your great life

Fertility advice from the Jeremy Kyle Show?

Did anyone (in the U.K.) see the Jeremy Kyle show this morning? He called it his Morning Surgery. Now, I NEVER watch that show because I HATE the format, the type of issues he covers, the type of people who are his guests, the shouting, accusing, and what I see as emotional manipulation. How do I know what it's like if I never watch it? Simply, I dislike the entire genre of talk shows that primarily exist to surprise, shock, allow their guests to attack each other's character and encourage the audience to loudly express their opinions. More specifically, I watch Daybreak and Lorraine in the morning while getting the children ready for school and see the promos for the Jeremy Kyle Show. On certain occasions when thechildren are in the kitchen with me, I have even had to turn off the TV if something really offensive is being promoted for the JK Show. It's the attitudes and behaviour...

That being said, I am always interested in how infertility is portrayed in the media, so I watched the entire show today for the first time. Jeremy had two doctors on with him this morning, *Dr Arun Ghosh  and *Dr Stacey Palastrand. 

There were four fertility "stories" told on the JK Show this morning:

• the couple who haven't conceived after 4 years of unprotected sex;
• the couple who have endured multiple miscarriages and the heartbreaking loss of their son only a few hours after his full-term birth, and are now 23 weeks pregnant; and
• the woman who gave birth at 57 to a child conceived through IVF  in a Russian clinic (I believe); and
• a 35 year old single woman, an employee of the JK Show, who decided it was time to be proactive about having what she really wanted in life, a baby.

The Pros and the Cons of this show:

• Pro:  the story of the 60 year old mother to a toddler was not overly sensationalized
• Pro/Con:  Dr Ghosh said that there should be an age limit on IVF because of the danger to the mother, the higher percentage of genetic abnormalities in children born to older mothers and the "limited money in the pot" for their care. While I applaud his intentions of keeping both mother and child safe and healthy, it wasn't clear at what age he would cut off women from having IVF... I must have heard wrong, because I thought he was saying over 35!
• Con:  Dr Ghosh kept talking about how unethical it is to treat women with a small chance of success with fertility treatment.  As long as there is no danger, as in the doctor doing harm, and there is no question of the woman's mental health being in danger, isn't that what freedom of choice is about?  Yes, it's emotionally difficult, however, so is remaining childless if you want a baby more than anything.
• Pro:   Thankfully, Dr Palastrand gave a  more balanced viewpoint on the issue of older women becoming pregnant and giving birth.  My understanding is that there is very little danger to the mother if healthy and given good medical care. Also, everyone is entitled to testing for genetic abnormalities in pregnancy, so surely there wouldn't be a large number of babies born with genetic defects.
• Pro: When asked whether having a toddler isn't exhausting for a woman of her age, the older mother answered with some feistiness, that it wasn't as hard as caring for an elderly person, which she had done for more than 15 years before having her baby at 57 years old. She had also worked with special needs children. (It's worth pointing out that her husband is substantially younger than she is.) It just goes to show that the decision of whether to provide fertility treatment should be done on a case-by-case basis, rather than a uniform ban on women over a certain age.
• Pro:  JK asked the question "Isn't it preferable for a capable, older woman to have a baby she will love and care for, rather than the unwed teenagers who neither want nor can care for the babies they are having?
• Con: Not enough was made of the infertile couple's admission that they both smoke. Surely, if they really want a baby and have been unsuccessful for 4 years, they would be committed enough to make this lifestyle change. They should have been told in no uncertain terms that smoking is not acceptable, not least because it could cause miscarriage or low birth weight if they do become pregnant.  It also made me wonder whether the JK Show couldn't have chosen a couple who have tried absolutely everything to conceive. 
• Pro/Con:  the couple with the previous losses were given a 4D scan of the foetus. This could have been a huge emotional shock to them if there was something wrong. Thank Gd everything seemed well.
• Pro/Con:  the scan and sperm sample given to the infertile couple were good for illustrating what could be an obstacle to conception, however, the Drs seemed to just say you're both fine and should have no problem conceiving. There could have been more discussion of the types of further medical investigations that should be done to discover why they haven't conceived in 4 years and how to access them. "Unlucky" was mentioned...that's not good enough.
• Pro: the single mother was able to see her 15-week old foetus and found out that she is having a boy. That was a feel-good moment for everyone.
• Con: Why did the JK show feel it necessary to pad out the program with a cosmetic procedure? It could have actually gone deeper with fertility issues and explore one more issue or give more substantive advice than it did.
• Pro/Con:  the Drs kept their advice simple and sensible, but perhaps too simple. Dr Ghosh's top 5 tips for conceiving are: 1) have sex 2 -3 times a week, 2) stop smoking, 3) maintain a healthy weight, 4) relax and 5) go see your Dr.

Interestingly, Dr Ghosh's profile on his Twitter page describes him as a "UK media GP" who runs a prescription addiction clinic in Liverpool, specialising in sexual health, obstetrics & gynaecology, weight management & CBT. Dr Palastrand doesn't appear to have a Twitter page, but completed her GP training in 2008, with aspirations to be a "salaried GP in a semi-rural practice." Although I would have liked to see more substantive information and advice from the two doctors, and links to helpful resources for viewers, they both came off pretty well and gave a balanced view of the issues.

