Archive for August, 2009

“Infertility is inherently stressful–it can affect how you see yourself, your sexual relations, your marital relationship, and your relationships with other people.” –Sharon Covington, Director of Psychological Support Services, Shady Grove Fertility and Reproductive Science Center, Rockville, Maryland

The treatment of infertility brings cycles of hope and despair–and turns life into an emotional roller coaster. Infertile couples need psychological support, whether it be from family, friends, doctors, counselors, on-line support groups or each other. Many infertile couples turn to Resolve, a nonprofit organization founded in 1974 to provide support and information to infertile people and to increase awareness of infertility issues.

Infertility’s emotional effects

Depression, anger, anxiety, frustration, irritability, and grief are normal responses to infertility. Hormones can have profound effects on emotion, so treatments that send hormone levels shooting up and down may magnify the turmoil. As months go by without success, the stress of infertility builds. For many couples, the second year of infertility treatment is particularly trying.

Infertility can have damaging effects on a couple’s relationship if concerns are not addressed. A partner may feel guilty or angry about the cause of infertility, if it is known. Both may feel frustrated if the cause is unknown. Couples often have different attitudes towards treatment that can cause friction in the relationship. One may want to pursue all options, while the other may not want to be as aggressive. As most infertility treatments are performed on the woman, the unequal emotional and physical burden she bears can strain the relationship.

Counseling supports treatment

Good clinics build psychological support systems into their infertility treatment program. For example, clinics supply reading material in the waiting room, such as flyers on upcoming support groups and Resolve meetings. These can help patients understand the treatment process and find out about available support services. Some clinics develop their own counseling groups, and a few clinics have on-site counselors. Your doctor may be able to recommend a therapist who specializes in infertility patients.

Professional counseling can ease the emotional problems of infertility and may even improve the odds of conceiving a child. Recent research found that couples who participated in group counseling sessions were more likely to get pregnant than couples who did not. It is not clear whether the counseling sessions caused the difference, whether the participants were more likely to try high-tech treatments because of the support, or whether it was just a coincidence.

Most people end fertility treatment because they run out of emotional energy, not money. Couples may find it difficult to make decisions about alternative treatments or to end treatment. There’s always another treatment available–something new to try. Counseling may help the couple press on–or realize when it’s time to stop treatment.

Types of counseling

baby counselingPatients can choose the style of counseling that best suits their needs–whether individual counseling, couples counseling, or group counseling.

When to consider counseling

Don’t view counseling as a last ditch effort, but as a way to get a better understanding of infertility and its effects. Counseling can help patients develop coping mechanisms and avoid common problems.

Infertility counseling is particularly useful at critical decision points in treatment. For example, most patients are “running on empty” by the time they face IVF treatment. Counseling before IVF can help the patients know what to expect and can boost their emotional reserve.

Many individuals develop depression in the time period that they are experiencing difficulties conceiving. Quite often, women are reluctant to take medication for their depression because of concerns that it might harm the baby. However there are several new antidepressants that are effective in treating depression and considered safe in pregnancy. One of these medications, ProzacĀ®, has been studied. It has not been associated with either increased miscarriages or birth defects. Frequently, the depression is alleviated by the good news of the pregnancy and the medication can be discontinued safely.

Women report symptoms of depression more often than men, although it can occur in either partner. Sometimes an individual is too depressed to identify their own depression. In those cases, the partner plays a crucial role in identifying the symptoms and getting professional help. Talk to your doctor if you think you or your partner is experiencing symptoms of depression. Your doctor can direct you to appropriate professional help.

Seek counseling when you notice:

  • infertility is affecting your normal functioning and relationships with others
  • persistent sadness and tearfulness
  • increased levels of anxiety or worry
  • isolating yourself from others
  • strained relationships
  • loss of interest in hobbies
  • difficulty concentrating or remembering
  • difficulty making decisions
  • difficulty accomplishing your usual tasks
  • change in appetite, weight, or sleep patterns
  • increased feelings of bitterness or anger
  • thoughts of death or suicide
  • continuing feelings of pessimism, guilt, or worthlessness

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Correction: Sleep-deprivation linked to infertility. (I had a feeling that would get your attention.) Did you ever consider that? How could you with all the other things to worry about:
You’ve cut down on alcohol, caffeine, and even processed food.

You’ve scheduled more time to relax and tried to reduce the stress in your life.

You’ve started a consistent exercise routine and detoxified your house.

You’ve charted your monthly cycle, bought ovulation kits, and still…nothing.

But you’ve overlooked one very important element: sleep, which you don’t get enough of.

The word “infertility” can quickly generate a response, especially among the 10 percent (more than 6 million) of women struggling with it. The topic routinely graces the covers of magazines and academic health reports.

Lately, the talk about toxins in our food, water, and air have been blamed for increasing the likelihood of infertility. But what if it’s much simpler than that? What if infertility can be partly blamed on how many hours of sleep you get a night. OR hours you don’t get?

