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Round and Round You Go: We Hope It Stops Where You Want to Go!

Unfortunately, it is more the norm for us to see or hear about couples (and individuals) that have undergone years of fertility treatments without success. Month after month, they take medications, inject themselves with hormones, and hold their breath as they wait for the pregnancy test results. For many of these patients, be it for medical reasons, financial reasons, insurance reasons, or misguided reasons, there is little that is changed between the negative cycles. We like to call this the merry-go-round effect: couples/individuals who continue the same ineffective treatments month after month without redirecting or reanalyzing the situation. It’s a bad situation that we want to help you change.

Let’s face it: after the same treatment, be it timed intercourse, oral medications, inseminations, or IVF, has failed continuously, something needs to change. Whether it be moving on to more aggressive treatments (or, as we say, stepping up the ladder!), tweaking the current protocol, or seeking a second opinion, you need to shake things up. There are many available fertility treatments that can be, and likely should be, utilized.

A patient-doctor relationship should be a partnership with give and take, as well as back and forth. Gone are the paternalistic days of medicine where the doctor speaks and the patient listens. Treatment decisions should no longer be dictated, but rather, discussed. If this is not happening for you and you find yourself in the merry-go-round rut, then you need to put the brakes on. Make a phone call, send an email, or sit down with your doctor to review your case. Bring your list of questions, and ask away.

If you don’t like the answers, don’t be afraid to take them and your struggles elsewhere. At some point, you have to either ask the attendant to stop the ride or simply hop off. Eventually, circling in the same direction stops being fun, exciting, or promising; it also makes you nauseous, dizzy, and loopy!

So be your own advocate, and shut this ride down. The park is huge, with so many more rides and adventures to explore.

Acceptance

Weather has a mind, a plan, and a path of its own. No matter how many times we open our weather app, if it’s going to rain, it will rain. We can’t will it away, wish it away, or watch it away (although you can go away and avoid it). It is the ultimate in uncontrollable. For all of us who have planned an outdoor wedding, an outdoor event, or have been derailed at an airport because of weather, you know what we’re talking about. To put it simply, battling uncontrollable elements sucks. Watching and waiting is beyond unnerving. But this is not a piece about the weather; we are for sure no meteorologists. It is about accepting the seemingly unacceptable, making peace with a fate you never dreamed, and learning to work through the discomfort to find a new calm.

On the surface, the connection may be hazy. However, that awful feeling of “I have no control” combined with “I have no idea what will happen” is not dissimilar to what you feel when trying to get pregnant, especially when it isn’t working. And while we are certainly not equating the weather to whether you’ll have a baby (we get how different they are), we are highlighting the similarities in the emotions we feel in situations that we can’t control.

When the pregnancy thing is not coming easily, the first emotion is usually shock. We have heard many a patient say, “I thought I just had sex and it happened. What is going on? Why is this not working?” The reality is that getting pregnant can be really hard. It can be really frustrating, exhausting, and frightening. In this situation, thoughts like “Will I ever be a mother?” run through one’s head on auto-repeat constantly throughout the day.

Additionally, our inabilities to will a baby into our belly can make us angry—angry with yourself, your partner, your friends (especially those that seem to get pregnant when they just look at their partner), and your doctor. These emotions are common and normal. Everything you feel, say, and want to scream is totally legit—for lack of better words, this sh-t sucks.

While we can give you a ton of advice about fertility, a lot of advice about GYN, and a good amount of advice on OB, what we can’t tell you is how to let the anger, frustration, and I-am-so-pissed-off-right-now emotions go. For each of us, it’s different. For some, it’s time. For others, it’s distance; for still others, it’s change. But whatever it is and for whatever amount of time it takes, when you finally arrive, it will be liberating. Acceptance of what previously may have seemed unacceptable will allow you to no longer stand still or move backwards but in fact take a leap forwards. The freedom to let it go is empowering and energizing—with this release, you have the strength to tackle your next steps.

Most women struggling with infertility probably never wanted to undergo fertility treatments, let alone talk to their GYN about why things were not working out. They never imagined doing IVF, let alone something like egg donation or a gestational carrier. The realization of where you are in relation to where you wanted to be can be mind-boggling.

