How To Keep Love Alive

In the Midst of Infertility Treatment

By: Qin Fan, PSY.D

When sex goes from being fun to being work, it can play havoc with your relationship. Infertility treatment is often experienced as an emotional rollercoaster, typically becoming an ordeal that either makes or breaks a couple. How can you support and deepen your love for one another in the face of emotional and relational adversity?

1. Understand that the fertility challenge affects every aspect of life. No one can entirely escape from challenges affecting their self-image, intimacy with partner, and sexual lives.

2. Remember that you are in this together. Inform yourselves and learn about what you’re up against so that you can face it together. The more you practice this together, the stronger you’ll become as a couple. Be considerate and tender toward your partner.

3. Recognize that you and your partner may keep a different pace on the fertility journey, and be understanding about it. Keep up the communication and give each other the chance to say what is on his/her mind. Remind yourself that the main thing is your common goal of making a family together.

4. Talk openly with your partner: Sounds easy, right? Yet, so often couples are cocooned in their own emotional anguish, or uncertain about what to say to each other when encountering infertility, that they literally become “speechless,” or shut down. Moreover, infertility can stir up a host of other personal or psychological reactions, including depression and anxiety. It is critical to discuss common reactions such as disappointment, shock, fear, envy, guilty, and rage.

5. Balance the need for privacy & support: What to say to family and friends, if anything at all? It is indeed a delicate dance. Research shows that isolation can be detrimental for couple relationship in the middle of infertility treatment. What is the right amount of disclosure so that the couple may benefit from support from family and friends? Each couple will have to negotiate and determine what is acceptable to them. No matter what you decide to say to others, the main thing is that you two are on the same page. The ability to open up to family and friends can not only ease some of the pressure and isolation but also boost the couple’s morale and overall wellbeing.

6. Redefine intimacy to include conversation at the dinner table, cuddling under a blanket, watching a favorite movie, and a hearty hug. Tell your partner when you need that hug and when you are feeling a little deprived. Go out to dinner at your favorite spot and do not talk about fertility for even one second. Reminisce about how you met and why you made a commitment to be life partners.

7. Plan to have sex, and then anticipate it, just like in the early days of your relationship.

8. Take care of yourself and each other: A healthy mind resides in a healthy body. Infertility treatment can be stressful and strain the relationship. Research suggests that setting time aside regularly, say once a week, to take walks, bike, treat yourselves with a couples massage, take yoga or dancing classes together, can help reduce stress and rejuvenate. Physical activities will not only help you boost your overall energy, but also facilitate a better outcome for your infertility treatment.

9. Seek additional emotional support: Infertility is a shared experience. Individual psychotherapy, couples counseling, and support groups can serve as a safe space for you to explore topics that might be otherwise difficult to discuss.

Qin Fan, Psy.D. 870 Market St., Ste. 659, San Francisco, CA 94102
Phone: 415.545.8606 www.drqinfan.com

ABOUT THE AUTHOR

Qin Fan, PSY.D. A licensed clinical psychologist and a member of the American Society for Reproductive Medicine, I support the family building efforts of all clients, including single women and men and same sex couples. Starting a family can be an exhilarating time for many, yet for some it can be an emotional roller coaster. To help you navigating through the fertility treatment maze, I offer psychological psychotherapy for individuals and couples dealing with infertility or fertility preservation; consultation for intended parents and recipients of egg, sperm, and embryo donation; psychological evaluation for your donor or gestational carrier. For more information or schedule a consult, please visit us at www.drqinfan.com

Preparing For Your Initial Consult

By: Kyra Lumpkin

So you have taken the plunge. You have called and scheduled your initial consultation! You are hoping that this visit will change your trajectory for having a baby. Now what? Every clinic is a little different, but the general forms that we describe below review the types of information that you should expect to provide at any new patient visit.

How to Prepare For Your Initial Visit

As the old adage goes, “you can’t tell where you are going unless you know where you’ve been”. Prior to coming to the office for your new patient consultation, we strongly urge you to prepare. Ensure that you have completed all of the forms in the New Patient Packet provided to you. This packet typically will include a Health and Physical History form for you to summarize your past medical history. Additionally, you will receive consents explaining our office policies, practice statement, and notice of practice privacy. Last, we have included a form to retrieve any pertinent medical records. These items are very important for us to receive prior to your appointment. After all, our goal is to optimize your fertility experience, and our physicians and clinical team need this information in advance to prepare for your visit.

