All emotions are common; maybe 99% of all couples going through this process experience them. The first thing I tell patients when they come to me stressed, or when they enter the group and write, “Help, I need help, I’m so stressed, I’m anxious,” is: it’s normal. It’s normal to feel this way.
What happens is that when you feel all these emotions, you start thinking, “Something is wrong with me, maybe that’s why I cannot get pregnant,” and then you feel shame, and then even more stress. It becomes a never-ending story. The first important thing is to tell yourself: it’s absolutely okay because it’s a very sensitive, very stressful period, and you are a human being who can feel all sorts of emotions.
The second step is to ask yourself: How can I take care of myself? We are all different, of course. You can start by listening to yourself and telling yourself: “Now is a sensitive period for me, and I have to take care of myself.” Perhaps, avoid meetings that afterwards make you cry or feel very sad. Sometimes you visit someone, and you are not happy with the communication with your doctor — it can happen — and you feel sad.
Now, you have the opportunity to get a second opinion, to change your doctor if needed. You can talk to your partner, and you can join a support group like ours, because sometimes it helps just to be part of a group, not to stay alone. As we know from post-traumatic stress disorder, it’s not just about what happened but how you digest it afterwards — who supported you, who was near you. That’s why it’s very important not to close yourself off but to find normal support, avoid what makes you unhappy.
If people love you — family, friends — and you are not able to join celebrations, they will understand. You can tell them: “It was just not the right time for me.” These are really basic things. It sounds easy to say, but if you try, maybe these steps can help.
Many couples that seek IVF treatment for infertility describe the experience as “emotionally taxing”. It is not uncommon to experience a deluge of contradictory emotions that dynamically change and evolve throughout the process. There are many reasons that this may happen and are likely contributing to a different extent, each for any given couple. One common reason cited by patients is the stigma of infertility. Although significant steps towards defying infertility on a social level have been made, and couples feel safer than ever discussing their difficulty conceiving, for many, this topic is still taboo and is associated with negative emotions in both partners. Women may experience feelings of inadequacy and jealousy over their close friends and relatives having children without issue, and simultaneously feel stress for their situation. Men with infertility may feel emasculated and insecure about their virility and sexual performance, which may, in turn, manifest as performance anxiety and result in a self-fulfilling prophecy. Infertility frequently affects the couple’s bond as well, with partners potentially blaming each other for the issue or, in their desperate attempt to conceive, turning sexual intercourse into a stressful obligation and their relationship into an unloving transaction. On the other hand, hardship can strengthen the bond of the couple and their resolve to proceed with IVF due to the shared burden, thus resulting in a positive experience, depending on the outlook of the couple.
Apart from infertility, the IVF process itself may constitute the primary cause of the rapidly changing emotions that most couples report. This is due to the multiple steps involved, from the initial fertility assessment to the final cycle outcome, and thus, the complicated feelings experienced when anticipating and processing the results as they come. Disappointment in abnormal results during pre-IVF testing, optimism over satisfactory baseline parameters, doubt, or anticipation over developing follicles during ovarian stimulation, anxiety over the egg retrieval process, elation over the number of collected oocytes, happiness, or sadness over the outcome of the embryo transfer and many more emotions are likely to be expressed in rapid succession at every step. This is further exacerbated for women due to the hormonal effects of the stimulation, which, similarly to pregnancy, may make them more expressive and prone to mood swings. The process is challenging for the partner as well, who needs to step up and provide emotional support to the woman undergoing IVF, often at the expense of their own feelings and needs, which are set aside, ignored and suppressed. Modern IVF practice guidelines have recognized this effect and advise couples to seek counselling during the process or actively engage in stress-relieving activities to mitigate its psychological effects, as well as strengthen their bond.
It is a roller coaster of emotions because it is a life-defining, huge thing. This desire to have a baby and the whole fertility process can change your life completely. A lot depends on the outcome of the process. It determines your whole life, so, normally, it is very emotional. The desire to have a baby is intense, and you build up an enormous amount of hope every cycle and every month.
Moments of hope and moments of despair are very close together. For example, at the end of the two-week wait, you have a lot of hope, and then when the test is negative, there is a lot of despair. These emotions are so close together. Even if you become pregnant, there is pure happiness, but if there is a miscarriage, then there is the deepest sadness. These moments are also very close together. This roller coaster of emotions is like a big plane taking off, going higher and higher, then suddenly crashing again.
