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What is considered infertile? If a couple has been actively trying to conceive a child for a year or more without success then it is possible one (or both) of them is infertile. Realistically a couple must also ensure they’ve tracked the woman’s cycle correctly and had the proper timing of intercourse around ovulation.
When a woman is faced with infertility it can be very stressful and she may find it difficult to believe she will ever become a mother. It may even put a strain on her marriage since it tends to take over a couples’ life. It is common that everything in their lives revolves around getting pregnant. The rollercoaster of emotions is tiresome especially if she has gone through multiple fertility treatments and hormone testing and still sees negative pregnancy tests month after month. This process is very disheartening and can discourage a couple.
Primary infertility refers to the inability to conceive or maintain a pregnancy.  If a woman has experienced a miscarriage or recurrent miscarriages then this may play a role in determining her fertility. Secondary infertility means a couple is having those same concerns after having a successful pregnancy.
There are several fertility treatments that a woman may receive which includes in-vitro fertilization (IVF), fertility drugs, surgery, and intra-uterine insemination (IUI). Acupuncture is a form of Chinese medicine that has been around for thousands of years and can be used solely as an alternative treatment for infertility or used in combination with those mentioned above.
Women in the Bay Area who have been struggling with infertility may find it reassuring to visit East Bay Acupuncture Clinic who specializes in fertility care. They are compassionate towards women who are dealing with this challenge. Their facility is located in Oakland near Kaiser and Alta Bates Hospital.  Within the next few weeks they will be launching an infertility support group that I will be facilitating along with individual therapy sessions as part of the clinic’s optional treatments.
Kim Shaieb
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“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, Prozac®, 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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Is fertility treatment really the emotional roller coaster I keep hearing about?

For most people, it is. While undergoing fertility treatment, many couples tend to live in month-to-month cycles of hope and disappointment that revolve around ovulation calendars and menstruation.

As they navigate a tight schedule of tests and treatments, they place their lives on hold — postponing vacations, putting off education, and short-circuiting their careers. Others find that the sorrow, anger, and frustration that can come with prolonged fertility problems invade every area of life, eroding self-confidence and straining friendships.

Realize and accept that you and your partner will have some ups and, most likely, a great many downs as you deal with your fertility problem. Examine your commitment to becoming parents and consider joining a support group if you decide to go ahead with treatment. Connecting with others in your situation is extremely important!

Why do women seem to suffer so much more than their male partners?

Most women are raised to think that they’ll become mothers someday. From the first baby doll to the last baby shower, girls and women are surrounded by images and expectations from parents, peers, religion, advertising, and the media.

For some women, motherhood is a large part of their self-image as a female. For others, it’s their highest ambition. Even women who don’t necessarily want to become mothers are aware of social expectations to do so.

The pressures to marry and raise a family can be enormous — to the extent that women who are unable to do those things can feel as though something must be deeply wrong with them or sorely lacking in their lives.

Men are not pressured in the same way to become fathers. And many men are brought up to repress their feelings or at least keep them to themselves.

A man may be feeling similar frustration and disappointment as he and his partner go through yet another treatment and yet another month without a pregnancy. But many see their role as being strong for their partner. Or they may be so used to holding in their feelings that they don’t know what they feel or that they can ask for help.

If the fertility problem is clearly his, such as poor sperm quality, then a man’s image of himself can start to suffer.

Studies show that, as a group, women with fertility problems are as anxious and depressed as women with cancer, heart disease, or HIV. One reason for this may be the physical demands of fertility treatments — blood tests, pills, daily hormone injections, ultrasounds, egg retrievals, and surgery can all be a source of stress and emotional upheaval in women.

Also, society often fails to recognize the grief caused by infertility, so people denied parenthood tend to hide their sorrow, which only increases their feelings of shame and isolation.

Our love life seems so mechanical now. Does this happen to other couples?

