Emotional support

October 6, 2016 by Shady Grove Fertility

A myth that has persisted for decades is that stress is a source of infertility and unsuccessful fertility treatment. Although there has been no consistent support of this supposition, myths about stress and infertility perpetuate. Let’s take a look at a couple of the most common myths and discuss the truth about stress and infertility.

3 Myths and Facts about Stress and Infertility

Myth: “Just relax and it will happen.” Individuals and couples experiencing infertility frequently hear this advice from well-intentioned family and friends. It’s often followed-up by a story about another couple they know who was having difficulty conceiving, took a vacation, and got pregnant. The implication is that stress is the cause of your infertility and unsuccessful treatment cycles.

Fact: There is no body of evidence that indicates that a woman’s level of stress affects her pregnancy rate. A recent and comprehensive review of the literature concluded that researchers who carried out rigorous and well-designed studies found no significant relationship between stress and infertility or fertility treatment outcomes. Women have always conceived during times of great stress, for example, during periods of war. Infertility is a disease. The levels of stress experienced by individuals diagnosed with infertility have been found to be similar to that of individuals diagnosed with other chronic illnesses, such as cancer, hypertension, and HIV. Relaxation is no more a cure for infertility than it is a cure for cancer.

Myth: “If you adopt you’ll get pregnant.” This is the idea that if you stop trying to conceive and instead pursue adoption, you’ll alleviate most of the stress in your life. And since stress is the source of your fertility problem, you’ll now be able to conceive and give birth. Those who espouse this myth also spout stories of couples who conceived following adopting one or more children.

Fact: Research consistently fails to demonstrate a relationship between adoption and pregnancy. One particularly rigorous study followed up with 817 fertility patients over the course of 5 years. Of the 48 women in this study who adopted a child, only one spontaneously conceived after adopting. So while it is not impossible, pregnancy after adoption is certainly not probable. In addition, the adoption process can be accompanied by its own emotional and financial stress, as well as a significant waiting period. Finally, this myth can be hurtful to adoptive parents as it implies adopting a child is just a path to obtaining the child they really want.

Myth: “You’re so stressed from IVF, if you stop treatment you’ll get pregnant.” This is another version of the belief that stress is the source of infertility.

Fact: Multiple long-term studies have found that following the cessation of IVF treatment, the rates of spontaneous pregnancy and a live birth ranged from 11 to 24 percent. However, it’s important to remember that those women who became pregnant and gave birth tended to be younger, experienced a shorter duration of infertility, and had a less severe fertility diagnosis. It is accepted that IVF treatment can be experienced as stressful, but numerous reviews of the literature have found no relationship between stress levels and IVF outcomes.

The Relationship between Stress and Infertility

Infertility is inherently stressful. Most individuals are used to planning their lives. They may believe that if they work hard at something, they can achieve it. So when it’s hard to get pregnant, they feel as if they don’t have control of their bodies or of their goal of becoming parents. With infertility, no matter how hard you work, it may not be possible to have a baby without help.

Infertility tests and treatments can be physically, emotionally, and financially stressful. Infertility can cause strain in a relationship, which increases stress levels. Individuals may have many doctor appointments for infertility treatment, which can cause them to miss work or other activities. All of these items can add up and, for many, stress is a consequence of fertility challenges and treatment.

Decreasing stress may not increase pregnancy rates or treatment success, but it may improve feelings of well-being and quality of life as you continue on your journey to create or expand your family.

Tips for reducing stress

Talk with your partner.
Realize you’re not alone. Identify sources of support you can rely on. This may include friends and co-workers who have experienced infertility. Shady Grove Fertility offers resources for our patients such as online communities, free support groups, and articles.
Breathe. Use relaxation exercises, for example, breathing techniques, mindfulness, and guided imagery to help you feel better emotionally and physiologically.
Exercise. This is one of the best ways to alleviate stress, but consult your doctor about maintaining your regular exercise routine during treatment.
Seek humor. Humor is a great tool to reduce feelings of stress. Watch comedy films and TV shows, read a humorous book, or download your favorite standup segments.
Establish a medical treatment plan with your doctor that both you and your partner are comfortable.
Prepare a response. Strategize how you or you and your partner want to reply and come up with a few snappy comeback lines for the next time someone says to you “Just relax and it will happen.”
Consider counseling to help you cope with and learn specific tools to reduce your stress. Shady Grove Fertility’s Psychological Support Services team is a group of highly skilled and trained licensed mental health professionals with an expertise in infertility counseling.

