The AFA Blog

Please exercise

by Fred Licciardi, M.D.

Please exercise.

In the preceding centuries, tremendous physical activity was required for human survival, and yet, reproduction carried on. Imagine the exhaustion and stress if we had to spend one week hunting or farming with few tools or resources. Yet probably, under these conditions, most women would be able to get pregnant.

Excessive extreme exercise causing weight loss will cause ovulation to stop because the body figures that there are not enough nutrients stored for both the woman and a fetus. If she can just barely feed herself, she can’t feed the growing baby. The same is true for an anorectic. But here we are talking about extreme extreme. Moderate exercise is fine.

Surprising to me, I did come across a paper from Harvard showing that women who underwent moderate levels of exercise had lower pregnancy rates that those who did not. Like we always say, it’s just one paper. I do not really believe it. The Harvard doctors that I know do not restrict moderate exercise.

Exercise is bad if you are taking fertility drugs because the medications make the ovaries grow. Normally the ovaries are about the size of a walnut, and the drugs increase the number of follicles, therefore the ovarian size increases. Sometimes the ovaries can get to the size of plums or even oranges. They hang inside the pelvis. As they become heavier, they become more likely to twist, and this is called torsion. Here the twisting cuts off the blood supply and causes the ovary to choke. This really hurts, and is treated by laparoscopy. Exercise will increase the odds of this twisting. So in this case, exercise is not good.

Exercise increases blood flow to all areas of the body. The uterus and ovaries are organs that would love to get as much blood flow as they could.

Exercise clears your head. Yes, endorphins are released with strenuous activity, and these can help us fell better, but I think it’s more than that. My theory is that it’s not just about increasing the good chemicals; it’s about getting rid of the bad. Increased blood flow flushes away the old stale thought chemicals that are just hanging around causing trouble. Get rid of them.

Even better, do exercise that requires tremendous concentration. This really clears you head. Any sport will do: sailing, golf, soccer, basketball, biking, you name it. Some are more strenuous than others, but they all work. Same thing; flood your brain with fresh blood and new thoughts, lose the waste products.

Exercise builds muscle mass. This is also good. It just makes you feel better if you have a little tone. Even if you think you are fat, the tone goes a long way. It’s healthier to have some tone and muscle. It helps with balance and lowers you chances of getting injured during an accident (falling, for example).

And people with a little tone just age better.

Not to mention all of the obvious benefits of upping your cardio-vascular reserve.

I am not an expert in Yoga, although I have happily done it a few times. It's very good alternative.

So you don’t have time for exercise? Yes you do, make time. If you are tired, go to gym tired, it works just as well. You will sleep better.

If you do decide to take my advice (and the advice of others), go all out. A little exercise once a week is better than nothing, but more is better. You need at least 2 sessions per week of vigorous activity to really make a difference. Don’t start on any aggressive workout without checking with our doctor first, and consider a trainer at least initially.

A world on fire.

  by Corey Whelan

It feels like the whole world is on fire right now.  Civil unrest and natural disasters have been nudging the stressometer up notch by notch in our collective unconsciousness for awhile now, I think.  I remember reading newspaper articles years ago about the Cold War and how constant anxiety about the bomb was increasing the daily stress that Americans (and I'm sure Russians too) lived with, like a sort of  low level whirring sound in the brain that you forget is there, but that never really recedes.  

Headlines this weekend about that fool, that monster, that idiot in Florida and the violence that has ensued since he burned the Koran pumped up the jam just enough to flip me out completely.  It just feels like open season now, not just on Americans world wide, but on the whole species Human Being.  As it has always been, I guess.

I thought about all this while I was running this morning.  Three miles in and I started to think about stocking up on bottled water.  Five miles in and I started to think about the talk I need to have with my children about all this and how I don't want to.  Seven miles in and I remembered the reason why I started running in the first place.

Many of you who haven't known me for forever find it hard to believe that once upon a time I weighed around 50 pounds more than I do now.  Pregnancy with multiples, and a marriage that was shredding itself to bits turned into a lust for bagels, maple syrup and low fat dulce la leche frozen yogurt that I deluded myself into thinking was ok for me to eat on a daily basis.  And then 9/11 happened.

