Fertility treatment can be incredibly tough emotionally as well as physically, which is why it is always great to be able to turn to someone who can help you feel like you aren’t going mad!! Sandra Hewit, the wonderful counsellor and Dr Chantal Simonis, gynaecologist and obstetrician at The Fertility Partnership were only too happy to help our reader Elaine
Q: “Dear Sandra & Chantal, I was wondering if you could help me…. Everywhere I go there are promotions for Valentines Day, with shops full of cards declaring love for your partner, chocolates in heart shaped boxes and Prosecco on special offer. It makes me want to run a mile. Don’t get me wrong, I am not ‘anti love’, in fact I am in love, well, I think I am…no, I am in love, I just don’t really feel it at the moment that’s all. I am married to a lovely man, but if I am honest, I have felt totally lost ever since I started my third round of IVF. I seem to have forgotten how to love or how to be loved.
I feel very up and down, angry, sad, emotional and scared. I am furious with both myself and my partner, that we still haven’t got the baby we are so desperate for.
I hate that my body doesn’t work. I don’t feel womanly, not just because I feel bloated, but because my body doesn’t work like a woman’s body is meant to.
I don’t feel sexy anymore and I certainly don’t want sex. My husband does give me cuddles, but still, it’s not like it used to be. I have actually forgotten what it is like to lust after my husband and I doubt very much he has lusted after me in a while….
I feel like I need a reset.
I thought perhaps I could start by trying to explain to my husband why I am not feeling myself and so I was wondering if you could help me explain to him what these IVF hormones are doing to my body and emotions and that actually it isn’t my fault that I feel like this?
If he could hear it from an expert rather than me just saying “I’m sorry, it’s the hormones!!” then it might ease things.
Actually, can I also ask you if there is anything I can take to actually balance the effect these hormones are having on me? Thank you!!”
A: “Elaine we are so pleased you have reached out to us. Chantal here. Let me start by telling you that research shows that infertility is increasing, with one in seven couples experiencing difficulty conceiving. That means you are not alone in feeling angry, sad, frustrated and scared. At a recent conference in Edinburgh, the British Fertility Society called for all clinics to provide better mental health support to their female and male patients. Support is available in a variety of ways, from face-to-face counselling, to online forums, but what is crucial is to ensure that all patients and their partners are aware of how they can access support.
The IVF hormones have several effects on your body and your emotions
To start with, the down-regulation hormones such as Buserelin (Suprefact) and Nafarelin (Synarel) put you into a “temporary menopause”, as they suppress your oestrogen levels. This can leave you feeling tired and irritable, and it can also cause headaches, muscle pain, vaginal dryness and acne. Often, sexual desire is reduced, and this can lead to both of you feeling upset and emotional. The spontaneity of having sex when you feel like it, not regulated by ovulation cycles, has been lost. It is absolutely not your fault that you feel this way, but unfortunately, these mood swings and other side effects will continue during the down-regulation phase for most (but not all) women. The good news is that once you start the stimulation phase of your IVF cycle (with medication such as Gonal F, Menopur, Merional), things start to look up. As follicles start to grow in the ovaries, more oestrogen is produced, and many of the previous, unwanted side effects, start to abate.
One of the crucial factors during this IVF journey, is to have support
This may be from your partner, family and friends, but valuable support can be provided by your IVF clinic as well. All clinics can direct you to a specialist fertility counsellor, with the option of face-to-face meetings, or Skype sessions if that is your preference. And in this “connected” age, many online platforms offer support – either through online forums or chatrooms, or if accessing information is your wish, by providing a multitude of different information sheets. Numerous forums are available including the British Fertility Society (BFS), the Human Fertilisation and Embryology Authority (HFEA), Fertility Network UK , IVF Babble to name just a few. It is important to ensure your partner feels supported too, as many partners state that their well-being has been affected by fertility issues. Men also describe stress, depression, anxiety and low self-esteem.
Some men feel marginalised during fertility treatment and struggle to find support groups dedicated to men. There is much more awareness now of the need for fertility clinics to accommodate the needs of male partners as well as female patients.
