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Posts Tagged ‘infertility counseling’

When you’re coping with infertility, certain comments and experiences can bring that pain to the forefront. Well-meaning remarks, family-focused events and sometimes even being around friends with babies can be painful when you’re longing to have a little one of your own.

Friends and family who have not experienced infertility have good intentions, but often don’t understand how sensitive the situation may be. Truthfully, navigating the waters can be incredibly difficult for aspiring couples, as well as their friends and family. Here are 12 tips to help all parties build strong, supportive relationships.

6 Tips for Couples Coping with Infertility:

  1. Anticipate when you might see children at events. If it’s too painful to be around youngsters, consider arriving just in time for the main event and not earlier.
  2. Consider social invitations carefully.  You have no obligation to go to parties and events heavily attended by children or pregnant women, especially if it’s too difficult emotionally. When in doubt, decline.
  3. Be prepared. Plan an answer ahead of time should someone inquire about your intentions to have children. While relatives and close friends will understand, couples are under no obligation to discuss personal details about their infertility experiences.
  4. To hold, or not to hold? Holding a baby for some can bring hope, while for others it can be incredibly painful. Everyone may want to share in the joy of a baby as do you, but you must always listen to your personal needs first.
  5. Focus on your relationship with your partner and spending quality time together without discussing family planning. It could be a ski trip or a romantic getaway, or a simple date night.
  6. Concentrate on friendships with couples who don’t have children. Surrounding yourself with couples who aren’t child-centric can ease the pressure of what you are facing personally. Plan to spend time with couples or friends who don’t have children should child-filled gatherings become too much to bear.

6 “Infertility Etiquette” Tips for Friends & Family:

  1. Show support. A helpful hug and encouraging statement can make a world of difference. Spend quality time together and make plans without children as the main focus.
  2. Don’t complain about your own past or present pregnancy. Couples dealing with infertility hope for the day they can worry about pregnancy woes.
  3. Avoid minimizing the problem by discussing parenting struggles or saying “there are worse things that could happen.” Until you are in a couple’s shoes, you are unable to understand how difficult infertility can be.
  4. Stay away from offering advice or tips for a couple looking to conceive. Topics such as exercise, food and lifestyle are off limits. If they are seeing a physician, they are already aware of your suggestions. Couples coping with infertility also often cope with the unjust blame they place upon themselves. No need to increase the burden.
  5. Never say: “Just Relax.” Everyone has heard it before – just relax, if it is meant to be, it will happen. But looking at a couple’s situation and reducing it to a simple statement is insensitive and careless. If couples have tried unsuccessfully for more than a year to conceive, doctors consider couples infertile. While stress often appears to be a contributor, the human reproductive system is complex and affected by a number of biological and physical factors.

Don’t push adoption. Each couple has their own approach to family building, and are well aware of their options. This is a tough topic to navigate, and pushing your opinion may not help them make a decision.

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Women who fail to become pregnant after undergoing in vitro fertilization treatment often grapple with the decision of whether to try IVF again. It’s a difficult one to make: The procedure carries hefty financial, physical and emotional costs, and there are no guarantees it will work.

Now a team of Stanford University School of Medicine researchers has developed a model to predict the outcomes of a subsequent round of IVF for those women who have already gone through a cycle. The researchers found that their test, which relies on taking clinical data from prior, failed treatments to provide more personalized predictions, is 1,000 times more accurate than the age-based guidelines currently used to counsel patients.

“Our findings show that the first IVF cycle can provide quantitative, customized prediction of the live birth probability in a subsequent cycle,” the researchers wrote in their paper. “This concept is radically different from the current paradigm, in which age is a major predictor.”

The paper, published online July 19 in the Proceedings of the National Academy of Sciences, was led by Mylene Yao, MD, assistant professor of obstetrics and gynecology. It follows previous work from Yao about another method she and her colleagues had devised that provides more accurate predictions about whether a woman undergoing IVF treatment will become pregnant. The newer test not only integrates more data into its methodology, but also its success was measured with a different outcome: live birth instead of pregnancy.

