Holiday Tips During Your Fertility Journey

For a couple that has been struggling with infertility, the holidays can be a particularly painful time. Family gatherings that may be filled with babies and children can serve as bittersweet reminders of what didn’t happen for you this year. You may have had one or more failed cycles or even miscarriages over the past several months. While you and your partner tried to avoid getting your hopes up, it is likely that with each embryo transfer you found yourself daydreaming of holding your precious little one at holiday family gatherings. Whether you’ve been private about your fertility journey or an open book, you can depend on the fact that you are bound to be subject to some uncomfortable conversations about your ability to bear children. 

One woman described a horrific episode early in her fertility journey. Her first retrieval had gone very well and the couple had gotten pregnant on the first embryo transfer. The elated couple shared the good news with both sets of parents and several friends only to learn that they had miscarried at eight weeks. To the woman’s mortification, her husband’s parents had shared the news of their pregnancy with friends who were eager to offer their congratulations at the family’s annual holiday party. She was faced with the task of glumly informing virtual strangers about the miscarriage throughout the endless evening. 

Here are some things to keep in mind as you face gatherings and celebrations with friends and family this holiday season.

  1. Discuss who you will share information with and be specific. Prior to discussing your fertility journey with anyone, it is important that you and your spouse clearly designate who is allowed to be in the know well as any particular details either of you would prefer to keep private. Key to avoiding situations such as the one described above is to tell the people that you confide in that you’d prefer to remain private about you efforts to conceive.

  2. How to handle booze. You might find yourself mid-cycle during the holidays and abstaining from alcohol. This can lead to eyebrow raises and even pointed questions about possible pregnancies. It can be helpful to plan how you are going to handle these situations. Some couples prefer to abstain from alcohol together, while some women feel more comfortable nursing a Sprite to blend in. Whatever your approach, it helps to think about what you’ll say and do when asked about your drink preferences so you aren’t caught off guard.

  3. Plan for invasive questions. It seems that almost every family has that person that asks the awkward and intrusive questions. It can be very difficult to graciously field Aunt Sally’s third degree about your sex life with your partner. Thus, it is essential to anticipate some common situations and plan some responses. Remember, you do not OWE anyone information about your private life and, conversely, the people who are prying are likely well-meaning. By thinking of pithy ways to handle questions and comments, you can avoid being caught off guard.

  4. Come up with a cue. Plan as you will to field awkward and intrusive family and friends, it is likely that one or both of you will find that you need to check in and get strength from one another throughout holiday festivities. It’s helpful to come up with a secret cue that can serve as a signal for your partner to come and give you support. A hand on the shoulder or a stolen moment in a hallway could be just what both of you need to get through a difficult moment at a party or function.

  5. Spend some time processing losses alone. Though the holidays are typically crazy, hustle and bustle times, it is important to make space to process the losses and trials you have been through over the past year. Set aside some time, perhaps a quiet evening, to burn a candle and take turns sharing your thoughts and feelings about your fertility journey. Don’t shy away from shedding tears or expressing your hopes and fears to one another.

  6. Give yourself permission to take breaks or go home early. Finally, it is perfectly acceptable to be choosy about where you go and how long your stay. There is no edict that says you must go to every single gathering for the entire time. Feel free to make brief appearances or choose to spend time with friends and family that are the most safe of supportive of you during this time.

Taking time to plan ahead and care for yourself and your partner can make the holidays more enjoyable. This preparation and thoughtfulness can also help you and your partner to feel closer and better supported by one another and by those you have chosen to include in your fertility journey.

Dr. Angela Williams is a licensed clinical psychologist, specializing in cognitive-behavioral and humanistic/existential approaches to therapy. She has extensive training in Brief Crisis Intervention as well as mindfulness based therapeutic approaches. Her therapeutic style blends strength-based acceptance with practical skill development. Incorporating mindfulness-based interventions, she helps her clients move through difficult experiences and be more present in their lives.

Communicating with Friends and Family During Infertility Treatment

One of the most difficult aspects of the fertility journey is the way that relationships can shift and change. Many people find support and comfort in unusual places while others are surprised at the insensitivity that they see in close friends. At times people report that their struggle with infertility is treated lightly and they are told by well-meaning friends to, “relax”, “go on vacation,” “stop trying so hard.” Other times, couples report encountering negative judgments about pursuing assisted reproductive procedures to have “their own” baby instead of adopting. Couples struggling with infertility are unable to enter the parenting phase of the life cycle and interactions with family and friends who have children are often painful reminders of their “stuckness.” Conflicts can arise when one member of the couple finds solace spending time with family while the other partner has difficulty tolerating family gatherings.

Couples need to work together to develop ways to interact within their support system during their struggle with infertility. It is helpful to explore the boundaries that existed prior to infertility and assess if these are still comfortable. Central to the navigation of social relationships during infertility treatment is the question of openness versus privacy. Because infertility treatment is often invasive and of a personal nature, both members of the couple need to discuss what they are comfortable revealing and whom they feel they can trust. Relatedly, it is important to consider how sharing of information may impact future offspring. Communication within the couple is key to navigating relationships with their support system and compromise will help each member of the couple get their social needs met without compromising the needs of the other partner. 

Below are some pointers for managing social relationships while struggling with infertility:

  • If possible, consider nurturing relationships with trusted others who have encountered their own issues with infertility.

  • Share your feelings with trustworthy friends and family members. Many people do not understand the emotional stress of infertility. Therefore, it can be helpful for you to identify and share your feelings as you move through the process so that people in your life can be there to support you.

  • Be specific about the types of support that would be helpful. For example, many people launch into problem-solving mode or want to make you feel better. However, sometimes what can be most helpful is a shoulder to cry on.