 

For known donor insemination, thorough discussion, legal advice and a contract are key to protect all parties, especially the children

There was a news item recently about a sperm donor who is involved in litigation over access to the two children conceived through artificial insemination using his sperm.  He had placed an advertisement in the Gay Times newspaper, stating that he was a gay male in a happy relationship, looking for a similar female couple who want to have kids. The children are now 7 and 9 years old. 

In this situation, there was apparently an agreement for some degree of co-parenting. Unfortunately, relations subsequently broke down and the women tried to rescind the agreement, forcing the father to get a court order in June this year. He won the right to see his children for almost half a year. The women are appealing the shared residency order.

We all know that any relationship can break down and that the fallout can be extremely difficult for father, mother and children. The complications usually arise from the emotional rift between the parents who, in all likelihood, once loved each other and intended to live together as a family. While lacking the personal hurt and emotional desertion, there are a whole host of other complications that can potentially arise from the breakdown of a donor/recipient relationship.

In some ways, it may seem that the very nature of donor/recipient relationships are  clear-cut in a way that a love relationship cannot be. You would think that all parties would have had ample time to discuss their desires and expectations and agree important aspects of the relationship before the children are born. However, no contract can really take into account the potential changes that people  will go through as they age, as their relationships evolve and as the children grow up.  While at least the donor/recipient don't have to deal with the particular ill will of a love relationship that has soured, they still have to work through unrealized expectations of each other as parents to their shared children.

If you are contemplating being a sperm donor to a known recipient, i.e. giving your sperm to a female acquaintance so she can conceive, or receiving donated sperm from a known male donor, through a private agreement, it's advisable to have your own legal advisor. 

• If the donation is completely altruistic and free of any intention to share parenting rights and responsibilities, there should be a written agreement that reflects this.  Regardless, under current legislation, upon turning 18 years old, the child will have the right to seek the identity of their biological father.
• If the donor wants to be involved in his biological child's upbringing, this intention should be stated from the very beginning and an agreement as to the extent of his involvement put in writing, signed by both parties and witnessed.
• Discuss access to the child, which could include co-parenting, visitation rights, holidays together or merely the agreement that one day, after a specified age, the child could reach out to meet his/her biological father. Contingencies should be discussed, such as whether the mother can move residence to a location out of the donor father's reach for visitation.
• Try to anticipate the fundamental issues involved in bringing up any child, such as what religion they will be raised in, who will have a say in medical decisions for their health and welfare, who is entitled to make decisions regarding their education, who can apply for a passport on their behalf and who will be named as their guardian if the custodial parent is incapacitated or deceased.
• Discuss financial responsibility for the child, including maintenance and education, including whether there are any contingencies, and until what age the responsibility is in force.
• Talk about emotive issues like gift-giving, especially if there is a disparity in the financial means of the donor father and the recipient mother/parents. Are gifts welcome at all? Do they have to be approved by the custodial parent? Should financial gifts be made directly or through a Trust?
• Agree who will be regarded as siblings, half-siblings and grandparents.
• A woman who is in need of donor sperm to conceive may make concessions during an agreement with a known donor out of desperation. For example, she may regret those concessions once she is a mother and raising a child without the benefit of child support from the donor father, or she may regret agreeing to visitation because of a different views regarding the best interests of the child. Either way, a change of mind is bound to upset someone and may be best mediated by a third party.

There are so many more areas to cover that this only scratches the surface. Even if everything above is covered by a written agreement before the child is born, one cannot anticipate what the child himself will think of the way in which he was conceived.  It's unlikely that he will wish it had never happened, as that would mean his own non-existence, however, he could wish it away, preferring to love and honour his biological mother and her partner, if any, to the exclusion of the biological donor father. What if the child identifies strongly with the donor parent and wants more access to him than any of the parties originally anticipated? The worst imaginable situation, would be for the child to become a pawn, moved back and forth by parents whose amicable relationship has ceased.

There are several sources of support, information and guidance for donor-conceived children and their families:

• The Human Fertilisation and Embryology Authority is a UK government reglatory body.  http://www.hfea.gov.uk/23.html 
• Donor Conception Network is a self-help network of over 1,300 families created with the help of donated eggs, sperm or embryos; couples and individuals seeking to found a family this way; and adults conceived using a donor.  http://www.donor-conception-network.org/ 
• Altrui provides a professional service to find altruistic egg donors for people who need donated eggs or sperm to help them start a family, and may provide an alternative for you to using a known donor. http://www.altrui.co.uk
• There is a service that helps people find their "perfect parenting partners" which has a good section on their website listing frequently asked questions and answers for people to consider. http://co-parentmatch.com

 

 

 

November ICLW

Hello to all visitors, and especially those who have found me through ICLW. Please use the topics "cloud" in the right column, the search function or just scroll down to see what I have been blogging about lately. As you have taken the time to visit, why not take an extra few minutes to leave a comment about what you have read. I check every day and really appreciate it when someone has something to say about what I've been thinking and writing about (except the spam comments I received last month...grrrr!). I am aiming for my highest comment total ever this month, so help me out by leaving your blog URL or ICLW# and I will do my best to visit you too.

Lisa

"My cousin's infertile... can you help her?"

