Top tips for surviving infertility treatment, day six--forgive yourself!

Today I've had the kind of day that has emphasized the need for self-forgiveness.   I suppose that each life has some sort of quota for days like these (at least I hope so, anyway).  However, a silver lining of today was that it reminded me of how important self-forgiveness is when you are going through infertility treatment.  Because trust me, no matter how hard you try, mistakes are going to happen.  You might snap at someone, or hurt someone's feelings.  Perhaps you have regrets about doing a cycle of treatment at a certain clinic, or not trying another avenue of treatment.  The list of potential mistakes, is, at least in my case, endless.

It's important to remember that infertility treatment is like anything else in life--there is a learning curve. It takes a while to get all the information and to get up to speed on the medical challenges you are facing.  And it takes even longer to learn how to function with all of the stress that you inevitably find yourself facing.  Therefore, it is imperative that you try to forgive yourself for whatever errors you think you might have made.  No one does the "infertility thing" perfectly.  There is no preparation for this phase of your life.   I'm sure you are trying hard, and doing the best you can with things.  After all, that's the most we can ever ask of ourselves.

I hope you had a better day than I did, and that you don't need to forgive yourself quite so much today as I do! In any event, I'll be back tomorrow, hopefully in a better mood, and with another tip for surviving your infertility treatment!  Thanks for reading!

Top tips for surviving infertility treatment, day five--fight feeling like a failure

Feelings of failure are incredibly common among individuals struggling through infertility treatment.  So often, I hear people telling me that they should somehow be able to transcend their physical problems, and because they can't, they feel a profound sense of failure and shame.  Rationally, people can usually see that they have a physical problem over which they have limited or no control, and therefore the situation should not be conceptualized as a success or failure per se.  Emotionally, however, it is almost always a different story.  Even though it isn't reasonable or fair, they often still end up feeling awful about themselves.

In my opinion, these feelings of failure are one of the most toxic emotional aspects of dealing with infertility.  They make an already painful, stressful, and difficult process harder.  Worse yet, they are usually self-imposed, unlike nearly everything else about infertility.

Thus, it is important to try to confront these feelings of failure.  I often tell clients that they wouldn't consider someone who had physically lost the use of their legs a failure because they were unable to walk a mile unassisted.  Likewise, they wouldn't consider someone who was bravely enduring treatments for cancer a failure, no matter what the outcome.  So why would they consider themselves a failure just because body parts x, y, or z were unable to do their part in the complicated process of reproduction?  I encourage them to remember these things every time they start noticing those feelings of failure creeping up on them.

To me, if you are trying to achieve your goal of building your family, you can't be possibly be failing at it.  Because there are so many things that can't be controlled about infertility treatment, you cannot be held responsible for the outcome.  You might get lucky, or you might not.  But little of that has to do with the effort put into treatment, or the desire for it to succeed.  

I know in my own infertility journey, I have struggled with these feelings of failure myself quite a bit.  Over time, I have come to the conclusion that I can't judge my life or my worth as a human being on the basis of my defective reproductive system.  I have learned that it is more helpful to look at all the hard work, grit, and ingenuity I put into my own struggle to have a family.  I hope that you do the same--I have a feeling that you will be impressed by what you see.

I hope you have a great weekend, and I'll be back tomorrow with another tip for surviving infertility treatment!

Top tips for surviving infertility treatment, day four--it's okay to be bitter

As a clinical psychologist specializin in infertility, I cannot count the number of times I have heard a client lament the fact that he or she is feeling bitter about infertility.  There usually is tremendous worry and guilt about feelings of bitterness.  For some reason in our culture, bitterness is one of the most negatively viewed emotions.  Of course, prolonged bitterness for years and years isn't a good thing, but a little short-term bitterness probably won't do lasting harm.  After all, there is much to be bitter about when it comes to infertility.  It is unfair and painful, and treating it is usually expensive, time-consuming, and fraught with stress.   I think it is unrealistic to expect that a person going through infertility treatment wouldn't feel bitter at some point.

If you ever find yourself feeling bitter about infertility, I would encourage you to try to accept these feelings as a natural result of your situation.  Most likely, they will be temporary.  Thus, although they are not pleasant feelings to sit with, they are usually not cause for concern.  By accepting and working through your bitter feelings, you are much more likely to be free of them in the long-run.

Thanks for reading, and I'll be back tomorrow with another tip!

Top Tips for Surviving Infertility Treatment, Day Three--The Devil is in the Details!

