Update on my Fertility Groups

I am moving the Friday Oakland Infertility group to Thursdays at 6:30pm bi-weekly starting this Thursday.  The Orinda group at Reproductive Science Center will continue on Mondays bi-weekly.  Contact me if you have any further questions.

amoreena@gmail.com

Read Full Post »

NEW support group in Orinda – Monday evenings

Infertility Support Group
RSC
Does any of this apply to you?

· I’m feeling lonely and isolated
· I have very few people to talk with about my infertility
· No one understands
· Everyone I know is pregnant or has children
· My partner is the only one I have who provides emotional support
· Infertility is affecting my work and career
· I feel that my life plan is out of control
· I’m having trouble navigating through my medical treatment options

This group will help you feel less isolated, empower you with knowledge and validate your emotional response to the life crisis of infertility.  You are not alone!  The goal of this group is to support you through this journey and give you mindfulness tools to help cope with the ups and downs.

Benefits of Joining a Support Group
One of the most important benefits of participating in a support group is a decrease in the sense of isolation so many people feel when they are experiencing infertility.  Plus, a 2000 study found that attendees of support groups had a higher pregnancy rate than women who didn’t attend a support group.

The mind/body infertility support group consists of 4 sessions biweekly with the option to continue longer.  The group will provide clients with tools to get the stress of infertility under control. We will discuss treatment and family building options, encourage questions and conversation, and provide support and understanding in challenging times.

Women in all phases of the infertility process are welcome, whether they are doing natural, IUI, IVF, or deciding what is next.

Components of the Group:

• Relationship between stress and infertility
• Side effects and consequences of stress
• Introduction to relaxation techniques
• Mini relaxation exercises
• Learning effective communication
• The impact of lifestyle behavior and infertility
• Introduction to mindfulness for fertility
• Cognitive skills for the emergence of healthy thought patterns
• Strategies for difficult situations and interactions
• Couples’ communication tools for interpersonal dynamics and issues
• Information on fertility treatment and family-building options
• Support from joining with others similarly challenged

Class fee: $40 per session – 4 sessions paid up front – Mondays 6:30pm – 8:-00pm – bi weekly

STARTS Sept 20th! Call me now 650-224-1796

Read Full Post »

Is Infertility Causing you Stress?

Is your infertility causing you stress? If so, read this article to find out what you can do to help reduce your stress.

We all know that infertility is stressful. Research suggests stress makes you less likely to conceive. Additionally, research has determined that the major reason for dropping out of fertility treatment is not finances, diagnosis, or prognosis, but stress.

Conversely, studies report stress reduction groups not only decrease depression and anxiety, but also result in significantly higher pregnancy rates. For example, in a study by Alice Domar, Ph.D. (Domar et al. 2000) of 184 women, there was a 55% pregnancy rate for the Mind-body fertility group compared to a 20% pregnancy rate for the control group. Managing stress enables you to make the best choices possible, stay the course of treatment, remain open to all family building options, and realize your dream of parenthood.

Our minds have the power to influence our health both physically and emotionally. Emotions represent physiological states that affect our bodies and our physical health in the same way as exercise, diabetes, or asthma. Stress reduction through the practice of mindfulness, or moment-to moment non-judgmental awareness, is now a vital component of medical treatment for a wide range of health challenges.

Discussing how the stress of infertility is affecting your life and receiving support and coping skills can help lead the way through this difficult journey. If you are interested in receiving further support and you are in the Oakland area contact me about getting into one of our support groups.  amoreena@gmail.com

Read Full Post »

Infertility Counseling: What to Expect

What to expect from infertility counseling from me, whether it is in a group , individual, or through couples counseling.

Individuals and couples with infertility often contemplate whether to seek counseling.  Some approach this decision with ease, but many others have questions about what is involved in a counseling relationship. In today’s blog, I will offer an inside view on the beliefs that have guided my counseling experiences with my infertile clients.

