Mental Health on Your Fertility Journey

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Mental Health on Your Fertility Journey

Focus on the present. You can’t change the past, so stop reliving the “should have’s” and “could have’s.” You can’t control the future either, so stop pre-living worries and anxieties. Try to stay in the present, because it’s the only place you can really choose to behave in ways that can reduce stress and anxiety.

Practice self-care. That means treating yourself even half as well as you treat your family and friends. Get enough sleep, exercise, time alone, and time with others to make yourself feel cared for. Practice being your own best friend! 

Talk to yourself. Give yourself a pep-talk, because what we say to ourselves is powerful. If others remind you that there’s always a way to build a family, it usually has little or no effect. But if you remind yourself that there’s always a way, your mood will usually lift. Try it!

Talk to others. There are many reasons to be reluctant about discussing infertility with family, friends, or in the workplace. You may want to keep medical issues private because you don’t want unsolicited advice, you don’t want to hear everyone else’s fertility stories, or because you feel there is a stigma attached to infertility. You may worry about keeping your job or even keeping your dating options open.

The result is that you may feel isolated just when you need understanding and support. Emotions are far more manageable when they are said aloud than when they’re buzzing in your head.

Focus on your work. As stressful and preoccupying as fertility treatments can be, work can provide an effective distraction from the persistent anxiety you may be feeling from infertility. Staying busy and active with projects can distract you, give you a sense of accomplishment, and help boost your self-esteem and confidence.

Try cognitive restructuring. Cognition refers to thinking; restructuring refers to creating new views. Together these terms tell us that we can choose to think in a new way, and the result can be new behaviors and feelings.

For example, when we focus on hopeless thoughts, we convince not only ourselves but also everyone around us that hope is not worth wasting energy on, and our inertia can make it true. This thought process is one of the major reasons patients drop out of fertility treatment. On the other hand, if we choose to be hopeful, we are more likely to approach problems with strategic behavior that leads to results that justify our hope—positive self-fulfilling prophecies. 

Check for depression. Mild depression may make you feel tired and sad. More severe depression may mean frequent crying, loss of appetite, and despair.

All signs of depression should be taken seriously and addressed to make sure that the suffering is alleviated as soon as possible. Whether it is triggered by hormonal therapy, recurrent pregnancy loss, treatment failure, financial or relationship stress, there is help available. Speak to your physician about a referral for therapy, support, and/or medication. A change or break in fertility treatment may help, too.

Work and play will help you cope with this journey, so don’t wait until you are overwhelmed. Make your mental health a priority now

Partner support through miscarriage

Miscarriage is something that impacts both partners, with each individual trying to process their recent loss. Even though as the partner you might not have felt the physical changes of pregnancy or miscarriage, the emotional loss and self-blame is still just as significant. As partners, you can experience things very differently, but the important part is being there for one another. Find out some of the strategies our fertility experts and counsellors recommend for staying connected and getting through it, together.

✅ Connect with your caregivers and be kind to each other.

Communicating is the first step, but sometimes you may need an external ear and this is where counselling can come in as an important element to help couples process their loss together. For the partner who did not physically carry the baby, they can place a lot of pressure on themselves to provide support for the person who did, and push their own grief aside. When you speak to someone such as a fertility counsellor, it can help both individuals by voicing their feelings out loud to someone outside of their relationship.

✅ Recognise that people experience things very differently.

As difficult as it is, try to remember that individuals experience things very differently, and try not to have expectations that your partner will feel or act in a certain way. Oftentimes, the grief is the same, but the expression of that grief can be different. Even if you’ve known your partner for years, they may not act in a way that you expect. And you don’t need to have the answer. The most important thing is to listen to each other, and let each other grieve in their own way.

✅ It’s ok to let the grief fill the room.

This can be uncomfortable, and that’s ok. Pregnancy loss is a very difficult thing to go through. Let yourselves acknowledge the hurt and the pain, together, and don’t be afraid for the grief to fill the room when you’re in a safe space.

✅ Keep connected and ask each other what’s helpful.

Because miscarriage and pregnancy loss is something outside of anyone’s control, it can take a few extra strategies to learn how to cope, and how to support each other through it. If you’ve been in a relationship for a long time, it can be easy to assume how your partner is feeling. This is why it’s so important to ask each other what you can do to provide support. You can each think about what is helpful for you and share these ideas. Sometimes, the partner who didn’t physically go through the pregnancy loss can feel that they are on the sideline. Each person in the relationship can become focused on processing things on their own – staying connected is important to prioritise. So take some time to do things you would normally enjoy doing together.