Let me just warn you that the story I am about to relate will make you begin to seriously doubt my intelligence, but I am sharing it anyway in the hopes that my stupidity will not be all for naught.  Remember folks, do as I say, not as I do!

During my first IVF cycle, I became acquainted with one of my least favorite parts of infertility threatment, progesterone in oil shots.  Each night, my husband dutifully administered them, and I went hobbling about my business afterwards.  In addition to all the physical pain and suffering they caused, the shots were having another unwelcome side effect.  Although I didn't have a lot of bleeding with the initial injection, I was having a lot problems with (brace yourself here) oozing.  Underpants, pajama bottoms, and sheets were getting seriously stained at a record pace.  I began a complicated and time consuming regimen of soaking, washing, and bleaching, followed by a frustrated and expensive regimen of discarding and replacing.  I was complaining about this to my ever-sensible best friend, who remarked, "Wow, Lisa.  I think you should call the doctor.  It can't be right that you are oozing through all of those band-aids you are using."  Band-aids? Nobody told me to use band-aids!  It had never occurred to me, and it probably still wouldn't have if she hadn't mentioned it. I'd still be trying to get out those damned spots.

Needless to say, a quicik trip to the medicine cabinet and my problem was solved.

Moral of the story here?  You can't control the big stuff, but you can improve the process a bit by micromanaging it a little.  Think it through, and try to figure out all the little things you can do to make the process more bearable.  Things to read in the waiting room.  Special little treats after each injection.  Really good distractions to look forward to can also help!  After our conversation, my friend bought me a box of sparkly band-aids that made me smile every time I saw them, and that did take the sting out of the injection just a little bit.

Have a great day and I hope you come back tomorrow for more tips!

Top Tips for Surviving Infertility Treatment: Day Two--Remember your body, not your RE, is the real boss

I was reminded recently of something that happened during the preparations for my first IVF cycle, so long ago now.  The nurse was going over my schedule with me, and explained that my menstrual cycle would have to sync up with the "on" weeks for the IVF lab.  "After this date," she stated with utmost confidence, "we will take control of your body and your cycle."  I remember being very impressed with this idea.  The doctor would take control of my recalcitrant reproductive system, and my problems would soon be solved!  Boy, was I naive.  My RE spent the next couple of years trying to "take control" of my cycle, and my body fought back.  Eventually, even he had to admit defeat.

All of this made me feel pretty awful and did not do great things for my self-esteem.  It was only later that I realized that I was not alone in having a body that didn't respond to medications in the typical way.  In retrospect, I think it would have been helpful if someone told me this in advance, which is why I'm telling you now--expect delays because your body won't "cooperate".  Cysts happen.  Late periods happen.  Lead follicles happen.  Cancelled cycles happen.  They happen all the time, and it doesn't mean that you are doing anything wrong, or even that treatment won't eventually work for you.  It just means that infertility treatment is part art along with the science involved.  That IVF schedule the doctor's office gives you is really all just a big guess about what they would like to happen.  Expect that your real life cycle might be very different.

Thanks for reading, and come back tomorrow for more tips for surviving infertility treatment!

Top tips for surviving infertility treatment: Day One

I hope everyone is starting off 2013 well.  I apologize for not having more new posts up lately.  I seem to have gotten swollowed up with the business that comes with the holidays, the end of the year, and the many viruses floating around the Chicagoland area.  To jump start myself back into writing more regularly, I thought  I would try posting each day for the next ten days, albeit shorter posts.  Each day during this period, I will be discussing strategies for getting through infertility treatment with some vestiges of your sanity intact.

Today's tip:  Manage your "infertility relationships".
 
Relationships are one of the most important aspects to surviving infertility treatment, especially when it comes to your treatment providers.  When someone feels their doctor, nurse or clinic is on their do side, they can weather a lot of turbulence in their treatment cycle.  On the other hand, I've seen treatment cycles nearly being driven off the rails by a rude receptionist or a mistake made in the medical billing office.

Now, I know that you are probably paying that doctor or clinic a lot of money, so you might think that they should be be the one to manage the relationship too, right?  I don't disagree with that, but the reality of the situation is that many doctors and clinics are very busy and are not always aware of the emotional subtleties involved.  In order for you to get the most out of your treatment, you may need to take this role on for yourself.

Thus, I think it important to think about each staff member involved in your case.  What role do they play?  What do you need from then in order to feel comfortable and supported?  Then, ask yourself if you think it will be easy to get what you need from this staff member.  If so, great.  If not, however, then you need to make a little assessment of the personality of the person in question, and try to figure out what would be the most effective strategy for getting what you need.  Sometimes, you just need to take the emotion out of the situation for a second and just look at things from an operational perspective. 