Schedule an Appointment

To schedule an appointment with Shady Grove Fertility’s Psychological Support Services team, please contact Sharon Covington at 301-279-9030 or sharon.covington@sgfertility.com.

To schedule an appointment with one of our reproductive endocrinologists, please call our New Patient Center at 1-877-971-7755 to speak with one of our New Patient Liaisons.

About the Author:
Dr. Erica Mindes is a Licensed Clinical Psychologist on the Counseling Staff atShady Grove Fertility, and with the practice of Covington & Hafkin and Associates, seeing patients at offices in Northern Virginia and Richmond. She has conducted research and written on the psychological responses to infertility and infertility treatment, and recently co-authored the chapter, “Counseling Known Participants in Third-Party Reproduction” for Fertility Counseling: Clinical Guide and Case Studies. Dr. Mindes is a member of the American Society for Reproductive Medicine Mental Health Professional Group (MHPG) and serves on the MHPG Executive Committee.

References:

Lawson, A.K. (2016). Psychological stress and fertility. In: Stevenson, E.L. & Hershberger, P.E. (Eds.), Fertility and Assisted Reproductive Technology (ART): Theory, Research, Policy, and Practice for Health Care Practitioners. New York, NY: Springer Publishing Company, LLC.

Pinborg, A., Hougaard, C. O., Nyboe Anderson, A., Molbo, D., & Schmidt, L. (2009). Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment. Human Reproduction, 24, 991–999.

Troude, P., Bailly, E., Guibert, J., Bouyer, J., de la Rochebrochard, E., & Group, D. (2012). Spontaneous pregnancies among couples previously treated by in vitro fertilization. Fertility and Sterility, 98, 63–68.

Wischmann, Tewes H. (2003). Psychogenic Infertility – Myths and Facts. Journal of Assisted Reproduction and Genetics, 20, 485–494.

August 17, 2016 by Shady Grove Fertility

Staying Resilient when Struggling with Infertility

Many women or couples struggling with infertility experience a profound sense of loss on many levels. Suddenly, you are a “patient” and not a healthy woman or couple. Let’s talk about how we can feel changed by the experience and also how to make this change work FOR you rather than AGAINST you.
You may need to have countless doctor’s appointments, tests, procedures, or consults. Your finances are drained. Your friends, coworkers, siblings, and neighbors all seem to be effortlessly building their families. You may feel a strong sense of shame or stigma for having an infertility diagnosis. And, perhaps the biggest loss of all, the loss of the dream of how your journey to parenthood would look and feel.
All of this adds up over time and you can start to feel like you aren’t the same person you used to be. Friends, family, or even your partner may tell you that you don’t seem like yourself anymore. Maybe you don’t even like this new person you have become. It might not be a pretty picture. Some common thoughts or feelings for those struggling with infertility include:

Feel irritable, sad, scared, or a “roller coaster” of emotions
Lose your sense of humor
Feel less able to “go with the flow”
Isolate yourself from others
Lose interest in things that used to be enjoyable
Feel jealous of others or have a sense that life has been unfair to you
Experience anger toward others or the world in general

Struggling with infertility can be viewed as an existential crisis, greatly affecting the way you view yourself and the world around you. You might be asking yourself questions like: Who am I now? Will I ever feel like myself again? What is the purpose of my life? Is the world a safe and predictable place? Am I being punished for something I did in my past?

Turn Grief into Growth

While it’s normal to question these things in the middle of a crisis, such as infertility, thinking through these types of philosophical questions might actually bring you closer to a sense of peace about your journey. In fact, one of the psychological goals of coping with infertility is learning to slowly integrate infertility into your life story and into the way you view yourself as a person.
It’s true that you may forever be changed by infertility. I think back to a Viktor Frankl quote that really resonates on this level: “When we are no longer able to change a situation, we are challenged to change ourselves.” This quote sends a powerful message in terms of what needs to happen for many of us to effectively handle all that goes into having infertility. Many people report that struggling with infertility was one of the hardest experiences of their entire lives, even if they were eventually able to have they family they wanted.

