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Rachel Gurevich

Fertility Blog

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Don't Ignore the Men

Tuesday May 27, 2014

Men really get the short end of the stick when it comes to care and attention in the fertility world. So much focus is on the woman. Yet, infertility is (typically) faced as a couple. When a woman can't get pregnant, there's usually a man standing next her who is just as eager for a baby and just as unable to have one.

Men also suffer through infertility.

When a couple can't get pregnant, the woman is told to see her doctor, not the man. Fertility testing is frequently first done on the woman, and only later male fertility is tested (and sometimes not tested for some time!) During treatment, the woman frequently has the most active role, with pills, injections, ultrasounds, and other invasive procedures. There are invasive procedures for male infertility, but they are rarely used. But that doesn't mean the man isn't also stressed.

Here are some key issues that we must not ignore about men and infertility.

Don't Ignore Male Fertility Testing

Basic male fertility testing is relatively simple in terms of procedure. There are no shots, ultrasounds, or needles placed elsewhere. Just a cup and a private room to produce the semen sample, which is then analyzed in a lab. Further testing need only be done if the results are abnormal.

However, male fertility testing is often delayed, perhaps because a woman sees her gynecologist first, who may not think of the male partner as her patient. Often, the male partner isn't tested until they are referred to a fertility clinic.

What's wrong with this? It may lead to treatments that are doomed to fail.

If the doctor gives the woman Clomid, it won't help them conceive if male fertility is complicating things. I know of a couple who went through several cycles of Clomid before his fertility was tested and discovered that his sperm count was abnormally low. All that exposure to Clomid (not to mention the emotional stress), for nothing.

Also, I think it's important to acknowledge that male fertility testing is simple in terms of procedure, but not necessarily in action! Semen analysis can be really difficult emotionally for some men.

Just think for a minute how you'd feel if someone said you had to go into a room alone and find a way to orgasm, on demand, for medical testing. Yep. Not an easy task for most.

Don't Ignore Male Infertility

Male infertility is largely ignored by the media. So much focus is on women and their biological clock. And yet, almost half of all infertile couples have male factor infertility involved, with some having only male factor infertility involved and others having both male and female factors involved.

Male infertility can be tremendously stressful for a couple, especially the man. But how many mind-body classes do you know that target men? Granted, not many men would be interested in participating, but maybe someone needs to start thinking about how to best support men with infertility.

Don't Ignore the Stress of the Male Partner: Whether or Not He's Infertile

Whether the man is infertile or not, he still experiences stress.

In the trying phase, sex can and does often become a highly stressful issue. Suddenly, he may need to have sex, whether he wants to or not, just because she's ovulating. And knowing that the only reason she wants sex is because she might get pregnant is not a turn on for most men. Sex is a big stress reliever for many men, and when sex becomes stress, it's difficult.

In the testing phase, the relatively simple semen analysis can lead to high levels of anxiety in many men. In the treatment phase, needing to support his wife and produce semen samples (if doing IUI or IVF) can be trying and difficult for many men. There's also the financial stress, which often lays heavier on the male partner even if both partners are high earners, mainly because of societal beliefs of who is responsible for supporting the family.

Then there are the fears that they won't ever have a child. But because men and women often handle stress differently, the woman may feel the man "doesn't care" when really he's just putting up a strong front, hiding his own pain and vulnerability.

Don't Ignore the Male Partner's Role in Improving Health

Women are told to lose weight, try yoga, improve their diets. There are guided meditations and mind-body programs created for women with infertility.

But what are the men told? How often are they told that losing weight may also help improve their sperm counts? How about improving diet? Or cutting back on drinking and quitting smoking, if those are factors? How about vitamins supplementation?

Many doctors don't mention any of this, even when male infertility is diagnosed.

While improving health habits is rarely a sure fire solution to infertility, it may boost your chances. Why all the focus on the women? Why are we ignoring the male partner's role?

Women, do you feel your partner was ignored during testing or treatment? Do you unintentionally ignore his fears and concerns? Men, do you feel your needs were ignored? Do you wonder why the media focuses so much on the women and so little on the men? Please share your thoughts in the comments. I'd love to hear from you!

