In this webinar, Karenna Wood, award-winning international Fertility Coach and founder of Your Fertility Hub, has provided some useful coping mechanisms that will help you with your IVF and afterwards.
Karenna Wood describes herself as being incredibly passionate about women getting more emotional support during infertility and finding the best ways to do that. She believes that we often leave this whole emotional piece a bit to the end, or we look into it like we are further down the road, but everybody who’s going through infertility needs that emotional support.
Karenna continues to describe her mission, which is to try to bring that support forward and help find ways to bring that emotional support to everyone. Also, she runs yourfertilityhub.com which is a website and an app called your fertility toolbox which is a web-based app which she further describes at the end of this session.
For people who are either approaching IVF, and perhaps feeling a bit apprehensive, people who are on their first time, people who have been through subsequent cycles, or people who have been through a cycle before and are just wondering how they might be able to cope a bit better, this is a tricky subject. Karenna defines IVF as a very tough roller coaster and a huge process to go through, not only from a medical point of view, especially if you’re having stimulated cycles, but also from that emotional side and the impact that it has on our lives. She hopes that after the session, people will have ways to be able to cope better and ways to journey through this in a better way.
In an attempt to reflect on this, Karenna asks us to consider and write down in a journal our thoughts about the next questions:
Based on her experience with the clients she has worked with for over a decade, she has decided to start by asking how we feel towards IVF. This is because for a lot of people, it just becomes very much about the process, about the appointments, and about everything going on in people’s lives, but they do not stop to think about their feelings towards IVF. It’s common to feel apprehension, almost veering towards real fear around this process, especially if you’ve not been through it before. We might be feeling happy and excited that, maybe, we’ve been trying on our own for a while, and now we finally feel like we’ve got some backup. However, we may be sort of on a slightly different page to our partner around IVF. That might be something that we’re feeling. But the really important thing is to recognize and be aware of how we’re feeling.
Next, she says the reason she suggests journaling is that science shows when we write stuff down, it changes how we process things in our brains. It’s powerful when we write stuff down. A lot of times, when your thoughts are going round and around your head, they’re in a loop, and they can’t get out, and maybe we are not able to find solutions for them by ourselves. But when we write our emotions down in just a stream of consciousness in a journal or a bullet journal, it brings that conscious awareness onto those feelings and helps us process them a little better. Also, in the case we are going through this with a partner or a husband, to open up with each other about how we’re truly feeling about this process because it’s really important to be open and honest around this and get the support that you need.
Karenna explains the next question by saying we can’t choose our situations. IVF is a club that nobody wants to join, nobody wants to come into this club, but we can’t control that. However, we can control how we think about IVF. We can control how we respond to IVF in our emotions and thoughts. She sometimes says we might feel like emotions become the boss of us like we’re totally out of control. That’s a really common feeling during infertility. But where we can take back control is in our feelings, thoughts and emotions, and it does start with our thoughts.
We have millions of thoughts, but throughout the day not all of them need to stay to reside and take up our brain space, and not all of them are healthy. For example, while going through a cycle of IVF, our daytime thinking is “This is never going to work” and “This is never going to happen for us”, even though we’re taking all the steps and actions to make it happen, our thinking is contrary to that, and it’s making a very difficult mindset situation for us. However, this is an area we can take control of by answering “How do we want to feel about IVF?”
By the time we’ve got to IVF, we will likely have gone through so many natural cycles so many hurdles tests, ups and downs. So, it is natural to feel pessimistic because the thing that we’re trying to get to hasn’t happened so far, despite doing all the things that we’ve done. We might also feel like we’re doing everything, all this checklist of things that people say, the acupuncture, the diet, the gentle movements, the supplements, and it’s still not happened. So you might be going in with a bit of pessimism.
Karenna also explains how we often build up pessimism and allow ourselves to sort of dwell on that pessimism because we feel it’s almost a bit of self-protection, like armour around us. According to Karenna, pessimism is not serving us, it is not helping you and it’s not healthy. We must go in with a realistic view.