✅ Find a way to acknowledge the pregnancy.

When it comes to pregnancy loss, whether it’s week 7 or week 20, there is so much more than the biology of that loss that needs to be grieved. The dreams of the future with the baby, the initial excitement of the pregnancy, the milestones that go with expecting. These are all suddenly taken away when miscarriage occurs. When a family member or loved one passes away, we have ceremonies and traditions to allow our grief to surface. Finding a way to acknowledge the pregnancy in a physical representation can be helpful. Couples may choose to do this by planting a tree in their garden, or having a memento that can be seen and taken out when they feel the need to honour their loss. Having a physical representation can also be used as a way to connect the loss of the baby to the parents’ children who are already a part of the family.

Progesterone and Fertility

Progesterone is an important part of infertility treatment, with fertility specialists often prescribing progesterone supplements to help improve pregnancy rates from IVF. So why is progesterone supplementation used and can it help with natural conception rates as well? Firstly, it helps to understand the role of progesterone in pregnancy.

❓What is progesterone?

Progesterone is a hormone produced by the ovary. It is first detected in the middle of the menstrual cycle when an egg is released (ovulation). One of the most important functions of progesterone is to prepare the lining of the uterus (endometrium) to allow a fertilised egg (embryo) to implant. If a pregnancy does not take place, progesterone levels will fall and you will have your period. If an embryo implants into the lining of the uterus, the resulting conception will produce the hormone Human chorionic gonadotropin (hCG) which in turn will direct the ovaries to produce progesterone until eight weeks into the pregnancy. After that time, progesterone will be produced by the placenta throughout the remainder of the pregnancy.

❓Do I need progesterone if I am trying for natural conception?

There is no evidence to suggest that giving progesterone supplements to otherwise healthy women in early pregnancy has any additional benefits or reduces the risk of spontaneous miscarriage. A recent randomized trial also found no benefit from progesterone supplements in a group of women with repeated miscarriage. However, despite this, there may still be some benefit from this approach in individual cases and you should discuss it with your doctor in the light of your own particular circumstance.

❓When and how should I take progesterone?

Fertility specialists usually prescribe progesterone supplementation to start a few days after the eggs are collected. Progesterone supplements generally come in the form of a vaginal suppository or intramuscular injection. Current research is focussed on improving the effectiveness of oral preparations of progesterone, as past studies have found that only 10% of progesterone is absorbed when taken orally. While both the suppository and injection methods appear to be equally effective, vaginal preparations are preferred by most patients and fertility specialists alike. Alternatively, luteal phase support with intermittent or several hCG injections can be used to stimulate the ovaries to produce progesterone. This is not advisable if more than ten follicles are found on ultrasound, as this may cause an ovarian cyst or ovarian hyperstimulation (OHSS).

❓What are the risks of taking progesterone?

Many studies have been performed to look at the use of natural progesterone during IVF treatment. These studies have shown that progesterone will pose no significant risk to you or your baby. Although, for some women, vaginal preparations can cause discharge and local irritation.

❓What is next?

If you have any questions about taking progesterone and the options available, please to our board-certified reproductive endocrinologist.

IVF is not the last resort

IVF is not the only option

Some fertility clinics oversell IVF as the most effective and final solution. This is simply not true.

IVF efficacy is comparable to that of medication treatment, while the latter could be 20 times cheaper. And most women out there perfectly qualify for it.

🤚But wait: When do I really have a problem?

There is a consensus in the medical community that if you are

  • ✅ younger than 35 years old and can’t conceive for 12 months, or
  • ✅ older than 35 years old and can’t conceive for 6 months,

 then you have to talk to a fertility specialist. Period.

❗️When can’t I avoid IVF?

If you have been unfortunately diagnosed with either of the following:

  • Confirmed obstructed fallopian tubes 
  • Genetic mutation with desire for elimination from offspring
  • Desire for genetic testing or family balancing
  • Using an egg donor or adopted embryos
  • Severe male factor infertility
  • Failed initial treatment with Clomiphene, Letrozole, Gonadotropins

then IVF seems to be a logical next step for you.

❗️If none of these applies to you, then IVF is not your next step at this moment. Please.

❓What can I do to avoid IVF?

Your options at this point are as follows:

  • ✅ Lifestyle changes
  • ✅ Hormones to support early pregnancy
  • ✅ Medication treatment

As for lifestyle, you have probably read tons of materials on the Internet about diet, exercise, supplements, breaking bad habits like smoking, alcohol. Let us leave it right there – we totally agree.

❓But what if it’s not enough?

For most patients lifestyle changes are not enough to get pregnant.