A new report puts the spotlight on exactly this issue. The highlights:

  • Missing your required number of sleep hours a night can impact your ability to conceive.
  • The average woman (30 to 60 years old) gets only 6 hours 41 minutes of sleep during the work week, according to the National Sleep Foundation, when she really needs 7 to 9 hours.
  • Sleep has a powerful influence on the body’s hormonal system, which controls a woman’s cycle and regulates ovulation.
  • Too little sleep leads to low leptin levels, the hormone responsible for appetite and which can impact ovulation.
  • Insomniacs have a significantly higher level of the stress hormones cortisol and adrenocorticotropic, both of which can suppress a healthy fertility cycle.

The take-home message is clear: you could be doing “everything right” when it comes to preparing your body to conceive and bring a healthy baby to term. But with so much focus on external factors like your environment and what you put in your mouth, the time has come to add another aspect to this big equation: sleep.

All the healthy, pure food in the world and all the attention to getting your body into tip-top prenatal shape won’t cure a hormonal system gone awry from missing sleep. So if you’re thinking of having a baby, put sleep on the list. At the top. And if you’re going to worry about your environment, remember to also think about the one in the bedroom.

Article by Michael J. Breus, PhD, DABSM

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When you are trying to get pregnant, it seems everyone around you is an expert on conception. One of the most common pieces of advice given is “just relax and it will happen.”

And while the theory of relaxing and avoiding stress seems simple enough, it’s actually one of the most difficult things to achieve while trying to conceive. In fact, trying to relax can sometimes cause more stress because you’re having to work so hard to make it happen.

Fortunately, there is a fairly easy way to relax and reduce stress in your life. Just laugh. In fact in some recent studies, women exposed to laughter therapy actually had higher pregnancy rates than those who did not participate in laughter.

Apparently there are laugh yoga centers and laughter yoga sessions are most often 60 minutes in length. In the first 15 minutes, or so, participants explore the space and begin to breathe deeply, warming up the abs, lungs and vocal chords. The instructor introduces the practice, and then the exercies begin. Laugh yoga exercises train and tone all the muscles involved in smiling and laughing, including facial muscles, abdominal muscles and more, in order to transition smoothly into free-flowing laughter. The last 15 minutes is a time for release, through group sharing and meditative smiling and laughing. Sessions end in quiet meditation.

Or another option to find laughter is to watch stand-up comedy live or on tv!

Dallas Infertility & Miscarriage ExaminerMichele Kennon

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They were surprised to discover new research indicating that nearly three of every four women with PCOS may have vitamin D levels that are below optimal. The Medical University of Graz in Austria studied 206 women affected by PCOS and found that 72.8% had insufficient vitamin D levels.

The most common treatment for polycystic ovarian syndrome is birth control pills or metformin. The issue of vitamin D adequacy is rarely if ever discussed.

Yet vitamin D is needed to help you reduce insulin resistance, which is thought to be a primary cause of PCOS. Vitamin D is also necessary for a multitude of functions in your body, including bone health.

Moreover, another report from the Royan Institute in Iran suggests that PCOS women have some genetic variation that affects how effectively vitamin D functions in the body.

It’s possible that these genetic variations may contribute in some way to insulin resistance and PCOS. The researchers said: “The findings of the present study indicate that genetic variation in the vitamin D receptor may affect PCOS development as well as insulin resistance in women with PCOS.”

The Austrian study reported a close association between metabolic syndrome, PCOS and low vitamin D. Metabolic syndrome has a lot of overlap with PCOS.

A few common symptoms of metabolic syndrome are large waist circumference, high waist-to-hip ratio, high blood pressure, high blood sugar, insulin resistance, and high blood fats. In this study, women with PCOS who also had metabolic syndrome also had the lowest vitamin D levels.

The bottom line is that if you are overweight, have insulin resistance or metabolic syndrome, it’s highly recommended that you get a vitamin D blood test. You could also take a supplement formula that contains a good level of vitamin D, such as d-pinitol. A small study from Aristotle University in Greece showed favorable results in treating overweight PCOS women with vitamin D.

What if you are lean? Your need for vitamin D may be less than for someone who is overweight. But who knows? Regardless of your weight, it’s wise to get a vitamin D blood test and find our where you stand.

Wehr E et al, Association of hypovitaminosis D with metabolic disturbances in polycystic ovary syndrome, Eur J Endocrinol. 2009 Jul 23. [Epub ahead of print]
Mahmoudi T et al, Genetic variation in the vitamin D receptor and polycystic ovary syndrome risk, Fertil Steril. 2009 Jun 5. [Epub ahead of print]
Kotsa K et al, Role of vitamin D treatment in glucose metabolism in polycystic ovary syndrome, Fertil Steril. 2008 Oct 16

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