Today, after a meeting, I was approached by a woman who wanted to tell me about relatives of hers who have had extreme problems with infertility and are childless. She was concerned about the couple, both for their individual happiness and for the future of their marriage. I listened to her story and then asked how I could help. The answer: "I don't know."

This wasn't the first time I have been in this situation and I know it won't be the last.  For people like my acquaintance, it's a relief to be able to unburden their worries about loved ones to someone who understands.  They feel helpless, unable to offer help directly to people who choose not to share the details of their infertility and the depth of their pain.  In my early coaching days, I thought a referral would follow, so I kept mental notes of the confidante and her story. I no longer have this expectation, because I know that the inquiry was as much about the enquirer's need for release, information and reassurance, as it was about the subject of our conversation. It makes them feel that they are doing something positive by checking with me and being reassured that there is help available if their family or friends were to seek it. Being there for them in those few moments is simply part of what I do.

It got me thinking, though, about those people who are worried about an aspect of someone else's infertility, and don't have the ability to tap me on the shoulder or motion me aside for a quick chat. Whether they are the want-to-be grandparent, the sister-in-law, cousin or friend, it can be a difficult position to be in. So, I've amswered some of the most frequently asked questions I get from them, below:

FAQ:  My relative has been married for several years and not had any children yet. I know they would want children, so I think one of them must be infertile. I feel really bad about inviting them to family get-togethers, knowing that it must be hard for them. What should I do?

Answer: Never assume the reason why someone is childless.  They may have decided to wait a while, or they could be having problems conceiving. If they haven't shared their reasons with you, it's because they want privacy.  Absolutely do not stop inviting them to be a part of family gatherings for a reason you have only guessed at. Even if they find these events difficult, it should be their decision to attend or not.

FAQ:  The rest of the family is speculating about my relative's supposed infertility. I'm afraid to ask questions, but I also don't want them to think that I am part of the gossip.  Is it better to be up front and tell them I'm concerned?

Answer:  Only you can know how thin-skinned your relatives are. However, the other side of the equation is how congruent you want to be. Is it important that you let them know that you are worried about them and that you want to be supportive? If you are just curious, can you justify possibly embarrassing the couple by asking about their fertility?  Balance your desires against their right to privacy, keeping in mind the strength of your relationship and whether it will withstand this conversation.

FAQ:  I can see that this couple is suffering, but I don't know how to handle it. What can I say?

Answer: If you feel strongly about reaching out, then I would suggest that you try to be as empathetic as possible; stand as if in their shoes and think about how you would feel if the highly sensitive topic of your infertility was raised.  What would make it okay for you...sincerity, warmth, a promise of confidentiality, an offer of support?

FAQ:  Can you help them get pregnant?

Answer: I can help them focus on what they want, align their process of trying to conceive with their value system, commit to doing everything they need to do to enhance their fertility health, reduce their stress and restore their confidence and hope.  In other words, everything we do together would be directed at helping them create their family. I believe most people in this situation would have a better chance of conceiving with specialized fertility support than without it.

FAQ:  I think my daughter-in-law needs some professional help coping with the stress of trying to conceive, but I don't dare suggest it. How do I let her know that help is available to her?

Answer:  Tread very carefully here. The difficulty is that a highly stressed, sensitive person could take great offence at the suggestion that they needed professional help, even if it's true. I suggest that you wait for an opening, i.e. a conversation about anything she and your son want to achieve.  You could mention having read an article about coaching and thinking how everyone could use that kind of support at one point or another in their lives. That plants the seed without you having to do any digging. Then just sit back and let the idea take hold.

FAQ:  I would like to refer my relative to you for fertility coaching, but I would be more comfortable if you contacted them directly. Is it okay for me to give you their details?

Answer:  I don't work that way.  It's important that the client have the opportunity to take the forward action themselves. They have to own the decision to go into coaching in order to commit to the process and believe that the desired result can be theirs. So, I ask that prospective clients contact me at first. I will offer them a consultation and then leave it to them to decide whether to be coached.

FAQ:  Can I give coaching as a gift to my children?

Answer: It's a generous gift and one which could be welcomed by your children if they want coaching but think they can't afford it.  You can arrange payment details directly with them and let me know how it is to be set up. However, you must know that the client is the person I see in sessions and our work is confidential.  I will not be able to discuss the progress of their coaching with you, regardless of who pays the session fees.

Planetary link to fertility? A British astrologer thinks so

Last week at the Fertility Show, I walked past the stand for Fertilityastrology.com without stopping. Honestly, I didn't think it was worth my time to stop and inquire what it was about, when I had a few dozen other practitioners on my list to see during the day.  I may have sold Nicola Smuts short.  According the The Sunday Times, Smuts has just agreed to let Shady Grove Fertility, a chain of U.S. fertility clinics, test her claims that women are most fertile when the alignment of certain planets are similar to when they were born.

