How to Survive Working in a Child Related Field- While Battling Infertility- Cece Vandermarks

You know when someone says “if you love your job, it’s not really work”? Well I have the two most amazing jobs in the world! The first is working with children with ASD (Autism Spectrum Disorder) and their families planning super fun, family outings. For my second “job” I run a small theatre school in my village – we offer summer camps, drama classes, workshops, dance classes etc. Both of these jobs mean that I spend a lot of time with amazing kids and their families. And I love it!

What’s not to love? Watching a child take their first steps on stage, listening to a boy with ASD speak with excitement about what he’s just seen at the museum, watching parents beam with pride as their child speaks their first line, cooks their first meal, bounces on a trampoline for the first time, and so many other reasons. I get to see children and their parents at their best, their happiest, their proudest. It’s a wonderful feeling to be included in these milestones, these magic moments.

And for the longest time I told myself that it was enough. It was enough to have this sideline view of family life. To be there for the tiny moments that feel huge. To be child adjacent.

When I started down this career path it was because I love kids, theatre and outings, and with both jobs being part time it was ideal! The thing I was not ready for however, was the loneliness it would bring out in me. The self doubt and the insecurity. As a theatre teacher or camp leader, who was I to tell a parent something about their child’s behaviour that day? I’m not a parent, what do I know? Sure I’d had classes on those topics and had been teaching for years, but somehow it sorta felt different now. When I was teaching English as a Second Language in my twenties I had all the self confidence that I needed to get along, what was different now? It all boiled down to that fact that in my twenties I wasn’t ready for kids. I knew I wanted them, but it was a “in the future” kind of thing. I was travelling the world, working exciting and all-consuming jobs, going to parties followed by brunches – you know, generally living in the moment. Also, when I was teaching in my twenties, I was much less likely to be asked about my own children. Now I’m at an age where most people assume I am a mother. Just this weekend an amazing father said to me “I thought you would bring your kids this time”. I made some feeble excuse and ushered him onto the waiting boat with his gorgeous family. Then I turned, took a deep breath and had a moment.

Just hearing that question… the one all people who struggle with infertility fear – “do you have kids?”. That one. Those four small, innocent words. The four words that can ruin my day. Figuring out how to answer that has been a struggle for me. I’m sure many people think I could easily just say no, but it really isn’t that easy. It depends on the day – am I coping that day? have I thought about having kids of my own at all? did something super cute just happen and I’m wistfully pining for my own kids in my head? A flurry of things go through my head before I can answer. And “no”, while it may seem like the simplest and easiest answer to many, is not easy for me to say.

So for awhile I started to answer with “No, I’m infertile.” But that was even worse. Seriously, the look on people’s faces – it was like I had wounded them. Like I was being mean, or hurting them. Which in turn made me kinda tetchy, afterall why were they wounded I’m the one who’s infertile! I knew it was concern and care, but it cut too deep; the empowerment I felt saying it was not enough to prepare me for the follow-up conversation.

Time to try another approach. I would answer “Not yet” or “Not right now”, I would pretend I had misheard or had to work on something else and couldn’t talk right then – basically I tried it all. And it all failed. Some worse than others. My hubby jokingly said that when people came up to me and asked “Which one’s yours?” at events, I should look slowly around the room and then answer in an odd voice “I haven’t decided yet”. His dark sense of humour made me laugh, but I can honestly say I never tried that approach!

In then end, I went with “No” or “No we don’t have kids” when most people ask. When I’m ready, or with people who I feel I can open up to, I answer “No, I’m infertile” and we talk, and it’s good.

I suppose as I come to terms with the fact that I will never be a parent, I am finding it easier to talk about. Easier to be honest about. Easier to be child adjacent – and loving every minute of it!
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An Open Letter to the Trying To Conceive Sisterhood- Jessica Melcher

If you’re reading this because it’s addressed to you, I’m sorry.

I’m sorry that even though you make it your mission to stay positive and grateful, you wake up every day with an ache in your heart that never seems to go away.

I’m sorry that people can be so unrelenting and naïve about your struggle with infertility.

“When are you having kids?”

“You just need to relax, and it’ll happen!”

“Have you tried tracking your cycle?”

“You should really just adopt.”

“Maybe your body is trying to tell you something.”

I’m sorry that when people are so unrelenting and naïve, you have to calm the lump in your throat before it turns into sobs, the anger in your heart before it turns into rage, and answer with dignity and grace when it feels like all you can muster is something far less becoming.

I’m sorry that you have to walk by that unfinished “guest room” every day and be reminded it was supposed to be a nursery a long time ago.

I’m sorry your relationship has been tested to the limits by everything you’ve had to endure together.

I’m sorry opening every baby shower invitation brings tears to your eyes when it should bring happiness to your heart.

I’m sorry you’ve been unable to make your parents grandparents when you know they’d be the best grandparents ever. I’m sorry you feel guilty because of it.

I’m sorry you have to watch the world go on around you when it feels like your whole world is falling apart.

