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

Infertility turns your life on its head. This is especially true of people who label themselves as planners or control freaks. Unfortunately, there seem to be a lot of control freaks and planners in the world of infertility treatment.

I really am not sure why this is so. There is nothing about the world that we can control, really. We can’t control the weather but maybe we can control the type of clothing that we put on. We can maybe control the type of food we put in our mouths. We can control how fast or slow we drive. You can control which clinic you work with. But when it comes to the big stuff, like a medical problem like infertility, we cannot control it at all. We can only control our approach to it.

Infertility treatment is physically, emotionally, socially, and financially challenging, as you well know. One of my patients called infertility, “controlled chaos. It is a lot of juggling.” All of the required medical appointments wreck your work life. The timing of an IUI or IVF cycle wreck your personal life. So what you do? You try to control other things. You go to the gym to work off the anxiety and try to control your body, because the hormones you are adding weight to your adorable body. You go to acupuncture and maybe take herbs. You quit caffeine and alcohol. You figure out how to eat “right” or perfectly.  I have wondered if planners take on the strict regimens of infertility treatment as a good thing or not so good thing. After all, it is something that can actually be planned. Another patient said, “Infertility feels like one too many things. It is so much to take track of.  Which times to take medicines. Which doses. Which days to be at the clinic.”

Control freaks are trying to control anything and everything, as a way to tamp down anxiety. In my experience this is the case prior to a diagnosis of infertility. The codes words “I am a worrier” are often my clue that I am working with someone who calls themselves a planner. Often this goes back to childhood. It is code for anxiety. The uncertainty of infertility sets up all kinds of “what if’s” that are beyond our control.  What if I get pregnant just in time for the family cruise to South America? What if I lose the baby? What if my boss doesn’t appreciate my working less? What if I drink too much coffee? What if I never get pregnant? And then there are always the coulda/woulda/shoulda’s.  Control freaks look for something—or someone—to control.  But control is a myth.  You can make as many plans as you want. Life has a way of happening right under our nose.

I feel for you. I really do. Humans look for answers and certainty. Medical problems like infertility offer question marks and uncertainty. I have learned over the course of my life that I don’t know nothin’ about nothin’ and that flowing works better than controlling or planning.  What I know, in truth, is that the only thing we can control is ourselves. Yeah, that sucks but it’s real.

Let me share something with you that is very helpful during anxious times. Break down time into 15 minute blocks. Most of us can control our lives in 15 minute blocks. When you get to the end of that time block, start the next 15 minute block.

You can plan, perhaps, for the next 30 minutes or hour or day, but don’t get too far out ahead of yourself, because anxiety is waiting to say hello and kick you in the behind. Meditation can help, too, but I think that moving meditation maybe works better for somebody who is anxious. Walking slowly, and I mean slowly, while you just observe your thoughts or physical sensations without judgment can be very helpful. Step by step.  Just like life.  Another way of moving meditation can just be to sway slowly back and forth and just letting things be.

So be aware of what you can actually can and cannot control.  Make plans as long as you know that plans are just a thing, not something that may come to pass. I’ll tell you personally that when you let go of the need to control your world, things ease up. It may seem counterintuitive but it’s true. And the 15 minute time block idea may change your world for the better…

#NAIW #ListenUp

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 14^th 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

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

I am writing this blog post on the day after the 2016 election. Many are attempting to understand the mystery of the unexplained. The unexplainable unexpected. Living in the no word zone. Mystery defies reason. The difficulty with the unexplained is that there are no ready answers, right now, when you need them.

