Friday, February 25, 2011

Fertility & Positive Thinking: Tool or Trap?

Two recent pieces of news/writing have prompted this post:
  1. A new article in Reuters about a study showing that stress may not have any impact at all on IVF outcome: http://www.reuters.com/article/2011/02/25/us-fertility-stress-idUSTRE71O0B520110225
  2. A post by the wonderful Deborah Lynn of The Resource Guid for Pregnancy at 40: http://www.over35newmoms.com/testimonials.html?entry=on-becoming-our-infertility
So here's my take on positive thinking, negative thinking, and the stress of feeling overwhlemed by infertlity:
In the world of women over 40 who are trying to conceive, the latest mandate is not to take your prenatals or avoid coffee: it’s to think positively.
In the more than two years I’ve spent in my “40+-and-TCC” online group, positive thinking has come up more frequently, and passionately, than any other topic.  When to start thinking positively (Envision your follicles growing with every shot!), what daily actions you can incorporate into your visualization-regime (Keep imagining a baby seat in the back every single time you drive your car!), and, most importantly, what to do when spirits flag (Never, never let the negative get inside your head.)
The advanced-maternal-age sector, along with the infertility community at large, has embraced the pop-culture trend of “if you build it, they will come,”  spawned from such best-sellers as The Secret and Creative Visualization: Use the Power of Your Imagination to Create What You Want in Your Life. But nowhere today does the admonishment to visualize success seem to ring more loudly—or, I’ve begin to think, more problematically—than in the Over-40-and-Trying-To-Conceive sector.
The support and caring and love that accompany the admonishments I mention above from my TTC online group: these are real and admirable and invaluable, and in no way to I mean to diminish that.  But their insistence on forcing us to deny or push away the stress and even the feelings of hopelessness that are an inevitable part of having our hopes dashed month after month: this is what I fear is harmful, actually.
As one oft-cited expert has written, “You can think yourself (in) fertile! It’s your choice.” And herein lies what makes the positive-thinking mandate so tricky: the corollary that the failure to conceive stems not from biology but personal shortcoming.  Similar criticisms have been made of applying positive thinking to the effort to overcome cancer, depression, etc.
But there’s another problem with compulsory optimism: the stress it can cause through denial of the natural lows accompanying infertility.  A handful of experts are starting to explore this paradox and the link between the suppression of negative feelings and an increase in cortisol, a chemical that may inhibit conception.  As Dr. Lisa Rouff has written, “It can be common for some infertility patients to [try to] maintain a very optimistic outlook… [But there are] pitfalls of this type of thinking as it relates to infertility treatment.” (http://www.lisarouff.com/blog1/index.php)
I’d like to propose an alternative to enforced optimism—and the only mind-set that has worked for me after four IVF cycles, one miscarriage, diminished ovarian reserve, and eight pregnant friends: allowing ourselves to experience our full range of emotions, and limitations, with compassion and acceptance, and then embracing our fierce potential to create our strongest possible bodies, ones that will eventually support either a healthy pregnancy, a deep appreciation of all we’ve already built, or a vibrant child-free life.  I’m not advocating giving into the despair infertility can cause, or allowing it to overtake us forever.  But I am advocating allowing ourselves to acknowledge it―and not blame ourselves for it―and even to feel it fully, before we expect ourselves to move on to what I believe is the true opposite of negative thinking: not willful positive thinking, but realistic thinking, supplemented with pride in ourselves for all that we achieve and create when we make it through one more day of infertility.

Wednesday, February 16, 2011

Missed Birthday

Today would have been our baby's first birthday, if it had ever been born, if it had ever lived past 8 weeks and 5 days, if its heart had kept beating.

I'm not sure what one is supposed to do on a missed birthday after a missed miscarriage after the only pregnancy one was ever able to concieve, after 27 straight cycles of trying (minus the 3 during the actual pregnancy-of-the-baby-that-never-was, the one after that baby-that-never-was's "missed" miscarriage, and one additional one when one and one's husband were on different continents and thus unable to try procreating), after 3 IVF cycles, 4 embryo transfers, and over two years straight of monthly minor heartbreaks or major depressions, depending on one's state of mind when one's period shows up yet again.

Does one cry inconsolably?  Hold some sort of missed-birthday ceremony?  Increase one's dosage of Zoloft?

I've done none of the above.  But I did stay in bed until past noon.  And then watch reruns on TV.  And then had a muffin and a coffee, neither of which is allowed on my fertility diet.  And then decided that I just couldn't take this feeling of being in limbo one second longer, with nothing to show for it.

So now, against all my better judgment perhaps, I'm writing out loud. About being infertile, in limbo, and in total confusion about how one goes ahead with one's life in any kind of productive way when one cannot seem to reproduce.

My questions:

  1. How does one make anything meaningful, achieve anything worthwile, while being chewed whole and spat out daily by the soul-sucking experience of infertility?

    --and, perhaps more easy to answer:--

  2. How does one mark the birthday of a baby-that-never-was?