I’m sorry that the emotional burden is not the only one you carry.

I’m sorry you have to put yourself into debt just to create the family you’ve always dreamed you’d have.

I’m sorry a diaper commercial can make you cry because you’ve held it together just long enough to get through the day without anyone knowing the sadness you carry.

I’m sorry you feel like your body has failed you.

I’m sorry you feel like you’re in this struggle alone.

But you’re not. I’m here with you.

The truth is, you don’t need me to tell you all the reasons why I’m sorry to be a part of this TTC sisterhood — you live it every day. You carry the same heartache and torment that I do. Right now, maybe what you need are all the reasons why I’m not sorry.

I’m not sorry you have learned to love yourself for your strength and courage. This journey is not easy, but you still get up every morning and find your inner strength even when it feels like there is none left.

I’m not sorry you have learned to be vulnerable with those whom you love. Sharing a private struggle like infertility can be terrifying, but vulnerability is not a weakness; it is heroic.

I’m not sorry this struggle will make you an even better mom someday. You have learned patience and compassion and gained a gentleness that can only be created through a heartache like this one.

I’m not sorry that your pain has helped you to find a voice to help others when they feel alone.

I’m not sorry that you’ve found the real meaning of friendship by learning to let some relationships go while growing others that are more fulfilling.

I’m not sorry you have learned how to really be there for your partner when they need you. I’m not sorry you’ve learned to let this heartache bring you closer instead of letting it tear you apart.

I’m not sorry you have had to learn how to put yourself first, placing your own needs before the needs of others.

I’m not sorry you have had to learn how to put all of your faith into something that carries no certainty, no guarantees but have learned to appreciate that there’s always a chance — always.

I’m not sorry that your infertility struggle has forced you to be grateful for all you do have in this life, and I’m not sorry that it’s taught you to appreciate the small things.

I’m not sorry that we’re all in this together.

Hundreds or even thousands of miles apart, we are all living the same story. So even if it’s just for today or even just in this moment, try not to be sorry you are a part of our sisterhood. We are some of the strongest women I know, and we’re all in this together.

Mind Your Own Womb- Nadirah Angail

Somewhere there is a woman: 30, no children. People ask her, “Still no kids?” Her response varies from day to day, but it usually includes forced smiles and restraint.

“Nope, not yet,” she says with a chuckle, muffling her frustration.

“Well, don’t wait forever. That clock is ticking, ya know,” the sage says before departing, happy with herself for imparting such erudite wisdom. The sage leaves. The woman holds her smile. Alone, she cries…

Cries because she’s been pregnant 4 times and miscarried every one. Cries because she started trying for a baby on her wedding night, and that was 5 years ago. Cries because her husband has an ex-wife and she has given him children. Cries because she wants desperately to try in vitro but can’t even afford the deposit. Cries because she’s done in vitro (multiple rounds) and still has no children. Cries because her best friend wouldn’t be a surrogate. “It would be too weird,” she said. Cries because her medication prevents pregnancy. Cries because this issue causes friction in her marriage. Cries because the doctor said she’s fine, but deep inside she knows it’s her. Cries because her husband blames himself, and that guilt makes him a hard person to live with. Cries because all her sisters have children. Cries because one of her sisters didn’t even want children. Cries because her best friend is pregnant. Cries because she got invited to another baby shower. Cries because her mother keeps asking, “Girl, what are you waiting on?” Cries because her in-laws want to be grandparents. Cries because her neighbor has twins and treats them like shit. Cries because 16-year-olds get pregnant without trying. Cries because she’s an amazing aunt. Cries because she’s already picked out names. Cries because there’s an empty room in her house. Cries because there is an empty space in her body. Cries because she has so much to offer. Cries because he’d be a great dad. Cries because she’d be a great mother, but isn’t.

Somewhere else is another woman: 34, five children. People say to her, “Five? Good lord, I hope you’re done!” And then they laugh… because those types of comments are funny. The woman laughs too, but not in earnest. She changes the subject, as she always does, and gives the disrespect a pass. Just another day. Alone, she cries…

Cries because she’s pregnant with another and feels like she has to hide the joy. Cries because she always wanted a big family and doesn’t see why people seem so disturbed by it. Cries because she has no siblings and felt profoundly lonely as a child. Cries because her Granny had 12 and she’d love to be just like her. Cries because she couldn’t imagine life without her children, but people treat her like they’re a punishment. Cries because she doesn’t want to be pitied. Cries because people assume this isn’t what she wanted. Cries because they assume she’s just irresponsible. Cries because they believe she has no say. Cries because she feels misunderstood. Cries because she’s tired of defending her private choices. Cries because she and her husband are perfectly capable of supporting their family but that doesn’t seem to matter. Cries because she’s tired of the “funny” comments. Cries because she minds her own business. Cries because she wishes others would mind theirs. Cries because sometimes she doubts herself and wonders if she should have stopped two kids ago. Cries because others are quick to offer criticism and slow to offer help. Cries because she’s sick of the scrutiny. Cries because she’s not a side show. Cries because people are rude. Cries because so many people seem to have opinions on her private life. Cries because all she wants to do is live in peace.