More on male fertility:

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This post was written for National Infertility Awareness Week (NIAW) 2012. Every year, RESOLVE: The National Infertility Association hosts a blog challenge on a chosen theme in honor of NIAW. The 2012 theme was "Don't Ignore..."

Photo: User Bacon_pola of Stock.chng

Is a Procreation Vacation a Vacation?

Sunday May 25, 2014

Some call it a procreation vacation, others an ovulation vacation. Some even call it a babymoon (though a babymoon can also mean time spent bonding with a newborn, or a vacation taken before birth.)

Couple in bed thinking about getting pregnant

Whatever you call it, the idea is pretty much the same - you go on vacation, with the goal of relaxing and getting pregnant.

These fertility-focused vacations are becoming quite popular. Some are aimed towards the fertile (as far as they know) crowd: couples who want a baby, and want to make the conception memorable. Or, according to this video at DadLabs.com, couples who want to not just make conception-night special, but are aiming for a particular due date.

Other fertility-focused vacations are aimed at the infertile couple. The vacation may include acupuncture treatments, massage, "fertility diet" foods, and that sort of thing.

Maybe I'm cynical, or maybe I'm thinking about this from the perspective someone who tried "to just relax" without success - but how can a procreation vacation be a vacation?

Vacations are for letting your hair down, hangin' out in the sun (or skiing down some slopes), and eating out at fancy restaurants, tie required of course. Vacations are for cuddling all morning, followed by breakfast in bed, and a show that night.

Vacations are for getting away from the stress. Not bringing it with you.

To me, personally, a vacation that focuses on conception is not a vacation. A pricey vacation that can "fail", if it doesn't end with a positive pregnancy test, hardly sounds like a relaxing adventure.

It also sort of reminds me of how unromantic it became to hear the words, "Let's make a baby," right before sex. After months (and years) of trying, that might be the biggest turn off possible.

For the couples without fertility issues, who think they are going to get the birthday or month they want, I can't help but smirk. Good luck on that. Even fertile couples do not have a 100% chance of success in any given month.

Even if you think you have timed it all perfectly, and you get pregnant when you planned, and your due date does fall on your dreamed birthday -- you still are unlikely to have a baby that day. Babies rarely arrive on a schedule.

I will say this: procreation vacations are great for the hotel industry. As a marketing scheme, it's an awesome idea. But for the couples that give out the big bucks for this baby-making mission? I don't know...

I just feel like focusing a vacation on "procreating", or even making it your mission to relax, is missing the point.

I think it'd be more appropriate to offer fertility retreats. The goal would not be to conceive that month, or "relax more to increase fertility", but instead, it'd serve as a get away from all the stress and pressure that comes with trying to conceive.

In other words, it would just be a vacation. From everything - even from the babymaking!

More on getting pregnant:

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Photo: Jamie Grill / The Image Bank / Getty Images

The “Who Has It Worse, Who Has It Better” Game

Wednesday May 21, 2014

There is a mind game that many of us play, a game I like to call, "Who has it worse, who has it better." The game is not unique to infertility survivors , but we do have our own version of the game.

There are two ways to play.

Couple sits angry on the couch.

Version #1 of Who Has It Worse, Who Has It Better

In this version of the game, we have it worse, and someone else (or everyone else) has it better.

I've been trying for four years, but she has only been trying for two.

I have no children, but she has at least one already.

They have only taken clomid, but I've done IVF.

They've tried for the same number of years as I have, done IVF as many times as I've done - but they at least miscarried once. They know they can get pregnant. I haven't even miscarried.

Husband and wives can play, too.

He only has to go into a room with a cup, while I get prodded and poked with needles and ultrasound wands.

She only has to deal with needles and procedures, but I have to live with the fact that I'm the infertile one.

You get the idea.

Version #2 of Who Has It Worse, Who Has It Better

In this version of the game, someone else has it worse, and we've got it better.

I've been trying for four years, and she's been trying for two - but at least I have the support of my family. I know I'm lucky for that.