Yes. Many couples say that once they start worrying about having a baby, sex becomes more of a chore than a pleasure. Most fertility treatments require you to make love at very specific times — hardly an ideal way to set the mood for romance or enjoy sexual spontaneity.

If you find your sex life deteriorating and yourselves unable to remember the meaning of romance, take a break from your treatment regimen for a month or two and try to revive the love and fun that brought you together in the first place.

Keep in mind that this crisis is temporary — sooner or later, it will be resolved, and once it is, you’ll want to continue a healthy, fulfilling sexual relationship with your partner. For now, if difficulties persist, consider couple’s therapy with a counselor who has experience with fertility issues. Look for a referral through RESOLVE, the American Society of Reproductive Medicine, or the InterNational Council on Infertility Information.
Learn how to avoid the most common pitfalls for couples facing fertility problems.

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When you are experiencing infertility, communicating with family and friends can be difficult and challenging. Even the most caring relative or friend may offer a “helpful” suggestion that will appear wildly insensitive to you.

Here are some tips for talking about infertility with family and friends, if you decide to do so.

  • Decide how much detail you and your partner want to share. Respect each other’s need for privacy about certain details.
  • It may help to rehearse exactly what you are going to say. Decide on specific words or phrases to use, such as of ”infertility” or “we are trying to get pregnant and seem to be having a problem”
  • Pick a time to talk when people are not rushed or distracted. Make sure it is a private place where you won’t feel embarrassed to show emotion.
  • Explain that infertility is a life crisis, and that 1 in 8 couples, or more than 7 million people experience it
  • Let them know how they can support you—whether you want phone calls, questions, etc.
  • Explain that you may need a break from family gatherings, and that it isn’t about them—it’s about using your energy wisely.
  • Tell them that you will share results about a treatment or procedure when you feel up to it, and not to ask about pregnancy tests or treatment results.

The following are scenarios that many of our members have found themselves in and responses you can use when you are asked a sensitive question.

What they said…
When are you going to stop concentrating on your career and start a family?

Response A:
“I don’t believe my job and a family are mutually exclusive. My career is advancing, and I’m very proud of my work. When we feel the time is right, we will consider starting our family.”

Response B:
“Right now I have two careers: one is my job which you know about and the other is trying to become pregnant. You probably wouldn’t believe how exhausting and time-consuming infertility treatment can be; it really feels like a second job.”

What they said…
“You used to talk about combining a career and a family. How are those plans coming along? Will we ever get to be grandparents?”

Response:
“I truly hope that someday you will have grandchildren. Whether I have children biologically or through adoption, I look forward to sharing that happiness with you.”

What they said…
“I wish you’d take one of my kids—they drive my absolutely crazy!”

Response A:
“Oh thanks, then they’d drive me crazy!”

Response B:
“I know that parenting is a really difficult job, but I’m really looking forward to that challenge and experience.”

What they said…
“You can always adopt.”

Response A:
“Adoption is an option I am considering. I have to resolve some medical issues and must grieve the loss of the possibility of not having a biological child before considering adoption.”

Response B:
“I have considered adoption very carefully and have decided it is not for me, and am considering a childfree life, if I am unable to conceive a child.”

How to deal when someone close is pregnant “Guess what? I’m pregnant!”

These are the hardest words to hear from a friend or relative. The best you can do with this one is explain why you are unable to celebrate wholeheartedly.

Response A (keep it short and sweet):
“That is great news. Congratulations.”

Response B:
“I’m happy for you, but it is difficult to hear when I cannot get pregnant. That is a really tough time for me, so please understand if I am unable to attend your shower or listen to your happy moments. I am working through my infertility, and the pain is still great.”

Resolve.org

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Setbacks and frustrations are a part of everyday life. Sometimes it’s really easy to slip into a negative mindset and look at things from the perspective of “what I don’t have”.