Many of you live with the unexplained every day. There are no answers for the infertility diagnosis that you live with. Your baby has died unexpectedly and nothing makes sense about anything. You or someone you love is diagnosed with cancer.  In the spirit of offering balance and healing, I offer 5 tips for living with the mystery of the unexplained:

1. Bathe yourself in compassion and love. Have it for yourself.  You hurt.  You are confused and frightened.  Love this person.  And offer it to others, even if you are not sure you have it for yourself.  We have been doing a lot of hugging today at Partners in Healing of Minneapolis, colleagues and clients. Connect with others from your best place.  I don’t have words for that right now but you will know what it is for you.
2. Allow yourself to grieve before you look for answers and options.  There will be some clarity about something at some point.  For now, mourn your loss but hold on to your dreams.  Let the world stop spinning for a few minutes and just mourn.
3.  Acknowledge your fears.  Actually, acknowledge all of your feelings, whatever they are.  It may help to express your fears to those you trust.  However, be selective about who you express your fears and other feelings to.  Look for comfort from people that you trust. Avoid people, for now, who either bring more questions or no empathy. This is not the time to hope that “that person” will come around and give you what you need. You don’t need to be pooh-poohed, or fixed, or pitied, or “adviced” by others.  Just ask them to listen.  If that’s not possible, thank them and move on to someone who can just connect with you.
4. Gently release the idea of control. Really.  The mystery of the unexplained is just beyond your and my control.  Just ride the wave of unexplainable stuff while keeping your head above water.  Ride the roller coaster with your seatbelt attached tight and hold on. You’re not sure where you are going yet.  Just hold on to yourself. It’s okay to turn off social media and the news. You do have control about that.  And your reactions to what you come across.  I understand that your reactions may not always be pretty.
5. Understand, truly, that the sun comes out every day and that every day is an opportunity to find something new. Sometimes that new thing will be painful. Sometimes that thing will be to learn to be still, just to explore the feelings and thoughts you have. Sometimes the answer will arrive in the most unexpected way or the most unexpected person. Always, always, look to love and compassion for your answers.

Love to you all, always,  Debbie

People sometimes wonder why others turn to gestational surrogacy as a way of building a family.  I am happy to add my two cents and expertise to this important topic because I work daily with Intended Parents and Gestational Surrogates.  These are lovely, loving people.  Here’s why gestational surrogacy is a blessing and here to stay.

For heterosexual Intended Parents, meaning people who wish to be first-time parents or add to their family, there is a long list of medical problems that can lead people to surrogacy including:

• Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH), a congenital condition that results in a woman’s uterus and vagina being absent or underdeveloped
• Cancer survivor, which can restrict use of hormones or have resulted in the removal of ovaries or the uterus
• Multiple miscarriages
• Bipolar disorder, schizophrenia, or other mental health condition that, if untreated, could be dangerous during pregnancy
• Blood clotting disorders
• Unexplained infertility
• Previous birth trauma (hemorrhage, uterine rupture)
• Too many C-sections
• Heart complications
• History of premature delivery, sometimes resulting in the death of a baby
• Diabetes

Gay Intended Parents want to be parents, too.  They want to be represented genetically.  Just like straight Intended Parents.

Surrogates, also called gestational carriers, want to meet the need.  And the need is growing day by day.  They are not “surrogate mothers.”  Surrogates are mothers to their own children, not to the child or children they carry.  They are quite articulate about that.  They will tell you every time that the child they are carrying “It’s not my baby. I’m just carrying the baby.  They are the parents.”

They believe it.  I believe them.

Do you?  I hope so.

Helping people to build their families is a blessing.

Here’s the thing that people who are anti-surrogacy need to understand. Surrogacy makes sense to Intended Parents and their families and friends. Surrogacy makes sense to gestational carriers, their partners, their children, their families and friends.  They all see this as a blessing.  If you are a religious person, you might even say that all babies come from God and this is one way that God can help to bring a baby into the world. To ease hurt and suffering.  To bring joy.  Gestational surrogacy works and is a blessing.

Ending or restricting gestational surrogacy would be like stopping a moving train with your hand. People would get hurt.  Badly.  But it will keep going.

What we need to do is to ensure that Intended Parents and Gestational Surrogates are safe in the process.

Legislation is needed to protect Surrogates and Intended Parents.

Now.

Here in Minnesota and across the United States.

Because gestational surrogacy is a blessing that’s here to stay.