It's not for nothing that we refer to the circle of life and the miracle of life. The fact is, that with all the advances in medical science, we still don't understand everything about fertility and conception. A hefty percentage of cases of infertility and miscarriage are unexplained. There are plenty of instances of conception after years of both, which are also unexplained. I have come to believe, over time, that we can develop subconscious blockages to conception; born from pain, fear, trauma, stress and anger, among other negative sources. I have seen the positive impact on women who de-stress, resolve deep emotional issues and take on an attitude of openness to possibility. I have spoken to women who swear that they were helped to conceive by acupuncture, yoga, reflexology and massage, all of which are regularly refuted in medical trials. However, when conception follows, I do believe that these changes contributed to a woman's success; not that they are a substitute for medical treatment or wholly responsible. Thankfully, neither does Smuts. In The Sunday Times article, she admits that her clients' success could also be "down to coincidence, a placebo effect or the power of suggestion."

So, why did I initially react with skepticism to Smuts' astrological service? I don't have great belief in astrology under any circumstances. If I read the weekly astrological predictions in the back of a magazine, I treat it the same as I do the fortune in a Chinese cookie: I ignore what I don't like and circle what I do. I think of it as a bit of fun, but I don't take it seriously. I suppose that I am afraid that women who have spent years and fortunes to have a baby and come up empty-handed, may be desperate enough to put their hopes in the hands of someone who may be spinning them a story.  I have nothing on which to base my belief or disbelief, so don't go by me.

It's true that our menstrual cycles tend to follow a 28-day pattern, like a lunar month. I just don't see the connection between where the planets were on the day I was born and my ability to conceive. I was born a month premature. Perhaps if I supplied Nicola Smuts with my birth details, she could help me understand if there was a connection between that and why I failed to conceive for several years, and why I conceived my two children when I did. Regardless, there are women who were labelled infertile who credit Smuts with predicting the conception of their babies.  If it's good enough for them, who am I to knock it? I would like some more proof, before I can suspend my disbelief, so I am looking forward to reading the results of the Shady Grove test when it is made public.

On World Kindness Day, being kind to yourself can be the greatest step forward of all

There's nothing like a little food for thought with your morning coffee, which is why I was happy to read Kindness: why people need it, in the December issue of Psychologies Magazine.  Generally, it's a good reminder of the value of kindness, which we could all use. That wasn't what caught my eye, though. It was the assertion that painful events leave stronger impressions on the mind than happy ones.  This was supported by a quote from American evolutionist Stephen Jay Gould, who said "One wicked action cancels out, in our perception, 10,000 acts of kindness." It struck me first as incredibly sad, all the moreso because I fear it could be true for most people.

Thinking back to school, I remember certain teachers by a single instance of using a harsh tone of voice that crushed my fragile child's ego, especially the gym teacher who taunted me for being useless at climbing the ropes. I clearly remember a certain boy who once made fun of me when I wet my pants in kindergarten, aged 4, but nothing else about him. A relationship that ended in heartbreak seems more significant in shaping my expectations of men than the one in which we agreed amicably that we should just be friends.  For quite a long time, these incidents seemed to define me and I took on the shame, embarrassment, insecurity and weakness associated with them. Now I know that it doesn't have to be this way, because, while I haven't forgotten the incidents, the emotion surrounding them is gone. They happened to me, but in some ways, a different me.

In contrast, I have observed certain friends over the years picking themselves up and brushing themselves off after hurtful incidents, rejection, grief and failure with less fuss, less self-pity and more forgiveness than most. It seems to be part of their make-up; their emotional wiring. It's not that they don't feel the negativity as deeply; they just don't hold on to it in the same way. I have no doubt that these friends of mine, and others you may know, are better off than those people who hold a grudge, continue to feel the same level of pain or offence and dwell on the 1 cruel act out of 10,000 kind ones.  There is less turmoil in their systems.  There is a lightness in their step.  The rest of us can wear pain and hurt like a heavy blanket, dragging us down. At its mildest, you invite labels like "drama queen." At worst, it separates you, like a Caution sign that tells other people to tread carefully, lest they re-open your wound in some way. Even after we think we have gotten over something painful, a chance reminder can momentarily bring back the pain like the twist of a knife.  However, even if you are not one of the lucky people who have learned on their own to move through their pain toward happiness, you can still learn to do it now.

Think of the most painful incidents in your life, interpreting pain however you like. It's useful to list them.  We are really talking about emotional pain here, but it may help you understand ourself better if you look at incidents of physical pain and how you processed those memories also.  I have memories of pain associated with injections, dental work, incisions and stitches that have resurfaced throughout my life, causing me to fear even what I know now is not as painful in reality as the memory. Just as I used those memories as justification not to have flu shots, fix a tooth and have a knee operation, I used my emotional responses to painful events to justify not stepping forward when opportunities presented themselves professionally, socially and personally. I'm grateful that I had a few people in my life who showed me ways to take the intensity out of those emotions so they no longer have power over me.

Without doubt, the most painful incidents in my life were surrounding my multiple miscarriages and infertility, including not only the events themselves, but also interpersonal incidents surrounding them. I know that if I continued to feel the sharpness of that pain now, I would not be able to function and I would no longer be married. As grief and anger turned into acceptance over time, I was able to put some of it behind me in order to find the happiness that I have now. The sadness remains, but put into the context of my life as it is now, I can say with some relief that the pain has nearly been eclipsed. I believe that we can all choose how we process our emotions. So, even if you think right now that you will never feel better after losing a baby, or never be happy until you are pregnant or have become a parent, never say "never." You can heal, by seeing the worthiness of other aspects of your life, refusing to manifest other peoples' insensitive remarks, giving yourself credit for your courage and by nuruturing yourself, among other kindnesses.

