FOR more than two years, Gemma* and her fiancé had been trying for a baby without success.
But the pair were in for some surprising news: there appeared to be nothing obviously wrong with 32-year-old Gemma or her partner. The frustrating diagnosis was one of ‘unexplained fertility’.
Keep trying, the doctors told them. But as the months wore on and their hopes of conceiving naturally dimmed, Gemma became more and more despairing. Interesting research on the power of positive thinking especially when it comes with evidence based research. But, I guess you are either a positive or a negative person so if you are on the more positive side, try these techniques below. They won’t harm you and will make you feel better, have better coping abilities, less dramatic meltdowns and a healthy, happy relationship with your other half.
Having tried a number of fertility treatments, eventually the couple agreed that there was no other option but to go down the IVF route.
But neither was prepared for the huge emotional strain the gruelling process would place them under.
“My whole life began to revolve around pregnancy. It was excruciating,” says Gemma. “I asked myself all the usual questions — why did it have to happen to us? What did we ever do wrong? It was a massive emotional drain. Every waking minute was consumed with the thought of having a baby.
“It put a lot of strain on us as a couple as well — every month you’d be roaring crying and trying to pick yourself back up again once you knew you weren’t pregnant. By the time we got round to doing IVF, the strain was tremendous.”
Exhausted after the failure of their first IVF cycle, as the couple embarked on a second attempt, they seized the opportunity offered by their fertility clinic to take part in a mind-body programme — an approach that has come to be known in the US as ‘fertility coaching’.
As well as dietary and health tips, the course focused on helping the couples feel more hopeful about their prospects of getting pregnant by using sessions of cognitive behavioural therapy (CBT). This technique is commonly used by counsellors and psychologists to help people overcome problems such as depression, by breaking them down into smaller parts and dealing with each small aspect separately.
These CBT sessions proved invaluable in the journey towards pregnancy, says Gemma.
“We learnt breathing techniques and relaxation therapy, which was very useful when it came to dealing with that agonising wait for the phone call to tell you how many of your eggs have fertilised.
“We also did yoga classes and picked up some meditation techniques — they were very simple things that could be used in everyday life but they were really effective.
“Plus, being surrounded by other couples who were in the same position as us was so much help. We began to feel much more hopeful.
“After that, we got pregnant pretty soon and although sadly we miscarried, now we are expecting twins and we are over the moon.”
While the CBT sessions helped Gemma and her partner regain hope that they would have their much longed-for baby, there is evidence to suggest that fertility coaching using CBT techniques can actually reverse infertility.
A study carried out by researchers at Emory University in Atlanta, Georgia, in 2006 showed that CBT appears to reverse stress-related infertility.
Sixteen women who had not had a period in six months — and who had been diagnosed with functional hypothalamic amenorrhea, a condition where the hormone that triggers ovulation was at a very low level — were studied.
Half were given regular sessions of CBT for 20 weeks while the other half were simply observed. Over the course of the study, six of the eight women given CBT regained full fertility with one showing signs of restored ovarian function. Two became pregnant within two months.
In the eight women who received no treatment, only one recovered her fertility.
US fertility expert Alice Domar has also carried out studies which show that couples who took part in a mind-body programme using CBT techniques were almost twice as likely to get pregnant than those who didn’t.
Doctors are uncertain as to what the explanation for this is. Is it because these couples had a more positive outlook to start with or were proactive about getting pregnant?
But Domar also found that those who did mind-body programmes were more likely to ‘survive’ the gruelling process of IVF and to continue on to what can often be the key third cycle.
Increasingly, couples and their doctors are now realising that in order to optimise their chances of getting pregnant, they must make sure that they are both physically and mentally equipped for the journey.
“We’re only beginning to realise now that the incidence of anxiety and depression among IVF patients is actually huge,” says David Walsh, consultant gynaecologist at the Sims fertility clinic in Dublin.
“These people, sadly, are much more distressed than doctors realised. Given that there seems to be a strong correlation between distress and pregnancy, from a medical point of view it makes sense to address those stress levels.”
The Sims Clinic now offers its own clients mind-body weekend programmes and encourages them to take part in regular counselling sessions.
London-based fertility guru Zita West, who runs clinics in Dublin on a regular basis, believes that Irish couples who have opted for IVF can be in for a tougher time than couples in the UK.
“Waiting lists in Ireland are longer than they are in the UK,” she says. “What I see with the Irish couples that I meet is that they’re panicking about getting on the ladder for IVF. So that doesn’t help.”
Having the right kind of emotional support to learn to deal with this stress is key to surviving the process, Zita believes, and her clinics make regular use of CBT techniques to help their clients cope.
“At every stage of that journey you need support. I find cognitive behavioural therapy very useful because it challenges your core beliefs. So many women think that pregnancy is never going to happen for them.
“We go right back to asking them about their behaviour in childhood, about their worries, fears and anxieties and then we come up with a plan of action.
“If a woman is stressed, tearful or anxious, then CBT can be very useful for her.”
Dublin-based counsellor Jane McNicholas has used CBT techniques to treat many women tackling infertility and believes it’s a very effective tool.
“CBT is very much ‘here and now’ focused and IVF is a hugely stressful procedure both physically and emotionally for couples who are going through it. One of the main things I focus on is their stress levels and how we can cope better with them.”
When a couple is faced with infertility, their whole world view is challenged, Jane says.
“Your ideas about predictability go out the window.”
For successful career women who have worked hard in the workplace and are used to achieving their goals, the idea that their body is letting them down can be very difficult to deal with.
“I was used to putting my mind to something and then getting it,” Gemma agrees. “So when the most natural thing in the world suddenly becomes the most difficult, that’s really hard.”
Joan Hamilton manages the patient-support services at the Rotunda Hospital’s HARI unit and has helped many couples cope with the strain of infertility. Counselling is offered at the clinic as a matter of course for couples.
“We try to find out is there anything that can be done to ease the burden of IVF for them, for instance by taking time out during the cycle of treatment,” she says. “We ask, do they have a good diet, what do they take to relieve stress, are they active in a gym, and if they are could they replace that with something more soothing like yoga or acupuncture or reflexology.
“It’s a rollercoaster ride for couples — there are massive sad days, where you have to let go of your hopes and dreams, but I wouldn’t like to portray it as being only a hard thing. Most people I see get through this programme pretty well if they’re united going in in the first place. It is not all doom and gloom.”
“I think it’s really good that doctors are beginning to realise how much stress levels impact on pregnancy itself,” says Gemma now.
“It hadn’t really occurred to me when I started out just how much stress does affect you, as I had always thought of myself generally as a fairly laid-back person.
“But I remember when I was going through IVF having a huge screaming row with my mother. She was saying, can you not just relax and try and take a break? Looking back, she could see the toll it was taking on me. But all I could think was that these were her grandchildren we were talking about — future generations of our family that may never be born and it was impossible to just relax and take a break from it.
“Now I realise that if you are going to be anxious it does affect you, and if there’s anything you can do to relieve some of the anxiety of infertility, it has to be worth doing.”
* Names have been changed to protect identities
The Sims clinic can be contacted on (01) 299 3920 and counsellor Jane McNicholas on 086 6083947. Zita West and her team of fertility specialists will be in Dublin on September 25 and 26. For more information http://www.zitawest.com