across this article about "fertility envy", written from the perspective of a woman without fertility issues who felt hurt and isolated when her closest friends distanced themselves during her pregnancy.   The author describes feeling disappointed and dismayed when her friends, who had not yet disclosed their infertility struggles, did not react with excitement to her pregnancy announcement.  As her pregnancy progressed, she felt increasingly isolated and unable to talk about her pregnancy and preparations for her children.  Instead, she felt burdened by having to spend time talking about her friends' infertility treatments.  In the end, she found herself spending more time with her friends who already had children or who were not interested in having children, and grew apart from her friends with infertility.

For me, the article stirred up a myriad of feelings.  On the one hand, I guess I couldn't help experiencing a little bit of "fertility envy" myself--after all, the author had no problems conceiving and carrying  beautiful twin girls.  Is it fair of her to be upset that her infertile friends, because of their own pain, couldn't be as excited about her pregnancy as she was?  On the other hand, though, it was an interesting perspective,  and one that as a therapist specializing in infertility, I don't often hear.  I suspect that many friends of mine may have felt similarly during their own pregnancies, but I don't think they would have ever felt comfortable admitting it to me.

I believe that disruptions in friendship and family relationships are one of the most painful aspects of infertility.  It seems that they are incredibly common and perhaps unavoidable.  However, what I find makes a pregnancy a "fatal blow" to a relationship is a preexisting problem in the relationship prior to the pregnancy.  Once a pregnancy occurs, the issue surfaces, and because emotions are so high, the issue is usually unable to be resolved.  For instance, in the article mentioned above, the author only learned upon disclosure of her own pregnancy that her friend had been struggling to conceive for three years.  To me, the fact that her allegedly closest friend did not feel comfortable sharing this with her prior to her pregnancy announcement was a sign that her friend was already having mixed feelings about the relationship.  It is also interesting that the author turned out to have several friends undergoing infertility treatment at the same time, none of whom shared this with her.  Rather than bemoaning the fact that her friends weren't available to her, she might be better served questioning why people she felt close to didn't feel comfortable opening up to her.  In a sense, what she really discovered is that her former friendships weren't really all that close anyway, and thus they were unable to withstand the emotional pressure of her pregnancy.

Much has been written about the difficulties that individuals struggling with infertility have when their friends and family members become pregnant.  I agree that this is often very difficult, but I think much of the difficulty comes from the attitude and expectations of the pregnant persons involved.  The pregnant person's reactions usually fall in one of two camps: either their is complete insensitivity to the feelings of the infertile person, or their is a high level of guilt and oversensitivity, which can then become burdensome for the infertile person to manage. 

Last year I had a relatively unique experience in this regard when I became pregnant (as a result of a frozen transfer from a prior IVF) somewhat unexpectedly, in the midst of working with several clients struggling with their own infertility.  I must say I was repeatedly impressed with how well my clients handled my pregnancy.  Perhaps knowing my long history of infertility, I got a "pass", but I think it had more to do with my willingness to understand and tolerate the fact that they would have negative feelings about my pregnancy, and that I didn't expect them to be excited for me.  In my own personal life, when I was embroiled in IVF, I found that I was able to tolerate, and to some extent enjoy the pregnancies of friends who understood that I was going to have my own feelings about it.  It helped that they listened to my feelings when I brought them up, but didn't force me to talk about it when I didn't.

As for the author's feelings of pregnancy isolation, I find this hard to believe.  It seems that our culture worships pregnancy and its related rituals and material goods, so it seems nearly impossible to me that she couldn't have found other women (other than the old lady in the checkout line) that would have been excited to share in her experiences with her.

I am curious to hear what your experiences with pregnant friends or family members and "infertility envy" have been.  Where there responses or attitudes that you found helpful, or that were less than ideal?

As always, thank you for reading, and please feel free to contact me with any questions or suggestions!

Upsetting things people say, and what to say back: self-protection during infertility treatment

If there is one thing that I have learned from my own infertility, it is that people can say some rather insensitive and mindless things! Enduring countless questions about when you are going to start a family, admonishments that you certainly aren't getting any younger, and other helpful "advice" can wear on a person, especially a person who is already experiencing a lot of stress and disappointment. The holidays, with their many family and social engagements, especially seem to be a hotbed of activity in this regard.

It's hard to know how to respond to these types of comments. I myself still struggle with this issue, and many of my clients describe similar dilemmas. In this blog, I will outline some creative strategies of responding to these situations that may be useful.