According to her words, realism means maybe looking at stats and figures or just taking a general view that IVF is successful. It may be successful, but it may not, rather than pessimism. She encourages us to be optimistic. She adds it may be a bit of a stretch, but it can be worked up towards this. By asking ourselves, “Why should we be optimistic?”. We are still doing this. We are still taking practical actions to get to our dream family. By aligning our thinking with that, it will happen. Our belief is at the basis of everything that we do. Allow ourselves to be optimistic. Unfortunately, if we do get a negative on our upcoming IVF cycle, we will still feel that pain. So, it doesn’t necessarily matter if we’re going in it optimistically or pessimistically, that pessimism can’t protect us from that pain.
What Kareena’s found over the years of working with women, is that when we go in with that optimistic sense, it lifts everything. Suddenly, it’s easier to be doing our diet, it’s easier to motivate ourselves, it’s easier to be social, it’s easier to make decisions and be clearer of mind because science shows that, when we’re optimistic, our mind is clearer, and we’re able to think better, and our relationships are improved.
Part of the IVF process is feeling a little bit out of control, feeling in the hands of the doctors. Karenna encourages us to be our own health advocates because, in the best sense, it is just another day at work for that doctor. They care about patients, but this is everything for us. So make sure that we are not being passive, that we are speaking up and asking questions if we don’t understand something. We should be assertive in this space and make sure that we get the experience that we deserve.
Being assertive, also might mean, seeking a second opinion at some point from another doctor or another clinic. We often wait and hold back on those decisions, but we have to remember this is your journey. It is important. That doesn’t mean aggressive at all. It just means being assertive about your needs and your desires.
Karenna says the same goes for relationships. She pushes us to be assertive and specific in our relationships by being able to say this is what I need. Sometimes it’s hard to have those conversations, but often people around us don’t understand ivf and they don’t understand all of the the ups and downs and the real trials of this process. It is part of our role to educate them on that or just to be specific about our needs, whether that’s on an emotional level, If we’re clear about it, that can help break down some of those unspoken barriers that can be in relationships. We must be our own advocates in every way and be assertive.
Unfortunately, at certain stages, IVF becomes all about the numbers. It’s about how many follicles we’ve got, how many are maturing, how many eggs we have. It just gets so big and everything becomes about those numbers. Those numbers are important, but so are you, and how you feel about everything. You must control that information flow. We may get desperate to find out all of those numbers. Knowing how communication will be given to you, is important.
Also knowing how we will manage these numbers, for example, when we are asking for numbers as a success rate or the chances of success within ivf. Coach here mentions working with people to whom doctors said their chance was less than one per cent to conceive, and they had their families in the end. But, in those darker hours, that 1 % played on their minds. Karenna advises us to be cautious about what we do with that number, especially in those darker hours when things are tough.
To test or not to test?
Unfortunately, once we have had our transfer, it is positive, or it is negative. The coach says she tells her clients that she’d like them to have a positive and negative plan. That gets them to think through what they are going to do. This is a real area of stress for so many. The question “to test or not to test?” We should have a plan to see how we are going to manage our mindset and manage any anxiety around that, or are we just going to wait for the result from your clinic? So that is one important area to decide on and to stay firm in your mindset.
When it comes to the results, what do we want to do if it is a positive? Who’s the first person are calling? We must think it through. If it is a negative, it is just important that we think this through as well. What do we need in that moment? Do we need to not be at work? Do we need to be by ourselves? Do we need to be surrounded by friends or family or a specific someone? Karenna encourages us once again to think about that now because that will help us in that moment. After all, our brain has already got a plan.
Another tip that the coach gives people is to often put a little time limit on a negative and on that grieving because it is grieving when you get a negative. We’ve been through so much and there was so much hope there that it is grief, a loss when we get that negative. It’s a loss of that hope and those dreams because we’ve probably already calculated forward: what that due date might be, what that means for us and our family, our work. So, we can put on a very basic time frame. The allowed amount of time that we’re going to allow ourselves to just be negative, to just allow ourselves to cry and get it all out. This doesn’t mean that when that time finishes, that straight up and out, but it just gives a bit of an endpoint in our mind to that feeling. She adds some of her clients called it “the 24-hour pity party” or the “72-hour I’m going down” By doing this, at least it will give us a little bit of structure around those days following a negative result.