My babies were small then.  I remember thinking, if I have to run out of a burning building with one kid under each arm, would I be able to do it?

And the answer was no.  I was too overweight and out of shape to run and get my babies and myself to safety if I ever needed to.

So I went for a walk.  A very long walk.  And a few days later I went for a run.  A very short run.  And I threw out the bagels and all the high carb crap I had let my PCOS insulin resistant body get addicted to and I slowly became my old, healthy-weight self again.  Strong, thin, and robust.  My own personal best for my own physical self.

People, look.  I don't know what's coming next, none of us do.  But I do know that no matter what comes, and also no matter what doesn't come, the species human being, all of us, deserve the right to be our own personal best.  For me it's being a runner who weighs 115 lbs.  For you it may mean being a walker or a tennis player who weighs 135 lbs.  But whatever your own personal health best is, I urge you to acheive it.  It is better for your fertility.  It will be better for your pregnancy and your baby, God willing.  It will be better for you no matter what life brings.  Really.  

Think about maybe joining in and doing what The AFA staff will be doing for NIAW.  Think about doing a Fertility Bootcamp, if that feels like a fit for you.  Think about doing something.  And then just do it.  

I don't know what's coming next.     

How do I support my infertile sister-in-law?

by Shari Degraff Stewart and Julia Fichtner Krahm

"My sister-in-law and her husband have been struggling with infertility for some time now. They have been married 11 years and have been very private about their struggle.

I have two children and the other families each have 4 children, so there have been many pregnancies and babies over the last 11 years, which I can see is very painful for her each time another pregnancy in announced.

Now we (my husband and I) are talking about adopting an older child from an orphanage in Haiti, and I can see that even that is hard for her to hear. I want so badly to care for her in her struggle, but I also don't want to withhold information about our lives if it is not necessary.  Sometimes I just don't know what is ok to talk about, especially at these holiday gatherings when everyone is asking what is going on in your lives.

Any advice you can give would be really helpful".

—Tammy

Your compassion is evident in your question.  While you cannot alleviate the core of her grief, you can offer your support in gentle ways that let her know the door is open, you can run interference for her in family gatherings, you can offer a relationship with you, when loss of relationship is the primary cause of her pain.

You and your family have naturally been cautious in approaching this subject with your sister-in-law out of respect for her privacy.  You have likely been waiting for her to indicate whether she wants to discuss her infertility or not.  In the grief and pain she is experiencing, it is difficult for her to take that first step.  As hard as it may be, I encourage the friends and family members of an infertile woman to see that taking initiative to bring up the topic is one of the greatest acts of support and kindness you can offer.  You will still allow her to choose how much to respond, but your gentle offerings or questions will open the door enough if she does want to talk. Your words will be a simple acknowledgment of her pain followed by questions that invite conversation if she chooses or offers of help or support.  You will want to be careful to avoid giving advice or trying to change what she feels.  Here are some simple statements you could use:

 I imagine this is painful for you and I’m so sorry.

 I’m so sorry for how hard this must be.

 I often wonder if you are struggling. I care about that and I want you to know that your pain does not go unnoticed.

I don’t know where you are and I don’t want to be intrusive, but I want you to know that I care and if there is anything I can do that is supportive of you and your pain, I would like to.

What do you need? 

I would love to be supportive of you and want to know what is helpful and what is not helpful.  What do you need? 

Regarding your possibly adopting a child, offer her a brief description of your plans about the adoption then let her know that, in general, you are not going to bring up the topic, but will wait and let her choose if she wants news or information.  Something like this:

You know that Dave and I are considering adopting a child from Haiti.  I’m not sure if this news is hard for you to hear.  I just want to let you know that I will talk about it anytime you want, but I will wait for you to bring up the subject.

Likely, at some point in the future, she will take you up on your offer.  When she feels like she has the strength, she will ask you a question or two.  Be aware that her initiating the conversation does not mean she has endless capacity to talk about this new child.  Create natural breaks in the conversation that allow her to move on to another topic.  If she wants to continue to hear about your child, she will let you know.  It might look something like this:

Her:  So, tell me what is going on with the adoption.

You:  Oh we’ve just found out that ….  And then we’re going to….  So we’re thinking we might….  Anyway, you were going to tell me about the trip you are planning.

