Navigating the Beta Test / (2WW)

Waiting to find out if you are pregnant is stressful, especially after IVF or FET. To keep the beta test result wait from completely taking over your life, make a plan of action in advance. While there is no way to not think about becoming pregnant, it is helpful to find comforting distractions and reduce obsessive thoughts. Most beta test days are typically 10-12 days post-transfer, then there is a secondary wait for the actual beta result, which can seem unbearable.

Use mindfulness to help let go of what you can’t control. You can’t control the outcome, but you can control your response. Find a mantra that helps, such as ‘so far, so good’ or ‘my body is ready to be pregnant’ to ground and center yourself.

Try to control obsessive thoughts re pregnancy symptoms, and resist the urge to take a pregnancy test before your beta hcg test. It’s truly too early to tell.

Stay busy: connect with friends; spend time with your partner not focused on pregnancy; practice calming rituals; do creative projects; deep breathe; get outside into nature; clean your house; or distract with reading fiction or watching relaxing media.

If you find yourself obsessing too much in unhealthy ways, give yourself up to 10 mins/day to structure formal worry time to express or write down all of your worries and then let go and move on with your day.

Sitting in uncertainty is challenging; waiting to find out if you are pregnant after a long infertility journey even more so. Make sure to continue to live your life and be hopeful, open and curious to what may happen next.

Impact of Infertility on Couples

One in eight couples experience difficulties trying to conceive. Infertility is a major life stressor and treatment cycles can be intensely stressful on partner relationships. Many couples feel like their lives are on hold and struggle with communication challenges and relationship dissatisfaction during fertility challenges. Additionally, one member (or both) may experience anxiety or depression. Other influences on relationship strength include:

  • Impact of unsuccessful cycles and the passage of time

  • Feeling left behind or not fitting in with peer group

  • Financial stressors of fertility treatment

  • Different coping styles for handling stress (emotional release vs problem solver)

  • Reduced intimacy and emotional connection

  • Secrecy - not sharing struggles openly with family or friends

  • Intrusive questions by friends and family (and society in general).

How to approach the stress of infertility as a team?

  • Remember you have the same shared goal: to become parents together

  • Be open with one another and express vulnerable feelings

  • Ask directly for what you need from your partner

  • Discuss treatment options, including your physical and financial limits around trying

  • Understand the impact of infertility on intimacy

  • Continue to live your lives - find ways to connect and enjoy one another.


If conflict has increased to a high level, it can be helpful to meet with a therapist for communication help and overall relationship support during the added stressor of infertility treatment cycles.


The Challenges of Donor Anonymity

Our modern world makes it inevitable that donor anonymity is simply not possible. More donor-conceived children (and sometimes their parents) are turning toward direct to consumer genetic DNA testing to find a possible genetic link to 1) the donor, or 2) a family member of the donor, or 3) a full or half bio-sibling. This can create confusing boundaries and ethical considerations on potential contact and what to do with this information. The ability to quickly find donors on Facebook using donor agency profile information adds to this modern reality. Egg and sperm donation is a mostly unregulated industry. These unique ways of making genetic connections and the lack of true anonymity will ultimately change that.

Have you ever had to keep a secret? Or made a decision in young adulthood that with time and reflection, was understood differently? It’s helpful to consider that privacy expectations of intended parents or donors may change over time. When that happens, it can be challenging to look for ways to reach out and promote connection or rescind contact. This is where direct to consumer genetic testing has stepped in for better or worse — to fill this void.

For donor conceived children, finding genetic connection can be an important part of becoming secure in one’s identity. For donors, it can be an important part of making sense of a younger decision to become a donor and help build families. Let’s start reframing this path to parenthood as a family story with connectors from the onset. Note the difference in hearing ‘this is how we had help in becoming our family and there are others who were also helped’ versus one day being sat down and told about donor origins and bio siblings with no context and no additional information. Time will stand still at that moment. A family story with openness to conversations over a lifetime, figuring things out together, and sharing information offers fluidity, closeness and integration over time.

Infertility During the Holidays

This time of year can be especially painful for couples experiencing infertility. Many couples feel isolated at family holiday gatherings and wonder how they belong if they haven’t yet become parents. Some notice an intense focus of being the sibling without kids or feel a heavy heart from the loss of not providing a grandchild for their parents. Some worry about other family members feeling sorry for them or fear that others are secretly talking about their infertility situation. The year-end also represents the passage of time, and can heighten feelings of loss around not having a family. It’s also the darkest time of the year when people generally feel depressed or have low energy, on top of general holiday stress for the most ‘wonderful’ time of the year.

Here are some ideas on how to navigate this complex time of year.

Plan together ahead of time how to respond to unwanted questions about family building or unsolicited advice from others. Some couples create a code word or phrase to help each other exit uncomfortable situations.

Be selective about which holiday parties to attend and try to focus on adult get-togethers without young children present.

Give yourself permission to step outside or even leave an event if you feel overwhelmed.