Shifting pain can take quite a lot of mental energy, but if it all seems like too much hard work, just think how burdensome the negative feelings are that you carry around. The built-up fear, anxiety, stress, disappointment, self-blame, hopelessness and anger around miscarriages and failed cycles can lead you to shut down different parts of yourself for self-protection. The emotional issues are manifested in physical ailments, such as headaches, stomachaches, stiff neck, lethargy or insomnia. Is it any wonder that you may have difficulty conceiving if you are holding on to all that? You have a right to feel the way you feel, but it's not necessarily right to feel that way forever. Not if it takes away your joy in living, takes priority over the good aspects of your relationships or keeps you from getting  what you want and deserve.

Think of the person you were before you were hurt in this way. Were you calmer, more patient, kinder to others, more open to possibility and trusting? It would be worth a little hard work to re-gain that image of yourself, wouldn't it? The focus here is not on suppressing your true emotions, but on releasing them. In order to do that, you have to first acknowledge and feel them. In coaching, some gentle questioning can help you reveal the painful event where those emotions have taken hold and stuck firmly. Various coaching theories and methods exist, including cognitive behavioral therapy and NLP, which can then help you shift those emotions, so that they cease to block your progress and your happiness.  I have had some really positive results with EFT as well, which uses a non-invasive stimulation of meridian points (similar to acupuncture but without the use of needles) using coaching to help reveal the specific, painful event and identify the emotions around it, and then EFT to help release that emotion. It's a really positive step forward.

How does this all fit in with kindness? Holding on to pain is the antithesis of being kind to yourself. You cannot be a happy person while you store up resentments, think of yourself as a victim, or believe the negativity someone else has sent your way.  Take steps to change that thinking and positive changes in your behaviour will soon follow. Be patient, generous and respectful of yourself.  Challenge yourself to be better and do better; then use the confidence that comes with success to push you a step further. Be kind to others and reap the reward of knowing you have made a difference in the way they see the world.  Even if, as Gould says, the one cruel act cancels out the 10,000 kindnesses, that is just in perception, not in reality. Every kind act you do, however tiny, helps you feel better about yourself and humanity, even if the feeling is stored away and given little attention. So, how about trying to cancel one cruel act with 10,00 kindnesses?

The key to reversing overwhelm: create a big picture or break it down into bits

I have written several times about the overload of information, as well as the sheer weight of emotion, that infertile people are subjected to while trying to conceive. It's rare that I come across a person, or couple, who has not felt that way at one point or another in the process. Some, more than others, of course. Our ability to handle these phases and move through them has to do with focus. As with any other challenge, if you keep your eye on the desired result, you will be able to re-group after a minor glitch.  Without focus, a minor setback can blow up out of proportion and create an obstacle that has the potential of throwing you off course. 

An example of this is the attrition rate from IVF. When Dr Sam Abdallah of the Lister Clinic spoke recently at the Fertility Show about the success rates for a fertility clinic, he pointed out that in a first cycle, approximately 30% of women under the age of 35 may become pregnant. Of the remaining 70%, half of them will give up and half will go on to a second cycle, and so on. So, take 100 women who cycle, in IVF terms, together. Of the 70 women whose cycle did not result in pregnancy, approximately 35 of them will decide for whatever reason that they cannot go through that experience again.  30% of the 35 who do repeat the IVF will conceive, making a total of approximately 42 of the original 100 pregnant, and so on.

Of those who drop out of an IVF program, their individual reasons may include financial stress, marital stress, the medicalization of what should be a natural, intimate process, the impact of the fertility drugs on their system, the imbalance in their lives caused by the obsession with conception, etc... In one way or another, they felt overwhelmed by the odds and decided that the trade-off wasn't worthwhile. I would bet that if these women were able to turn the overwhelmed feeling around before it became so big that it eclipsed the desire to go through IVF again, the numbers would be different.

Think of how it feels to be overwhelmed. You may disconnect from whatever you are involved in and shut it out. You can get a headache or migraine which interferes with your ability to listen. You may feel dizzy. You may be aware that someone is trying to talk to you, but feel that there is an invisible, glass wall between you. You may fantasize about being at home under the comfort of your duvet. You can feel very tired. You will have difficulty concentrating. Maybe nothing makes sense. To keep pursuing conception under those circumstances may be counter-productive as stress and negativity can suppress the hormones you need to conceive.

Create a big picture - There are times when we have to look at the big picture for everything to make sense. A rather literal example of this is a painting in the pointillist style, such as those by artist George Seurat.  The image created with hundreds, if not thousands, of small dots of colour on a canvas may be difficult to decipher, however, in taking a step back from the painting, the eye sorts out the play of light, shadow and shapes and the "big picture" is revealed.  In a similar way, all that you are thinking, questioning, learning, doing, feeling and discussing can overload your senses to the point that you lose sight of where they each begin and end or how they fit together. Step back from the process of trying to conceive and look at why you are doing it, to reinforce your priorities and justify the amount of effort you are putting in. Then, begin to break down that picture into small bits.