Based on her own experience, this has been helpful. When we put the time and energy into ourselves and into thinking about how we can cope better and use some of the tools and strategies she explains later on in the session, that can support us to feel stronger if we do get a negative.
Continuing with the train of thought, we should ask ourselves: what are our plans for after IVF? She regards it as important to have some sort of plan around: are we going to do another cycle if it’s a negative? Are we going to take a break? If it is positive: where will we go for our pregnancy care? Where will we go for birth? Coping afterwards can be helped by having that plan.
Nevertheless, thinking about us and getting back to us and our plan: What does IVF mean for us? Where do we want to go? And to know that it is okay to take a break to refresh, to reframe and to be able to go into another cycle. We can often be fearful of losing time, especially because there’s that real-time pressure on us, particularly with age. We don’t have to put that pressure on ourselves because we don’t want to go into another cycle, maybe back-to-back if we are not ready. So that afterwards, we can have no doubts that we did all that we could do. We don’t want to have to play those mind games around: did I do everything that I could? Was I in a good space?
Karenna brings into the sessions her commitment to supplying women with practical tools to support women. This is the reason why, after so many years of meditations, mindset tools and talks, and workbooks, she built her own app “Your Fertility Toolbox” to share her tool with everyone out there. Wider than just her one-to-one clients. Now, she has supported over three and a half thousand women to find a better way through infertility.
Some of these tools can help us to cope better through IVF. She encourages us to look at it as a buffet, something that we can pick from or like our toolbox in the shed that we pick out something when we need it. Certain clients of hers will benefit more and gravitate more towards meditation. That’s their thing. If that’s not our thing, that’s okay. She recommends us to give it a try.
Meditation in our general sense of it, we always think of someone sitting there in peace, hands up, cross-legged and chanting. Karenna says she prefers guided meditations and guided visualizations because it’s very hard when someone’s going through infertility and ivf to still the mind. To do so, she uses these guided visualizations to just walk people through a journey. She talks to people all the time. There are some of them on YouTube. She invites us to check them out. They can be a really good way of completely changing our mindset.
She then starts commenting on mindfulness as having some sort of popular culture these days. It means just being in the present moment. This is hard because infertility is all about the future. So we are so often in the future or past decisions reworking things in our brain, while very rarely being in the present moment. This applies to the majority of people out there, not just those having infertility. Karenna adds that sometimes mindfulness isn’t achievable in that easy way, as we’re going through this tough life crisis. So, what she often suggests is trying mindfulness as a mindful walk. To start, go out in nature, walk and just be aware of our feet on the pavement, the sensations of the cool breeze, and listening to the cars or the birds. What can you see? What can you smell? And every time that your thoughts just drift off into something else, we just gently bring them back. There’s no judgment. Mindfulness is practice, so the more that we do it, the easier it will become. When we’re having a great moment, enjoying it with our partner, for example, we must just stay in that moment and enjoy it, not allowing our thoughts to drift.
Coach proceeds to comment on Connection and support. She says that, sadly, a lot of people going through IVF feel very alone. They may have an odd friend who’s gone through it before them; they may be in online groups or forums that give some information. But overall, we feel alienated and quite alone. She expresses how sad this situation makes her feel and reassures us that that is her mission with your fertility hub. Make sure that those people don’t feel that way. And that’s what she reminds every client and member of the toolbox. Karenna is here to walk with them every step because that’s what everybody deserves as they’re going through infertility, particularly through IVF.
At this point, the coach tells us to review our support network and to think about who our support people are and who we can turn to no matter what. However, it may also be that we need to reach out for more support. We shouldn’t fear going to see a professional. There are fertility coaches like her, a fertility counsellor at the clinic, which is mandatory in the case of Australia she adds. We can also go to see a separate therapist or our GP. There is support out there.
She explains that the reason she set up your fertility toolbox separate and away from social media is because social media is a wonderful thing, but it can also be quite damaging to our mindset. Our social media feed is controlled by someone else, and your fertility toolbox feed is controlled by Karenna, to be a positive and inspiring place. Where we don’t talk about information, we just talk about how we feel and support each other.