  • Be honest with friends and family about your preferences about attending child related functions. If you are finding yourself resentful when asked to attend, you may need to put some limits on how often you attend child centered events.

  • Make time to do the things you love with friends and family.

  • Participation in stress-reduction techniques can be very helpful during your infertility journey. You may want to ask a friend to join a local yoga or meditation class.

  • Plan how you are going to respond to awkward or invasive questions or comments such as, “When are you going to start a family?” or “I guess we’ll never be grandparents!” or “Are you sure you want kids, you can have one of mine- haha!” Be firm and pleasant in your responses and know that you are entitled to share as much or as little about your family planning as you want.

Dr. Angela Williams is a licensed clinical psychologist, specializing in cognitive-behavioral and humanistic/existential approaches to therapy. She has extensive training in Brief Crisis Intervention as well as mindfulness based therapeutic approaches. Her therapeutic style blends strength-based acceptance with practical skill development. Incorporating mindfulness-based interventions, she helps her clients move through difficult experiences and be more present in their lives.

Coping Styles and Infertility

Receiving a diagnosis of infertility can be incredibly stressful for couples. Often couples report changes in the quality of their emotional and sexual relationships (Schmidt, 2005a; Peterson et al., 2007). Other stressors include alterations in relationships with family, friends and coworkers and interactions with a complex medical system. Infertility may call into question your life expectations and deeply impact the way you see yourself, your relationship, the future and the world around you. Because the diagnosis of infertility often comes out of the blue, couples may find themselves unprepared to cope with the multiple stressors that accompany it.

How one copes with the unanticipated stressor of infertility can significantly impact the level of distress one experiences. Researchers studying the effects of infertility have identified four basic coping styles and analyses have revealed the impact that these styles have on stress levels. It can be helpful to reflect on your own coping style and assess whether there are changes you might make to help you get through this difficult time with appropriate levels of support.

One coping method commonly used is active avoidance. This may include avoiding pregnant women and children, keeping feelings related to infertility to themselves and engaging in outside activities to avoid thoughts of infertility. People who are high utilizers of this form of coping report higher levels of personal, marital and social distress (Schmidt et al., 2005a; Peterson et al., 2006a; Peterson et al., 2008). One reason for this may be that avoiding infertility related thoughts and activities may lead to social isolation and lack of support.

The passive avoidance coping style is characterized by hoping for a miracle and feeling that all one can do is wait. This coping style is also found to be linked with greater psychological distress and infertility stress (Terry and Hynes, 1998). A recent study found that when both members of a couple are high utilizers of this coping style they report higher levels of distress (Peterson et al., 2008).

A coping style that has been linked with more positive outcomes is active confronting. Active confronting is characterized by sharing feelings about infertility and actively trying to find solutions to the problem. This coping style has been linked with improved short and long-term adaptation (Vershaak and Hammer Burns, 2006). People using this coping style avail themselves of greater sources of support and feel an increased sense of control over their situation.

Meaning-based coping is a style that has been linked with more positive outcomes (Vershaak and Hammer Burns, 2006). People engaging in this coping style redefine the meaning and implications of infertility. They often report that the experience of infertility has helped them grow as a person. Many apply themselves to other life goals after they have accepted the reality of infertility.

Though you may be reeling from a recent diagnosis of infertility, it is important to be mindful about the coping strategies you use. While avoidance may bring temporary relief from the tempest of feelings that infertility elicits, it has been linked with greater distress in the long-term. Openly communicating to your partner and trusted others about your thoughts and feelings related to infertility can go a long way in establishing a robust support system. Also, working collaboratively with your partner to address problems related to infertility will help you regain a sense of control over the aspects of the situation that you can impact. If you are feeling overwhelmed and unable to cope with your situation it may be helpful to seek out additional support. RESOLVE(www.resolve.org) is a national resource community that provides information about infertility as well as online support groups.

Dr. Angela Williams is a licensed clinical psychologist, specializing in cognitive-behavioral and humanistic/existential approaches to therapy. She has extensive training in Brief Crisis Intervention, which she uses in the treatment of patients who are struggling with infertility. Her therapeutic style blends strength-based acceptance with practical skill development. Incorporating mindfulness-based interventions, she helps her clients move through difficult experiences and be more present in their lives.

 REFERENCES

Peterson, B. D., Pirratano, M., Christensen, U., & Schmidt, L. (2008). The impact of partner coping in couples experiencing infertility. Human Reproduction, 23(5), 1128-1137.

Peterson, B. D., Newton, C. R., & Feingold, T. (2007). Anxiety and sexual stress in men and women undergoing infertility treatment. Fertility and Sterility, 88, 911–914.

Peterson, B. D., Newton, C. R., Rosen, K. H., & Skaggs, G. E. (2006a) Gender differences in how men and women referred with in vitro fertilization cope with infertility stress. Human Reproduction, 21, 2443–2449.

Schmidt L., Holstein B. E., Christensen, U., & Boivin, J. (2005a). Communication and coping as predictors of fertility problem stress: Cohort study of 816 participants who did not achieve a delivery after 12 months of fertility treatment. Human Reproduction, 20, 3248–3256.

Terry, D. J. & Hynes, G. J. (1998). Adjustment to a low-control situation: Reexaming the role of coping responses. Journal of Personality and Social Psychology, 74,1078–1092.

Verhaak, C. & Hammer Burns, L. (2006). Behavioral medicine approaches to infertility counseling. In: Covington SN, Hammer Burns L (eds). Infertility Counseling: A Comprehensive Handbook for Clinicians, 2nd ed. New York: Cambridge University Press,169–195.

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