Another woman: 40, one child. People say to her, “Only one? You never wanted any more?”

“I’m happy with my one,” she says calmly, a rehearsed response she’s given more times than she can count. Quite believable. No one would ever suspect that alone, she cries…

Cries because her one pregnancy was a miracle. Cries because her son still asks for a brother or sister. Cries because she always wanted at least three. Cries because her second pregnancy had to be terminated to save her life. Cries because her doctor says it would be “high-risk.” Cries because she’s struggling to care for the one she has. Cries because sometimes one feels like two. Cries because her husband won’t even entertain the thought of another. Cries because her husband died and she hasn’t found love again. Cries because her family thinks one is enough. Cries because she’s deep into her career and can’t step away. Cries because she feels selfish. Cries because she still hasn’t lost the weight from her from her first pregnancy. Cries because her postpartum depression was so intense. Cries because she can’t imagine going through that again. Cries because she has body issues and pregnancy only exacerbates it. Cries because she still battles bulimia. Cries because she had to have a hysterectomy. Cries because she wants another baby, but can’t have it.

These women are everywhere. They are our neighbors, our friends, our sisters, our co-workers, our cousins. They have no use for our advice or opinions. Their wombs are their own. Let’s respect that.

What Makes a Healthy Egg?- Todays Parent

What are doctors looking for?
Doctors can’t really tell if an egg is high or low quality simply by looking at it. There may be abnormalities, such as discolouration or open spaces in the eggs, but these irregularities may not affect the egg’s ability to be fertilized, says Robert Casper, a fertility specialist at Trio Fertility in Toronto.

All mature eggs are fertilized and the embryos are cultured for five days (until they reach the blastocyst stage). If the embryo makes it to the blastocyst stage, there is an estimated 50/50 chance that it will have normal chromosomes and result in a baby. “What we’re really looking at is how the egg fertilizes and develops into an embryo,” says Casper. “If the embryo implants, it doesn’t really matter what the egg looks like; it means the egg was normal and the quality was okay.”

“The primary determinant of egg quality over the course of a woman’s reproductive life is her chronological age,” says Ari Baratz, a fertility specialist at the Create Fertility Centre in Toronto. As women age, the quality of their eggs diminishes, and so do the chances of getting pregnant without assistance, he says. Typically, the peak of good-quality eggs is around the age of 25, with quality declining after the age of 35.

What matters more: quality or quantity?
Both quality and quantity matter. It’s possible that a woman could have difficulty conceiving if she has a large quantity of poor-quality eggs or a limited number of high-quality eggs. But having a good supply of eggs can be helpful, says Baratz, because having a large quantity usually implies that some eggs will be viable in women under 35. In any given egg population, not all the eggs will be healthy, so it’s good to have a decent number to work with. (Women over 40 may experience egg-quality issues, even if tests show that they have lots of eggs.)

What is ovarian reserve, and how do you test for it?
Ovarian reserve is the technical term for the number of eggs a woman has. A woman’s ovarian reserve is assessed via ultrasound and various hormone tests. One of these hormones tests is for Anti-Mullerian Hormone (AMH), a hormone that helps indicate if a woman has a lot of eggs or not. The higher the amount of AMH found in a woman, the more eggs she has. “If the AMH is quite low, that doesn’t necessarily mean that the remaining eggs are poor quality,” says Casper. “It doesn’t predict pregnancy. But it does mean that people may run out of eggs early or may not respond well to fertility medications.”

Can you still get pregnant if you have poor egg quality?
As Casper says, it isn’t an all-or-nothing situation. “Usually the percentage of normal eggs decreases over time, but it doesn’t go to zero necessarily until people probably get into the age range of 44 or 45,” he explains.

While there really is no single treatment to improve egg quality, you still have options. “One could move to donor eggs, or eggs from another female, as another treatment for very poor egg quality,” says Baratz, “but that would be after multiple times of treating a woman with her own eggs if all else failed.”

What can affect the quality of an egg?
Smoking, drugs, prolonged exposure to environmental contaminants or pollutants and intense radiation or chemotherapy can lead to a decrease in healthy and normal eggs, as well as a reduction in the number of eggs.

Are there ways to improve the quality of an egg?
Some studies have shown that coenzyme Q10 and vitamin D can help improve the quality of eggs. Coenzyme Q10 increases energy production by mitochondria (the battery of the egg), which increases the likelihood of a good chromosomal makeup for the eggs and boosts the chances of pregnancy, explains Casper. Also, research has linked a vitamin D deficiency with lower pregnancy rates.

What I’d Wish I’d Known Before My IUI- Todays Parent

HomeTrying to conceiveInfertilityWhat I wish I’d known before my first IUI
What I wish I’d known before my first IUI
From how long it takes to what it feels like, here’s a first-hand primer on IUI.