The medication treatment is about stimulating. Most of these drugs have been around for more than half a century, delivering results to millions of happy parents.

Medications and hormones are not just enough. Please add thorough evaluation and an experienced fertility specialist to your formula of success.

Puzzled? We want to hear from you, please send us your questions. Our mission is to provide timely and accurate answers on your fertility journey. It’s free.

What is the difference between OB/GYN and REI?

Have you ever wondered what the difference is between a REI doctor and an OBGYN doctor? While both specialties deal with women’s reproductive health, there are some important distinctions between the two. When it comes to women’s reproductive health, there are a variety of medical professionals who can help. Two of the most commonly heard of are REI doctors and OBGYN doctors. But what do these terms mean, and how do these doctors differ? In this article, we’ll explore the key differences between them.

What is an REI doctor?

Reproductive endocrinology and infertility (REI) doctors are medical specialists who focus on diagnosing and treating hormonal imbalances and infertility in both men and women. They receive extensive training in the reproductive system and its function, and are experts in assisted reproductive technologies (ART) such as in vitro fertilization (IVF).

REI doctors work with those coping with thing such as:

– Endometriosis

– Polycystic ovarian syndrome (PCOS)

– Male factor infertility

– Tubal factor infertility

Unexplained Infertility

What is an OBGYN doctor?

OBGYN stands for obstetrics and gynecology. These doctors specialize in women’s reproductive health and childbirth. They provide a wide range of services, including routine check-ups, prenatal care, labor and delivery, and menopause management. They are also trained to perform gynecological surgeries.

obgyn doctor
Gynocologist

What are the key differences between REI and OBGYN doctors?

While both REI and OBGYN doctors work in the field of women’s reproductive health, there are some key differences between the two. One of the main distinctions is that REI doctors focus primarily on fertility and hormonal issues, while OBGYNs provide a wider range of services including pregnancy and childbirth care.

Another key difference is the training required for each specialty. REI doctors typically complete a three-year fellowship program after their residency in obstetrics and gynecology, while OBGYNs complete a four-year residency program. This means that REI doctors have additional training in fertility and hormonal issues, which is not as extensive for OBGYNs.

Finally, the types of procedures and treatments that each specialty provides are also different. REI doctors specialize in general infertility (ART) procedures such as IVF, while OBGYNs perform a wide range of gynecological surgeries.

Conclusion:

In conclusion, while both REI and OBGYN doctors work in the field of women’s reproductive health, they differ in their focus, training, and services offered. REI doctors specialize in fertility and hormonal issues, while OBGYNs provide a wider range of services including pregnancy and childbirth care. If you have concerns about your reproductive health, it’s important to consult with the appropriate specialist to ensure you receive the best possible care.

Fertility Myths

Here are some of the most common female fertility myths:

❌Age does not matter:
✅Many women are of the notion that they can wait as long as they want to and can comfortably get pregnant in later years of their life. While it is not impossible to get pregnant at an older age, it is important to note that age is the single most effective factor when it comes to female fertility. A woman is born with a definite number of eggs at the time of birth, and as age progresses, the fertility keeps on decreasing. According to many experts, female fertility starts declining sharply after the age of 35.

❌Lifestyle does not affect fertility:
✅Various studies have found that women who live an active and healthy lifestyle have better chances of conceiving as compared to those living an unhealthy lifestyle at the same age. Unhealthy diet and activities like smoking, consumption of alcohol, drugs, etc. greatly reduce the fertility potential over a period of time. Women who are obese also find it difficult to conceive. Obesity not only contributes to female infertility but can also contribute to various other health risks like diabetes, cardiovascular problems, etc.

❌Women who already have a child do not have fertility issues:
✅Another common myth surrounding female fertility is that women who have had a successful pregnancy have no fertility issues. It is quite common that women who had their first babies without any issues often face difficulty while conceiving for the second time (this is known as secondary infertility). There can be various factors leading to secondary infertility like age, other health problems, etc.

❌Treatments always result in multiples:
✅There is another common myth that infertility treatment methods like IVF, ICSI, etc. always result in multiple babies. While it was relatively common in the past to have multiple babies due to infertility treatments, these days there is hardly any risk of multiple babies as modern technology allows embryologists to carefully select the embryos before implanting.

❌Female infertility is the only reason for infertility:
✅Most people assume that infertility is always related to females, which is not the case. For a successful conception and pregnancy, both the male as well as the female need to be fertile. If either of the partners is infertile, it may lead to infertility. Moreover, male fertility is also quite common and contributes to a large number of cases of infertility.

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