View Infertility as an Opportunity

So, how can you transform this traumatic journey into an opportunity for growth and wisdom? Even though it might feel next to impossible to do, try to think of the “gifts” of infertility:

Developing a closer relationship with your partner
Finding increased support from certain family members or friends (and clarification on which relationships really matter)
Learning to prioritize your own needs and take better care of yourself
Advocating for yourself in a challenging medical environment
Learning a new set of healthy coping tools
Finding a new sense of compassion for others who are struggling
Finding gratitude in your life
Feeling more connected spiritually
Learning how strong and resilient you really are

These are potential ways you have learned to adapt and grow as a result of struggling with infertility. Work toward leaning into the change instead of resisting it. Look for daily signs of meaning and purpose in your life. Consider a daily mindfulness or gratitude practice to notice the positive changes you are making. You may be transforming into a new person, but that new person is strong, courageous, and worthy of the family of her dreams!

Schedule an Appointment

If you are struggling with infertility and need additional support during your infertility journey, Shady Grove Fertility support groups can be an invaluable tool as you surround yourself with others who “get it” and where you can normalize your feelings and your changing sense of self. Individual or couples counseling is also available. For more information about our support groups or to schedule an appointment, please contact our New Patient Center at 877-971-7755.

About the Author:

Mia Joelsson, LCSW-C is a licensed clinical social worker in Pennsylvania and Maryland. She has a special interest in working with individuals and couples facing reproductive challenges of infertility, pregnancy, pregnancy loss, and postpartum adjustment. Mrs. Joelsson is passionate about helping “infertility graduates” who are adapting to the new realities of pregnancy and parenting after struggling with infertility. She sees clients primarily in Harrisburg, PA.

May 12, 2016 by Shady Grove Fertility

By now, you have likely seen or heard of Whitney and Spencer Blake, a couple who openly discussed their infertility through humorous infertility announcements on their blog. Just likely many couples, they were inundated with pregnancy and birth announcements on their social media feed, and it was a constant reminder of what they were sourly missing, “We try to be happy and congratulatory, but when we are at the heart of our struggle, it’s really devastating,” says Whitney to Good Morning America.

humourous infertility announcement - dead end

While their project has struck a chord with thousands of women and men struggling with infertility, it also opened the topic to the fertile crowd, “We heard people that said, ‘Wow, that made me think about it in a different way’ [and] it’s nice to hear that.”

Shady Grove Fertility’s Director of Psychological Support Services, Sharon N. Covington, MSW, LCSW-C, told ABC News that the photos were touching and “right on target.”

“Infertility is an experience that touches so many people in this country, yet is something that is still, for many, very hard to talk about,” Covington said. “There’s a lot of private shame and pain associated with it. Our patients talk about how social media can be a powerful source of support, but a painful one as well. They [the Blakes] did this with humor and were able to speak to the core issues.”

After years of unsuccessful infertility treatments, the Blakes decided to pursue adoption, and are now the proud parents of two boys. View the Blakes’ complete set of infertility announcements and read more of their story on their blog.

To take your first step in overcoming infertility, please call our New Patient Center at 1-877-971-7755 or click here.

February 25, 2016 by Shady Grove Fertility

Avoid These 4 Phrases if you Know Couples with Fertility Issues:

Couples with fertility issues and couples who are trying to conceive often feel pressure from friends, family, and even strangers when it comes to building their family. Often, well-meaning loved ones can say something innocently but it can come across as insensitive, or ask a seemingly innocuous question but it’s construed as intrusive. If you are a loved one or friend of someone who is trying to conceive or might be trying to conceive, we offer these questions and phrases as best to avoid, and four other phrases to use instead.

When are you having kids?

This question can be especially hurtful to struggling women and couples with fertility issues. It can be a longer process for some couples when age or other medical factors are involved. Chrissy Teigen, supermodel and wife of John Legend, recently opened up about her struggle, and said “Anytime somebody asks me if I’m going to have kids, I’m like, ‘one day, you’re going to ask that to the wrong girl who’s really struggling, and it’s going to be really hurtful to them.”

4 Helpful Phrases that Show Support for Couples Trying to Conceive

The best thing a friend or family member can do is to offer support, a listening ear, and to become informed. It would be very encouraging for friends and families members to show support through phrases like, “I care about you and what you’re going through.”

Some people also feel cared for when friends and family members show a genuine interest in the process (without offering advice). A phrase such as “Can you tell me more about …?” or “If ever you’d like to talk, know that I’m always here” might be a nice conversation starter that shows you have a genuine interest and offers your loved one the opportunity to open up if he/she chooses.