She will either move into this new conversation or will slow you down with another question about the adoption.  What I want you to notice is that you will create ways for her to manage the length of the conversation.  Depending upon your relationship, you can ask her, “How is it for you to talk about this?   The lovely thing about questions is that she can respond to your invitation to talk more if she wants, or she can politely say something simple, like “fine,” and you will know she doesn’t want to open up more about he r feelings at this time.

In family gatherings when it is natural for loved ones to talk about all of the children a nd especially your possible new child, you can do several things. 

• At the gathering, if much of the conversation remains on the adoption, you turn the conversation with a simple phrase, “Oh I’ll fill you in on all of that later, when are we going to play cards?”  In a follow-up conversation, you may say to one of the family members:  “I didn’t me an to cut you short, I just thought it might be painful to talk about the adoption too much with the whole family present.” Your words offer gentle education to this family member about your sister-in-laws needs.

• You can also offer her a break from the conversation by asking her to help you make some coffee in another room.  You might ask her in the kitchen, “Are you okay?”  Your open-ended question allows her to choose what and how much she discloses.

• If you’re hosting the gathering, encourage this couple to choose when and how much they attend:  “We’re thinking of eating around 6:00 and then maybe play some cards.  Do you want to come for all or part of the evening?”

Offer and make available girl-only or couple-only times when she can just be a person, a friend, or sister-in-law and doesn’t feel like she is always wearing a capital “I” for Infertile on her chest.  Dinner with you and your husband and no kids or an afternoon with you shopping or indulging in a manicure will offer the healing that comes from relationship.

Children encapsulate every relationship and feeling in our life.  She grieves not just being a mother.  She longs to re-experience her own childhood in a daughter, or see a glimpse of her husband’s boyhood in a son.  She knows she would touch the life of her mother and grandmother in holding her child in her arms.  She even recalls the thrill of falling in love with her husband as she instantly falls in love with her child.  It is all of these losses that she grieves.  Your friendship doesn’t fill this loss.  It does offer some respite from it and it offers some healing.

Reprinted with permission from the Stewart Institute for Infertility

Just dance.

by Corey Whelan

There are some weeks when my days begin like bubbling cauldrons.  Too much work (a good thing, seriously).  Too little time.  A book to illustrate.  A teenager to placate.  A life to live.  That makes me one of the lucky ones, btw.

One day last week I popped on my headphones and turned on my computer and found, well, nirvana.  The AFA's dear friends and allies at Associacao Portuguesa de Fertilidade, had posted a Michael Buble video on their Facebook wall with the simple affirmation "Music Break".  Ok, that I can do! Because music, and movement, shifts reality in only positive ways.  But of course, you already know that.

My dear sisters.  For those of you who are currently TTC and gritting your teeth.  For those of you who are pregnant after TTC and freaked out.  For those of you who are finally mommies and haven't brushed your hair in three days.  Breathe, girlfriends. 

Oh, and by the way?  For you brave and amazing men who just "don't know what she wants, how the hell can I be there for her anymore?" I have a simple directive for all of you.

Just dance.

Hey people.  It's Monday morning.  What could be more important than this?

Just dance.

 

 

Your infertility arsenal for 2011

by Corey Whelan

A new year, a new you. 

Easier said than felt, particularly for women who have spent the last year (or longer) trying to get pregnant, without success.

Let's face it, we often experience Infertility as a powerful enemy.. And one of this most hated enemy's weapons is it's ability to diminish the feeling of control that we so covet, even require, in our own lives. 

While it's true that you may not be able to eradicate infertility at will from your own life, you can absolutely opt to disable this element of the experience and to achieve more balance, and control, than you currently may be experiencing.  And you have the right to do that.  Believe it or not, you have an arsenal at your finger tips.  You simply need to call it up, and now is a good time to practice doing that.  While every woman's arsenal will vary somewhat, there are a few handy dandy items you should always tote around in yours.

Laugh. Ever hear the expression "fake it till you make it"?  There's nothing wrong with having fun, and joy in your life. It's not fattening and it won't stop you from getting pregnant.  Funny movies and television shows are more than just a diversion. They are often a life saver.  Pick your pleasure, and pick it often.

