During this National Infertility Awareness Week, write yourself a love letter.  A loving, compassionate, kind letter, telling you that you are wonderful. That the world is blessed by your presence.  That you are doing your best with a very challenging situation.  And most of all that you will get through this.

xoxoxoxoxo,

Dr. Deborah Simmons

#NIAW  #ListenUp


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I read an article recently entitled “­Mother who spent £20,000 on FOUR rounds of IVF says she was made to feel ‘selfish’ because she already had a child – and reveals her battle to conceive felt like a ‘shameful secret.’ (www.DailyMail.com, March 30, 2017).  Note the “FOUR”, as if that’s SOOOO much.  It’s not.  Most of my patients do whatever they need to do to build their family.  If a doctor told them to stand on their heads and cluck like a chicken, they would do it.  And they are often judged negatively for it.

Secondary infertility is the red-headed stepchild of the reproductive world. Secondary infertility gets no love at all.  It is confusing and maddening.  This is an ache.  Yearning. There is nothing logical about wanting a child or children.  We just want it.  The pain and obsessiveness of the chase is very similar to primary infertility with one big difference: people are fresh out of empathy for you.  Even people who are trying to make their first child don’t quite understand your distress.

I’m learning to live without you now

But I miss you sometimes

The more I know, the less I understand

All the things I thought I knew, I’m learning again…

“The Heart of the Matter”

By Don Henley

Let’s say your first child was conceived in the bed with some pleasure or in a doctor’s office.  Great! That went well enough.  Let’s repeat a successful process.  Wait. Things aren’t working.  Time is passing.  Things are getting more confusing.  It can be a crushing blow when attempts at the second child go flat.  There is a sense of panic because you are trying to make sense of something that makes no sense.

WHAT THE HECK IS GOING ON HERE!?

Inseminations worked before.  Why aren’t they working now?

IVF worked for us.  Why can’t we get good embryos again?

Nobody ever told me that I might not be able to get pregnant again!

Why am I having miscarriage after miscarriage?

When did my AMH (Anti-Mullerian Hormone) level plummeting?

Unfortunately, there are seldom answers to these important questions.  Urgency and anxiety grow in the absence of data and certainty.

This is when the questions and “helpful” comments start from others.  Let’s list them, shall we?

  • What’s your problem? At least you have a child.
  • You’ve got what you wanted. Why can’t you just be grateful that you have a child?
  • Aren’t I enough? (This one seems to be is a specialty of the male species.  She loves you a lot but she needs something more.  Read my earlier blog post No Fellas, She Needs a Child, Too.”)
  • Maybe it’s meant to be. Move on. Get over it.
  • It’s not the end of the world if you have one child.
  • This is God’s way of saying (________).
  • Why would you spend money to have another child? (Hint to the helpers: why wouldn’t you?)

Exhausting, all this “helpful” advice.

I understand your pain.

I wish other people did, as well.

It is hard to explain to your child that he or she may or may not get the sibling they ask for.  You are trying.  So hard.  It’s not your fault.  You are a good person.

Your very real medical problem is being dismissed by others who cannot understand that your family is not yet complete.  Ask yourself how many children you have wanted.  I’ll bet that the number comes to you right away.  I don’t know of any research that explains that instant number that everyone seems to know.  I know that you are setting the table for another person.  You have invited them but they are not here yet.  And they may not be coming after all.

This is when empathy from others would go a long way.   It’s National Infertility Awareness Week from April 23-29, 2017.  If you have the energy, teach the people around you about your pain.  Because it’s real. I’m doing my best to do the same.

Please hang in there.  Hold on to the dream, if there are different paths to take that might make the dream come true.  And if you are at the end of the journey, your grief is real and true.  Your tears speak to what might have been, and who you are now.  Give yourself the time and grace to heal. Because you will.  And new dreams will form…

#ListenUp #NIAW


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I have noticed that fertility clinics are not chatty places.  I also hear many of my patients talking about why they don’t talk about infertility with others.  Why is that?

I think it’s infertility shame.