The problem is that a negative mindset impairs your ability to effectively deal with infertilty. For one thing, it may cause an increase in stress hormones, which can worsen PCOS-related symptoms or infertility issues. A negative outlook can also contribute to depression.

It’s natural to focus on what went wrong in your day and forget about what went right. A good way to counteract this tendency is to focus on what’s right in your life and the things you can be grateful for.

Start a gratitude journal and, each day, write down five things that you’re thankful for. Do this for at least two weeks and notice how much better you feel.

Take any notebook and turn it into a journal that’ll be a record of all the things that make you happy.

Fill the first few pages of your journal with the following wonderful details about:

Positive thinking has power and practicality.

1. Your family.

Think about why your family members are special to you. Is your mom funny? Is your dad an advice champ? Is your sister sweet? If your family treasures conversations over dinner, then write that down. You could also highlight the traits that your clan is famous for. Think about the things that make you proud to be part of your family.

2. Your friends.

What endears your friends to you? Do they make you laugh when you’re down? Do they keep your feet on the ground? Remember the times when you realized that the bond you share had a profound effect in your life. Pick moments where your friends proved that they would be there for you no matter what.

3. Your home.

The place you live in may not be perfect, but surely there are things you love about it. Maybe you take pride making your home livable, comfortable or stylish? Think about the memories that you made in your home. Did you have an impromptu party with your friends one night? Did you have a blast trying to paint your walls? Every home has happy moments that should be relived.

4. Your work.

Work is often associated with stress. But that’s not all there is to it. Your job is where you acquire new skills. You get a chance to learn from a mentor and, perhaps, be one yourself. You also bond with the people you work with. Your workplace offers a lot of silver linings despite deadlines, marathon meetings or difficult clients. Write down what makes your workday worth it. Is it the lunchtime chats with your workmates? Or is it the sheer joy of loving what you do? In this way, you’ll see your office as a happy place. Write down the things that make you look forward to work.

5. Your neighbors.

Even if you aren’t that chummy with your neighbors, they play a part in making your life pleasant. Maybe the mother next door always tells her kids not to bother you when you go out for your run. Perhaps, the nice man two doors down recommended some reliable dog walkers to you. Or maybe you like the fact that the family living across the street just minds their own business. These are neighborly niceties that you may overlook.

You can go on to write about the things that you’re grateful for in other aspects of your life. You’ll realize that your blessings outweigh the setbacks.

You’ll see that your life is actually more wonderful than you think. The fact that you have so many good things going for you will help you keep your chin up. You only need to go through the pages of your gratitude journal when you’re feeling blue.

And it will help you better manage your infertility issues too!

The PCOS Review

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More men may be firing blanks

Increasingly, doctors are seeing a rise in male infertility as well.“Male infertility now contributes 35 to 40 per cent of all cases that we see,’’ said Dr Selvaraj. Low sperm count, erectile dysfunction and a low libido could all lead to low fertility levels, she said. While Dr Dinakaran placed the figure at 30 per cent, she too agreed that this seemed to be on the rise. More men were becoming diabetic and getting hypertension at a young age, often in their early thirties, Dr Dinakaran said.Incidence of diabetes in the city now stands at nearly 17 per cent. “Earlier it always used to be women who would be blamed for the inability to conceive, but families are beginning to realise that there could be problems with men as well. At least, in cities, the realization has sunk in. “In rural areas, even now, the woman is held responsible. The man can always marry again and it is socially acceptable,’’ said Dr Dinakaran, relating the case of a man who married three sisters all of whom were unable to conceive. In the end, a hospital test confirmed his infertility.“The work environment, pressure and the intensely stressed out lives men lead – all contribute towards this. If they have diabetes or hypertension, it just adds to the difficulty in conception,’’ said Dr Dinakaran, adding that expectations were now higher than ever. Lack of a nutritious diet and exercise exacerbated this. Heat generated from sitting too close to computers or laptops may also be a possible factor, Dr Dinakaran added.

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