Break it down - The other way to reduce your anxiety is to identify all the different aspects of your life that are contributing to the overwhelmed feeling. It may seem more manageable to deal with each one of them individually, either one or a few at a time.  Once you remove the first few obstacles, the renewed sense of control will allow you to tackle some of the more difficult or complex obstacles. At this point, you should be able to put the rest of the obstacles into context and order them by priority. Before long, the feeling of overwhelm should be gone.

Change the way you process responsibilities -

1. Look back at what set you off in the first place. Were there any warning signs that it was all getting too much for you? If you can, list those signs so you will recognize when you are in danger of feeling overwhelmed again. 
2. Learn to respond rather than react. Don't let it all pile up on you to the point where you burst out of frustration or stress.
3. Analyze each situation, thinking "what is being asked of me?" Is this something I am capable of doing?  If so, put it on a to-do list; if not, figure out whether the best course would be to delegate, ask for help or say "No."

Example of overwhelm: You are hoping for the go-ahead from the fertility clinic for treatment. In the meantime, you're busily researching the condition you think you may have (let's say endometriosis), as well as every medical term you have heard in your appointments. You are trying to find the right fertility charting software, so you are trawling the online forums for recommendations. You have found a fertility-friendly food and fitness plan but your cabinets are full of high-fat and high-sugar snacks you have to finish first. You have been told by the nutritionist to get a fortune's worth of vitamin supplements.  You have to use your lunch hours to see the acupuncturist, while 2 evenings a week are spent on webinars given by the big-name clinics.  You're only a few pounds overweight, but you don't want any obstacles to conception, so you are cutting down your food and weighing yourself 3 times a day. You want nothing more than permission to get started, but the thought of injecting yourself with the fertility meds in a few weeks makes you so uptight you can't breathe.  You feel exhausted and are having mood swings.  Lately, if anyone so much as uses a sharp or impatient tone, you get tearful and run from the room.

First, list everything that is overwhelming you in the most simple terms, leaving out any description or emotional language. So, the above situation can be broken down like this:

• medical tests
• learning about endometriosis
• find the best infertility glossary
• find the best fertility charting method/software
• start posting on a fertility forum and "friend" some regulars
• clear out the larder/freezer of junk food
• get the vitamin supplements into a workable system
• find time for the acupuncturist
• lose 5 pounds
• reduce the fear around self-injecting

Put it away - Once you have made your list, I would recommend that you put it away until the following day. Some people will look at the list and panic that it is so long, while others find a sense of relief just from getting this far. Knowing that the list exists may be enough to feel some of the weight temporarily lifted. That part is due to personality, but it doesn't need to affect the end result.  When you return to the list, categorize the entries under headings in a new list, such as: medical, informational, connections, diet and nutrition, complementary therapy and emotional wellbeing.

Let's take Diet and Nutrition, under which you will have listed:

1. Banish junk food
2. Take vitamin supplements
3. Lose 5 pounds

Then, under each entry, break down the goals further into manageable tasks with time frames:

Ex. - Banish junk food

1. Over the weekend, remove all sweets, crisps and high-fat food from kitchen cabinets to a box and put in the boot of the car and possibly donate as "party food" to a local group;
2. On garbage-collection day, throw out all high-calorie, high-fat and high-sugar frozen and refrigerated food.
3. Make a list of healthy, lower-calorie foods and plan meals for the week.
4. Go grocery shopping with  list to replace junk food with healthy food.

The immediate result of making your list is that you will begin to focus on a narrow area. Intially, you may only be able to picture the tasks and the desired result, but once you begin acting on them, you will recognize a new sense of control and the context; how it relates to and impacts upon the whole process of trying to conceive.  By focusing, you will cease to worry about the enormity of everything you have to do when taken in total.  In fact, by following this path, you will see a knock-on effect that will shine a little light elsewhere as well.

Ex. - Eating more healthily may mean you can reduce the vitamin supplements you take, and give you more energy. Eat better -> less tired -> less moody -> lose a few pounds -> you may experience a boost to your self-esteem. What next? Perhaps, feeling good will make introducing yourself on a fertility forum that much easier. Be friendly -> attract followers -> share your experience of the diet and nutrition plan -> earn friendship, gratitude, support -> ask for recommendations of fertility charting method and other peoples' stories of how they dealt with the fear of self-injecting -> feel connected and supported -> the feeling of being overwhelmed goes.

You can see the process. If you are committed to creating  family, you are in for some hard work, but you can handle it. If it ever seems like it's all too much for you; step back to give you the time and space to identify the essential actions required of you.  Break down the elements into manageable portions and systematically tackle each one separately.  Use the positive results in one area to motivate you in another area. When you feel that some control has been restored, start looking at the separate parts in the context of the whole process again, so that it makes sense.

It's important to have public events related to fertility in the annual calendar

Okay, so the UK is a relatively small country and we can't necessarily support the number of events taking place annually in the U.S.  However, there were 706,248 live births in 2009.  More than 36,000 women have IVF in the UK each year.  Around 1.5% of all births and 1.8% of all babies born in the UK are the result of IVF and donor insemination, according to the HFEA.