Maybe you already know what I’m talking about. Suffering in silence. Keeping your head down. Not telling other people in your life about the fertility struggles you are having because you are embarrassed. Feeling that there is something wrong with you. Learning through others’ stupid comments that it’s not worth trying to talk about it.  Infertility shame tells you that you are a failure because getting and staying pregnant are not happening in the way that you were promised.  That you are different. You are living in a bait and switch world.  We have all been told that you get pregnant any and every time you have intercourse.  Well, that story happens for some people, I suppose.  But if that was true of everybody all the time, the Earth would be groaning with the weight of trillions of people.

I’ve been there.

I never understood my reproductive “stuff” because doctors told me that everything was normal. Before I really even understood what intuition was, I knew that my reproductive stuff was NOT working correctly. Getting a period and bleeding for weeks and then nothing; repeat. Terrible cramps. Menstrual migraines.  You get the picture. It didn’t make any sense at all. And then…I tried to get pregnant.

My husband and I were told to use a basal body temperature thermometer and chart my cycle. Let’s cut to the chase, shall we: there was no obvious ovulation. Ovulation kits were expensive and the 14th day of my cycle was as crazy as any other day. I detested BBT thermometers. I remember my ritual with my husband of cursing them and throwing them in the garbage. By some miracle we were able to get pregnant, even with wonky ovaries.  And then… I tried to stay pregnant.

What I found out ultimately was that the bottom segment of my uterus doesn’t work when it has too much baby in it. My uterus was not meant to be pregnant, not really. Aha, maybe that was what my intuition was about!  I felt like a failure for not having a body that would make things easy and for putting a baby at risk unintentionally. It took me some therapy and some compassion for myself to learn that my wacko uterus and wonky ovaries were beyond my control. I have learned that my uterus may have been “defective”, but I sure as hell am not.

And you are not defective or a failure either. You have some intuition about your body, too. Something isn’t working, or maybe something isn’t working for your partner. That is nothing to be ashamed of. It is beyond your control. It is something to work on, or work through, or work with. That may be with a fertility clinic or an adoption agency.

Shame is personal. It’s the shitty things we tell ourselves about ourselves. You sure wouldn’t say shitty things about your neighbor’s body, right? For other people you have a sense of conscience and compassion. You are kind and empathetic (hopefully) and you offer to listen.

Here’s the thing: for you to listen, somebody has to speak. Now let’s turn that around so that you can start to beat down your infertility shame.

For other people to listen, you’ve gotta talk.  You’ve gotta let it out into the sunshine. Shame is the shadow in our lives. You have to talk back to your infertility shame and beat it by letting it out. Sometimes that is talking with family or friends or colleagues at work. Unfortunately, that may or may not end up being a good idea, depending on the often dumb responses from other people from other people. Going to a Resolve meeting near you or online can be a lifesaver. Facebook groups, Twitter, Instagram, and Pinterest are great places to talk with other people, too.

www.bigstockphoto.com

You are not alone! One in eight couples in the United States struggle with infertility. In Canada, it is one in six couples.

It’s time to work with your Self. Please stop saying shitty things about yourself and your body. Stop apologizing, or explaining, or justifying the fact that you are struggling with infertility. This is a physical, medical problem, just like cancer or thyroid disease. You did not bring this on. With help and compassion, you may be able to beat it.

So listen up. The best way to beat infertility shame is to do it together. You and your Self.  You and me. You and Resolve. During this National Infertility Awareness Week, April 23-29, 2017, let’s work together.

Let’s. Beat. Infertility. Shame. Together.  #NIAW #ListenUp


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Listen up!  It’s National Infertility Awareness Week, a week that is so important in my life and the lives of my beautiful patients.  This year’s theme, “Listen Up!” is a call to action for a multitude of interested parties:

  • For people struggling with infertility, it is a call to do what must be done, to treat infertility sooner rather than later. Avoid regrets by taking action.  It is also imperative to talk openly about the physical, emotional, and financial difficulties that come with crappiness of infertility. Together, we can beat infertility shame! #ListenUp
  • For couples struggling with infertility, get on the same page about what to do. This may mean getting to a specially-trained therapist who understands the emotional rollercoaster and medical issues of infertility.  You can find me and other therapists through the American Society for Reproductive Medicine.   Or you can talk with me in the office or online on videoconference.  Your relationship will be strengthened by working together.  #ListenUp
  • For people who love someone with infertility, it is a call to action to learn and listen with a full heart, not to offer quick fixes or religious advice. Ask your friend or family member how they are.  Hug them when they cry. Drive your loved one to an appointment.  #ListenUp
  • For OB/GYNs, it is a call to action to refer patients to fertility clinics quickly, especially if they are close to or older than 40. When your patients get pregnant with the appropriate fertility treatment, they will come back to you, with a grateful heart. #ListenUp
  • For fertility doctors and OB/GYN’s, it is a call to action to refer your patients to Resolve and to specially-trained therapists before they are crying in your office. Thinking about your patients in a holistic way will buy you a lot of brownie points with your patients. #ListenUp
  • For insurance companies, it is a call to action to change the ways in which you disenfranchise your subscribers from receiving the MEDICAL treatment they need and deserve. It’s 2017.  Infertility is not a desirable treatment, it is an illness process requiring medical treatment.  Here’s the truth: Fertility treatment doesn’t cost you that much. It is worth gold to your subscribers.  #ListenUp
  • For legislators, it is a call to action to recognize that reproduction and parenting happen in many ways. Enact laws to recognize and support gestational surrogacy and to update parentage laws that recognize parenting through gestational surrogacy.  #ListenUp

We humans do best when we have a purpose and take action.  Listen Up!  It’s National Infertility Awareness Week.  #NIAW


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Dealing with infertility and its treatment is challenging.  With it comes choices.  That’s the good thing.

And the hard thing. It means that you are responsible for making choices.

I know that these choices are forced choices. You feel forced into doing things you never thought you would have to do. Or things that you don’t want to do.

If things were working reproductively, we wouldn’t be having this conversation.

It’s not that you don’t have choices.  You do.

It’s that you don’t like the choices you have.

You don’t have a choice about your fertility and its challenges.  You DO have a choice about what to do about it.

When you don’t have a choice, make a choice.

There will not be a perfect, right choice.  But there will be one or more choices you can live with.  Here are 5 choices you DO have about infertility.

Choosing not to freak out. It helps to keep your wits about you.
When faced with an infertility diagnosis, people go through a variety of emotions:  shock; disbelief; denial; embarrassment; fear; sadness; anger; panic; failure; and shame, among many more.  The same thing can happen when something you try doesn’t work.  You absolutely have the right to feel whatever you feel whenever you feel it.   That makes you NORMAL.  Don’t let anyone tell you to buck up or be grateful for what you have. That “advice” isn’t empathy.  What is im­portant is to keep your thinking cap on, however you can, whenever you can.  You might be scared or pissed off at yourself, your partner, God, or the world.  Use your head to figure out what to do about it.  Don’t just get mad at infertility—get even with it.  Figure out a plan you can live with.

Treating the fertility problem. Or not.
To treat or not to treat.  This is the question. Whether ’tis Nobler in the mind to suffer…  You get my point.  There are good fertility clinics and acupuncturists out there. Lots of them.  You can try some dietary changes and see if they can “reset” your fertility.  You can choose to treat the problem now. Or you can wait. Or not treat it at all.  Figure out how much time you have to consider your options.  Consult with the right doctor to get the data you need.  Talk and maybe negotiate with your partner.  Most important, check in with yourself about what plan makes sense and feels right to you. Make a choice.  Move forward.

Choosing the level of treatment.  Not everyone jumps straight to IVF.
Sometimes the problem you are struggling with can be treated with low-tech options, like ovulation predictor kits or oral medication. Because you may have insurance coverage for inseminations and medication, it might make sense to give that intermediate step a try for a short while.  But for some problems, like a fallopian tube blockage or poor sperm quality or no sperm at all, I’m sorry to say it but you will need a higher level of treatment.  Some people like to go step-wise with their treatment, adding on treatments as needed.  Pacing yourself is fine.  Others want to get this journey over with.  Which one are you?  Be realistic.  Make a short-term and a longer-term plan.  Be strategic.