Another very positive way to show love is to commend their bravery and acknowledge their strength, endurance, and determination by saying, “Wow, you don’t give yourself enough credit. I admire how brave you are to have endured so much.”

Lastly, let them know “I will support you no matter what you choose.” This lets them know that they are free from judgment and that your love for them is unconditional—a truly powerful message to send.

For more information about infertility or issues with fertility please visit our website at www.shadygrovefertility.com or call us at 877-971-7755 to schedule an appointment. Couples with fertility issues often find support from our support team by attending support groups or one-on-one sessions.

January 25, 2016 by Shady Grove Fertility

Written by: Sharon N. Covington, MSW, LCSW-C, BCD
Director, Psychological Support Services

Infertility is an inherently stressful experience, yet one of the stresses often not talked about in regard to infertility and your relationship is the conflict that can occur in a relationship during fertility treatment. Whether in a heterosexual or same sex relationship, couples often find that they feel and deal very differently from their partner regarding their emotional response to fertility treatment. This is not surprising as you each bring your own unique personality and life experiences into the relationship that will impact how you deal with your feelings. Understanding and being respectful of these personality differences, rather than qualify them as being “better or worse” than your own, is important.

Tips for Diminishing Conflict: Infertility and Your Relationship

Here are some techniques I have found to be very helpful over the years of working with couples in fertility treatment to assist in diminishing conflict and increasing closeness during fertility treatment:

“You learn more from listening then you do from talking.” This was something my father said to me as I was growing up and, as a therapist (and a wife), I have found it to be important words to live by. In the midst of a disagreement, you can believe that the more talking you do, the greater chance you will have to be able convince your partner of your point. The reality is seldom the case! It can be helpful to practice “active listening” techniques whereby one speaks and the other listens, and then reflects back what you hear your partner saying. Following up with a question, such as “Have I got that right?” or “Is there anything else?” can also be helpful.The point is that taking the time to truly listen to what your partner is saying may help bridge the gap and increase empathy. One of our most basic human needs is to feel truly understood and when you feel your partner “gets” you—what it is you are thinking and feeling—even though not necessarily agreeing with you, empathy is established.
Apply the “20 Minute Rule.” An extension of #1 and a time-honored technique for communicating during infertility, it can be helpful to put boundaries around talking about a problem or worry. The rule is that a couple agrees to talk about infertility for 20 minutes every day—but only 20 minutes! A time is set during the day to talk (and literally setting a timer can be helpful) and you each get 10 minutes to talk about what you want while your partner listens, and then you switch positions. At the end of 20 minutes, the discussion is put on a shelf until the next day and the conversation moves on to other things. Couples find this technique extremely helpful, especially if one partner feels that if they start to talk it will never stop, while the other fears they will never talk.
When at odds in decision-making, agree to switch and take on each other’s position for a week. It is quite common for couples to find they feel differently about what to do next in treatment, even finding themselves in polar opposite positions. When I am working with a couple and we are at an impasse in regards to a decision they are trying to make about treatment or family-building alternatives, I will have them physically switch places in the room. Then I will ask them to take on the persona of their partner and state exactly what it is their partner believes and feels about the issue. The partner listens, without commenting, and then confirms or corrects whether the other has got it right.Before they leave the session, the couples is given an assignment to continue this role, immersing themselves in learning all they can about their partner’s position. For example, if “A” wants to pursue adoption while “B” wants to use donor gametes, A will spend the week learning more about donor and B about adoption by reading, searching the internet, speaking to others, etc. Afterwards, you talk about what you have learned and how it has felt to go through this process. This technique often helps to shift things and open up the logjam.
“A feeling shared is a feeling diminished”….except when its not! This is something I have frequently said to my clients in encouraging them to release difficult feelings they are holding in. While therapy is a process about getting feelings out so they can be understood and dealt with, constantly talking about the same thing over and over again with no change is not moving through it. As Einstein said, “Continuing to do the same thing over and over again and expecting different results is the definition of insanity.” So if you find your interactions sounding like a broken record, something isn’t working and changes need to be made. This may be a good time to seek out help from a mental health professional who is trained in fertility counseling to help you cope with infertility and your relationship.While conflict is a normal part of all relationships, how you handle it and the ways you find to work it through will have a profound effect on couple stability. In fact, being able to work though conflict by using some of these techniques will have a long-lasting effect on intimacy and closeness. Hence, conflict can create opportunities for closeness in a relationship rather than threatening it with emotional distance.