Talk. It's no secret that infertility puts a strain on the hardiest of relationships. You may be feeling this in your romantic life, your family life and your friendships.  But always remember, you are loved, even if you may not be feeling an avalanche of the kind of support you need coming at you from friends and family right now.  Something that might help is this.  Enlist the shoulder of the person that you feel is best armed to support you through this piece of your life, and request of him or her an oasis of time, just for you, on a daily basis to simply talk.  This is your opportunity to dump, to scream, to cry, to blurt out everything you are feeling without judgement or even that person's opinions or comments (unless you request them).  If you need to enlist more than one person, that's ok.  And if no one comes to mind but this sounds like something you could use, well, that's what therapists are for.

Choose.  Not everyone will be able to hang in there with you through this time.  It doesn't mean they don't care about you or you about them.  But you have the right to choose who you spend time with and who you don't.  If you can't handle that annual family get together or party, then don't go.  Baby showers?  Up to you.  And, if you get a nagging feeling that a friend is not able, or willing to support you through this right now, gently put a hiatus on the friendship. You're in control, remember?  Exercise that control.

Move.  Movement displaces anxiety.  Take a walk, take a run, take a yoga class, but take your body to a transformative place by giving it time to breathe, and heal, through movement.  Your body, despite it's current trying to conceive and not getting there state, is still an instrument of joy, and pleasure.  Let it be that for you.

Touch. You have the right to enjoy your sex life.  Baby making sex is not the only kind of sex there is, remember?  Find creative ways to get back in touch with that, and then, find some more.

Thank. Think about what you have in your life to be grateful for and give thanks for that.  You are still you, and there is more to you than this experience.  Try giving thanks for what you currently have.  If this feels too difficult for you right now, let it go for a day, or two. Consider it a goal for tomorrow.  But hold onto this one, it's a goal worth acheiving. 

Remember. Yesterday is gone, and tomorrow is a new day.  Your life will not always feel like this.  Remember to be kind to yourself and to hold on to all of the tomorrows, and all of the dreams, that are still ahead of you.

Happy New Year to all of the women who so want to be mommies but who are not there yet. I hope that 2011 will be your year.     

Reprinted with permission from examiner.com

Photo: 123RF

The Gift of the Present Moment

By Brenda Strong

I have a confession to make.  I have been stressed out lately.  Yes, even yoga teachers can let life circumstances get the best of them.

The Holidays can be a challenging time for most of us.  We all long for closeness of family, warmth and an intimacy that may resemble our favorite memories from childhood.  If our childhood memories of family don't fill us with warmth, we may seek out a fantasy of what we think family could be that it wasn't. Either way, the holidays can fill us with a mixture of feelings that may be difficult to navigate; and unfulfilled expectations can leave us feeling lonely, especially if the family we long for isn't created yet. 

For many of us going through reproductive difficulties, it may be a time filled with sadness, longing, isolation and stress.  How can we navigate through this time without having a nervous breakdown or going into a depression?  The key is found in a word that is tossed around the holidays a lot.  Presents.  But instead of the kind that are tied up neatly in a bow with beautiful paper, the kind I'm talking about is free and available to us at all times.  Presence.  It is learning to be present, that allows us to receive the greatest gifts in life, the ones that touch our hearts, give us hope and connect us to ourselves, our bodies and each other.

How does one become present?  It's simple.  The quickest way to become present is through our breath.  Simply observing the breath as it passes through us, and watching it, brings us fully into this moment. When we watch the breath and are present, the body does a miraculous thing.  It opens.  And when our bodies open, our monkey mind slows down and so does our heart rate, and we become aware. When we become present to what we are feeling, we give these sensations an opportunity to release their power over us.   When we are in the presence of pure awareness, there is an opportunity to release the baggage of the past and the fearful projections of the unknown future.  There is just NOW.  And inside now, there is nothing to resist or grasp at, there is just what is.  There is a simplicity of BEING.  From this short time of connecting to our breathing, we are able to de-stress the body, release anxiety and receive the gift of this moment.  As we do this, we can start to string those moments together, and before we know it, we are on the other side of our feelings peacefully.

So this Holiday Season, as you gather together your presents for others, don't forget to give yourself the gift of the PRESENT moment. 