Both female and male infertility are on the rise. HFEA statistics are released a few years later, so I don't have figures for 2009, however, other government figures show that the number of live births in England and Wales in 2009 decreased for the first time in eight years, compared with 708,711 in 2008. This is the first fall in the annual number of live births since 2001. If you haven't heard about infertility in the news, you must be boycotting TV, radio, the web and print media, because it seems to be the topic on everyone's lips.

Unlike a situation in which you are ill and your doctor explains your condition on a need-to-know basis, infertility is an umbrella topic that requires affected people to acquire a huge amount of information. The difference is that people first have to fill in the gaps in their knowledge about how their reproductive systems are meant to work. This learning curve comes from our reticence to talk about our reproductive organs, our sex lives, procreation and our most fundamental yearning to have a child. Once people begin to learn the way it all works, they question why their own system isn't working the way it should.  It can take a while for a general practitioner to respond to questions about infertility; many, it seems, sending their patients back to "try a little longer," or "relax and let it happen." Patients' frustrations then motivate the acquisition of more information, but their search is based upon guesswork.Once the investigations get rolling, there is more specific research to be done, to make sense of a possible diagnosis or treatment options offered.

Infertility patients who don't get answers they understand, like or can accept, will doggedly seek and consume every bit of information they can get in an effort to beat the odds on their chances of conceiving.  There is a pervasive feeling in the UK infertility community, and perhaps everywhere, that infertile people have to be their own best advocate and expert, because otherwise the fertility-medicine and fertility-business communities will ignore you, let you down or fleece you.  Not satisfied with laymens' terms, the self-made fertility expert wants to know a condition's or a procedure's Latin name and its acronym, letting medical jargon drip off their tongue with ease. That level of familiarity helps them feel in control when in a medical environment; it sees off intimidation and condescension, makes them feel a part of the process or the team and helps them make decisions. 

Fundamentally, the fertility patient and her/his partner need to know:

• how their body should work,
• reasons why it may not be working as intended,
• the investigations that can lead to a diagnosis, 
• how to get their doctor to take them seriously and refer them to a specialist,
• the options available for treatment (both traditional and alternative therapies),
• the risks, side effects, possible consequences and costs of undergoing each treatment,
• the success rates associated with certain treatments,
• success rates as applied to each fertility practitioner/clinic,
• the government regulations relating to various treatments, 
• the emotional wear and tear of undergoing treatment,
• the impact on a child of being born through the use of assisted reproductive techniques and the legal aspect of the parent/child, donor/recipient and surrogate/adoptive parent relationships.  

Where will they get this information?  Trawling the internet, though vastly more efficient than the old-fashioned search through the stacks at the local library, is dangerous as potentially causing information overload about infertility.  Sifting through the immense number of articles is time consuming. The best sources will bring information together in one place: a website like that of Infertility Network UK  or a fertility event that attracts exhibitors, speakers and visitors from one end of the spectrum to the other; funded treatment, private treatment, natural and mild treatment options, more aggressive intervention, self-help and third party support.

The Fertility Show, which took place recently at Olympia in London, is the major fertility-related show in the UK; a new focal point for the annual calendar whether you are a patient, medical professional, complementary therapist or company selling products which support fertility, conception and pregnancy.  It has filled a huge gap in the provision of essential information needed and demanded by the consumer. The question is, with such a great need, why is it virtually the only UK fertility event? The formerly fabulous, women's health event, which was largely fertility-related, held by the Wellbeing of Women, is endangered, having attracted less than 50 visitors this year.

What would you like to see offered? Would you support smaller fertility health events? Would it help if they were regional, as opposed to being centralized in London?  Is the entry price an issue? What do you regard as crucial to a fertility event's success...seminars, check-ups, demonstrations, appointment times to see various exhibitors, prize draws...? Please email me directly with comments on this one, at lisa@yourgreatlife.co.uk.

What I took away from the Fertility Show; knowledge, contacts and a rubber model sperm among them!

I planned to write all about my visit on Friday to the Fertility Show, however, yesterday I went back for a second visit.  On the first day, I circulated among the 109 exhibitors' stands, saw one of my clients, sat in on a few of the seminars on offer and met with colleagues in the fertility support community: among them, Karin Thayer of Fertility Planit, Sarah Holland of Fertile Mindset, Kristen Hayward of Positive Birth, Camille Strachan of To Hatch, Sophia Villiers of Nourish Naturally and Jane Karsten of Windsor Reflexology. It was a fantastic opportunity for us to meet and see what we each bring to the table for people hoping to conceive and/or pursue an alternative method of parenting. 

At the end of a packed day, I struggled home with bags of leaflets, business cards and quirky branded items like one of Santa's elves dragging a sack behind him. My family was bemused to see me unload my bounty on the kitchen table: stress balls, numerous pens, chocolates, a diary, a pregnancy test and a rubbery model of a sperm!  The bonus of the weekend, in terms of assisting my professional work, was an Embryo Replacement Catheter courtesy of Smiths Medical/Wallace.  It wasn't one of the items they were giving away to the general public, but after a demonstration and at my request, they kindly gave me one to help calm possible fears of clients who are anxiously awaiting IVF. 