Another reason why it feels like a roller coaster is that, as a fertility coach, I see that a lot of people in this process for some time get into a kind of tunnel vision. You’re so focused on the target of getting pregnant and the whole fertility process that you don’t see the other nice and valuable things in your life anymore. You get stuck in a kind of tunnel, and these other nice and valuable things you don’t see anymore are very important for your emotional resilience. If you don’t see them and just focus on one thing, it’s like standing on one leg and becoming unstable. This loss of stability contributes to the feeling of big ups and big downs.
These are the main reasons why the fertility process feels like a roller coaster of emotions.
Because it is – it is exactly that! It is such an accurate and vivid description of the emotional experience of fertility challenges.
Let us start by explaining what emotions are and how they are created.
And I apologize if this might spoil it for some of you by challenging any romantic ideas about our emotional experiences…but here it comes anyway!
Emotions are nothing but Chemistry. They are totally related and created by the production of hormones in our bodies. This is one of the reasons why we have clear somatic expressions of emotions – we might sweat when frightened, we might go red when embarrassed or angry, our breathing patterns may change depending on the emotional state we are experiencing. Our parasympathetic system is responding without necessarily consulting our cognitive capabilities.
Endorphin for example is one of the hormones of excitement and happiness, Cortisol is an important stress hormone, Oxytocine is related to pleasure and reward and so on and so forth.
Now, let’s think about the processes, decisions, and outcomes of the ‘Fertility ride’.
Yes – No, Now – Later, Go ahead – Wait.
Ups and down in the process itself are the name of the game. And to make it teeny-weeny bit more challenging we have many nerve-racking waiting times in between…
In the beginning of any reproductive cycle – whether you are at the stage of TTC – Trying to Conceive, spontaneously, or following ART, an Assisting Reproduction Therapy protocol, you start with Action and Hope. You are working towards a specific goal with a desired outcome. These circumstances are directly linked with the way your body responds in terms of the production of hormones of adrenaline for example, and thus the experience of specific emotions.
Then usually a waiting time plateau comes – the nail-biting waiting times where one needs to manage the stress and the anxiety, the fear of the unknown outcome, the uncertainty that brings about a sense of lack of control.
And finally, the third stage of our rollercoaster – is it a hit or a miss?
Is it a positive result that will get us to the next stage or do we need to re-consider, re-evaluate and re-position ourselves within the process?
So, hell yes, it is a ride – it can be a scary one and at the same time an exciting ride.
Emotional management is a very important skill within the Fertility and sub-fertility journey, and within any Life’s journey!
It can make the difference that makes the difference in our experience, in our relationships and most likely in our OUTCOME. And that is the reason I highly recommend and urge you to get VALID and RELIABLE psycho-social support when travelling this path. I have been through it myself and I have made it my mission to provide personalized psycho-social support for people in this life stage, respecting their unique needs. Because no journey is the same.
It may feel like a rollercoaster to most of us but is our very own rollercoaster ride – depending on who we are, on our experiences, timing, circumstances, relationships, values and beliefs – that marvellously unique WORK OF ART that each of us is.
It feels like a roller-coaster of emotions because it is and there’s a whole range of things you’ll feel; anger, guilt when you’re not happy when a friend announces a pregnancy, shame that maybe you’re letting your partner down if the issue is with you or if you’re a female and you’re getting your period each month, if its a male factor and you might blame yourself . All of these emotions are in a new context, so you’re going from one to the next and you might find one month if your period is a bit late that there’s hope but then your period comes and there’s sadness. Because it’s constantly changing and there’s so much uncertainty there, it can feel like a real roller-coaster of emotion, therefore it is important to be kind to yourself and understand that this is unfortunately, part of the process and the better you become at coping with these different feelings, the easier, each time they come, it will start to feel.
Trying for a baby over a long period of time generates a huge amount of hope and positivity and optimism. At first, there’s a lot of hope. It’s something that the couple really wants. You might have been trying for a long time, you might have been wanting this baby for a while and everything in you wants it to work. Everything in your hopes that it’s going to happen and every month you try and try and try and you go through this kind of cycle of hoping for two weeks and then waiting and waiting until the period comes and then suddenly there’s the terrible anguish and despair: it hasn’t worked again. This can go on for some people for like a couple of years before, in the UK at least, before you get a chance to have treatment on the NHS and for some people it’s even longer depending on where they are living. That goes on for a long time, the up and down of hopes and despair over and over again. Maybe they enter the world of fertility treatment and you feel like okay now this is it, this is gonna work for us, we’re gonna be able to have a baby now and they’ve found out what’s wrong and they’ve done the diagnosis and they’re gonna just overcome the problem and we’re going to have a baby and so that there really is a lot of positivity and especially if the treatment cycle is going really well. You just feel like more and more and more hopeful as time goes by as each stage goes really well until you’re really really hoping for it to work and then tragically maybe there’s a negative pregnancy test or maybe have a positive pregnancy test and the end their feelings go washing up into the stratosphere of excitement and you’re so pleased finally you’ve made it, you’ve got there, you’ve got this positive pregnancy test and then for some people they have a chemical pregnancy which means that a couple of days later they have a period and they come crashing down and just so full of absolute, abject despair and heartbreak and sadness and disappointment. It’s such these feelings are so powerful that people use the analogy of a roller coaster to describe the shooting up of the of the hopes and and the possibility that this baby might finally be coming and then suddenly yet again it’s not happening and even during a fertility treatment cycle an IVF cycle or something everything can be going well and you know the hopes can be going up and then maybe something goes a bit wrong and then they crash down again and honestly it is just such a intense and distressing experience. It’s just really not an easy experience and it’s it’s for no reason that people refer to it as an emotional roller coaster.