Create rituals for you and your partner as a family of two.  

Spend time treating yourself or doing activities that you enjoy.

Exercise or at least get outside for a walk daily to have a release.

Make space for your feelings.

Turn to your partner and friends who can hold what you are going through for support.

Should You Freeze Your Eggs?

Are you considering freezing your eggs? The decision to freeze one’s eggs for the possible preservation of future fertility is subjective and full of complexity. Professional reproductive/medical organizations (ASRM and ACOG) have promoted oocyte cryopreservation for medical reasons (e.g. prior to chemotherapy treatment) for decades. However, fertility specialists and private egg banking companies have increasingly been promoting fertility preservation for elective reasons, such as delaying childbearing, making this option readily available to all women. 

The egg freezing process involves: 1) stimulation of the ovaries through hormone self-injections and monitoring follicle growth via ultrasound, 2) the egg retrieval procedure, which is quick and performed under sedation, and 3) the egg freezing procedure done through vitrification and subsequent storage of the frozen eggs. Remember, this is just the egg freezing process. You will later need to undergo the rest of the IVF process (using sperm from your partner or a donor to create embryos, and transferring embryos into the uterus) in order to become pregnant using frozen eggs. 

In making the decision, it is helpful to explore the numerous psychological, emotional, spiritual, financial and medical considerations involved in this process. Also look at success rates based on your age and fertility, as well as possible risks involved. Have an understanding that the procedure is invasive, that egg retrieval / freezing and storage costs are expensive yet separate from later IVF fertilization and transfer expenses, and there is no guarantee of future success. Take time to imagine how you would feel building your family this way, or what it may be like to be an older parent.

You should also consider the research: ACOG/ASRM studies have shown that the age of the oocyte (egg) at retrieval correlates with success rates, with viable studies ’supporting the use of these technologies in well-selected patients aged 35 years and younger,’ while ASRM/SART state that ‘even in younger women (under 38), the chance that one frozen egg will yield a baby in the future is around 2-12%.

There are many pros/cons to consider in making an informed decision. It can be helpful to meet with a reproductive mental health professional to explore feelings and navigate expectations and possible outcomes so you may make the best decision for yourself.

For more information and resources, check out:

Motherhood, Rescheduled: The New Frontier of Egg Freezing & the Women Who Tried It
by Sarah Elizabeth Richards

 

Decision-Making for Third-Party Family Building

There are many things to consider before moving forward with third-party assisted conception. One of the most essential tasks is understanding that having a child with donor assistance is more than just a solution to infertility. It’s considering the future child’s experience and needs,  as well as your own. Here are some questions to start exploring this path:

  • What are your assumptions about alternative family building? 
  • How would you or your partner feel about the absence of a direct biological link to your child? 
  • Have you processed feelings of grief around this genetic loss?
  • Would both you and your partner feel comfortable having a third-party involved in your family story? 
  • What is important to you in choosing an egg or sperm or embryo donor?
  • With genetic/ancestry testing and social media, do you believe anonymous donation truly exists?
  • How will you talk about your family story and share your child’s origins with your child? 
  • How do you feel about the possibility of bio siblings?
  • What will you share with friends or family about your child’s conception?
  • How will you respond to your child’s direct questions about the donor’s background or wanting to meet the donor or bio siblings? 

There are many ways to become a parent, and there is much to consider before choosing this path to parenthood. It can be helpful to meet with a mental health professional to explore these and other considerations. Find someone with whom you feel comfortable exploring thoughts and feelings around this decision.

 

Infertility Between Friends

While friendships naturally evolve over time, infertility can really test a friendship. Learning that a friend has become pregnant, while you have not, is unbelievably hard. You are happy to hear about the pregnancy, but the news is painful and naturally may bring up feelings of envy and frustration. You become angry from yet another reminder of your own challenges to conceive. Having these feelings in response to your close friend’s news creates feelings of guilt, so you end up feeling even worse.

How can you handle this situation? It’s important to be honest with your friend. Let her know that you are having a difficult time due to your current infertility experience. You are thrilled for her and would like to be there for her, but it’s simply too much at this time. 

Take some time to consider your history together and determine your needs in this relationship. Also look at your personal limitations on what you can offer your friend during her pregnancy.

•    Has she been supportive during your infertility experience? 
•    How have the two of you handled past friendship concerns? 
•    Are you comfortable offering support and remaining close during her pregnancy?
•    What are your boundaries around her sharing pregnancy details and baby shower planning? 
•    Do you want her to continue to check in with you around your fertility treatments? 
•    Have you considered her experience of being the one who became pregnant? What if it was you?
•    What changes would be needed to keep the friendship intact?

Infertility is a stressful time and requires support from friends who can hold what you’re going through. Remember you’re not always going to feel this way. Identify what works for you and express those needs to your friend. Many women have navigated fertility friendship bumps with grace. Some may decide to let the friendship dissolve, while others are able to reconnect when they are ready. Give yourself time to reflect on the support you need and find resolution that makes sense to you.