Jun 21, 2016 Sarah Kelsey 0

When our doctor first suggested that we try intrauterine insemination (IUI), I was actually excited. My husband and I had been trying to conceive for a while without any luck. Our tests turned up relatively normal and we were told that we should be able to conceive, yet month after month, I failed to conceive. The diagnosis was frustratingly vague—unexplained infertility (with potential male factor)—so IUI offered a bit of hope. Here was something that could potentially help us have a child.

IUI is one of the first assisted reproductive technologies typically recommended by a doctor. It’s commonly used when the male partner is experiencing low sperm count or decreased sperm motility, but it can also help those suffering from unexplained infertility, endometriosis or cervical mucus issues and assist same-sex couples. I liked that the procedure is relatively non-invasive: It simply places healthy sperm as close to the Fallopian tubes as possible, giving them a bit of a head start in the race toward the egg.

Like all things to do with infertility, navigating the IUI process was overwhelming. I quickly became emotionally, physically and financially invested in something I didn’t know a whole lot about. I had a ton of questions: What happens? How does it feel? Will it work?

Here’s what I wish I’d known before doing my first IUI.

What happens?
Step 1: The checkup
On Day 3 of my cycle, I did blood tests that checked my hormone levels, and my husband had his sperm analyzed to gauge the concentration, motility and morphology of his little guys. We had two options: a medicated IUI or a natural one. The former involves taking fertility drugs so that more than one follicle (typically two or three) matures and improves the odds of pregnancy; the latter doesn’t involve medication (so only one egg is released). Because it was my first fertility treatment and we didn’t want to do anything too invasive, we chose a natural IUI.

Step 2: Cycle monitoring
I began daily cycle monitoring at my clinic on Day 10. I had to arrive early—between 7 and 8:30 a.m.—for blood work and an internal ultrasound every day for a week. Though I knew the process would give my doctors insight into how my hormone levels and follicles were developing, I couldn’t help but feel like a pincushion. By Day 17, my nurse let me know that a mature follicle was ready to ovulate. (It was about time—I found this gruelling.)

Step 3: Trigger shot
My trigger shot was the first hormone injection I had ever received. I was given the pregnancy hormone hCG, which helps follicles mature and ensures that ovulation occurs within 36 hours. Doctors administer this hormone to help time insemination—they want sperm to be waiting for the mature egg (an egg survives for only 12 to 24 hours post-ovulation, while sperm can live in the Fallopian tubes for days). I don’t mind needles, but I was used to getting them in my arm, not my abdomen. While the trigger shot didn’t hurt, I know I flinched because it felt so weird (my hubby maintains that I took the injection like a boss).

Step 4: Pre-procedure
On Day 18 around 7 a.m., we arrived at the clinic for IUI day. To say that we were nervous is a bit of an understatement—neither of us was sure what to expect. Would the procedure hurt? Would my husband be allowed in the room with me? There was also this great sense of anticipation—we desperately wanted the IUI to work.

I did my usual blood tests and internal ultrasound and my husband produced a semen sample. We were told to return to the clinic around noon—this gave the andrologist time to “wash” his swimmers. (Sperm washing is the procedure that separates the sperm from the semen and weeds out the low-quality “tadpoles.”) To ensure that there is enough sperm available to wash, men are typically asked to abstain from sex or masturbation for two to four days before an IUI. One hour before the procedure, I had to consume one litre of water, as a full bladder helps the doctor guide and angle the catheter into the uterus.

The wait between our early-morning appointment and the procedure was odd. At around 8 a.m., we found ourselves wandering around Toronto with nothing to do for four hours. For a while, we had no idea how to spend our time—it was clear that we both wanted the IUI to be over. We filled up our car with gas, bought groceries and treated ourselves to brunch (an awkward meal spent talking about everything but what we were thinking about). We laugh about the weirdness of it all now.

Step 5: In the ultrasound room
Once back in the ultrasound room, I sat on the exam table and placed my feet in the stirrups. We were shown a vial of my husband’s sperm and asked to acknowledge that the information on the label matched ours. I remember thinking “I sure as hell hope so!” but all I did was laugh out loud. It was such a funny—but important—request. I think I read the information 100 times before saying “Yes.” I was then asked to lie down and the doctor inserted a speculum into my vagina.

Step 6: The insemination
As the technician performed an external ultrasound, the doctor inserted the catheter into my vagina and my cervix. Using the ultrasound screen as her guide (which I watched closely throughout the procedure), she pushed the catheter through the cervical canal and pointed it toward the top of my uterus and right Fallopian tube (the side with the mature follicle). She injected my husband’s sperm through the catheter and into my uterus and advised me to stay seated for a few minutes. The process lasted only about 60 to 90 seconds.