Sharon Covington, MSW, LCSW-C – Director:

Director of Psychological Support Services, Mrs. Covington is a licensed clinical social worker in Maryland and a Board Certified Diplomate in Clinical Social Work with over 40 years of experience as a psychotherapist. An internationally recognized leader on the psychological aspects of reproductive health, Mrs. Covington is an Assistant Clinical Professor at Georgetown University School of Medicine, Department of Obstetrics and Gynecology, and Associate Investigator in the Intramural Research Program on Reproductive and Adult Endocrinology at the National Institutes of Health. She recently edited and authored Fertility Counseling: Clinical guide and Case Studies, and is the co-author and editor of the classic text Infertility Counseling: A Comprehensive handbook of Clinicians.

If you would like to find more support for coping with infertility and your relationship or would like to learn more about our individual or couple’s psychological support services offered through Shady Grove Fertility, call 301-279-9030 or sign up for a support group.
To schedule a new patient consultation at Shady Grove Fertility, please call 877-971-7755 or schedule an appointment. online.

November 19, 2015 by Shady Grove Fertility

by Tara Simpson, Psy.D., Licensed Psychologist
Shady Grove Fertility Counseling Staff

Infertility is often one of the hardest obstacles most people have faced in their lives or relationship to date. The negative emotions, stress, and an overwhelming feeling of loss of control can often prevent those needing treatment to seek out or to continue with the very treatment they may need to overcome this obstacle. Here are five myths about seeking infertility counseling and five ways counseling may help you stay emotionally well throughout this process.

Infertility Counseling Myth #1: I already talk about my fertility struggles too much and that doesn’t seem to help.

While we can believe that we are repeatedly sharing our story of struggle, such as what treatment we are doing, shots we are taking, and/or the results of the latest tests, we often aren’t as candid with others about our true thoughts and feelings about these struggles. Therefore, while it feels like we are sharing a lot of facts, we aren’t actually processing the feelings (such as sadness, anger, and/or fear) that we may have about the process or outcomes of fertility treatment. Infertility counseling can be a safe and neutral place to discuss feelings and thoughts.

Infertility Counseling Myth #2: If I start really talking about my feelings and crying, I am afraid I will feel worse or my tears will never stop.

Contrary to what some believe, talking about how we feel doesn’t make us feel worse. We usually already feel really lousy; however, talking about how we feel allows us time to share as well as gain perspective. Infertility counseling can often provide new coping tools for how to deal with these feelings.

Infertility Counseling Myth #3: I should be able to handle this—I just need to relax and “get over it.”

But why should you be able to handle this? Infertility isn’t something that we are taught to expect. Fertility treatment is a very stressful process that impacts us as an individual and couple. It isn’t just something we are struggling with in the current moment but also something that threatens our dreams for the future. It can also cause us to focus on the past with the “what if?” and “if only” thought processes. Infertility counseling can help you stay focused on the present so that you can feel more in control, while at the same time accept the current state of flux that your life is in.

Infertility Counseling Myth #4: Other people have worse problems than me.

Sure. Some do. But this may be one of the toughest things you have had to face and it is difficult for you. Just because someone has seemingly worse things going on shouldn’t invalidate the stress and distress that you have. It can be helpful to be grateful for what we have in comparison to others who are burdened by more. However, it doesn’t help us to make ourselves feel worse simply because we judge our situation to be “less important.” The reality of infertility is that it can be stressful and it is essential to take care of yourself at this time.

Infertility Counseling Myth #5: The only thing that will make me happy is to get pregnant.

Well, absolutely. But we can learn to manage our emotions while we are on the journey. The purpose of talking to a qualified mental health professional who specializes in fertility issues is to help you cope with the process of fertility treatment. Our counselors will help you articulate the things you are worried about as well as help you make a plan for how you will endure while you are attempting to achieve that goal.

If you would like to learn more about our individual or couple’s psychological support services offered through Shady Grove Fertility or to sign up for a support group, please call 301-279-9030.

To schedule a new patient consultation at Shady Grove Fertility, please call 877-971-7755 or schedule an appointment online.