Yao said she’d like to see the new test widely available for clinical use, and she and co-author Wing Wong, PhD, professor of statistics and of health research and policy, have founded a company, Univfy, to develop and market prognostic tests to support clinical decision-making in infertility. Stanford holds the patent on this test.

Each year, close to 100,000 IVF cycles are performed using a woman’s fresh eggs, and around 29 percent of the treatments result in live births. Physicians typically use age-based data, with adjustments based on other clinical factors, to counsel patients on the probability of success. But given all the factors at play — including the number and quality of eggs and the total number of embryos implanted — age may be misleading as a prognostic factor.

Consider this scenario: A 38-year-old patient is told that women in her age bracket have a 33 percent chance of becoming pregnant from IVF. But because she has a lower-than-usual number of eggs, her physician says her chances are actually less than 33 percent. “The problem is that the patient will ask, ‘How much less?’” said Yao. And currently, the answer is at best an educated guess from the doctor.

Co-author Lynn Westphal, MD, an associate professor of obstetrics and gynecology who treats patients in Stanford’s Reproductive Endocrinology and Infertility Center, said a woman’s decision to repeat IVF is influenced by several factors, including financial considerations and her chances of becoming pregnant. “Many patients, even if they have insurance coverage, will drop out — either because they don’t understand what their odds are or they find it’s a very emotionally challenging experience to go through,” she said.

Westphal said improvements in the ability to predict a patient’s chances of IVF success would make counseling more meaningful. “The more information, the better,” she said.

It was the goal of Yao, Westphal and their colleagues to develop a way to provide patients with more personalized predictions. They took data from 1,676 IVF cycles performed at Stanford Hospital & Clinics between 2003 and 2006 and identified 52 factors — such as patient age, levels of certain hormones, number and quality of eggs and individual characteristics of each embryo — that influence a woman’s chance of having a baby. They then developed a computer model that sorted patients into subsets defined by similar clinical characteristics (so-called “deep phenotyping”) to predict live-birth probabilities in a subsequent round of IVF.

When testing their model with data from a separate set of more than 600 IVF treatments performed in 2007-08, the researchers determined that the model’s predictions were significantly different than the age-based predictions in 60 percent of patients. Interestingly, out of this group, more than half were assigned greater odds of having a baby than what age-related data indicated.

What’s more, in further verifying the accuracy of their new method, Yao and her colleagues determined that their model predicted outcomes with 1,000 times more accuracy than the age-based guidelines widely used in clinics.

Their findings, the researchers said in the paper, indicated that “the current age-based paradigm may provide misleading live birth outcome probabilities for a large portion of patients.”

Yao noted that because it’s critical to have data from previous treatment, this model wouldn’t be able to predict chances of success for those embarking upon their first IVF. But she said having personalized, accurate prognostic information would be invaluable in assisting women’s decisions to keep going or not. “For some of the patients, we may be able to reassure them and help them move forward and do another cycle if they have good odds,” agreed Westphal. “For other patients, if they’re in a poor category, we’ll help them move on to consider better options.”

Source: The first author of the paper is Prajna Banerjee, PhD, a postdoctoral scholar in obstetrics and gynecology. Other Stanford co-authors include Bokyung Choi; Lora Shahine, MD; Sunny Jun, MD; Kathleen O’Leary; and Ruth Lathi, MD. Funding came from the National Institutes of Health and the Coulter Foundation Translational Research Program at Stanford University.

More information about Stanford’s Department of Obstetrics and Gynecology, which also supported the work, is available at http://obgyn.stanford.edu/.

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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

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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

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I am frequently hearing from my clients their concerns about doing IUI or IVF are primarily because of the stress it puts you through emotionally and physically.  Most of these concerns are a result of what others have experienced and have either shared with these women or posted online somewhere.  In my experience we are more likely to hear the horror stories rather than the good ones. So I am writing this post to discuss how to keep your head screwed on straight during the treatment cycle and how to have a positive experience.  You may be thinking, yeah right that’s not possible. But it really is and from personal experience with IVF recently you can do it!

