With over 45 years of combined experience in reproductive psychology, FertiCalm Co-founders Dr. Alice Domar and Dr. Elizabeth Grill had so much insight and practical tips to share during our Instagram Live on managing common stressors during infertility.

From unsolicited advice and pregnancy announcements to baby showers, upsetting news from your doctor and potentially, loss – the journey includes multiple stressors that may be hard to manage on your own. Their app, FertiCalm, provides a variety of more than 500 custom coping options for over 50 specific situations which have the potential to cause distress throughout the family building journey.

Below are some common scenarios and the advice and coping techniques Dr. Domar and Dr. Grill shared with us during our Live:

When friends or family pass comments or give unsolicited advice

When this happens, your response depends on what you’re comfortable disclosing. If, for instance, someone asks you when you plan on having kids, you can either use humor in your response, or otherwise try to educate that person so they don’t make the same mistake again. If you’re comfortable sharing what you’re going through, you can say something on the lines of, “We’re seeing a physician for fertility issues”, or “That didn’t land well, here’s why:”. Many people going through infertility aren’t comfortable sharing what they’re going through, and it also depends on the person you are talking to and your relationship with them – is it worth investing the time? When it comes to people who you know will never change their approach, you have to protect your boundaries – they’re not worth your time or hurt.

As Dr. Domar suggests, it helps to prepare for these kinds of conversations. Think of the comments that hurt you the most, and memorize some self-protective responses. Think of the person saying these things – is it someone you want to be polite to? Is it someone you’d like to educate? It’s ok sometimes to shut people down if they’re constantly bringing you down when they’re fully aware of what you’re going through.

Dr. Grill suggests that in advance of family events, you make a plan with your partner that if you get too uncomfortable, you have a way to leave. As an example, squeezing your partner’s hand three times can be the sign that it’s time to ‘suddenly have an issue at home’ or some other scenario you need to leave for. Preparing yourselves together ahead of time makes you feel less anxious and more supported – that you won’t have to suffer through the situation on your own.

In all of this, as Dr. Domar emphasizes, you have to be self-protective. You can’t let people say things to you that are going to keep you up at night – you need a way to shut it down. Just remember these coping techniques are not something you’ll need to incorporate into common events or daily life forever…

“This is a temporary crisis. I’m being self-protective in the moment so that I can survive what I’m going through.”
Dr. Elizabeth Grill, FertiCalm

“It’s 100% normal to be triggered at thanksgiving dinner tables or baby showers, or when you turn the tv on”, explains Dr. Grill. “In our world, if someone is going through infertility and they’re anxious and depressed, it means they’re normal”, adds Dr. Domar.

 

“Self-preservation and self-care are very different than being a selfish person. As you go through this, being self protective and practicing self care is so much more important to survive this process”

Dr. Elizabeth Grill, FertiCalm

It’s common to receive unintentionally hurtful advice after loss, too. ‘At least you got pregnant’, or ‘It was God’s will’, are just two examples of comments women are subjected to. A more sensitive reaction from those around you can be, “I am so sorry” or “What do you need? What can I do to support you?”.

When you’re invited to a baby shower

Dr. Domar suggests a number of creative ways to get out of baby showers. As she says, she often gives her clients “Doctor’s orders: do not go to a baby shower.” She suggests coming up with a reason for not going, that you’re feeling unwell, for example. “I’m not somebody who coaches people to lie”, she says, “but infertility constitutes an enormous crisis. At the height of the pandemic, our infertility patients still rated infertility as more stressful than the pandemic.” Little falsehoods are not wrong when it means you’re protecting yourself.

When it comes to shopping for a baby shower gift (and even if you don’t attend, you can still support with a gift), do not go to baby shops; an option is to buy some of your favorite books from childhood – online or from a local bookstore – and gifting those instead.

With most baby showers organized remotely in the past year, it’s a bit more difficult to claim you’re unwell. They suggest sending a gift, and popping into the zoom and then leaving (who doesn’t have internet issues, after all?). Another option is to send an email to the person, explaining you’re going through a tough time, but that you couldn’t be happier for her. You decide how much of what you’re going through you want to divulge.

As Dr. Grill notes, don’t regard yourself as selfish – what you’re going through is a temporary crisis and you’re simply being self-protective at this moment in time. She adds that there is a significant difference between self-care / self-preservation, and selfishness. Practicing self-care is very important to survive this process.