She already has one child, and I have none. I can't imagine how she spends so much time around kids, thinking she may never have another. She knows what she's missing.

They've only take clomid, and we've done IVF - I remember what it was like just starting out with treatments. Everything so new and foreign. Now, I'm practically best friends with the ultrasound tech, and that familiarity has made things easier, in some ways.

I can't imagine what it's like to be so close and then lose a pregnancy. That must be so heartbreaking.

You can play either version of the game, no matter what your situation is. After all, there is always someone who has it better or worse than we do.

Version #1 will probably make you feel worse about your lot in life. Version #2 - while it won't take away the pain of what you're going through -- might actually help you feel a tiny bit better.

Not comparing ourselves to others is probably best, but most people can't resist playing at least one version of this game. Which version of the game are you going to play today?

More on coping with infertility:

Would you like to receive trying to conceive tips and fertility information every week? Sign up for a free fertility newsletter here.

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Don't Ignore Your Needs

Sunday May 18, 2014

Do you sometimes feel less like a person making choices, and more like a puppet being bounced around in a play about infertility? Infertility can make you feel like it's in charge, instead of you. When you begin fertility testing, you may feel the doctors are in charge, or the tests are in charge. Same with treatments. You may go about your day in a daze, or carry out your doctor's instructions with a great sense of helplessness.

Man speaks with female doctor about fertility problems.

Despite how it feels, however, you are still in charge of your life. You do have choices. And you have needs that should not be ignored.

Don't Ignore Your Need to Ask Questions

While your doctors know more about infertility and reproduction than you do, they don't know you like you do. You may have questions, and they should answer them. Don't put them too high up on a pedestal and assume every plan of action is unquestionably the best one. Maybe their plan isn't right for you. Or maybe what they have in mind for your treatment isn't what you're willing or ready to do.

Ask questions. Ask them to explain to you test results and what they mean for your prognosis. Ask them why they recommend treatments and if you have any other options. When treatment fails, ask them why they think things went wrong and what can be done differently next time.

And don't be afraid to ask for a second opinion, especially if treatment isn't going how you'd like or if you've had multiple treatment failures.

Don't Ignore Your Need to Think Things Over

If you're sitting in your doctor's office, and in a period of a half hour find out your only chance for success is IVF, you may not be ready in that moment to jump into a treatment plan. Maybe you will be - but if you're not, that is ok. You have a right to think things over.

I talk about the need for speed a lot, reminding my readers that their biological clocks are ticking. However, waiting a few hours, days, or even a few weeks, is not going to make or break anything. If you have a big decision to make, take a step back. Tell your doctor, if they don't suggest it themselves, that you need time to think.

Don't Ignore Your Need for Support

Infertility often feels like a lonely journey, but you are not in this alone. There are millions of people like you living with infertility. There are support groups, like RESOLVE, and there are therapists who have training to help you deal with your struggles.

Don't forget about your friends and family, either. Not every person will be able to offer you support, but I believe you should have at least one friend and one family member who you can speak to about your fertility woes. Don't ignore your need for support. Reach out!

Don't Ignore Your Need for a Break

Taking a break from the infertility roller coaster isn't an easy decision, but for some people, it can be the best decision they ever made. Speak to your doctor about how long you can afford to take a break from trying to conceive, and if you feel you need a good amount of time to not focus on trying to conceive, take that time.

Personally, I can tell you my husband and I took a two year break in the middle of our trying to conceive years, and it made a huge difference. I will embarrassingly admit that I had hoped the break would also somehow cure me. I thought we'd finish our break, we'd start trying, and miracle of miracles, I'd get pregnant right away! Instead, it took three more years before we finally conceived and had our twins.

But I am very happy I took that break. It reenergized me. It made me feel strong again, like I could handle the disappointment. It also allowed me to rebalance my life, and remember that life isn't only about getting pregnant.

A break for you might mean a few months, or it may mean a year or more. Whatever you need, take it.

Have you been ignoring your needs? Have you ever taken a break? Asked for more time to think? Sought support? Feel free to leave a comment, I'd love to hear from you!