First word of advice is to not compare yourself to anyone else who is going through or has gone through IUI/IVF.  We all have different reactions to medications and no one’s experience is identical to another.  Also we tend to follow in people footsteps when we hear about how badly it went for them. We then anticipate a horrible experience, work ourselves up and therefore, have a horrible experience.  So avoid chat boards with negative stories and avoid getting other peoples opinion other than your Dr. or therapist.

Next I would suggest to make sure you are getting the support you need.  That may be going to a support group or getting your own individual therapy in order to have a place to process your anxiety.  Getting the fears and anxieties off your chest can make for a much easier experience and being able to connect with others in a group is extremely validating.

Focus on the miracle you are making everyday rather than the negative aspects of the medication or the fact that you have to resort to extreme measures to achieve pregnancy.  It’s a miracle how far fertility treatments have come and some of us would never have the opportunity to get pregnant if it wasn’t was the advancement in science. So remember how lucky you are to even be able to get to take advantage of it…some people just can’t afford it and therefore their journey stops there.

Take care of yourself whether that would be giving yourself time to be alone and read a book, take a nap, go for a run, or get acupuncture.  Make sure you are doing something for yourself daily and it can be just taking 20 minutes to focus on your breathe….just make sure you do something.  This is the time to baby yourself and enjoy your body and the miracles it brings you on a daily basis.

Again this doesn’t have to be the worst experience ever.  I wouldn’t sign up for it as a good time, but I don’t think it has to be dreaded and you definitely don’t want to go into this IUI/IVF experience thinking you will fall apart.  Good luck to you all, you are true warriors and what great parents you will be after going through this journey!  Be proud of yourselves!

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Are you letting this “infertility” battle take control of your life and ruin it? Are you losing sleep over your fertility issues and withdrawing from life?  Don’t worry, I have been there too. 

There so many people who may not know if they are infertile. However, chances are high that if you have had some problems getting pregnant, then thoughts of whether you can really conceive and give birth to a child must have crossed your mind, at least at some point in your life. You will surely question why, or what’s wrong and wonder whether you could be infertile.

You ask, yourself what the signs of infertility may be or think I am over 35 and my odds are going against me. Time is running out!  You begin to think that your dreams of having children may never happen. Your emotions can really get to its worst and then you become desperate, mad, totally stressed out and go into despair. For God’s sake, don’t let that happen to you! If you think that you are infertile, what you should do is try to learn everything you can on this subject.  The trick is to not let this consume you and ruin your life. Easier said then done, right. Not really, only if you “think” it is too hard will it be.

In my Oakland bi-weekly “fertility” group we are working on “letting go” and to not continue to focus on what we are lacking but more on what we have now, today.  All we have is today and if we are in our heads about tomorrow or yesterday then we are missing the beauty of life today.  I truly believe that being mindful during this process is the key to being able to handle it and successfully getting pregnant.  But you need to come to a place where you are okay with either way it works out. You don’t “need” a child, you only “want” one…that is the goal that I want the women in my group to walk away remembering.  I am a licensed MFT therapist in the East Bay area who has been practice since 2000 and have had a personal journey with fertility issues.  Trust me, I get it. 

If you are interested in more information about this topic, individual therpay, or our groups, please contact Amoreena Berg at 650-224-1796 or email amoreena@gmail.comwww.amoreenabergmft.com

Baby Dust to you all in 2010!

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My practice is fortunate enough to be in a holistic wellness center that has wonderful practioners of all types.  Because of this I am able to offer unique packages to my clients at reduced rates.  Currently I am running a great special on first time clients with an intial consult for 1.5 hrs and a 30 minute massage (by a professional massage therapist) following our appointment!! This package is $130!  Ongoing massages from any of the therapists will be discounted if you are a client of mine.  So take advantage of this opportunity.

There are a variety of ways to relieve stress, depression, and anxiety. Traditionally talk therapy is extremely helpful, but along with other modalities the recovery rate is much higher.  I believe in treating the body as a whole instead of parts which is why I practice at a center that offers all these options.  If you are interested give me a call or email at 650-224-1796 or amoreena@gmail.com.

Happy Thanksgiving!

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