In my own experience, my first contact with a client usually is in a telephone conversation. On the telephone I try to learn how the prospective client (almost always a woman) defines the problem(s) she wants to work on; what her partner’s feelings are about being involved in counseling; whether she or her partner has ever been involved in counseling before; at what stage of diagnosis/treatment they are; and where they are currently getting medical intervention. I then offer a bit of information about myself, including possible appointment times that I have available; fees and insurance coverage information; and my office location. I also ask whether she has any questions that she would like to ask me before we meet. Then we set a date and time for the appointment or when the next support group is that is appropriate for her to join. Not all clients are ready for a support group and not all groups are appropriate for everyone.  Some groups have a specific focus and others are more open format.

So here are some things that are typical of my first meeting with my new clients. It is not unusual for the person with whom I have spoken on the telephone to take the lead in introducing me to her partner and in saying something along the lines of “I think I’m going crazy!” or “I don’t know how much more stress I can take.” And my response to that introduction is usually to point to my nearby box of tissues and to say that being upset comes with the territory of infertility. I also try to work in something about the courage it takes to begin a relationship with a counselor, since getting help will involve talking about difficult issues.

I ask both of them if they are comfortable with my taking notes as we speak, since I want to be sure to remember accurately how they portray their situations. And then I say that in my experience, each of them may have their own unique “take” on their infertility, so I will be encouraging both of them to clarify for me the dimensions of this experience that are important to them. This also opens the door for them to see each other’s perspective and to learn how important it may be to keep both perspectives on the table. It is here that I say to the partner of the telephone caller how much I appreciate his/her coming to this meeting, and how much I believe that person’s presence can help all of us to move forward in working on the issues connected with their infertility.

With those introductory remarks, I remind all of us that we have work to do, that our session will end in “X” minutes (I meet with clients for 50 minute sessions), and I encourage them to tell me how they hope I can be of help. I am careful to have both members of the couple speak about their own perspectives and to summarize my impressions of what seem to be the most pressing issues. I am interested in knowing how the couple has already tried to address their challenges and what successes and difficulties they have encountered. That will more than fill up the first session, and probably will spill over into subsequent sessions as well. Before ending, I ask the couple how they are feeling about the time we spent together today, whether they would like to return and, if so, whether this is a good time for regular future appointments, and whether I can look forward to having both of them at subsequent sessions. I tell them that after a few sessions I should be able to give them some idea of how many meetings we may need in order to address their concerns, and I express my appreciation for their openness in sharing with me today the challenges they are facing. I ask if they have any questions for me, which I try to answer as succinctly as I can.

I do not think of myself as a therapist who lets my clients entirely drive the counseling process. I tend to be fairly interactive in offering feedback to clients on their skills and resources. I am respectful of the social work edict “Start where the client is and stay with him/her.” To me this means that I should be respectful of where my clients want to focus, but it doesn’t prevent me from testing whether they are ready to be pushed to new places. If they have had an infertility intervention for months that isn’t working, I am likely to push them to ask their physician to make a plan with them that includes how long to continue with one intervention before moving on to a different one. If they have spent many dollars and many years on infertility treatment, I may revisit an earlier statement that they won’t consider adoption or a surrogate, by asking if they would consider collecting information about either of their previously rejected options. If I see areas of difficulty on which they have not asked for my help, I may make an observation that such-and-such an issue seems to be an “elephant in the room,” and I am wondering whether there is a reason they haven’t felt ready to examine it. So, even as I try to stay apace with my clients’ issues, I also push and prod a bit, just to see whether new growth and resilience enables them to feel resilient enough to consider new directions. If not, I step back, and I am not surprised when, weeks later, they may raise the question of the proverbial elephant for future examination.

So, for those of you who are contemplating seeking counseling for any of your infertility issues, I hope that my own disclosures about the way I think of the counseling experience will help you in your own interactions with a therapist. Keep in mind that not everyone shares my perspective that client partners are the first choice when providing counseling, nor that the families of the couple may be the “elephants in the room,” nor that the therapist takes as active a role as I do, nor that assertive behavior with health care providers is a place for therapeutic intervention. But all therapists should be able to be clear with you about areas in which they can offer new knowledge and skills, how they observe confidentiality, and their comfort with the ever-so-present issues of loss and mis-communication.