More on coping with infertility:

This post was written in honor of National Infertility Awareness Week (NIAW) 2012. Every year, RESOLVE: The National Infertility Association hosts a blog challenge on a chosen theme in honor of NIAW. The 2012 year's theme was "Don't Ignore..." Check out the RESOLVE website.

Photo: Rob Melnychuk / Getty Images.

Trying to Conceive Obsessions

Thursday May 15, 2014

When you're trying to conceive, it's difficult not to spend ridiculous amounts of time thinking about different aspects of the experience -- especially if it's taking longer than you hoped and even more so if you're using fertility treatments.

Infertility commonly causes anxiety.

When will you ovulate? Will you ovulate?

Am I pregnant this month? Is it time to take a pregnancy test? Or another test?

How many embryos will survive? Will our chosen egg donor produce enough healthy eggs for us?

Will I ever get pregnant?

It's enough to drive you mad. You may find yourself spending way too much time online reading about infertility, browsing fertility forums, or Googleing different symptoms.

And while I know it's hard, and it feels impossible, try to spend some time every day not thinking about trying to get pregnant. (I know, impossible, right??)

One way that may help is to schedule time every day to obsess. Set aside 15 or 30 minutes to go crazy thinking and Googling your symptoms away.

Be sure to use a timer, or you may find yourself sucked into an obsessing vortex!

For more on coping with infertility and the two week wait, check out these articles and quizzes:

Would you like to receive trying to conceive tips and fertility information every week? Sign up for a free fertility newsletter here!

Photo: Paul Bradbury / Getty Images

From Mother's Day to Mothering Day

Sunday May 11, 2014

Mother's Day can be an emotionally sensitive day for those in the trenches of infertility and those who have been in those trenches. (You may imagine that having a child takes away the pain of Mother's Day, but for many women, it doesn't, not completely.) Just trying to avoid the over-the-top marketing that surrounds mother's day can be overwhelming.

Have a heart on Mother's Day

But what if, instead of celebrating only mothers on Mother's Day, we also celebrated those who lovingly mother others? You don't need to have biological or adopted children in order to be motherly. (Sadly, there are plenty of traditional mothers who have no idea how to mother or nurture others.)

Think back to those in your life who have mothered you. I can think of a few special women who mothered me, as a child and as an adult. I cannot imagine who I am today without their special love, care, and attention.

And I am sure you have mothered others yourself. I'd say there's a high probability that someone out there felt nurtured and cared for in a special way by you. You may not know it. But they do.

I'm not saying focusing on mothering instead of traditional motherhood will make the pain of Mother's Day disappear. But I do think it's important to recognize that you don't have to be a mom to mother another person. I think it's important to recognize how much we can impact the lives of others, regardless of whether they are our son or daughter.

So to all those women out there who have lovingly mothered others, Happy Mothering Day to you!

More on coping while trying to conceive:

Would you like to receive trying to conceive tips and fertility information every week? Sign up for a free fertility newsletter here!

Photo (c) User andreyutzu of Stock.xchng

Do You Douche or Use Vaginal Washes? Don't!

Wednesday May 7, 2014

The practice of douching, or forcefully squirting a liquid solution meant to "cleanse" the vagina, has been passed down from mother to daughter, or from friend to friend, in many social circles. Those douching likely think they are just "keeping themselves clean." What they may not know is that they are instead washing away the natural flora of the vagina, which keeps infection out. They are also increasing the risk of vaginal infection and irritation, and setting themselves up for trouble with getting pregnant.

A study found that up to 60% of US women use douche products or insert lubricants like Vaseline or KY Jelly vaginally. The use of these products was correlated with yeast infections and  bacterial infections, which also raise the women's risk of contraction a sexually transmitted infection. Many of the women had no idea they were harboring infections.

It is possible that the women were trying to treat symptoms of the infection with the douche and lubricant products, not even realizing they had an infection. While a healthy vagina has natural odors and secretions, a really strong bad smell or very strong fishy smell may be a sign of infection, and secretions that are green or itchy may also be signs of an infection. Be sure to see your doctor.