Someone once said, “The past is history, the future a mystery, and the present moment is all we have...that is why it is called a 'gift'."

Just remember, to receive the gift of life all you have to do is take it one breath at a time...  :-)  

Na "mama" ste

Brenda Strong is a certified 500hr E-RYT who created the Strong Yoga4Fertility program to help women worldwide.  She is the first national spokesperson for The American Fertility Association as well as a member of the board of directors. Her day job is playing “Mary Alice Young” on DESPERATE HOUSEWIVES.

Miscarriage and the Sense of Personal Failure

by Kim Kluger-Bell, MA, LMFT

Lisa Ling, the former View host, revealed this week that following a miscarriage at 7 weeks into her first pregnancy she felt like a failure, and that she also felt very isolated and alone because no one talked about it. For this reason, she is speaking out and has created a website where women can anonymously share their experiences with miscarriage called Secret Society of Women.

 Ten years ago, when I wrote “Unspeakable Losses: Healing from Miscarriage,Abortion and Other Preganancy Losses” I felt exactly the same way. The silence surrounding miscarriage only makes you feel more freakish and alone. Here is what you need to know about miscarriages:

 Miscarriages are Common

 Approximately one in 5 pregnancies in the US end in miscarriage every year. That means hundreds of thousands of women experience miscarriages every year. And most of those miscarriages occur in the first 12 weeks of pregnancy. In fact, your chance of miscarrying after that time is only 3%.

 Having One Miscarriage Doesn’t Mean You’ll have another

 Most miscarriages, however, are usually random and isolated events. Having one miscarriage only slightly increases your odds of having another one.

 The Emotional Impact can be Devastating

 For many women, the attachment to the child she is carrying begins at the moment she knows she is pregnant. That is when we begin dreaming about the baby we are carrying and imagining how our lives will change in only nine short months. Few of us hold back our excitement due to fears of a first trimester miscarriage. Instead, we start taking extraordinarily good care of ourselves—eating right, getting plenty of rest and avoiding alcohol, caffeine and tobacco products. When a loss takes place despite all of these preparations, you can feel like you did something wrong. Even the word—miscarriage—seems to imply that you did not carry your baby properly.

 It is Not Your Fault

 In many, if not most cases, the cause of your miscarriage will never be known. Again, most miscarrages are random and isolated events. Doctors now believe that at least 60% of miscarriages are caused by chromosomal abnormalities in the developing embryo or fetus, and that another 10% are caused by various uterine abnormalties (most of which can be corrected with surgery). The remaining 30% of miscarriages may be cause by immunological factors, infections or environmental factors (including smoking and heavy alcohol use).

 Recovering from Miscarriage Takes Time

 It is often more difficult to recover emotionally from a miscarriage than it is to recover physically from one. Even if you had to have a D & C, the emotional fallout from a miscarriage can stay with you for months afterward. Guilt, shame, sadness, anger, and a feeling of powerlessness are very common emotions. So is a sense of generalized anxiety and the fear of another loss. It is not uncommon, especially if you are not able to become pregnant again quickly, to have an ongoing awareness of  how far along in the pregnancy you would have been if the loss had not occurred. Many women feel particularly grief-stricken around the time of the due date of that pregnancy. Miscarriage is a traumatic experience—it takes time to heal from a trauma of any kind.

 It is important to be gentle with your self and find people to talk to who are compassionate and will not judge you for the intensity of your feelings. It is also important not to blame yourself, or to isolate yourself too much. It may be impossible to spend much time around pregnant friends or those with babies or young children, but if you don’t have people in your life who are willing to share their own experiences of pregnancy loss with you, there is a large group of people out there who have been through a miscarriage, and there are many on-line resources and books available to you that can help you feel less alone.

 Websites:

• Facebook page, “Whisperers”
• www.nationalshare.org
• www.missfoundation.org

 Books:

• Empty Arms by Pam Vredevelt
• Empty Cradle, Broken Heart by Deborah L. Davis
• Unspeakable Losses by Kim Kluger-Bell
• Miscarriage: Women Sharing from the Heart by Marie Allen, Shelly Marks

Kim Kluger-Bell is a psychotherapist and marriage and family therapist in private practice in Berkeley, California. She specializes in helping individuals and couples heal from such reproductive crises as infertility, pregnancy loss, and abortion. She lives in Albany, California, with her husband and son.