Picking the time to do treatment. Just don’t wait too long.
Some of you have been trying to conceive for longer than you ever thought possible.  Hope, finances, and some level of denial can make people wait even longer to get started on treatment.  I have been with so many people who wish they could have started treatment sooner.  You get to pick the timing of when you start treatment with one caveat: If you are nearing 40, don’t wait.  Go.  Run to the fertility clinic, NOT your OB/GYN. OB/GYN’s are awesome at pregnancies and delivering babies, not fertility challenges.  You also get to pick the timing of when you take a break or trying something different.  I really don’t want you to have heartbreaking regret about wasting precious time.

Choosing to be open to different options. Your partner needs to do that.
One of the challenges of life is that choices can be limited.  Again, you may not like your choices.  Not at all.  Not one bit. If you are absolutely closed to adoption or donor sperm, that is your right BUT you may be limiting your partner’s opportunities, too.  Think about fairness.  She or he may grow some mighty resentments toward you if you won’t even explore possible choices.   It has been a certainty in my practice that when people take the time to learn more about adoption, IVF, donor eggs, or donor sperm, and challenge their negative assumptions, they become more open to the possibilities of building a family in a different way.   Data and facts are always better than assumptions!

These are 5 choices you DO have about infertility.  What’s most important is to make a choice.  Get unstuck.  Something can work.  Something different can work.  Life moves forward.  You can move forward, too.


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Infertility takes over your life.  How can you get to the clinic before your big presentation today? Is today ovulation day?  Did you do your injection at the right time in the right dosage?  Will your spouse be home from the work trip in time to give a semen sample? How many BBB’s (Big Bellies and Babies) are you going to see at the grocery today?  How many blogs can you read today about infertility?  How sick of infertility are you?

Infertility takes over your mind, too.  It is very hard not to think about.  I bet you know what day of the cycle you are on.  I remember how confused and angry I was every month when I wasn’t ovulating but my doctor kept pooh-poohing my concerns and my intuition.  I could not stop thinking about it, only to be told that I was obsessing, not to worry, and to relax.

I know what you are going through.  I am sorry that you hurt and you are scared that the hurt won’t ever end.

Until that moment when the pregnancy test is positive.

No way!

Could this be happening?

Do another few tests at home.  They are still positive!  What does this mean?! Everybody says that you should feel happy about a positive result, right?

Not when you have been trying for months or years.

When you have been in the infertility trenches and you are now pregnant, you are in what I call a

Prove It Pregnancy

Yes, that’s right.  A Prove It Pregnancy.  Yeah, yeah, other people stay pregnant and have babies. Could that be possible?

Infertility tells you, “Hold on there, honey. This can’t possibly work out well.”  It’s the Too Good To Be True Factor.  But this could be real.  Truly.  Really.

When you get pregnant after months—or years—of undergoing fertility treatment, there is shock, disbelief, and excitement.  Shhhhhh!  Don’t jinx it!  That first ultrasound can scare the jeepers out of you.  But it might be real.  You may not really believe it until the next ultrasound.  Maybe not.  Maybe later.  Am I pregnant?  Prove it.

Transferring your care from the fertility clinic to an OB/GYN or midwife care can be disorienting and even frightening.  This means that your pregnancy is continuing, despite your fear.  Can this really be happening?  Yes.  I know that you may have had a close relationship with the fertility clinic doctors and nurses.  You can learn to trust a clinic that can help you deliver a baby.

Really?!  Yes.  It is possible.

And there may come a time when you consider investing in the pregnancy and a baby, but fear still may remain.  Superstition is normal in a Prove It Pregnancy.  Others want to invest in baby stuff.  No. Thanks.  Maybe. Later.  It is okay to put things off.

As one gentleman recently said to me, “I may think about investing in the pregnancy when we get to 26 or 27 weeks.  When it seems real.”  And a woman I know thought it might be okay to peek at Pinterest.  Sure.  For just a moment.  And honestly, it may not seem real until a baby is warm and squawking in your arms.  That’s okay.

 

It’s a Prove It Pregnancy.   

 

 


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