Source: Connie Shapiro, PhD

Read Full Post »

Is Secondary Infertility on The Rise in the US

When thinking of infertility, everyone turns to women who don’t have children. But what happens in those cases when a women already has a child, or two and is going through years of pain and anguish from being unable to conceive again?

Inability is generally measured as no success after one year of trying if you’re under 35, or six months of trying if you’re over 35. It can be caused by reductions in fertility due to age or there can be a variety of reasons for secondary infertility.

Thyroid problems play a big part in this, an STI, or ovarian cysts. And lets not overlook that woman’s tubes can be blocked after the previous delivery.

Doctors take this issue lightly, or at least they did. If after years of trying women goes into unexplained miscarriage she is sent home with little or no explanation. The easiest way to explain is always “a generic disorder”. But no one ever explains what causes it in healthy couples.

Today more than 80% of American women suffer from thyroid problems, starting as early as teen years. Only 30% are treated with medication and are provided help. For the remaining 50% there are unexplained health problems that can cause:

Unexplained female problems (tumors, fibroids, ovarian cysts, endometriosis, PMS, cramps, (dysmenorrhea), amenorrhea, female cancers, spontaneous abortion, cyclic seizures, dry vagina and infertility), weight problems (usually high, sometimes low), gallbladder disease (six times higher in women with excess estrogen or on birth control pills or ERT), heart disease, cancer, colon problems, low blood sugar, attention deficit disorder (ADD), adrenal exhaustion from excess secretion of adrenaline, and osteoporosis (from excess estrogen leading to excess adrenaline and then to excess cortisol), depression.

The screening blood tests provided in the hospitals for thyroid are only 30% accurate, which leaves all those women sent home without any explanation on why they are going trough so many health issues. It is common for a hypothyroid person to have a completely normal thyroid panel.  This is why the Thyroid Panel is considered by many to be inadequate. They are mostly treated for something that has nothing to do with the issue at hand.

It is common for a hypothyroid person to have a low TSH value, which is usually interpreted as hyperthyroidism, not the reverse, despite many symptoms of low thyroid (depression, dry skin, weight problems, chronic infections, female problems, hair loss, low blood sugar, and so on).

TSH tests are not as scientifically accurate as they need to be. TSH tests are not as high in sensitivity as the tests that identify if you have anemia. If you are told by your doctor that your TSH test came back normal despite all your symptoms talk to him about more testing. Let him know that you are informed about test not being as high in sensitivity and specificity as red and white counts.

There is a sophisticated test to reveal even mild low thyroid and it is the TRH (Thyrotropin Releasing Hormone) test. This test requires an injection, followed by one or more blood draws at 15, 30 and 45 minute intervals. This test is accurate, but is expensive and inconvenient for both patient and the lab.

If you are experiencing secondary infertility, or you have had an unexplained miscarriage talk to your doctor, ask questions about the possible health problems such as thyroid problems, an STI, tubal blockage, or ovarian cysts. Seek more tests, and look at the issue from every possible way.

Source: Suzana Uzelac (aka Firefly)

Read Full Post »

Is Chemical Exposure a Cause of PCOS?

Did you know that over 80,000 chemicals have been released into our environment? It’s scary that no one has tested all of these 80,000 chemicals to determine their effect on your health. No one has performed medical studies to find out how all these 80,000 chemicals interact with each other or how they interact inside your body, or what their combined and cumulative effect is on your health.

Folks, we are in the middle of a chemical crap shoot. No one knows how this will turn out. But the limited research so far is mostly bad news.

Here is a recent example: a chemical called “bisphenol A” and its possible relationship to PCOS.

Bisphenol A (BPA) is sometimes referred to as an “endocrine disruptor” or “hormone disrupter”. This chemical is found in numerous consumer plastic products and canned foods to which you are exposed.

The University of Buenos Aires in Argentina recently completed a study of rats exposed to BPA. The researchers exposed baby female rats to BPA.