Whatever you do, don't douche or use products line Vaseline or KY Jelly to cover up or relieve uncomfortable symptoms. Speak to your doctor instead, and protect your fertility and your vaginal health.

More on this topic:

Would you like to receive trying to conceive tips and fertility information every week? Sign up for a free fertility newsletter here.

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Will You Be Celebrating National Infertility Survival Day?

Sunday April 27, 2014

May is almost here, which means that in two Sundays it will be Mother's Day. But thanks to Beverly Barna, author of Infertility Sucks! Keeping it All Together When Sperm and Egg Stubbornly Remain Apart, you can celebrate a week earlier on National Infertility Survival Day.

Have a little chocolate on infertility survival day!

On Sunday May 4th, the week before the moms get to celebrate, those with infertility get a day of their own.

Are you thinking, "Why should I celebrate infertility?!"

Well, it's not celebrating infertility, but more of a pre-Mother's Day inoculation.

Mother's Day can be emotionally difficult for couples trying to conceive. Moms certainly do work hard and deserve a day of recognition, but some of us work hard at just trying to become a mom. You deserve this special day, believe me.

So whether you decide to go out for dinner, get a massage, take a lovely walk outdoors with a loved one, or maybe just watch a favorite movie at home, remember that you're worth celebrating, mom or not.

More on coping while trying to conceive:

Would you like to receive trying to conceive tips and fertility information every week? Sign up for a free fertility newsletter here.

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Photo: Blend Images - Colin Anderson / Brand X Pictures / Getty

What Did You Say?! Insensitive Comments from Friends and Family

Friday April 25, 2014

"Don't worry about it! You can always do IVF."

"Just adopt!"

"You still want kids after you've seen mine?! You can have them!"

Hearing insensitive comments regarding infertility hurts.

I'm pretty sure that every couple who has dealt with infertility and shared this information with others has heard insensitive comments from friends and family. I really don't think they say these things to hurt us intentionally. Usually, they are trying to "help" with their unhelpful or uneducated advice - but their intention is to help.

Given that, I've written an article -- for your friends and family -- on 12 things not to say. Please feel free to share it with those who know about your infertility.

Heck, if you're "out" about your infertility, share it on Facebook or Twitter, so more people will stop saying these things.

I think we've all managed at one time or another to put our foot in our mouths (I know I have!), and if you frequently find yourself sick with foot-in-mouth disease, check out this awesome compilation of what-not-to-say's on a variety of conditions.

What's the worst thing someone said to you? What was the most supportive? Tell us in the comments below, or share your experience here.

More on friends and family:

Join the conversation!

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Photo: Stockbyte / Getty

Does Your State Make the Grade? Check Its Fertility Score.

Tuesday April 22, 2014

Where you live can make a huge impact on whether you have access to fertility treatments, or can afford them. This is true on a world scale and a national scale.

Living in a remote area may limit your access to fertility treatment.

To illustrate the importance of place in the United States, RESOLVE: The National Infertility Association and EMD Serono created an interactive, easy to use map, where you can find out how well your state does.

Each state received a grade - A, B, C, D, or F - based on whether the state has an insurance mandate (a law requiring some sort of fertility coverage), the number of fertility specialists available in the state, the number of RESOLVE support groups available, and the number of women in the state who have had difficulty conceiving or carrying a pregnancy to live birth.

Making honor roll with grade A's are Connecticut, Illinois, Maryland, Massachusetts and New Jersey. Coming out at the bottom with F's are Alaska, New Hampshire and Wyoming.

(I do feel, however, for Alaska, who likely has difficulty attracting doctors to the cold, remote area. According to the map statistics, Alaska has zero fertility specialists in the state, and just over 15,000 women struggling to conceive.)

The map also lets you know if your state legislature has a track record for trying to pass laws that could limit fertility treatment access, or if your state's fertility mandate is at risk.

Check out the map here:

More on infertility and fertility treatment:

Would you like to receive trying to conceive tips and infertility information every week? Sign up for a free fertility newsletter here!

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Photo: jzlomek / Stock.xchng

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