Preparing For Cost

A benefit check is done before you come in for your initial consultation to better prepare you for any monies that you may have to pay. After scheduling your appointment, take a moment to snap a picture of your insurance card, front and back, and then forward it to your clinic. After your picture is received, the billing department will run a benefits check against the insurance information you provided to assess what will or will not be covered. The results are then emailed to you with an explanation of the findings. You will then be equipped with everything you will need to know about the costs of your appointment. If your clinic doesn’t do this routinely, be proactive and ask for this information or call your insurance company yourself. Most fertility patients are healthy individuals who have had little reason to use their insurance for more than a $20.00 office visit co-pay or a $10.00 prescription. This experience will be different for most patients.

What to bring

When you arrive at your initial consultation, please have a valid form of identification, any fees you will have to pay, and your insurance card ready.

What to Expect At Your First Appointment

The New Patient exam lasts approximately 60-90 minutes, and your partner is encouraged to come with you. During this appointment, the physician will perform an antral follicle count (AFC) using a transvaginal ultrasound. Afterwards, you, your partner and your physician will discuss your medical history in detail. This is the perfect time to ask any questions or present any concerns you may have. This visit is for you, so the physician is listening intently to understand what your fertility and family goals are.

A few examples of good questions to ask are:

  • What are your success rates?
  • I am still young, why do I need fertility treatment or Pre-Implantation Genetic screening (PGS)?
  • What are my chances of success if I don’t do PGS?
  • On average, how long does a full cycle take, from initial consult to transferring my embryos?

Taking control of your fertility challenge is a huge step. It takes bravery and patience. To aide in your own success, do not be afraid to ask as many questions as you feel you need.

Experience Excellence

At Lane Fertility Institute we are a team. A team dedicated to giving our very best at all times. A team that will do all that we can to assist you in achieving success on your journey to parenthood. We pride ourselves on providing the optimal experience from your very first phone call. Whatever clinic you decide to work with should have a similar attitude. If you don’t feel that the fertility team is in line with your needs, never be afraid to make a change. Fertility is already taxing on your emotions and resources, you should have an expectation of excellence every step of the way!

Good luck on your fertility journey!!

ABOUT THE AUTHOR

Kyra Lumpkin. Kyra Lumpkin is the Administrative Coordinator for Lane Fertility Institute. Kyra has been in the Administrative field for over 7 years. She commits herself to patient satisfaction and outstanding patient service. She has a strong belief that one’s business is only as good as the treatment provided to its patrons. Being a parent herself, Ms. Lumpkin is passionate about her ability to aide and prepare patients for their journey to parenthood. Her email is kmlumpkin@lanefertility.com

FAQ’s for our New Moms

By: Sandra Cisneros, RN

Sometimes getting pregnant is just as scary as the journey itself. After all the work to get to pregnancy, couples are petrified of anything that could jeopardize the pregnancy. The good news is that most pregnancies that have had two normal ultrasounds with a good fetal heartbeat each time and good interval growth between the first and second ultrasound have a terrific chance of reaching live birth. Here are some of the most common questions that we get from patients.

What foods should I avoid?

The American College of Obstetricians and Gynecologists (ACOG) has developed a document to assist patients with understanding the safety recommendations around food during pregnancy. If provides the most current evidence based research on this topic. It can be found at this link (http://www.acog.org/Patients/FAQs/Nutrition-During-Pregnancy)

Can I have intercourse?

In general, the answer is yes. By the time that you leave your fertility physician, you are likely between 6-10 weeks pregnant. The pregnancy is well implanted by this time. In most cases, intercourse is fine. However, if you have had vaginal bleeding during the first weeks of pregnancy or have had bleeding after intercourse, your physician may recommend that you abstain from intercourse.

When should I see my obstetrician?

You should plan to see your obstetrician between 8-10 weeks. Each office will have specific guidelines. This allows your physician to order certain blood tests and ultrasounds to further confirm the health of the pregnancy.

Am I now considered a “high-risk” pregnancy?

In general, the use of fertility treatment to conceive does not make your pregnancy high-risk. There are specific reasons that you may, however, fall into that category. Some examples include high-order multiples (more than twins), diabetes, maternal age, or high blood pressure to name a few. Typically, your obstetrician will refer you to the high-risk service if they deem it necessary.

When should I tell people that I am pregnant?

This is a very individual question and there is no right answer. Usually couples wait because they are trying to ensure that the pregnancy is “ok” – meaning that the risk for miscarriage or genetic abnormality is low. In general, pregnancies in which there have been two normal ultrasounds, which show good interval growth and positive heartbeat, are likely to reach live birth. Many couples already know that their pregnancy is genetically normal from embryo biopsy. If you are using non-invasive prenatal testing, chorionic villus sampling or amniocentesis, you may want to wait for those results. If the only parameter is time, typically most miscarriages happens within the first trimester (by then end of 12 weeks of pregnancy).

Can I exercise?