Honouring Father’s Day for the Infertile- Blog- Our Mis-conception

Honoring Father’s Day for the Infertile

JUNE 14, 2013 – 4 COMMENTS

Well, Father’s Day will be here in just a few more days and although I am not yet a father (in spite of 6 years of trying), I think us man-folk spend our lives ‘pre-child’ in father training. I guess that makes all of the issues we face battling infertility kind of like some terrible, grueling father boot camp. So, let’s put a slightly different spin on things this Father’s Day by considering the qualities that you would use to define a good father and see if it takes those same qualities to be at this crazy infertility/family building game for the duration that some of us have. Here are a few of the qualities that I have identified as necessary to be a good father: being patient, stoic, and resourceful. DISCLAIMER: I started typing this and saw that it was getting to long, so I limited it to 3. The 4th would be compassion.

A dad has to be patient. How else will you deal with the ever-changing personality, demeanor, and motivations of a growing child? Definitely, if you are a hot-tempered person, it will be difficult to deal with a son that transitions from wearing what you tell him, to wearing baggy pants and everything black, to wearing t-shirts and flip-flops (talking about myself if anyone was curious). Looking back at what I would wear, my dad must have been very patient to even walk with me in public. With fertility, it is the exact same, patience is a MUST! You cannot go through an extensive IVF stimulation, retriveal, transfer, and pregnancy test cycle without some extreme measure of patience. I am talking melt steel with your eyes, Superman-style, kinda patience. Now do all of that and have the result be negative, hopefully you have some patience hidden away in the garage or tool box to call in order to get back on that crazy infertility train.

Are you stoic? I think a good dad must be able to be rapidly inserted in nearly any situation and be able to respond calmly and rationally. What if you just found out your son was lying to you about going to school and was actually skipping 2-3 classes a day (Yep, me again)? Would you respond with anger, throwing stuff, and cursing? Not my dad. We talked. He wanted to get to the bottom of where this rebellion was coming from and how the thought in my head could be changed to remove the mysticism and positivity that my new-found rebellion allegedly offered. For us hopeful-to-be dads, there is no way around a stoic disposition. How else would we be able to console our wife/girlfriend who is wrapped in a thorn-riddled emotional vine on the couch after finding out our latest round was not successful unless we are stoic? Do we want to cry…(Men don’t cry, they leak water) sure. Do we want to destroy our house because we don’t know how to properly express our anger and frustration… obviously. What do we do? We sit on the couch, unsure of what to say, unsure of what to do, and unsure of where to even put our hands. But we do it without letting any of our feelings show because we think that being stoic is the best way to help her through what she is feeling.

Resourceful. If your dad was resourceful, he would do things like fashion a home-made trolling motor mount on the family canoe so that he could spend some time with you on the reservoirs fishing and having father/kid time doing something you both enjoyed. (Example from me again, get the trend yet?) For my fellow gents in the fertility trenches, I have to brag, we are a resourceful bunch. We have to be. How can you wrap your head around the idea of inflicting pain on your significant lady-person every night and make it bearable for her without being resourceful. You can’t. So, you incentivize it, “Alright sweet lady-person, for every sub-Q shot, you will earn a $1 for maternity clothes. For every intramuscular shot, $2.” Will you go broke…nope you are already there. Will it help her cope…hopefully. You buy stupid-silly bandaids and make a big deal out of them so that when she is getting ready for the next shot, you can both say good bye to the Muppets Animal bandaid that kept her company the night before. We do everything we can to help take some of the burden away, to distract her, to convince both yourself and her that ultimately it is all worth it. Yep, we are resourceful.

So dad, thank you for being such a patient, stoic, and resourceful person as I grew and still today. I hope that my child or children will think the same of me.

One final thing, there are those guys out there that have had only a brief time with their child as a result of child loss or miscarriage. Although I cannot directly relate to your feelings, know that your ability to be a father is not limited to living children. I believe that the memories that you carry in your heart and mind and that feeling in the back of your throat is not only your love for your child, but also your child honoring the father you were while they were with you.

Happy Father’s Day to all men out there that either have a family or have dreams of having a family!

Coping with Mother’s and Fathers Day- Resolve

Coping with Mother’s Day and Father’s Day
It can be particularly difficult to face the many emotional issues raised by infertility at a time when everyone is celebrating motherhood and fatherhood. RESOLVE urges men, women and couples who are experiencing infertility to plan ahead for Mother’s Day and Father’s Day, acknowledge their feelings and prepare themselves emotionally to handle questions and comments from family and friends.

Take a Proactive Stance
Think ahead about the day and plan a strategy in advance. Don’t wait until the holiday is upon you to make plans.

Focus on Your Parents/Grandparents or Special Parental Figure
Make this a special time for them. If a family gathering is planned and it will be pleasant for you, go and enjoy. But, if lots of children or pregnant relatives will be present, and you know this will be upsetting, consider other possibilities. You might plan to see your mother/father at another time during the weekend.

Recognize Potential Painful Situations
Restaurants, for example, may be a source of discomfort. They may ask if you are a mother or a father in order to give you a complimentary item. Be prepared for this question so you are not taken off-guard.

