SO WHAT’S THE BIG DEAL ABOUT INFERTILITY?Infertility: facts and figures Infertility is defined as the inability of a couple to get pregnant despite having regular unprotected sex over a period of two years (NICE, 2013). It is estimated that one in seven UK couples has difficultly conceiving (HFEA, 2006). About 40 per cent of infertility is due to male factor, 40 per cent due to female factor, and 20 per cent from complications affecting both partners (World Health Organisation, 2013). In women under 40, more than eight out of 10 couples will conceive within one year if they are having regular intercourse, and nine out of 10 will be pregnant within two years (NICE, 2013). Eighty two to 92 per cent of couples will conceive within 12 menstrual cycles and 90 to 98 per cent will conceive within 24 menstrual cycles. Emotional Rollercoaster Part of my role is to help women through the difficult and often all-consuming emotions they can experience while trying to conceive or going through fertility treatment. Women are increasingly aware that their emotions may impact on their fertility. Sometimes they will say to me things like: ‘I’m stressed that I am stressed, because I know it’s bad for fertility!’ They are often caught in a vicious cycle of trying to relax, yet feeling incredibly stressed and out of control. Not only is struggling to conceive an emotional rollercoaster, but it is subject to many external stressors that often add to the problem. Is Stress ‘bad for’ Fertility? Actually stress in moderate amounts can improve our performance and keeps us focused on a goal. However, when this is sustained over a period of time our bodies adopt a ‘fight or flight” response, which prompts the adrenal glands to secrete cortisol (stress hormone) and adrenaline into the blood stream. Increasingly people are running insanely busy lives and trying to juggle too much and it can lead to burnout and yes inability to conceive. The opposite response of the nervous system is ‘feed or breed’ or ‘rest or digest’; this response tells the body that all is well and it is an optimal time to conceive. It tells the body that it is safe. Science is beginning to look at the impact of stress on fertility and early studies show the likelihood of natural conception is reduced when stress levels are high. A recent American study of 501 couples over 12 months found a 29 per cent reduction infertility and a two-fold increase in risk of infertility in couples demonstrating high levels of stress. Research also shows that patients who become overwhelmed by their infertility tend to be less happy, engage less socially and have reduced libido and the longer it takes couples to conceive the higher their levels of stress rise. The Stress Factors of Infertility Make no mistake about it; infertility is very stressful, misunderstood and under supported. Infertility is a big deal! Most people wrongly assume that because there is often no illness, as such, that there is no suffering. Infertile couples often suffer in silence as they battle alone in an area of medicine that is increasingly underfunded. The issues are many and varied;
Lack of information; many couples and individuals struggle to get good clear information regarding their infertility. Services vary depending on where you live and it is often potluck as to how good the advice you receive is. Many areas now do not fund IVF at all leaving patients to fend for them self.
Too Much Information: conflicting information is everywhere. Doctor Google is one of the main problems and conflicting information creates fear. Fear is everywhere; it is in the papers, in the chat rooms and fear begets fear. Too much information can overwhelm patients and add to their stress.
Passing of Time: because fertility declines with age the passing of time adds an additional pressure. Time is eroded very quickly and it can feel that with every passing day the situation is getting worse.
Choosing Clinics: many couples or individuals will have no choice of clinic. But those choosing to go privately will have to really do their research into which clinic is best for them. What the success rates mean and who to put their trust in.
Money Stress: couples and individuals often spend thousands of pounds on funding their own fertility treatment. Treatments are costly and multiple treatments maybe needed with no guarantee of success. It can also be hard to know where the money is best spent. Many couples borrow above their means just to support themselves through fertility treatment.
Lack of Emotional Support: the true suffering experienced by couples or individuals who cannot conceive is huge. Many suffer pregnancy loss, IVF failure, crippling gynaecological conditions, baby loss or months of trying without success. There is little support available and most patients report feeling misunderstood, isolated or unsupported.
Poor Communication Skills: this is a highly reported problem, along with poor use of language and a lack of understanding of the hurt that careless words causes. Recently on ITV breakfast TV show the hostess was interviewing a Doctor regarding IVF. During a question and answer session a woman who had failed IVF 4 times called in and asked for advice as to what to do next. The Doctor answered by telling her to ‘Relax’ which quite rightly sparked outrange in the IVF community. Sadly this is a regular occurrence and careless communication can impact on patient’s wellbeing.
Intense Medical Treatment: treatment schedules can be difficult and treatments are invasive and can impact on the wellbeing of the patient. Mood swings, bloating, constipation and lack of sleep are common side effects.
Relationship Stress: the stress that infertility puts on couples is immense. It can completely change the dynamic of the relationship. Grueling IVF treatment, timed sex, poor semen results, hormonal injections, steroids; can all impact on even the strongest partnership.
Family Stress: it can be very isolating and although families often want to support, they can struggle to know what to do for the best. This can be painful put an additional strain on the couple or individual who may feel misunderstood.
Social Stress: having to constantly be happy for others joyful news can cause immense pain and feelings of failure. This is often followed by feelings of shame that they are not able to feel happy for their friend, colleague or relative. It can be particularly difficult to hear the ‘oh we only did it once’ news. Isolating themselves from their social groups and their friends and family is common.
Work Pressure: infertility can mean having to take time off work for appointments and treatments. If treatment is prolonged this can put a strain on working women who have to decide if they tell their employees about their infertility or not. Either way it can cause stress and anxiety. Women often get trapped in jobs that they are not happy in because they feel forced to stay due to their fertility struggles. Or they are holding out for maternity pay. This can mean that their career stagnates and they become increasingly unhappy in a situation that does not serve them. Moving up the career ladder, while going for treatment is often impossible for most women.
Putting Life on Hold: infertility often consumes all areas of life; holidays are put on hold, major life events go past uncelebrated, home moves are delayed, as the focus on fertility dominates everything.
My experience in supporting couples and individuals over the past 23 years is that they do better when they are well supported and their options are clear. Many women are in fear. This fear comes from multiple places; what I do is try to move women away from fear and show them that they have resources; inner and outer. I believe that feeling safe and supported creates the optimal conditions for conception to take place. I work through The 5 pillars of FERTILE; flexibility, creativity, nourishment, transformation and belief. These elements all play a key role in helping couples and individuals meet their emotional challenges in a new and positive way. This gives a framework in which they can manage the stresses of infertility. My approach to fertility is to create bespoke holistic and integrated programmes of care for couples supported by the 90 days FERTILE programme. No two situations are the same and it is vital to look at the individual circumstances in order to create a journey that is appropriate for the couple or individual. Knowing what options are available either medical or holistic can bring relief to the stress. Having a plan and a strategy can make all the difference. 90 Days Fertile is a digital programme designed to support the fertility journey; delivered into your in box on a daily basis. Through videos, meal plans, fertile tips, guided meditations, recipes and much more, it explores THE 5 PILLARS OF FERTILE and how to can bring them into life, everyday. It includes several guest appearances from a consultant gynaecologist to give some medical input. This programme is not designed to replace medical advice but IT IS designed to support you emotionally at whatever stage of trying you are at.