The American College of Obstetricians and Gynecologists (ACOG) recommends that women become active and exercise at least 30 minutes on most, if not all, days of the week. This will decrease symptoms of pregnancy including backaches, constipation, bloating and swelling. It may help prevent or treat gestational diabetes. It will improve your mood and energy.

Safe forms of exercise include walking, swimming, cycling, and aerobics. Women who were runners prior to pregnancy can likely continue during their pregnancy. Activities to avoid are generally those with a high risk of falling. Examples include gymnastics, water skiing and horseback riding. In addition, downhill skiing, contact sports and scuba diving are not recommended.

For further information refer to the ACOG document

 

ABOUT THE AUTHOR

Sandra Cisneros, RN, Ms. Cisneros is an IVF Nurse at Lane Fertility Institute. She has been in the field for almost 20 years. After receiving her nursing degree from the College of San Mateo in 1993, she began her career in the field of fertility. She has worked at Pacific Fertility Center and UCSF Center for Reproductive Health prior to her current position. Ms. Cisneros’ goals are to help patients achieve their dreams of being parents. She strives to lessen their stress along the way. She is currently very interested in empowering women to take control of their future fertility with egg freezing and embryo banking.

A Fertility Story – A Patient’s Experience With Her Insurance Benefits

By: SUZANNE – A patient at Lane Fertility
(Names in the article have been changed to protect patient identity)

This is my second time getting help from a fertility treatment facility. The first time I paid out of pocket. While this was expensive, in a way it made everything easy, because I did not have to deal with the insurance company and I could focus on just staying calm and getting ready for the journey. We underwent a cycle of In Vitro Fertilization (IVF) and had a successful pregnancy the first time. When my daughter was almost 2, we decided to try again.

The second time we had insurance coverage. We thought that this would be great from a financial perspective. However, in order to access the benefits, I had to go through a very painful and emotional process in order to obtain insurance approval. This felt like the last thing that I needed as I started my fertility treatment!

After visiting the clinic and developing a treatment plan, the fertility treatment clinic submitted a request to have my treatment authorized. This took a long time and left me very nervous. I was constantly thinking “What if they don’t approve me?” “Who are they to decide whether I can have more children or not.” After weeks of waiting, a representative called from the insurance company to ask questions, and ordered me to get some lab work done. The fertility treatment clinic had anticipated this and had asked me to take care of the bloodwork several weeks before. I explained to the nurse that my physician had already sent the results along with a letter explaining why I needed the specific treatment. But the representative was unaware of this and asked me to do it again. She also said that a nurse would be calling me in 24 hours to go through a questionnaire.

Lane_Mag_2015_Questions_AskedI waited and waited, and finally three days later I received the phone call from the nurse. Conveniently, I was right in the middle of taking a walk with my daughter and my dog. The nurse then began to ask questions that were very emotional and somehow painful. It felt awkward to answer these questions in the street, but all she wanted to hear were straight answers. There was little sensitivity to the private nature of the questions she was asking.

After answering the questions, the insurance company completed its process and the treatment was approved. However, after the initial cycle was unsuccessful, Suzanne’s insurance refused to authorize her to do a second round of IVF. Suzanne’s fertility treatment center has appealed this denial on her behalf.

I have found that the insurance process involves great deal of frustration and personal intrusion. It is important to understand this if you are going to use your insurance benefits to obtain fertility treatment services.

The Girlfriend’s Guide To Surviving IVF

LFM_Surviving_IVF_Feb2015Let’s face it, IVF can be taxing. It uses emotional and financial resource – often more than we expect. Most women enter the process having been successful at controlling their lives – careers, relationships and health. However,

  • Pick your team – You cannot do this alone! You cannot do this alone! You should not do this alone! So whether you are are single, married or partnered, find someone to help you. You may need emotional support, a ride from your retrieval or help picking up medications.
  • Be your own project manager – there are a lot of moving pieces in an IVF cycle. There are appointments, consents, medication orders, procedures, and endless decisions to be made. Keep a master file of everything from your calendars to your receipts.
  • Dress for success – hormonal injections result in bloating and weight gain. Most women gain somewhere between 5-10 pounds during their stimulation. And since the goal is pregnancy this weight will likely not go away. So put away the skinny jeans and pull out the maxi dresses!
  • Just say no! … To everything else. An IVF cycle takes all of your focus and energy. So, while you are in the process give yourself permission to say no to all of the other commitments in your life. It is the wrong time\
  • Hire a housekeeper – OK, not really. And if you are like most people going through IVF, you are already stretching your budget. But instead do plan ahead. Prepare food in advance, do some extra laundry and get your partner or friends to pitch in and help you.

What worked for you? Share your tips with our readers.