Infertility issues: The highs and lows of IVF

Hope. Loneliness. Frustration. Stress. Inadequacy. For any woman dealing with infertility and going through IVF, riding the physical and emotional can be overwhelming.

Since 1978 and the advent of in vitro fertilisation (IVF), more than eight million babies have been born as a result of this and other advanced fertility treatments. Global statistics estimate that more than 500,000 babies are born each year, providing hope for women for whom simply ‘falling pregnant’ is not a natural option.

And getting pregnant isn’t a given, even for the healthiest adult. According to both British charity Fertility Network UK and the US’ Centers for Disease Control and Prevention, fertility problems affect 1 in 8 couples. Put in real terms, the average 29 to 33-year-old couple with a normal functioning reproductive system still has only a 20% chance of conceiving each month.

For Cassie Destino, founder of IVF Support UAE, and an Emirates Home Nursing wellness partner, each woman’s journey is uniquely challenging. In 2014, as a newly landed Abu Dhabi expat, she underwent two cycles herself before conceiving on the third attempt, and her personal experience was the catalyst that led to the creation of this welcoming, and well-informed fertility resource for would-be parents.

BE PREPARED

Once you’ve made the decision to undergo IVF, Cassie advises couples to take a deep breath and do their research, as she explains: “It’s very important to have informed and realistic expectations from an IVF cycle. One of the best things you can do for yourself is to ask your doctor a lot of questions and it’s a good idea to keep an IVF notebook where you can write down all your questions.

“Having a good understanding of your particular case will also help when it comes to knowing what to expect, so you can lessen the impact of any unexpected circumstances. All of this will help you feel empowered as you move through your cycle.”

She adds that knowing that things can go wrong or that something unexpected may crop up is also part of the preparation process. Cancellation of a cycle or last-minute changes are extremely discouraging but knowing that it’s a possibility is part of the coping mechanism, if and when it happens.


IVF STIGMA

There’s no way around it, infertility is heartless, and Cassie says that around the world there is a stigma when it comes to acknowledging, talking about and addressing the topic.

“Many women feel ashamed that they are unable to conceive a child naturally and this certainly impacts their mental health. If a woman is already struggling with depression or anxiety, the impact of infertility can be even greater,” she says.

“Our culture tells us that a woman’s role is to get pregnant and become a mother. When this is not easily achieved, many women begin to suffer mentally and emotionally. Although there is not a lot of evidence that suggests the psychological stress can cause or exacerbate infertility, it is certainly understood that infertility can cause psychological stress.”

In recent months, Michelle Obama has spoken publicly about her struggle to have children, with both her daughters conceived through IVF treatment when she was in her mid-30s. Social media is also playing an important role in offering access to information and even support, with industry journal Fertility and Sterility reporting that

that more and more women and couples are using Internet resources, such as chat rooms, websites, blogs, and Facebook, to communicate with their doctors and other patients – helping remove some of the stigma and loneliness of infertility.

While it isn’t the job of a reproductive endocrinologist (fertility doctor) to look after emotional wellbeing during an IVF cycle, Cassie says that many doctors in the region are sensitive to the emotional hardship that having IVF brings, but as professionals their first responsibility is your medical care and the outcome.

“They have important work to do and their energy is best spent elsewhere than managing the emotional response of (often many) patients. That is why it is vital to look after your own mental health and be an advocate for yourself,” she cautions.

COPING TECHNIQUES

For anyone who has been through several unsuccessful cycles, it’s often a struggle to stay positive, but there are tools and techniques to help get you through it.

Says Cassie: “If you’ve been struggling with infertility for a long time or you have had multiple failed cycles it can feel devastating. Depending on personal circumstances it can become an emotional as well as financial burden, and that can really affect your mental health.

“It’s often a good idea to speak to a counsellor or other mental healthcare professional to develop a set of skills to help you cope with prolonged stress and anxiety. Infertility is a complex issue, and many people benefit from speaking to a third party.”

As well as ensuring that you are fully informed, educating yourself about the IVF process can also be empowering as knowing what to expect at every stage helps alleviate anxiety and fear of the unknown. It’s also worth taking time to discuss any difficult decisions or negative situations at the beginning of your journey, to help mentally prepare for both worst- and best-case scenarios.

Stress management techniques are an obvious go-to with experts recommending yoga, meditation and breathing techniques as effective tools to reduce or release stress and help build resilience as you go through IVF.

LEAN ON ME

Groups like IVF Support UAE, family members and close friends are invaluable when it comes to being there to help you through the experience, whether it’s for advice and support from other people who have been through it or simply a listening ear and warm hug.

Says Cassie: “If you feel you need further emotional support there are places where you can find it. Joining a support group of other women going through the same thing can be very helpful. Having an opportunity to talk with a group of people who understand your fears, hopes, worries, and to ask questions, can help you feel less isolated.

“It can be a really lonely journey but connecting with a friend who is going through it can make a huge difference to your wellbeing. Not only are you talking to someone you can uniquely understand but you can often get a fresh perspective on your situation. They may remind you of a question you want to ask your doctor, or suggest an acupuncturist that they found useful, or go with you to a fertility yoga class. By allowing yourself to remain social during your infertility you can help yourself to get some positivity and joy from a difficult situation.

One question often raised is how can your other mum friends offer support, especially when they may feel guilty for having children already and not know how to comfortably handle the situation?

“Most women going through infertility feel happiness and joy for their friends and relations who have a baby. But they may also feel jealously and a sense of life not being fair,” says Cassie, with complete honesty.

“There is no reason to feel guilty if you are able to have a baby, but your friend can’t. It is helpful, however, for you to be sensitive to their situation. Try not to complain about your pregnancy or your children to your friend who is struggling to conceive. And resist offering them advice if you yourself have never dealt with infertility. Chances are that anything you can think to suggest to your friend, she has already thought of. Just listen and tell them that you care about them,” she adds.

MOVING ON

It’s not something you may even want to begin thinking about, but what if IVF doesn’t work?  

It's very common for women and couples to feel an intense sense of bereavement when cycles are unsuccessful as no matter how hard you try to not build up expectations, it's completely natural to hope for the best. The common and immediate reaction is to find someone to blame, whether it’s the clinic, your doctor or yourself.

Says Cassie: “Deciding to stop fertility treatment can be a very hard decision. It may also be decided for you by factors outside of your control. If you have not been able to achieve a pregnancy or not able to afford to continue treatment, accepting that you are not able to have a baby can be heartbreaking.

“Some couples may wish to consider alternative means to create their families. Adopting or fostering children may be an option, for example. But if you have decided that you can no longer attempt to have a child then you need to make peace with that decision.”

Anger at your perceived personal failure can easily drag you down and having clear and open communication with your partner is something that Cassie says is key to being able to start to move on.

Speaking with a counsellor is also a good conduit for helping process feelings and your clinic may have a counsellor on staff or a referral who you can talk to, either for free or for a fee. They are usually specialists who have experience of working with people going through fertility treatment. They can help you truly get to the bottom of understanding – and accepting - why IVF hasn’t worked for you, which can be anything from low fertilisation rates to poor embryo quality on transfer days, or a host of other reasons.

Finding a way to be happy also involves taking time out. Book a holiday instead of going back to work and facing well-meaning but often stressful colleague situations. Find a new interest such as a hobby or activity that offers real-time distraction. And set yourself some new life goals so you can find your happiness.