Consider Joining a Support Group
A support group will help you feel less isolated, empower you with knowledge and validate your emotional response to the life crisis of infertility. Visit the RESOLVE Calendar of Events to find a support group in your area.

Speak to Your Rabbi
Before a religious service, talk with your clergyperson (or write a letter) and educate him/her about the experience of infertility. Perhaps he/she would be willing to say a prayer or offer words of support for those struggling with this crisis.

Plan an Enjoyable Day Together
It is important to work as a couple during these difficult days. Consider tuning out the holiday emphasis entirely and make it an opportunity for a fun day together plan a day outdoors to go hiking, bicycling, or walking on a beach. See that movie you’ve wanted to see or create a special meal.

IVF- Its Overwhelming at Every Turn- The Guardian

Here’s something we all understand about conception: it’s a private thing. So what was most difficult about in vitro fertilisation (IVF), says Gareth Farr, was juggling issues around conceiving a baby in the midst of a busy working life – but when no one else knew what was going on. “I’d be in a meeting or teaching a class and I’d have to pretend I needed to use the bathroom so I could go off and find an empty room and take a call to find out how many embryos had been fertilised,” he says. “And then I’d have to phone my wife, Gabby, and tell her whatever crucial information had been imparted from the clinic, and then race back into the meeting or class and pretend nothing had happened.”

IVF is enormously stressful, but as a society we’ve not really begun to unpack what that means for an individual, for a couple and their relationship, or for wider relationships within a family. With assisted conception on the rise – 2% of all babies born in Britain are now conceived this way, and the number is increasing – it’s becoming more important for the issues to be understood and for us as a society to at least acknowledge them, and perhaps to do more to help couples through what’s involved. That’s Gareth’s view and based on his and Gabby’s five-year quest for a baby, and all they went through, he’s written a play that seeks to grapple with the issues – it opened this week in Birmingham before travelling to London.

I felt by turns emasculated, embarrassed, pathetic and ashamed
Gareth Farr
Like many couples, Gareth and Gabby thought that once they made the decision to have a child, one would simply come along. They’d met in 2003 at the Young Vic – she’s a theatre producer, he’s a playwright and drama teacher. He remembers mentioning, on a visit to his GP to talk about something else, that they’d been trying for a baby for several months. “She said 80% of couples get pregnant within a year of trying, just keep at it,” he says. “But then it got to a year and we were like, oh. Ok. So we’re in the 20%.”

When they embarked on infertility treatment, they decided not to tell family and friends. “For a long time we didn’t tell anyone else,” says Gareth. “We thought, this is all going to work out, and then there will be a baby and we don’t need to tell anyone how it all happened. So there was all this pain and anxiety and sadness in our lives, but we weren’t sharing it … I wasn’t sharing it with anyone because I was too proud.”

What they hadn’t realised – and this is one of the big issues Gareth aims to explore in the play – is how enormous the toll of that is on a couple and their relationship, as well as their work and career. “I felt by turns emasculated, embarrassed, pathetic and ashamed,” remembers Gareth, 38. “But I wasn’t sharing it with anyone, I was just desperately trying to cope. It’s a man’s role to support his partner, but while I was trying to support Gabby, I was crumbling inside. The IVF journey saps your energy, it takes you somewhere you didn’t even know existed. It’s overwhelming and shocking at every single turn. It’s a bit like going through bereavement or cancer, but no one knows what’s happening to you.”

IVF: ‘I had the dread feeling that I was part of some greater experiment’
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The other major issue for Gareth, and again one he explores in the play, is how it feels when something that should happen in the most private and intimate arena of a life, moves instead to a hospital clinic, a sperm production room and a laboratory.

“It has a big impact on your sex life – in fact, at times you aren’t even allowed to have sex,” he says. “I used to have to mix Gabby’s drugs and then inject her and it absolutely wasn’t how I’d ever thought we’d be making a baby.”

Another issue, he says, is that although conception should be a shared experience, in IVF the focus – often for understandable and necessary reasons – is on the woman and her body, but that can make a partner feel redundant and uncertain about what’s required of him. “All the needles and the tests and the dropping your knickers at every turn was for me,” says Gabby, 39. “Gareth said quite early on: ‘I wish I could do my share.’ At least I felt I was doing something – it was very physical, there were all these drugs and needles and tests.”

“For me,” says Gareth, “it felt a bit like watching from the sidelines.”

You won’t find any pictures of our ‘perfect family’ on social media. I remember all too easily how that felt.
Gabby Vautier
The turning point for Gareth came when Gabby dragged him along to an infertility support group. “I thought, I’ll just sit in the corner and say nothing,” he remembers.

In fact, they couldn’t shut him up – and as well all the poured-out feelings came the realisation, from talking to others in the room, that theirs was a universal experience. “I’m a playwright, so I’m always looking for human drama – and it was very clear I was surrounded by it,” says Gareth. “Also, this is a subject that hasn’t been much explored in the arts, especially the performing arts – and there are important issues here that deserve an airing.”