Striking a chord

I think one of the hardest aspects of responding to upsetting comments is that they often stir up our own feelings of inadequacy or self-blame about our infertility. As I have discussed in a prior post, it is quite common for individuals experiencing infertility to worry that somehow their medical problems are caused by their actions, beliefs, or feelings, despite all evidence to the contrary. Thus, hearing, "You just need to relax" for the zillionth time can reinforce our feelings that we are somehow doing something wrong, and that is the root of the problem. Our emotional reaction doesn't take into account that rather than a lack of relaxation, there are medical issues at play--and the speaker likely does not have any expertise in this area. In addition, if infertility has already taken a toll on self-esteem, hearing about how so-and-so became impregnated merely by her husband looking at her can heighten feelings of inadequacy.

When you are experiencing negative feelings about yourself, it can be hard to formulate a response to the comment or question right in the moment. This is why I believe it is important to try to anticipate problematic comments or questions in advance. I'm not suggesting getting paranoid about it, but it can be helpful to consider what might be said or asked, and by whom. As you start thinking in this way, you will find that certain situations call for such comments, and that certain individuals can be counted on to say something insensitive or unfortunate. Planning in advance can help you to develop a plan you can implement if and when verbal misfortune occurs.

They started it!

When responding to insensitive or inappropriate comments or questions, it is important to consider that although society teaches us to answer questions when asked, and to try to be polite no matter what, in reality we have much more freedom in terms of our responses. In my way of thinking, if somebody else has already crossed a social line, then all bets are off! We often fear breaking a social rule because we worry the consequences will be severe. After you try it in one of these situations, however, you will realize that in actuality we have much more flexibility than we may believe.

Let's say someone has just said something inappropriate or upsetting to you regarding infertility or family building. How do you respond? I have a few approaches you may not have previously considered that might work for you depending on your needs at the moment.

Stonewall.

Sometimes saying nothing at all says the most. We are trained otherwise, but it is true that just because someone asks you a question doesn't mean you need to answer it. So many times, the questions that people struggling with infertility must endure are very intrusive. For instance, you probably don't go around asking fertile people with whom you are merely acquainted what sexual position they used to conceive their children. So a silent stare, and a change of subject, might be just the trick in these situations to set your boundaries in place.

Educate.

Many times, instead of answering questions or responding to comments, I have found myself giving a little manners lesson to my unfortunate conversational partner. I don't know whether they found this to be a helpful lesson, but I do know it certainly made me feel better. I was especially inclined to do this when someone pressured me about not having children, and not getting any younger. I would tell them, "You know, let me give you a piece of advice. You really shouldn't be going around making these statements or asking people these questions. You never know if someone is having a problem having children or not, and if they are, the things you are saying can be very painful. I'm sure you wouldn't want to cause anyone to feel upset, so this is why I bring this up." This usually shut down the conversation right away, although not surprisingly, I never got the sort of thanks I felt I deserved for imparting this sage wisdom.

Be outrageous

Sometimes in these situations it is most effective to think outside the conversational box. The best example of that I can think of is not infertility related, but does illustrate the point. When I was growing up, my mother provided foster care and adoptive homes for orphaned cats. Sometimes, quite a few of them were with us. Of course, they had to eat, and my mother, being thrifty, wanted to buy the cat food when it was on sale. She would get embarrassed though, buying all the cat food because people would always ask her questions about how many cats she had, why she had them, and wasn't she crazy for having all of those cats? Finally, she got so tired of this that she sent my father to buy the cat food instead. He loaded his grocery cart full of cat food, and as usual, he was approached by a woman who wanted to know how many cats he had. With a straight face, he looked at her and said, "Ma'am, we don't have any cats." He left it at that, and rolled off his cart as she struggled to contemplate what other possible uses there could be for all of that cat food.

I am sure you can come up with similar zingers for your particular situation, especially with a little advance planning. Not only will you be able to protect yourself and effectively end the line of conversation or questions, but you also may enjoy doing so.

Get the heck out of there

Sometimes, none of the above strategies are going to work. You might already be so overwhelmed with emotion that you can't continue the conversation any more. In these cases, if it feels too hard to continue, then simply excuse yourself. Try to do something that will comfort you and help you feel better, whether it's a good cry in the bathroom or hanging up the phone and yelling at the wall. You can always deal with the consequences of exiting the situation later, and hopefully the person will understand. If they don't, then it doesn't reflect well on them, does it? Dealing with the difficulties of your own situation is probably hard enough--you don't need to worry about saving the feelings of everybody else too.

A cautionary tale of two treatments--the roles of emotion and the scientific perspective in infertility treatment

Being a clinical psychologist, I am naturally drawn to thinking about emotions. They are the currency of my work; it almost always seems to me like it's a good idea to discuss them, understand them, and draw them out. And yet, when it comes to infertility treatment, both my professional and personal experience have taught me that they must be managed differently than we manage most things in our personal life. Too often, our emotional issues can blur our vision of ourselves and our treatment, and we are unable to see what is really happening at the time it is occurring.