And while we are certainly not minimizing your emotions or making light or your situation, we are hoping to push you forward. As your pacers, we know what awaits you at the finish line. We can see the end way sooner than you can because we have run this race alongside many other women many other times. We have some serious experience on this course and know its ins and outs, turns and curves. We want to guide you to the finish and achieve the dream of parenthood.

There may be no bigger control freaks than us at Truly, MD. Admittedly, we too are type A++++ women who like to check, double check, and then triple check. Gambling is not our thing, and we almost never leave anything up to chance. It’s just not our style. But through years of both professional and personal trials and tribulations, we have had to learn to let go—to give in to the unknown and to say okay to the previously unacceptable.

While we are certainly not recommending that you just go along for the ride on your fertility treatment merry-go-round (we want nothing more than to empower you to ask questions and participate actively in your treatment), we do want to help you close that weather app and accept what’s going on outside. You may not get pregnant on a bed of roses listening to Sade…it may be in an operating room with bright lights and a speculum. It doesn’t mean you failed or are any less of a woman. In fact, most would say you are even more of a warrior woman and will make an even better mom because of all you went through to become a parent.

Although the weather forecast may look bleak, remember, things can change as the days and time get closer. And even if it doesn’t, even if it rains or snows or hails in April, you can get through it. You may need to go to Plan B or Plan C, but at the end of the day, if you hang in there, you will be a parent. You will have a family, and you will reach the end of the fertility journey.
If you can find a way to accept your forecast, the skies will be bright on the other side; you may just get wet on the way.

Do I Have to Put My Gym Membership on Hold While Doing Fertility Treatments? Exercise during IVF

From Twitter to Instagram and Facebook to Google, we are constantly surrounded by other people’s thoughts, opinions, and advice (with the latter often being unsolicited). Do this; don’t do that. Eat this; don’t eat that. Wear this; don’t wear that. It’s overwhelming. One of the most hashtagged topics is what a woman should and should not do while she is either pregnant or trying to get pregnant. And while most advisors are well intentioned, their advice is often not well researched. This can not only be frustrating but also confusing; deciding whom to listen to can add to an already stressful process. Exercise and fitness top the list of hotly debated topics when it comes to preconception and pregnancy. But we are here to tell you to lace up, because your daily gym routine is unlikely to be the one to blame for your fertility struggles.

Exercise has taken quite the negative rap when it comes to preconception and conception. It has been blamed as the culprit for infertility, failed IVF cycles, miscarriage, early delivery, and everything in between. Keep your heart rate below 140. Don’t lift greater than X number of pounds. Don’t run more than three miles…the list goes on and on. But the science behind these data is weak, making them more fiction than fact. While there are times during fertility treatment where you may need to modify your regimen, it actually has less to do with the impending pregnancy and more to do with the size of your ovaries.

Fertility treatments, specifically IVF, cause the ovaries to grow in size. Bigger ovaries have a bigger chance of twisting (medical term = ovarian torsion); this is a medical emergency and requires surgery to correct. To reduce the chance of this happening, old-school fertility recommendations included a blanket recommendation: “Don’t exercise.” However, with more modern treatment protocols and a slew of exercise regimens, this is no longer the case. While you may not be able to run the New York City marathon three days before your IVF retrieval, you can certainly participate. The key is modification (and moderation!)—just as you would modify regimens and activities when pregnant, you can do the same while trying to get pregnant. But you don’t have to stop. It is likely what makes you feel good about you and what makes you sane. The medications can mess with you (both mentally and physically), and we want to help you maintain every aspect of what makes you YOU.

No one regimen, routine, or practice has been demonstrated to be the best. You should always share with your doctor what you are doing and let them referee your activity level. Additionally, if exercise is a big part of your life, then pick a doctor who gets it and your needs. Being avid exercisers ourselves, we get the yen for a good sweat. We have ways to alter your IVF treatment plan so that we can keep you moving throughout the entire process.  There will most certainly be a brief pause to any impact exercise at some point in the process, but the resume button can be hit pretty quickly!

You may not be a world-class athlete or make the next Olympic team, but if exercise is important to you, then you should not have to stop. Motivating yourself to move can be hard. We commend you for wanting to keep “moving it,” no matter what the season, the occasion, or the situation. Although you may have to move slower or lift lower, we can find something that you can do to keep that blood moving and the endorphins flowing, even when you might be growing!