Mental Health Coping Strategies From A Fertility Expert
October is Mental Health Month, and the aim is to raise awareness that good mental health is vital to our overall health and well-being. It is certainly true when it comes to facing infertility or undergoing fertility treatment, which are often likened to an emotional rollercoaster – a journey that also impacts your mental health.
At the recent Fertility Show Africa 2023, Dr Mandy Rodrigues – resident clinical psychologist at Medfem Fertility Clinic – shared the best copying strategies from her own fertility journey and her 30 years of experience in the field of fertility care.
Medfem Fertility Clinic’s Dr Mandy Rodrigues works with individuals and couples, helping them cope with the fertility journey and assisting them with making life changing decisions, based both on her own fertility journey and on her three decades of experience working with couples facing infertility and undergoing fertility treatment.
She tells: “I went through IVF or in vitro fertilisation myself in the 90s. At that time, the success rates were very low – just one in ten IVFs would work. I did three retries, and none of them worked. I also had two miscarriages. I know the crippling loss, the shock, the desperation, the disappointment, the negative results, the difficult decisions – which often causes intense mental health issues like anxiety or depression. And then, after all of that, my children were born!”
Here are some of the mental health coping strategies Dr Rodrigues shared at her talk during the recent Fertility Show Africa 2023.
While the success rates of ARTs (Assisted Reproductive Therapy) and especially IVF are so much higher than before, it is more important than ever to remember that even with advanced fertility treatments, not every egg is fertilised, not every fertilised egg implants to become a pregnancy, and not every pregnancy results in a live birth.
Even in a young couple with no fertility challenges, where both partners are healthy and under the age of 30, the chances of a pregnancy is just 20% during each month or menstrual cycle.
Fertility treatments like IVF increases the chances of a pregnancy to 33% per cycle. But even with good quality eggs and sperm, not every IVF will result in a pregnancy or a live birth.
However, it is possible to have peace of mind while undergoing physically demanding treatments while on an emotional rollercoaster that could include treatment failure.
Create peace of mind
The ideal cognitive way to go into IVF treatment, especially the first IVF cycle, is to view the IVF treatment not as the only opportunity ever to have a baby, but rather as going through a invasive, emotionally trying and also expensive medical procedure, that will provide better information about your unique and specific fertility challenges.
You can experience more peace about the outcome of a treatment if it is not regarded as a finality, but rather as an exploration stage you have to go through. There are many factors that cannot be determined without completing a cycle of IVF. Determining these different factors that possibly impact the success of your treatment, enables you and your fertility team to identify more specifically the problem and to go back to the treatment drawing board. This increases the chances of the next IVF being successful. Many couples require two or more IVF cycles to achieve a pregnancy, and the success rate among couples who have three IVFs is 95%.
It is also helpful to be realistic about the process and have a longer term perspective. Perhaps plan for a year ahead with maybe three IVFs setup. This kind of realistic thinking also provides space for other life goals and helps create peace of mind.
Break the process up into steps
Another excellent coping strategy is to break a big process up into smaller, more manageable steps. For example, long distance runners completing the 90 kilometres of the Comrades Marathon break up this seemingly impossible goal into smaller stretches, demarcated by milestones along the way. The focus is not on achieving the seemingly impossible grand end goal, but just on completing the step at hand, and then the next one.
Adopting this approach also helps couples to cope with the many possible disappointments along the way. Many patients are worried about how they will cope with a big disappointment, such as a failed IVF cycle, but the truth is that during the IVF process, there can be many seemingly devastating setbacks. Maybe at the first scan a problem is identified, or maybe aspiration is not successful, or perhaps you get bad news while the embryos are in the lab. These are called abandoned cycles.
But whether an abandoned cycle or a failed cycle, it’s easier to cope with the stress and the possible disappointment, if you go through it one step at a time. Breaking the process down into steps also helps to create more predictability, another great coping strategy.
Studies have shown that the first IVF is usually the most challenging because it’s so unfamiliar. If you have to go through a second IVF cycle or even a third, each one becomes easier because it is more familiar each time, and that makes it more predictable. There is less psychological trauma.
So how can you make IVF more predictable? You plan for what you’ll be going through!
At Medfem, Dr Rodrigues creates an IVF calendar for each patient that shows each step in their IVF process, as well as the mood they can expect during certain days. When you divide the process into smaller steps like that, you make it predictable. You can plan for the difficult days and structure your routine around how the IVF goes, for example, by taking the afternoon off at work on difficult days, or not going to a family dinner the day before a procedure. You can also use a fertility tracker.
Everyone that goes through IVF is stressed. Everyone is stressed by aspiration. Everyone is stressed when the embryos are growing in the laboratory< Everyone is stressed when they wait for their results. The good news is that this acute stress is not bad stress. Studies show that this acute stress goes up and down, and it does not impact on number of embryos on viability on birth rate.
The big concern is long-term or chronic stress, what is called time urgency perfectionism stress or TUPS. You can manage this stress – and you can find out how at tups.co.
Manage your relationships
The shock of an infertility diagnosis and the strain of undergoing fertility treatment have a huge impact on relationships, not only between couples, but also in their relationships with family and friends, and colleagues.
Sadly, many couples don’t speak to one another. When couples facing infertility try and avoid one another about the topic, it is called independent coping. So, the husband might start coming home later, or may be too upset to ask how his partner’s day was, or is too scared to mention someone at work is pregnant. So, the male partner often copes with his fertility in one way, keeping to himself and not talking about it. His wife wants to talk about it, but since her husband won’t, she withdraws and tries to cope independently.
Talking about your infertility, hopes and priorities as well as other important issues, such as how much support you expect from each other and who you will tell about your fertility challenges, is crucial to prevent relationship breakdowns. By communicating and supporting each other, you have a better chance of success.
Trust your specialists
Trust your fertility specialists! If you choose a fertility specialist that is accredited by SASREG, you can rest assured of fertility expertise and experience that will help you improve your chances of a pregnancy, and professional support and care during every step of your fertility journey.
Also find a psychologist who not only specialises in infertility but also experienced a fertility journey, and is able to really understand the intense emotional rollercoaster ride you and your partner are going through.
At Medfem Fertility Clinic, we are a committed and understanding team of medical professionals, who have the experience, knowledge and desire to provide you with the best chance of a successful outcome at the end of your treatment.
Since the 1980’s, Medfem Fertility Clinic’s team has assisted couples struggling with infertility to experience the joy of parenthood, helping to bring more than 18,000 babies into the world.
If you would like to meet one of our fertility specialists, simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.
Our Fertility Specialists can also meet with You During a Virtual Consultation Via Zoom or Skype. Click here to book a virtual consultation now.
We look forward to meeting you!