These emotional experiences, as I've discussed at length, are difficult to manage, and are likely to color both our medical experiences and our decision making. In particular, those feelings of self-blame or doom, are often present. As discussed in a prior post, these feelings can make the success or failure of treatment seem like some sort of spiritual or karmic comment on your worth as a person or fitness to be a parent.

The science experiment mindset

In addition to being unpleasant, such feelings cloud what I think is the real truth of the matter: instead of being about you as a person, infertility treatment is all about chemical and hormonal reactions and cells in a petri dish. And what those cells and hormones decide to do is, in many ways, out of anyone's control. It's really your own personal science experiment. The doctor has a hypothesis based on past research and clinical experience, and he or she tests it out on you to see what happens. If it works, great--if it doesn't work, then there is more information to be used in the development of the next hypothesis, or treatment plan.

The best way I can think of to illustrate this point is to describe some of my own experiences in infertility treatment, to show you how I came to this point of view--and why I am so convinced of its usefulness.

Please do as I say, not as I did....

I learned the importance of taking a scientific perspective on my infertility treatment the long, hard, and painful way. My first few IVF cycles were emotionally devastating for me, fraught with feelings of failure, frustration, and disappointment. Aspects of my infertility were unexplained, and I filled in the scientific blanks with karmic explanations--perhaps I was somehow a bad person, and that was why this was happening to me. Of course I knew it wasn't logical, but in my experience logic usually never stops anyone from believing the worst about themselves, if they are already so inclined. In addition, my RE was the warm and fuzzy type, and seemed visibly upset whenever things didn't work. During one transfer, he was actually praying out loud to God that it would work this time (no pressure, right?) It didn't. I started to feel that not only was I failing my husband and myself, but I was failing him as well.

Eventually I couldn't take it anymore and I quit treatment. Screwing up all of our last remaining courage, we decided to adopt, and that process, although it had many, many bumps along the way, worked out in our favor. It was only years later, when we wanted a second child,that I began to even consider the possibility of infertility treatment again. The adoption climate had changed, and adoptions in my daughter's birth country had become extremely difficult.

I knew that if I were to reenter infertility treatment, I couldn't do things the same way. So we went to a different RE, who although he was known for his clinical excellence, was often described as cold or lacking in his "bedside manner". During our first meeting, it was clear right away that this guy didn't care one whit about me or my problems. And I had an epiphany--instead of feeling hurt by this, surprisingly I felt incredibly liberated. If my treatment didn't work, he wasn't going to be emotionally hurt by the situation. In addition, the new RE was able to systematically review my prior cycles, and explained all the variables that might have caused them not to work. Amazingly, he none of them included karma. Instead, it was all about the numbers--the clinical techniques used, the statistical success rates of the clinics involved, and the advancements in science since I had left treatment. Again, another epiphany--this was really just all a big, very expensive science experiment. The clinic would try some different protocols on me and see what happened. If they didn't work, it was just more scientific information about what might possibly work in the future. And if it didn't work at all, than it was because science hadn't yet developed the solution to my problem.

I decided that if I could hold on to that viewpoint about treatment--that it was just a science experiment--I could probably survive another go at things. And that treatment experience was much more tolerable, even though it certainly had its ups and downs. I would never say I wasn't emotionally invested in the situation, because of course I was. But I was also able to get a tiny bit of distance from things and think rationally about what was going on at the time. Medications, which may or may not be effective at their purpose. Cells in a dish, with their own agendas. Thankfully this time the a few of the cells' agendas aligned with my own, and I became pregnant with my second child.
But even without that positive outcome, I had learned something profound--by holding on to the idea that it was a big science experiment, it was possible for me to go through a treatment cycle without becoming overwhelmed by my negative feelings.

And believe me, if I can do it, you can too! It is my hope that by sharing this story, you will be able to avoid some of my mistakes, and that you and your course of treatment will benefit.

So try to remember this mantra when treatment gets stressful--in the end it's about the science. About chemical and hormonal reactions. About cells in a dish. And maybe this will give you a little bit of emotional distance, enough to see your options clearly, and to make the decisions that are right for you.

When she's pregnant and you're not: infertility, envy, and acceptance

One significant psychological challenge for those encountering infertility is dealing with the constant stream of pregnancies in the lives around them. Whether it is at work, with friends or family, or just walking down the street or through the mall, pregnancy is everywhere. When I first was diagnosed with infertility, this struck me as unfair--how could everyone else move on with their life goals when I was completely stuck? Even now, I am occasionally caught off guard by my reaction to the pregnancy of others. The other day, my neighbor, who is a lovely and wonderful woman, stopped by to invite me to her son's birthday party, as well as to announce she was pregnant with her third child (a fact which I had sussed out weeks before...but more on that later). "I just had a third one in my heart. What about you?", she asked. Without thinking too much, I blurted out, "Wow, it never even occurred to me that it could just be up to my heart!"....and created yet another of my trademark awkward social moments.