Although you cannot actually take anything to counteract the effects of the fertility hormones, there are ways to alleviate some of the symptoms
Most importantly, try to give yourself time to do things you both enjoy, whether that is getting outside to exercise or even just having a walk, going to the cinema, having a meal out. Try not to lose interest in other, important aspects of your life. It is crucial to focus on other things in your life, even though it is hard to do that when it feels like the IVF journey is so overwhelming. In helping to prepare for your next round of IVF, self-care is vital, and this can take different forms for different people. Self-care relates to things you can do to look after yourself and your partner, both physically and mentally. For some people, this means looking at your diary and reducing the number of other commitments you might have. For others it might be spending time with close friends and family. But the first step towards dealing with psychological distress is to actually acknowledge it – and you have done that by getting in touch with us!”
Q: With Valentines Day coming up, I would like to have at least one day where I feel like me. I miss feeling womanly. Do you have any advice to help us try and reconnect? I need to change things before we totally drift apart
A: “Hello Elaine. Firstly it’s great that you want to improve your relationship with your husband. Things can slide and you can feel you have no control. Everything you have described is very common for couples to experience, particularly when time stretches out without a successful pregnancy.
I hope that Chantal’s explanation above about the effects of the hormones taken during IVF is helpful. Most of us can understand how a medical condition and its treatment might impact on our body, and we can plan for recovering when we are fit again. But it’s not so easy to take the same approach with our mental health, especially when we have difficulty conceiving. Our thoughts and feelings will often turn inward and self-blame comes into play. This can happen to men but is particularly common for women: we feel it is somehow our fault.
So two initial points to remember here: the treatment will affect your mood, hence the range of emotions and the ‘ups and downs’ you are experiencing (so it’s normal!). Secondly, try to think of this as medical – which it is. You say you are ‘furious’ with yourself and your partner, and ‘hate that my body doesn’t work’. That fury is understandable, so try not to fight the emotions. In counselling we talk about ‘sitting with’ a situation and the emotion; you have to go through it but remind yourself you will come out the other side – whatever the eventual outcome.
Acceptance is a big part of counselling (especially in the humanistic and Gestalt approaches); the biggest challenge with fertility treatment is accepting uncertainty, but there are many aspects of your life that become difficult, including your relationship with your partner.
Feeling you have lost it, unsure of how you feel about your relationship – and how he feels about you – not having the desire for sex like you had before: these are all common emotions and worries which, when added to the grief of not having the baby you so long for, have a depressing effect on you.
You say above that you want to explain to your husband how the hormones affect your mood and that’s a good idea. Partners can be perplexed or even short tempered because women don’t ‘take the rough with the smooth’ and don’t ‘snap out of it’ as quickly as they do. So the more he can understand how and why you feel the better. And vice versa. Both try and accept the differences between you.
Now, to Valentine’s Day. Firstly don’t beat yourself up about your appearance. Hormones aren’t your best friend, so try to recognise the negative dialogue you have and don’t dwell on these thoughts. Tell yourself there is a revitalised you waiting round the corner, once this is over.
Having said that, a bit of pampering never goes amiss, so treat yourself to a spa day or have your hair or nails done. Make the evening a Date Night, whether you go out or not. And on this occasion, make the conversation about something other than IVF and how you are feeling. A movie might be better than a meal if three hours of conversation feels like a stretch. If you stay in you could devise a quiz about the funny and romantic scenes in your relationship. Where were we when you proposed to me? What three things did you find endearing about me? What’s the cheesiest thing I’ve said to you? You get the idea. You could each visualise the best holiday you had; close your eyes and describe what you see to each other, really bring that happy feeling into the room.
Do the things that make you laugh and things you bond over and enjoy doing together. And when the going does get tough again keep up those conversations.”
If you are feeling low or anxious and need some guidance from Sandra or Chantal, drop us a line at firstname.lastname@example.org and we will reach out to them. Remember, you are not alone.