Yesterday, I went back for another full day. I was able to meet more of the exhibitors, go to one more seminar and found Sandra Walker, a reflexologist from Hatfield, whose interests coincide with mine. I met some amazing colleagues from the fertility community, from hypnotherapists to embryologists, and was able to see the fire in their eyes when they spoke about what they do to help people conceive the baby they want so much. It took my understanding of them and their work "off the page" to a different level.  There are several people from both the UK and the U.S. I look forward to talking with further, working together or feeling comfortable enough about to refer my clients.

Of course, there were people on various stands who seemed to be more the "pack them in and sign them up" type, but that was good to see too. I won't name anyone here.  While a worried and impressionable couple might be drawn in by the slick efficiency of that type of fertility clinic, seen in isolation, it's my belief that they stood out like a sore thumb when viewed side by side with the more personal, caring approach of their competitors. Yes; success rates, cost of treatment and location of a clinic are all important, however, not as stand-alone factors. Take them together, and with other factors such as language spoken, accessibility, after-care and patient support offered, a willingness to listen to your concerns and flexibility of approach.

Of the seminars I attended, the one that impressed me the most was given by Dr Sam Abdalla, Director of the Lister Fertility Clinic: Is anyone too difficult to treat? While conceding that not every woman will be able to conceive, Dr Abdall's philosophy is not to turn anyone away if there is some chance, however small. He did state that if a woman had zero chance of conceiving, it would be unethical to treat her.  However, rather than only taking in patients under a certain age (there were those at the Show that had a cut-off) , or with a high chance of success, as a means of keeping the clinic's success rate high, he believes that the best policy is to inform the patient of her options, her chances and give her the choice of whether to proceed. Remember, whereas years ago, a woman with low ovarian reserve may have been out of luck, now of course, she has a good chance of conceiving over several cycles of IVF, with different tratment options or with donor eggs. The choice is hers.

I will be writing more this week on some of the topics that came to mind during my visit to the Fertility Show, including how to get the best patient services from your fertility clinic, questions relating to going abroad for fertility treatment and how to decide whether complementary therapies are right for you.

Were you at the Fertility Show? If so, I would love to hear what you thought of it.  I am actively seeking comments, as I am trying to decide whether it would be beneficial for me to take a stand for next year's event.  Please let me know what you thought of the Show.

"What if I do all this extra work and I still don't get pregnant?"

Yesterday, my daughter asked "What if I do all this extra work to do well on the secondary school entrance exams and I still don't get into one of the schools I most want to go to? Now, we know very well that this answer will never satisfy a child, nevertheless, most of us with a few decades of adult life behind them would tell her that she will still have the knowledge she's acquired, she'll have the satisfaction of knowing that she tried her best and that she has to be positive! I did. She rolled her eyes, heaved a big sigh and high-tailed it to her bedroom. I'm not all that surprised. I certainly didn't mean to condescend; I was sincere and actually, there was little else I could say. But that doesn't mean that the answer feels acceptable to the recipient.

The same goes for a conversation along the same lines with a person who is trying to conceive and not getting anywhere fast. Once they have suspected that there may be a problem, all sorts of homework is done. There is so much to learn about our bodies, our reproductive system, medical treatment, health and complementary therapies that infertile people are practically embarking on a fairly intense home-study program. In books, on the internet, in monthly magazines, newspaper supplements, leaflets at the doctor's office, conversations in support groups, on blogs and on TV, there is an enormous amount of information.

Everyone tells you what to do: read everything in sight on infertility, find the best doctor, review the food you eat and make healthy choices, keep your weight up or down, take supplements, abstain from alcohol, de-stress with yoga, balance your system through acupuncture or reflexology, don't smoke, don't sit anywhere near a smoker, cut out any food that could give you a bacterial infection, such as listeria, get enough sleep...try Traditional Chinese Medicine on its own, chart your temperature, and on and on. You may think at first that you will be willing to do any of these things if it will bring you the pregnancy you want so much. However, after many months and no rewarding result, all of the effort you are putting out to be "good" can be really tiring and frustrating. At some point, you too may ask: 

"What if I do all this extra work and I still don't get pregnant?" Will it help for someone to say "You'll still be healthier and more knowledgeable, you'll have the satisfaction of knowing that you tried your best and you have to be positive?" It may be true, but that's not what you want to hear.  Unfortunately, the answer remains the same, and just as I told my daughter, life isn't always fair. So, in those despairing moments when you begin to think that the efforts have been wasted, think of these points:

• Learning is never a wasted effort;
• Neither is becoming healthier;
• You are investing in yourself. If you really go for it, you will feel you truly own it in a way that you can't if you are only half-hearted in your efforts;
• Even if you don't conceive, you will be stronger and more able to take on the next challenge, which may be to investigate another route to parenthood;
• You are in charge of all that is within you to change: attitude, behaviour, focus, commitment, discipline, etc. Taking that control will have a enormously positive, knock-on effect on the rest of your life;
• You are never 100% in control of your body and it's responses, regardless of how much you have changed, therefore you are not to blame when it responds differently than you would have liked. No fault, no blame, no failure;
• As much as we all wish you didn't have to go through any of this at all, the fact is that you are. It's up to you if you are going to let it beat you, or if you come out of the challenge with a greater sense of purpose, more resilience and a better understanding of yourself and your capabilities;
• If you don't give it your very best shot, you will never know if you could have achieved what you want. That's where doubt and regret set in; and finally,
• Anything worth having, is worth working for.