DebG
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The cure IS worse!
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Therapists' top ten tips for coping with fertility problems
The pressure to raise a family can be enormous, and the thought of not being able to can make many people feel something is wrong with them. We talked to respected psychologists who work with couples with fertility problems to find out which coping strategies really work.
Recognize that a fertility problem is a crisis. A fertility problem may be one of the most difficult things you'll ever face. Acknowledging this is a key to coping, says Kate Marosek, who's counseled couples with fertility problems in the Washington, D.C., area for more than ten years. "It's normal to feel a monumental sense of loss, to feel stressed, sad, or overwhelmed. Don't chastise yourself for feeling these ways." Facing and accepting your emotions can help you move beyond them.
Don't blame yourself. Resist the temptation to blame yourself or to listen to the little voice in your head that may be saying, "I shouldn't have waited; I'm being punished for having that abortion; I should have lost more weight or taken better care of my health; I shouldn't have assumed that I could have children when I wanted," or whatever.
People can get caught in negative-thinking patterns that only make things worse, says Yakov M. Epstein, a psychologist at Rutgers University and co-author of Getting Pregnant When You Thought You Couldn't: "Instead of berating yourself, look forward to how you and your partner are going to manage the situation." When you start feeling like you "should have" or "could have," remind yourself that your fertility problem is not your fault. Even if you could have made different decisions in the past, they're behind you. Concentrate on your future.
Work as a team with your partner. You and your partner should help each other through this time (and definitely not blame each other for your difficulty getting pregnant). This doesn't mean you need to feel the same thing at the same time — that's one of the most common pitfalls for couples facing fertility problems. It does mean paying attention to what your partner's going through. "If you're taking care of each other emotionally, you can unite to fight the problem," says Marosek.
Work together to find practical ways to share the burden, too. If you're undergoing treatment, he can take care of the insurance papers. Or if he needs injected therapy, you can administer the shots.
Educate yourself about fertility problems. Read as much as you can about fertility problems, and ask your doctor and other couples in your same situation questions. This is especially important when you're dealing with a fertility problem because the technologies behind the treatments are complicated and change quickly. "You've got to understand what's happening medically," says Epstein, "or you won't be able to make informed choices."
See our resource guide for a list of books, Web sites, and organizations that can help, or learn the basics by starting at the beginning of our Fertility Problems area.
Set limits on how long you're willing to try. Some couples decide from the get-go that they won't go to extreme measures to have a baby. Others spend years and thousands of dollars trying out all their treatment options. No one can tell you when to stop trying to conceive — that's a decision you need to make with your partner and doctor — but you'll feel more in control of your life if you start thinking in advance about how far you're willing to go to get pregnant.
Start by discussing your medical odds of getting pregnant, which treatments you're not willing to try, and your end goal. (For more help making this decision, see Making the decision to end fertility treatment)
Decide how much you're willing to pay. With in vitro fertilization (IVF) averaging $10,000 to $17,000 a cycle, it's no wonder couples feel anxious about money, especially since women often need to go through multiple cycles before becoming pregnant. To cope with the anxiety caused by the high costs of treatment, sit down and develop a financial plan. Start with your insurance: Find out exactly what it does and doesn't cover. If it covers some or all of your treatments, decide whether you or your partner will monitor the paperwork and negotiate with the insurance company. Then look at all your assets and determine how much you can spend and on which treatments. "You should always have a plan B," says Alice Domar, a Harvard University Medical School psychologist who specializes in helping couples with fertility problems. "Because nothing, especially with fertility treatments, is certain."
Get support from professionals or others with fertility problems. Society often fails to recognize the grief caused by fertility problems, so those denied parenthood tend to hide their sorrow, which only increases their feelings of shame and isolation. "Finding other people who are going through the same thing can help you see that fertility problems are widespread and your disappointment is understandable," says Linda Klempner, a clinical psychologist and mental health consultant at the Diamond Institute for Infertility and Menopause in Millburn, New Jersey. Connect with others who can relate on one of our Fertility Problems bulletin boards.
If you'd like to talk to a therapist, look for one who understands fertility problems. "Fertility problems are very complex, and if a therapist does not understand the medical issues he or she won't be able to help," says Epstein. Ask RESOLVE for a referral or check out the InterNational Council on Infertility Information's list of therapists.
Just say no to baby-focused activities. If certain gatherings or celebrations are too painful for you — all your siblings had babies in the last two years, say, or you keep getting invited to baby showers — give yourself permission to avoid them or at least to have a good cry afterward. To avoid hurt feelings, send a gift, but send children's books to save yourself a troubling trip to the toy store or baby boutique.
Balance optimism and realism. "You need to be optimistic to go through a procedure," says Epstein, "but if you're too hopeful, if your hope is unrealistic, you'll be setting yourself up for a huge fall." By keeping up to date on the technology and your diagnosis, you can get a good handle on what chance of success you have with each treatment.
The array of medical technologies available today leads many couples to keep trying month after month, year after year. But about a third of couples treated for fertility problems won't go on to have a biological child, and often they must make peace with that before they can move on with their lives. Staying realistic can help you make smart choices as you work your way through the emotional minefield of treatment.
Take care of yourself by pursuing other interests. Being treated for a fertility problem can feel like a full- or at least part-time job, so it's important to keep up with some of the activities or hobbies that bring you pleasure. "It won't be easy," says Marosek, "especially if you're doing something like going in for a blood test every other day, but look for ways to take care of yourself." She recommends that people get a massage, have a manicure — anything that can give them relief from the focus on fertility treatment.
If your old activities are painful — maybe all your friends are parents now — look for new diversions. If hiking is your thing, do that. Or take a class — painting, dance, or something else that's always tempted you. And remember, laughter is one of the best healers. See a funny movie, head out to a comedy club, and re-read your favorite funny novel.
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