 

 

Tis the season to feel guilty. Past abortion history and current infertility issues.

by Corey Whelan

"Dealing with infertility after an abortion is fraught with complexities, surrounding feelings of guilt and  anxiety about whether one's last chance to have a baby may have been squandered.  Some patients feel that the pain of infertility is their divine, and justly deserved, punishment". - Joan Winograd, L.C.S.W.

Despite the fact that the overall rate of abortions in the United States have declined, the CDC reports that in 2006 (the most current data available) 846,181 recorded abortions were performed in this country. 

Current data also indicates that one in 136 women (about two million annually) are currently under a doctors care for infertility.

Staggering numbers aside, it might be assumed that these two seemingly separate populations of women do not overlap.  However, many women who have a past history of one or several abortions  will at some point during their reproductive years find themselves in the unfortunate position of not being able to conceive a baby.  Advanced maternal age, pelvic inflammatory disease, endometriosis, polycystic ovarian syndrome, premature ovarian failure, and other diagnosis unrelated to abortion will often be found as the reason why conception is now a challenge.  What won't be found, most of the time, is a link between past abortion history and current infertility.  Simply stated, rarely does a link exist. 

According to Long Island based reproductive endocrinologist  Daniel Kenigsberg, M.D., "Previous abortion is not often a problem for future fertility.  As with any medical procedure, there are complications (of abortion) that can occur, such as infection, or scar tissue formation.  Fortunately, both are very infrequent.  One aspect often overlooked is that previous cervical dilation, which is necessary for the abortion procedure, may predispose the woman involved to cervical weakening, which can lead to premature delivery or even midtrimester pregnancy loss.  If you have had an abortion, please tell your doctor, and make sure that your cervix is evaluated frequently during your pregnancy."

Despite clear evidence to the contrary, women experiencing infertility who have a past abortion history often blame themselves and believe that their current situation was created by their past choices.

The Infertility and Adoption Center's Executive Director, Joni Mantell, L.C.S.W., asserts that lowered self esteem may often be to blame.  Says Mantell, "Human nature is to seek cause and effect.  It is not uncommon for women who have had abortions prior to infertility to think that there is a causal relationship to all of this, even though in most cases medical evidence does not exist."

She goes on to state that "the mindset of a woman suffering from infertility is often one of great shock, disappointment, fear about whether they will ever be able to have a baby, and often loss of self esteem, because they cannot in fact do what they always thought was an essential part of their role as a woman.  Lowered self esteem is in fact, fertile ground for self blame.  Women may look back over their past,  to try to figure out where they went wrong.  This may be part of our human need to find rational explanations for the ills that befall us, or conversely, may actually be a form of self punishment, fueled by guilt about the prior abortion and also about not being able to conceive currently".

These feelings may be confusing to many women experiencing them, since the most common emotion experienced immediately after an abortion is performed is relief.  However, according to Ms. Mantell, "Women may not have been aware of their feelings of prior guilt.  Infertility can bring this emotion closer to consciousness, and  with it a painful realization to confront at an already highly charged, stressful time.  Renewed grief about the baby that could have been born, yet was instead aborted, may need to be worked through on a deeper level.  These feelings would be occurring simultaneously along with the raw, immediate experience of pain and loss resulting from infertility".

Safe, legal abortion does not cause infertility in women.  If you have had one or more abortions, you should talk to your gynecologist honestly about your past medical history and your concerns.  If you are unable to conceive without the additional support of a reproductive endocrinologist, you have the right to acquire that support.   If you feel that you would benefit from seeing a therapist, you should do so.  Most IVF centers have highly competent therapists on staff who are ready to support you. 

Your reasons for having had an abortion are your own.  No matter how you currently feel about that past choice, it is important to acknowledge that your choice did not result in infertility.  

Reprinted with permission from Examiner.com

A Baby at Last

 

by Carolyn Berger, L.C.S.W.

As those of you who religiously follow the AFA Blog know, Wednesday night’s

Illuminations NYC fundraiser was a remarkable success.