Once you have your strategy, you will reduce the element of surprise (at least unpleasant surprise) and you will be more able to immediately employ your strategy and improve the situation.

Let me know what you think, and look back tomorrow for more tips!

Infertility treatment, and being social pioneers

Recently, I had occasion to listen to the famous semi-autobiographical book Little House on the Prairie by Laura Ingalls Wilder.  I hadn't read the book in over thirty years, and it was interesting to come back to it again from the perspective of an adult.  As a child, I took in the Ingalls' adventures and travails as they settled in Kansas at face value.  As an adult, I couldn't help being a bit shocked by all the chances that "Pa" took with the lives and the fortunes of his family.  Luckily, most things turned out alright in the end, but there were certainly many instances in which disaster was a likely possibility.  As I listened to the book, one thing became clear to me:  I would have made a lousy pioneer, because I am naturally risk-adverse, and I don't feel lucky.

And yet, it also occurred to me that because of my medical condition of infertility, I became a social pioneer without really thinking about it.  By creating a family through international adoption and IVF, my husband and I essentially got the covered wagon ready and started heading west.  We aren't alone, as there are many in a similar situation.  But the social territory in this new land has yet to be fully settled.  Also, even as we try to put down our roots, the terrain keeps changing, making it difficult to feel secure, and competent in this new land.

For instance, when we adopted our daughter, now ten, from India, it was in the height of a wave of international adoption from a number of countries, such as Russia, China, and Guatemala.  At the time, we lived on a street with four other internationally adopted children.  Whenever I went to the doctor's office or grocery store, I almost always saw other families built through international adoption.  Because the world of international adoption has changed so much, I almost never see babies or young children adopted from other countries anymore. It seems odd to me that there was a large generation of children who found their families in this way, and yet now, there is only a small one to follow them.

In my opinion, the changes in international adoption, and the declining US birthrate in terms of babies available for domestic adoption, have pushed more prospective parents in the direction of third-party reproduction.  I was once interviewed by Scott Simon, the NPR journalist who wrote an excellent book on adoption.  During the interview, he asked me which I thought would "win"--adoption or infertility treatment.  I responded that I thought that due to the changes in circumstances, infertility treatment had already "won".  I got the sense he didn't like my answer very much, but the fact remains that there are more babies being born with the help of egg donors, sperm donors, and gestational carriers than ever before.  I can't help but wonder what this will be like for this new generation of children in terms of their psychological and social identity.

Much has been made of the problems that these children will encounter because of their often unknown genetic origins.  Because the stories of their beginnings are different from the the norm, it is assumed that these children will encounter problems.  And perhaps that may be.  After all, there is a certain reality to the situation--these children may not have access to genetic information, may look different than their parents, and have come to be via different means.

The thing is, though, that in the end, societal viewpoints and norms are plastic.  They change over time, and in response to events and situations.  People define them, and they change them. 

As infertility pioneers, it seems to me that we have a good opportunity to help redefine social norms and values in this regard.  Why can't we help shape what all this means for ourselves, and for the children of the IVF generation?  Instead of just reacting to others' negative opinions, we can put forth our positive opinions instead.   For instance, just because something is different, it doesn't mean that it is bad.  Perhaps the differences actually just make things more interesting.

Of course, by the time we really accomplish all this, I predict the landscape of infertility will change again.  I believe that the donor egg/sperm era is but a temporary one.  Science is advancing at a rapid rate, and I think that in my lifetime, scientists will discover a way to revitalize damaged eggs and sperm or restart their production.  Then we will have a whole new set of issues with which to struggle.

Such was the case with the Ingalls family in Little House on the Prairie.  After spending an arduous year building a homestead on the Kansas prairie, the family learns they must leave their farm because they settled 3 miles over the boundary into Indian Territory.  All of their hard work and investment was lost.  On the way back East, the family encountered a lone wagon stranded on the prairie.  The couple inside had lost their horses  to horse thieves, but refused the Ingalls' family offer of a ride into town because they didn't want to leave their worldly possessions behind.   As the Ingalls family rides away, Pa comments that the couple are "tenderfeet"--they didn't use chains to tie up their horses, preventing their theft, and they had no watchdog to watch over their things.  Even though Pa had made a huge mistake in picking the wrong spot to settle, he had still learned a great deal about life on the prairie. 

And so have those of us dealing and struggling with infertility.  Although our landscape will most certainly change, I hope that we can use our knowledge and experiences to change things and make it easier for those who will follow after us.