“Infertility is a temporary crisis. You are not going to be infertile and going through this for the rest of your life. So during this hopefully short phase of your life, you need to be as caring and protective of yourself as you possibly can.”
Dr. Alice Domar, FertiCalm

When you receive disappointing results from your doctor

As Dr. Grill and Dr. Domar explain, nobody is as mean as your mind, so they’ve added a coping mechanism into FertiCalm to deal with negative thoughts. When you receive news that is not as positive as you hoped, your mind goes into catastrophic thinking of everything falling apart. Try instead to reason things out – ok, so maybe this is the result, but let’s see what happens with x,y, and z next steps or possibilities. Don’t jump too far ahead to negative conclusions that still may not occur. Listen to a relaxation technique to calm yourself down, and distract yourself with a book or by calling a friend.

“At the height of the pandemic, our infertility patients still rated infertility as more stressful than the pandemic.”
Dr. Alice Domar, FertiCalm

When social media becomes too much

Social media platforms we use daily are full of pregnancy announcements and baby photos. Close it down for a while, and if you feel better after a couple of days (which should tell you something) stay away longer. The priority is to take care of yourself.

When you and your partner are not in the same place emotionally

Dr. Domar notes that she has yet to see a couple in her decades of experience, who were both at the same place at the same time. As she explains, the way you’re thinking and coping with infertility is the right way for you, and the way your partner is dealing with it, is the right way for them. Women tend to be a little ahead in the process – they want to see a doctor, they want to consider treatment. But, partners shouldn’t be pushed to make decisions they’re not ready to make.

You must first identify your needs and wants to be able to communicate them to your partner. Dr. Grill and Dr. Domar share that they do a lot of empathy training and communication training with their patients. They note that one of the hardest things to deal with is when someone else gets pregnant. Men react differently to women – the woman may want to avoid contact with the pregnant person, but the partner may react differently, often in a more logical and rational manner. They often feel that the friend’s pregnancy has no bearing on their own journey TTC – while the woman in the partnership draws a much closer connection or comparison. Educating their patients about the psychological aspect of infertility and that what the partner is experiencing is normal, improves relationships and communication.

When a partner wants to isolate and pull away, and the other doesn’t understand, try to negotiate a way that is ok for both. For all social situations, make a plan in advance so you’re both on the same page.

Finally, when it comes to therapy – whether you go both as a couple and individually as well, both Dr. Grill and Dr. Domar consider it essential to see a therapist who specializes in infertility and knows the implications of the medical aspects. You want someone who can match your medical knowledge and even go above that. In the US, there are 600 therapists specialized in counseling couples and individuals going through infertility.

When you’re dealing with secondary infertility

Research shows that secondary infertility can be just as difficult emotionally as primary infertility. As Dr. Domar explains, secondary infertility is really hard and isolating as you already have a child which can put you in a different category than the community who doesn’t – but you’re also not in the category of parents who have the multiple children they hoped for naturally. You can feel anxiety about ending up with an only child or having a large age gap between children – and you want to avail yourself of every possible resource that you think is going to work for you. What you’re feeling is valid.

When it’s recommended to move from one tier of fertility treatment to the next

Moving from one tier of infertility treatment to the next (for example from IVF to surrogacy) might be a quick decision for your doctor, but it takes time to move psychologically as you need to grief and then reconcile. Focus on the ending; how that child comes into the world is somewhat less important.

“I think you have to focus on the end game, and the fact that you want to parent another child, and how that child comes into this world is somewhat less important than the fact that you’re going to parent this child for the rest of your life.”
Dr. Alice Domar, FertiCalm

When egg freezing (especially during the COVID-19 pandemic) isn’t what you thought it would be

Egg freezing is a big decision in itself – it also requires coming to terms with changed plans. As Dr. Domar and Dr. Grill explain, it requires dealing with the grief that comes along with not being where you planned to be at that point in life (whether in a relationship or otherwise). While egg freezing is empowering – as you’re taking control of your reproductive future, to a degree – many women are caught off guard by the grief part of it. Many are also unprepared at the medical side of it, as for a few days, you become an infertility patient. Sometimes it also takes more than one cycle until the ideal number of eggs are retrieved so you should be emotionally prepared for this scenario.

You can learn more about the FertiCalm app here and follow FertiCalm on Instagram for exciting news and updates. Find out what inspired Dr. Grill and Dr. Domar to create FertiCalm, and much more, in our recent GoStork Spotlight of Dr. Domar and Dr. Grill.

Thank you Dr. Grill and Dr. Domar for lending your voices to our Instagram live series, for sharing such helpful advice, and for everything you do to support those navigating the stress of trying to conceive.