When the female rats became adults, they discovered that their BPA exposure was associated with increased testosterone and estrogen, and reduced progesterone. This is an unbalanced hormone pattern commonly seen in women who have polycystic ovary syndrome.

In addition, the exposed female rats had much reduced fertility. Also, their ovaries had large numbers of ovarian cysts.

If it can happen to a rat, can it happen to you? Think of the rats as canaries in a coal mine. If the canary dies, the miners are in trouble. One recent study showed that 99% of pregnant women had at least one urine sample with detectable levels of BPA. That’s 99 of every 100 women!

Even though it’s invisible, you can start by reducing your exposure to BPA. It is used in a multitude of hard plastic products such as water bottles, food containers, infant bottles and medical equipment and supplies. BPA may also be found in the lining of canned foods and in many other non-obvious products such as thermal-printed cash register receipts and some dental sealants.

We suggest that you reduce the use of canned foods and eat more fresh food instead. Try to use glass containers instead of plastic for food, water and beverages. Don’t use plastic bottles to feed your baby; use glass instead.

Finally, it is critical that you improve the quality of your diet. Why? Because a diet that is free of chemicals as a diet can be is the best option.

Source:
Fernandez, MO et al, Neonatal Exposure to Bisphenol A and Reproductive and Endocrine Alterations Resembling the Polycystic Ovarian Syndrome in Adult Rats

Read Full Post »

How many Embryos is Enough?

So you’ve gone through the entire IVF cycle, jabbing yourself with needles several times a day. Dragging yourself to your doctor’s office for what seems to be a dozen visits and blood draws.  You survived the egg retrieval and are still a bit sore and bloated.  You’ve anxiously awaited word from the clinic for the fertilization report the next morning. but now you’re past that. Now it is time to go to the clinic for your embryo transfer. Then it hits you, more than it has in the past, that you have to decide how many embryos you are actually going to have transferred.  You’ve thought about it before, even had discussions with your doctor, but suddenly the risk of getting pregnant with twins or triplets or not getting pregnant with a single embryo transfer seems much less of an abstract risk.  You ask yourself, “Am I making the right decision?” What is the “right” decision? What is the magic number?

The good news is that in the United States the decision of how many embryos to transfer is left to the patient and her doctor.  That’s not so in many European countries…however the costs are less in other countries.  The risks and expense of pregnancies with multiples is used as a rationale for limiting, by law, the number for embryos that may be transferred in other countries.

Since they have gotten better at IVF the number of high order multiple (HOM) pregnancies have decreased.  Before the success rate was only 15-20% so doctors would often transfer three, four or five embryos in the hopes that one would stick.  This resulted in not many getting pregnant but the ones that did had multiples.

So back to the original question….there is not one number that is right for every patient, and this should be an individualized decision.  There are guidelines however which states the greater your chance of pregnancy the fewer embryos you should have transferred.  Three main factors are: 1) age, 2) stage of embryo development, and 3) prognosis. The guidelines are strongly encouraging transferring only one embryo in those felt to have the highest chances for success.

So I wish I could be more specific in my answer but the bottom line is discuss your success rates with your Dr. and multiple pregnancy rates for that specific clinic. Sometimes it will be more clear and other times it will be more difficult.

Good luck to you all!

Source : Resolve.org Dr. Frederick Larsen

Read Full Post »

11 Tips to for a Better Life During the Infertility Journey

1) Take a 10-30 minute walk every day and leave your cares behind. Have a spring in your step and smile. If you encounter someone, smile or say hello.

2) Sit in silence for at least 10 minutes each day. Talk to your God about what is going on in your life.

3) When you wake up in the morning complete these statements: ‘My purpose is to__________ today. I am thankful for______________’

4) Don’t compare your life to others. In spite of appearances, you have no idea what their journey is all about.

5) However good or bad your situation is, it will change. Nothing stays the stagnant, time moves forward.

6) No one is in charge of your happiness except you.

7) Make peace with your past so it won’t spoil your present.