He’s also very aware, he says, that he and Gabby survived their IVF journey at least partly because they have a strong relationship – so how much harder must it be for a couple who are already feeling their connection is a bit ropey? Not to mention the fact that needing several rounds of IVF dents a couple’s finances big-time – another guaranteed relationship iceberg. “The couple in the play struggle, as Gabby and I struggled, with how IVF chips away at every bit of your life,” says Gareth. “Of course there’s humour, because there has to be humour in any journey you go on – you absolutely have to look for the lightness, you have to find it anywhere you can, because that can be a lifesaver.”

Gareth and Gabby and their twin daughters, Astrid and Florrie, now 18 months.
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Gareth and Gabby and their twin daughters, Astrid and Florrie, now 18 months old. Photograph: Frantzesco Kangaris for the Guardian
If you want to know the ending of Gareth’s play you’ll have to go and see it: but here’s the ending of his and Gabby’s real-life story. On the fourth round of IVF, having remortgaged their London flat (they live in Surrey now) and having survived the emotional rollercoaster of three failed attempts, Gabby’s pregnancy test was positive. “Gareth said straightaway: I bet it’s twins and I bet they’re girls,” she remembers.

It was, and they were. So now it’s Gareth and Gabby and 18-month olds Florrie and Astrid. “We’ve become exactly the sort of couple I always hated when I was going through IVF, the kind whose stories end like this,” says Gabby.

While their lives have gone through another seismic shift to parenthood – the shift they wanted all along – they both try very hard not to lose sight of the fact that many other couples and individuals are still out there, still on the IVF journey, still hoping, and still very sensitive to other people’s stories. “You won’t find any pictures of our ‘perfect family’ on social media,” says Gabby. “I remember all too easily how that felt.”

Accompanying the play will be two day-long fertility festivals, which aim to open up discussion on many of the issues explored in the play. “We want to give people the space to talk about these incredibly difficult issues,” says Gabby. Even when it’s over, it’s still there in the background. “It changes you – it’s left scars, and it will always be part of us,” says Gareth. “We’re different from the parents we would have been.”

He and Gabby know, too, that they are the lucky ones. Most people who go through IVF and experience all the emotional strain they experienced, don’t emerge with a baby at all. How much tougher, they ask, is the fallout likely to be for them?

The Quiet House by Gareth Farr is at Birmingham Repertory theatre until 4 June, and then at the Park theatre, London, 7 June to 9 July. The fertility festivals are on 28 May in Birmingham, and 11 June in London. For the full programme see fertilityfest.com

PCOS- Shady Grove Fertility

PCOS: ONE SIZE DOESN’T FIT ALL
By Shady Grove Fertility • June 1, 2016 • 6 Comments
treatment for pcos
With nearly one-third of all infertility diagnoses in women, polycystic ovary syndrome, or PCOS, is the most common ovulatory disorder in women of reproductive age.

While myths persist that women with PCOS cannot get pregnant, the reality is that PCOS is highly treatable and nearly every women with PCOS should be able to get pregnant. In fact, many women will experience increases in fertility through lifestyle changes and modest weight loss. Others will find success with basic infertility treatments and medications. And for those that need additional help conceiving, in vitro fertilization (IVF) is a highly effective form of treatment for women with PCOS.

pcos: cause of infertility

WHAT ARE THE SYMPTOMS OF PCOS?

PCOS affects approximately 5 to 10 percent of the population, and is most prevalent in Hispanics, African Americans, and Caucasians while some studies suggest that there is a rising rate in women of Asian descent.

Some of the most recognizable symptoms of PCOS include acne, excess hair growth, and absent or irregular menstrual cycles. While many people may consider obesity as a main symptom of the disease, approximately one-third of women with PCOS are normal weight or underweight.

WHAT CAUSES PCOS?

Polycystic ovary syndrome (PCOS) is caused by hormonal imbalances that curtail or prevent ovulation—the body’s process of producing and releasing eggs from the ovary. Essentially, women with PCOS have an inappropriate production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). As a result, they experience limited egg development and an increase in testosterone and other typically male hormones (androgens).

FSH is responsible for stimulating the growth of follicles in the ovaries that contain the maturing egg. A lack of FSH for an extended period of time will prevent the follicles from maturing, keeping them as small, resting follicles within the ovary.

Increased levels of LH cause the body to produce too much estrogen and male hormones (androgens), including testosterone, which can cause the endometrial tissue in the uterus to get very thick, resulting in heavy and/or irregular periods. The increase in androgens is also responsible for the excess hair growth and acne.

Another cause of PCOS is an insensitivity to insulin, which is responsible for an excess of male hormones. This, many times, results in increased weight gain and obesity that places the patient at higher risk for diabetes and cardiovascular disease.

HOW CAN I GET TESTED FOR PCOS?

All Shady Grove Fertility, patients undergo basic fertility testing including day 3 blood testing and ultrasound. The ultrasound can determine if ovaries are enlarged and contain immature resting follicles, a prominent symptom of PCOS.