Karenna mentions at this point of the session, that she had a client who had stage four endometriosis, and she was in all these groups tuning into all the information around endometriosis. That would have been important for her at one stage. But now she was trying to conceive. She was still consuming all of this information about endometriosis, and how dangerous it was. So, she was creating this environment of fear around her. The coach asked her why she was not just pausing on some of those groups, those emails. With this example, Karenna adds that sometimes controlling our environment, and our mind, can help with our mindset.
Moving on to mindset is basically, together with everything that was previously mentioned, being conscious of your mindset and working on it. It is possible for us to feel more positive right where we are. We have to use the tools that work for us towards that mindset. Power is in our hands. We’ve got the strength to do it because we’re already IVF warriors.
Then, gratitude is to be grateful for the things that we do have. Infertility so often is around lack (what we don’t have), so we lose focus on that. We then lose focus on what is good in our lives. So, by placing some importance back on that, maybe just by writing in our journal three gratitudes each day, thanking our husband, for the people around us, and it just starts to shift our focus. It sounds small, but this alone can have a huge impact even in just a couple of weeks.
And to everybody’s surprise, Karenna introduces the tool life outside IVF. She says this is just a gentle reminder from us that there is life going on outside IVF. It doesn’t feel like it right now, but sometimes we might need to venture out into other areas, into some social or creative things that we used to do. We need to keep engaging with those elements that are important for us, outside of ivf to keep you balanced. We may also need to stop some things as well, to help us cope and keep balance. We are the only ones who know these things. We need to do a bit of an audit there.
Then, regarding relationships, they can get tricky during ivf. Karenna says she spends quite a lot of time talking with clients about their relationships. So this must be an area that we work on as well because that can help us cope a lot better. As she said earlier about being specific with what we need with people in our life and seeking out any support, it is okay to reach out for couples therapy or individual therapy if we are experiencing relationship issues as we go through IVF. This is because it is common and puts a huge strain on our relationships.
And finally, affirmations, which is the last little tool Karenna brought for us, is a positive affirmation. If we search for information, on Google, for instance, fertility affirmations, it would say an affirmation is a positive forward-facing statement. Some examples of this could be “I believe my body can birth a baby” “I believe my body can conceive”, “I choose positive thoughts”, and “We will become parents” The coach says these are the ones she sends out to members in the toolbox, and tells them to stick them all around their house, on their fridge, phone screensaver. She advises us to read these positive statements every day, several times a day because every time we go to the fridge, we are reading it, our subconscious is reading these words, and that can help to build up a more positive mindset. Consequently, it is about surrounding ourselves with positivity to help us cope better.
Experience IVF in a better way.
As part of her conclusion, coach Karenna says IVF is rough. It is one of life’s biggest rollercoasters. She doesn’t want to diminish that in any way. She also adds that one study has shown that going through infertility has the same effects of stress anxiety and depression as a terminal illness. So, we should never underestimate the impact this has on us, and if we need to get support, we must reach out and get it. However, we should also know that we are strong enough to do this and to use some of these tools to cope a little bit better and experience IVF in a better way.
Karenna also has a very popular podcast with over 60 episodes now. You can delve into those. There are some interesting interviews and stories, and also tips from the coach on some of the things that she developed during this session. You can listen to that on your favourite podcast provider.
She also does some limited one-on-one coaching with clients, if that’s something you’d be interested in. You can find that on the website and of course on all the social media. It all starts at yourfertilityhub.com. There you can find out everything about the app, the podcasts, the blogs and social media channels.
This is a tricky time for you. A tough time. Your first IVF. I’m not sure of the journey you’ve been on to get to this date, but no doubt it will have been a real journey, even just to get to this point. Now. It’s concerning to me that you’re not able to have any communication with others around this. I know we often want to keep this private, but you need some support. So. what are the support mechanisms that you have that you can use to talk around it? I know it’s tricky to feel comfortable, so maybe just edge into this, maybe into a support group online or a virtual support group. We run one in the virtual toolbox. You don’t have to turn your video on. You can be in the toolbox anonymously. And there are other things around out there just like that, where you can stay anonymously if you don’t yet feel comfortable. It’s important when you’re talking to other people about it, that you have almost like a prepared answer. You need to have a prepared answer to those awkward, annoying questions that people come in with. Having a prepared response to that and having a prepared response to IVF is important. These have to be your words. It’s possibly just writing it down, what you want to say to people about it. Potentially just saying “Yes, we’re going through IVF at the moment” or “Yes, we’re trying” or something that feels comfortable for you.