 My favorite part of the evening was giving Dr. Zev Rosenwaks, Dr. Marc Goldstein, and Mark Fuerst our Media Award for their recent book, A Baby at Last.

 If truth be told, I was just a bit anxious before getting up in front of our 170 guests. Would I suffer from “brain freeze,” forget someone’s name, or, even worse, trip on the step up to the stage?  To make matters even more dicey, I decided a minute before I went up that I wouldn’t follow my script, but would speak from my heart instead.  I just didn’t feel that what I had written was enough.

 So I got up there and told people that after I finished reading the first chapter of the book, “You Are Not Alone,” I knew I had to get a second copy.  I counsel fertility patients in two separate offices, and I wanted this book by my side in both places. It would make me a better therapist.

 I’ll tell you why.  The book takes the very complex world of fertility treatment and simplifies it—something that patients and clinicians alike can appreciate.  It intersperses scientific information with vignettes of true-to-life couples struggling to have babies—and it imparts hope.  Each chapter ends with “Take-Home Messages,” which cull the essential ideas and can act as quick reference points for busy patients who don’t have time to re-read chapters looking for one important piece of information.

 Something else I like about the book…. In a world where female fertility issues often take center stage, Dr. Zev Rosenwaks and Dr. Marc Goldstein, both of Weill Cornell Medical Center, have joined together to give male and female fertility equal play, including chapters on both male and female fertility evaluations and treatments. (This is all to the good since while male and female factors each count for 40% of cases of infertility, male-factor infertility has not gotten the attention it deserves.)

 So, my introduction of our Media Honorees went just fine in the end.  Dr. Zev Rosenwaks took out a sheaf of papers when he reached the podium—and then put them aside.  He spoke from his heart instead.  Dr. Marc Goldstein did the same. And Mark Fuerst followed suit.

 It was just that kind of evening, hopeful and celebratory all at once, and when I went home I was smiling.

 Carolyn Berger, LCSW, is Founding Board Chair of The AFA.  She has a practice devoted to Fertility, All Forms of Family Building and Adoption in Westchester and Manhattan.

 

How our Infertility Affects us as Parents

 

by Iris Waichler

We had a beautiful fall day this week and my husband, daughter, and I went for a walk in the woods.  We came across a huge oak tree that was down over a river.  It was the perfect bridge and my Stanford Gymnast husband and adventurous daughter jumped at the chance to explore every inch of each limb.  As she climbed midway over the river I felt my anxiety climb with her as she took each additional step.  I called to my husband “keep an eye out” and heard my daughter quietly say “mom’s being protective again.”

            I flashed back to when I was in the midst of my infertility and had multiple miscarriages.  I also thought about the support group I lead for people who had gotten pregnant after infertility but could not shake feelings of anxiety and fear that something would go wrong during their pregnancy. You sacrifice so much to get to be a parent battling infertility that you want everything to go right. Group members needed that additional peer and professional support to help psychologically manage their pregnancy.  It was a common theme and members were shocked that they were not alone in these fears.

            My personal and professional experience as a clinical social worker has offered me many lessons.  My contact with people who built their families through infertility treatment and adoption taught me the feelings associated with infertility do not completely vanish with successful family building.

            The anxiety associated with the difficulty of conceiving a child is buried deep.  In the midst of infertility treatment we are so worried about getting pregnant that we don’t think about what parenting will be like after the baby comes. When you have a child those past feelings can emerge at times as you remember how difficult it was to get there and you relive past failures.  The key is to remember that those memories and feelings are in the past and keep them there.  You don’t want those feelings to negatively impact your ability to develop a healthy relationship with your child as time passes and the boundaries of independence evolve and change with time.                                                                      I had gone halfway out on that log.  But I turned around and chose to stand on the river bank, watch her sense of adventure, curiosity, and the fun she was having exploring with her dad.  They teased me about being afraid to come out with them.  They both know I have a fear of heights. But in spite of that I climbed Mt. Kilimanjaro and trekked the Himalayan mountains of Nepal.  My anxiety does not stop me from allowing me to do the things that are important to me.  So when my 10 year old daughter asks “when can I walk to school with just my friends and no adults?” and my initial thought is “when you’re 25” I tell her “let’s wait and see how it goes these first weeks and talk about it.”