8) You don’t have to win every argument. Agree to disagree, or simply accept the other person’s perspective for what it is and move on.

9) Remember that you are too blessed to be stressed.

10) Life isn’t fair, but it’s still good.

11) Your job won’t take care of you when you are sick. But your friends will. So stay in touch!

Source: PCOS review

Read Full Post »

When to decide to get more aggressive with Fertility Treatments?

This is probably one of the hardest decisions a couple going through infertility has to face.  When do you decide to get more aggressive with treatments and how far are you willing to go?

There are many factors that go into this decision process and the number one would be your age.  The older you are the more aggressive you might want to be considering since time is a factor and these treatments do take some time just to get them started.  Another important factor would be diagnosis, if there is one yet.  Many times it takes going through more aggressive treatments to figure out exactly what is going on but also depending on your diagnosis it can determine whether you would be a good candidate or not.  Don’t waste months being in denial of your situation and not getting your standard tests completed. Too many times couples wait and then find out it might have been a simple fix or maybe it is not but at least they know the answer.

The next factor would be financial, and given most insurance companies cover little infertility costs this is something to take into account.  I firmly believe this should be treated like any other disease and women should get coverage on treatments within reason.  There is no need to put a 40 year old through 3 IUI’s before she can try IVF meanwhile wasting another 3-4 months and possible more loss. But that is the state of our affairs currently.

Of course the treatments are extensive and mentally challenging, but with the right support systems and coping skills you can manage it.  I highly recommend getting all the support lined up from the beginning of deciding to go down this journey.

Sit down with your spouse and have an honest conversation about what each person wants out of the process. How long are you both willing to do this? How much money are you willing to spend?  How far will you go medically?  Would you do IVF, surrogate, donor eggs, adopt ect?  Before you rule out anything, get the facts to make an educated decision.  Every option won’t be right for every couple, but it’s important to either get united on your stance or compromise.  You can’t do this alone, you need each other to support and cheer you on to the next level. It is taxing on the relationship and can be more so if you aren’t in agreement on the timeline or treatment plan.

Most of all have faith and believe it can happen. I have seen the impossible happen!

Read Full Post »

What does mindfulness got to do with Infertility?

So, you may be asking, what does mindfulness got to do with it and how is it supposed to help my situation?  Great question and this just dawned on me the other day while I gave a mind and body talk for Resolve.

Here’s some definitions of mindfulness:

Mindfulness, a deceptively simple way of relating to experience, has long been used to lessen the sting of life’s difficulties, especially those that are seemingly self-imposed. “a moment-by-moment awareness” Mindfulness lies at the heart of Buddhist psychology. Mindfulness is a skill that allows us to be less reactive to what is happening in the moment. It is a way of relating to ALL experience-positive, negative, and neutral-so that our overall level of suffering is reduced and our sense of well-being increases.

So whether you are going through this journey or not Mindfulness is a great tool to deal with suffering and pain in all areas of life. It just so happens that there has been a lot of research done on what helps women and couples go through this infertility journey and Mindfulness is one technique or practice that is getting a lot of attention.

I have to admit I wasn’t very mindful prior to my infertility journey, but now I embrace the moments I have and it has helped me tremendously in dealing with all challenges in life.  Usually whatever is happening NOW is ok and we can handle. So if you can get out of your head chatter, out of the what if’s and the should of, would of, and could of…then you will be better off.  And in the end isn’t happiness what we are all looking for?

What are examples of Mindlessness?

-rushing through activies without being attentive to them

-breaking or spilling things because of inattention

-failing to notice subtle feelings of physical tension or discomfort

-forgetting a person’s name as soon as we have heard it

-being preoccupied with the furture or past

-snacking without being aware of eating

The more we stray from the present the more we suffer. Mindfulness can help us to step out of our conditioning and see things freshly- to see the rose it is. This is why most professionally lead infertility support groups incorporate Mindfulness practices into their groups.

We are re-starting our group here in the next 2 weeks, but new members are always welcome to come along during the ongoing group to get started.  We don’t want you to have to wait to get support.

Read Full Post »