Human reproductive psychologists often use this metaphor to explain to our patients what they will feel during fertility treatments.
In effect, it refers to a constant and sometimes unexpected rise and fall of emotions.
If there is one thing that characterises these processes, it is uncertainty.
Faced with the great emotional discomfort that is generated, many patients try to control their emotions, or avoid them or even block them.
We now know that this is not the best way for the vast majority of people to manage them, as the result is an increase in frustration at not being able to achieve it.
It is very important to have real knowledge of what we are going to face and to generate adequate resources for its management. It is easier to dance with emotions than to try to keep them in a drawer!
Trying to conceive, even if naturally or via ART, IVF, IUI, sometimes is stressful, why? Because we are focusing on something, we have a goal and the goal is to be parents, so sometimes that goal becomes an obsession and not a priority. And the idea is to make it a priority, accept that what we are entering, the journey of parenthood, is difficult. So if we have that kind of awareness, we would be putting a little bit of ease in our journey but as humans, we never have that kind of awareness so we just jump into things. And the fact that we are trying to conceive, we are trying, and trying, and trying, if we can’t, it brings us stress in our lives, and right away; anxiety, sadness, depression, then “what if it doesn’t work?” becomes a loop, and that loop creates that roller coaster of emotions, it’s just that simple.
What is the solution? The solution as I said is easy to say but very difficult to take action on it. But it’s a practice and what is it? Be aware, acceptance is very important, what is acceptance? Look, I am entering into a world, into a ride that is a roller coaster. What do people do when they ride on roller coasters? They try to bring adrenaline and enjoy that craze, let’s do the same. How can we do it? Accepting… what do we need to accept? That it is a difficult journey, it’s something that is not in our control. I cannot say today ‘oh let me go and have intercourse with my husband and I’m going to get pregnant, yes’ no! When we know that it’s something out of our control, so what can we do? The only thing that we can control is the attitude and the intention that we are putting upon it. Okay, it’s not easy, I’m not going to get pregnant tomorrow maybe it’s going to come next month, maybe it’s going to take a little bit more time, but let me also put a little bit of joy into this. So, every time I’m going to have intercourse with my husband I’m going to enjoy it like it’s supposed to be and bring more kind of fun into this journey that cannot be that spicy. Again, it’s not easy to take action on it, it’s easier to say, but that’s the solution, and its baby steps. When we are aware that we cannot control everything, but we choose to control our action on something, it can solve a lot of problems and it can ease any journey we are taking.
The infertility roller coaster – it really is probably the best description of going through infertility because it is such an up and down journey, unfortunately. Not only hormonally do we change throughout our cycle, so you may experience those natural ups and downs through your cycle from your hormones but, also, of course, you have those changing expectations through your cycle. As you approach ovulation there’s hope, and as you then approach potentially your period and another month of trying, it can be really hard and actually getting your period can be very difficult. So not only have you got those natural flows but you also have the impact that infertility is having on you and your life and that is very wide-ranging, impacting your work, impacting your relationships, not only with your partner but also your family, friends, so it’s impacting on your social life as well, impacting on all the things that you’re having to do for infertility.
In terms of diet and those kinds of things, if you’re making changes in your life to diet, or environment, or to exercise, it can be really hard to motivate so you can be up and down in those kinds of things as well. The best advice is to really try and stabilize yourself, you are the core of this journey so it’s really trying to find yourself again, who are you right now within the middle of this journey and finding what makes you have strength, and what makes you feel good and well right now. And that can really help sort of bolster your bottom line almost so you can weather this storm, this up and down storm of infertility a little better, and there’s so much support and tools out there for you.