In addition to basic testing, your medical team will determine if there are any physical signs of excess androgens present, as well as the quality of ovulation through the length and regularity of your menstrual cycles. Once your physician has a complete picture and can make a diagnosis, he or she will work you to create an individualized treatment plan.

CAN DIET AND EXERCISE HELP WOMEN WITH PCOS CONCEIVE?

For overweight women with PCOS, weight loss is often the first step to increasing your chances of pregnancy. The benefits of weight reduction include improved ovulatory function, improved chances of conception, a safer pregnancy for both the mother and baby, and—if needed—better response to fertility medications. Studies have shown that by losing just 5 percent of body weight, a woman can actually restore her menstrual cycle and ovulate on her own. Weight loss has also shown to reduce other symptoms such as hair growth, acne, and balding.

WHAT MEDICATIONS ARE PRESCRIBED FOR PCOS?

For women with PCOS who are actively trying to conceive, it is advised to consult with your OB/GYN or a fertility specialist, since many women with PCOS are not ovulating. Your physician can prescribe medication to help stimulate ovulation.

Oral fertility medications like clomiphene (Clomid or Serophene), which have been available for many decades, continue to be widely used to produce an ovarian follicle containing an egg. Clomiphene acts by blocking the action of estrogen in the brain (the hypothalamus and pituitary). As a result, there is an increased production of follicle-stimulating hormone (FSH) causing the development of one or more follicles. If ovulation is still irregular, an additional medication, metformin, may be prescribed. Metformin helps to decrease glucose production and make the body more sensitive to insulin, thus leading to more regular ovulation.

It is only recommended to stay on a medication-only protocol for three to four cycles, after which, chances of this protocol resulting in a pregnancy decrease.

medication study for pcos

WHAT FERTILITY TREATMENTS ARE AVAILABLE FOR PCOS?

Depending on the initial testing, a fertility specialist may recommend a patient start with timed intercourse or intrauterine insemination (IUI) (with medications to induce ovulation)n that can be scheduled around the development of the follicle(s), provided that the Fallopian tubes are open and the sperm counts are normal. The typical success rates with IUI are about 15 to 25 percent per cycle; a woman’s individual success rate with IUI is largely impacted by her age.

If after a few attempts with IUI, or if the patient is presenting with other factors, such as blocked Fallopian tubes, her physician may recommend in vitro fertilization (IVF).

DO WOMEN WITH PCOS ALWAYS HAVE FERTILITY PROBLEMS?

Women with PCOS have a very good chance at conception. Patience and dedication may be necessary to allow an adequate amount of time for lifestyle modifications to enhance fertility naturally, as well as being proactive about the appropriate amount of time to proceed with medical therapy. With the proper treatment, PCOS can be managed for the long-term and patients can live relatively symptom free.

Editor’s Note: This post was originally published in September 2011 and has been updated for accuracy and comprehensiveness as of June 2016.

Todays Parent- All about Infertility

Infertility

STRUGGLING WITH INFERTILITY

It can be devastating to deal with infertility. But it’s incredibly common: one in six couples have difficulty conceiving. We’ve created a resource of information and personal stories in the hopes of making this process a little less daunting.

  • MELANIE’S STORY
    STRUGGLING WITH INFERTILITY

    Melanie's Story

  • ELLEN’S STORY
    WHEN IVF DOESN’T WORK

    Ellen's Story

  • TARA’S STORY
    FACING SECONDARY INFERTILITY

    Tara's Story

  • ERIN’S STORY
    INFERTILITY AND IVF

    Erin's Story

  • COULD I BE INFERTILE?
    WHAT TO DO NEXT

    Could we be Fertile?LEADING CAUSES OF
    INFERTILITY

    Causes of InfertilityHOW INFERTILITY AFFECTS
    YOUR RELATIONSHIP

    How Infertility affects your Relationship

  • 5 REASONS YOU’RE NOT
    GETTING PREGNANT

    5 Reasons of Not Getting PregnantHOW TO MANAGE
    INFERTILITY STRESS

    6 Ways to cope with Infertility Stress

  • FERTILITY TREATMENT GUIDE

    Treatments

  • INFERTILITY TREATMENTS
    WHAT TO EXPECT

    What to Expect with Treatment

  • SECONDARY INFERTILITY

    Secondary Fertility

  • WHAT IS IVF?

    IVF

  • WHAT IS IUI?

    IUI

  • WHAT’S A HEALTHY EGG?

    Egg Quality

  • WHAT’S A HEALTHY SPERM?

    Sperm Quality

  • ADVICE FOR COUPLES STRUGGLING
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    Advice for People struggling with Infertility

  • WHAT NOT TO SAY TO SOMEONE
    DEALING WITH INFERTILITY

    Things not to Say

  • WHEN A FRIEND CAN’T GET PREGNANT
    (AND YOU CAN)

    When a friend can't get Pregnant

  • YOUR OPTIONS WHEN
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    IVF Don't Work

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  • CAN YOU BOOST YOUR
    FERTILITY?