Thanks to research done on those struggling with infertility, as well as my own clinical work, I know that, unfortunately, I'm not alone in these types of responses. In this post, I will explore some of the common reactions that people experiencing infertility have to the pregnancies of others, and will also suggest some coping strategies that may be useful in dealing with these feelings.

The dark side

One distressing facet of infertility is that it can bring up feelings that we'd rather not experience. Nowhere is this more true than when it comes to reactions to the pregnancies of other women. Although reactions to pregnancies will vary, depending on the people and situations involved, it is quite likely some of them will include intense negative feelings such as envy, jealousy, and anger. While understandable, this is often very difficult for people to tolerate. If a person is not used to feeling this way and is not consciously aware of their capacities for these feelings, it can be very shocking to be confronted with such negative emotions. I frequently hear clients berating themselves because despite their best efforts, they can't "just be happy" for the pregnant woman, and instead are flooded with envy and anger. I have also heard countless confessions of clients who shamefully admitted they imagined hitting, tripping, or yelling at pregnant women on the street. (As you might expect, these were just fantasies--no pregnant women were ever harmed!) And all of these clients hated that they felt this way.

Most people are very uncomfortable acknowledging their own capacities for negative emotions. And yet, they exist in us all, despite our efforts to keep them out of consciousness. I think they are probably "hardwired" into our emotional system, in order to give us the energy and the will to protect ourselves from physical harm. Dealing with them is a little trickier in modern day society, in which harmful situations often don't require a physical response, but a psychological one.

Like it or not, the natural psychological response to seeing someone else get something you desperately want, and for which you have been working very hard to achieve, involves feelings of envy and anger at the unfairness of it all. Add to the mix that the desire to have children is usually very strong and a fundamental part of life, and the stage is set for some very strong feelings and emotional reactions. Unfortunately, I don't really see a way around it. You can, and should, control your actions around these feelings--for instance, not acting on the urge to trip that nice pregnant lady--but you can't just will your feelings out of existence.

Thus, the first step to dealing with these feelings is to remember that even though they are unpleasant, they are normal. Beating yourself up for having them really isn't fair, and it's probably not going to change how you feel. Although you may have to live with these feelings, you can find ways to cope with them so that they are not too overwhelming.

The invention of "pregdar"

I'm not the kind of person who loves a surprise, particularly when it's the kind of surprise that is going to send me into an unpleasant emotional tailspin. When I was in the beginning of my infertility treatment, I was not attuned to the pregnancy plans, or slight changes in behavior or appearance, of the women around me. However, a few painful pregnancy disclosures later, I had learned to spot the telltale signs of early pregnancy. While I am not always right, overall I have a pretty good track record. My "pregdar" has been very helpful to me, because if I could anticipate a pregnancy before it is announced, I had the luxury of processing my negative feelings in advance and in private. Now, I am not suggesting you make every woman you see pee on a stick, but I do think it is helpful to be aware of the possibilities and anticipate upsetting pregnancies ahead of time.

Being honest about your feelings

Sometimes just being honest about how you feel may be useful, although it will not work, nor would it be appropriate, in every situation. If the pregnant woman in question is a good friend or relative, yet you are finding yourself having negative emotions about her pregnancy, telling her about them gives the two of you the chance to process these feelings together. Chances are, if you say it nicely, and she's an important person in your life, she is going to understand how you feel. She may be worried about your reaction anyway, and will welcome the chance to discuss it. Many times, after these negative feelings are discussed, they greatly lessen in intensity, making room for more positive feelings, including "just being happy" for the other person.

If all else fails...

Of course, there are some situations in which you just can't process your feelings with the pregnant person. And others in which processing these feelings did not produce the desired result. Further, there are some pregnant women to whom, for various reasons, you will react to more strongly. In these cases, avoidance can be a useful short-term strategy. Much has been written about this strategy already, so I won't belabor the point. But remember, you can give yourself permission to skip the baby shower or bow out of pregnancy related conversations when possible. Although it's not ideal, you are just a human being, and you have your limits, just like everyone else. Acknowledging them, at least to yourself, can give you the freedom to control when and where your negative emotions are experienced and expressed.

In sum, although negative emotional reactions to the pregnancies of others can be distressing, they are understandable and to be expected. Accepting and acknowledging these feelings allows you to be more in control of when and how you express them. As these feelings are not exclusive to infertility treatment, learning to deal with them now may be one of those little "fringe benefits" of the current situation, because in the future, when they are stirred up again, you will have a coping strategy already in place.