Dealing with others. It is very tricky because you’re dealing with people often who don’t understand IVF, who don’t understand the process, who don’t understand the emotions and all the decisions and the very deep impact of it. So it is about choosing your support stars, as I talked about before, who are the people that you do have that you can talk to? And leaning into those relationships and being specific about what you need in those, but you don’t have to deal with everyone else around it.
Not everybody needs to know if you don’t want them to. You may need to be clear with one person at work. If it’s about taking time off work, sometimes you require some sort of ally at work, like your boss in confidence about that. But whoever it is, it’s really up to you to define the boundaries of those relationships and to be clear about those you have to be your own advocate. Even with your relationships. So be clear about what you require from the people around you. But please, to me, it sounds like you haven’t yet got enough support. If I said to you, “Have you got enough support going through IVF? What would be your answer? I’m worried it would be no. So please go and try to think of the people in your life who are there to support you. You are also maybe some extra support, whether that be professional support or something online where you feel comfortable.
This is an interesting question. I’ve done a lot of research myself in the area, particularly about the impact of stress and fertility because there’s a lot of talk about “Does stress impact infertility? According to the latest research, the jury is still out. We don’t have enough research to show whether the emotional state is having an impact. In my view, in some cases, often the more extreme cases of extreme anxiety and extreme stress, I feel it can affect the body. We do have this mind-body connection around affecting the body. But I don’t honestly think it’s an argument that’s worth getting into because, what we do know conclusively, is that when we work on our mindset positively, it has a huge impact. So that is the area where you need to place your emphasis. It is on creating a positive mindset because it creates a better environment for you now, as you go through this process.
This journey and where you’re in right now is just as important. So there isn’t, unfortunately, a very clear definitive answer I can give you on that, in terms of what affects that outcome. Some new studies are showing they’re measuring the cortisol stress levels and stress hormone levels in people’s hair as they’re going through IVF. But what they are showing is that when we work on it positively and when people feel supported when they’re going through IVF, we often get better outcomes. So it is about just putting your best foot forward and putting your energy, instead of into that question, into the known positive benefits and positive outputs you can get from really working on not just protecting your mental health with well-being but enhancing your mental health well-being. I honestly believe that you can actually improve and move forward with that, even during all of this stress.
This is common when partners are often on a different page at different times you go through IVF and if you’re on donor eggs, this isn’t your first rodeo I’m sure. So there’s been a series of events that have led up to now. Now, we don’t know exactly what’s going on in your husband’s mind and how he’s feeling around this. And I think that’s what’s hard because you might be reading him in a certain way, so him being passive, may mean him being just not wanting to talk about it. Shutting down on the issue is not necessarily a good thing by any means. It could mean that he’s not wanting to hurt you by bringing it up and talking about it.
In terms of you saying he’s being very negative, that might be him putting up his self-protection armour because he’s been hurt, just as you have as you’ve gone through this journey of course. But your attitude and your mindset is not his. Of course, you’re going to bounce off each other. You need to put some clear boundaries in there for you, for your mindset, and you can do this. For your July transfer, you need to go in saying “I am going to be positive” and “I am going to do this” because you can’t control other people. We can try as hard as we want, but it never works. You can’t control your husband, how he feels, how he reacts. The only thing you can control is yourself, your reactions and your thoughts. So, create a positive environment for you and perhaps have a very open and frank discussion with your husband.
Just saying your emotions are really impacting me or just to be able to say “Look, I want to be positive going into this. Please, can you be supportive of that?”. And maybe just checking in to see if he needs to get some support as well because he might not have anyone that he talks to. He might not be going on webinars like you are. So, he might be lacking that support. So maybe just sort of opening the door for him, to get some support outside your relationship, or even support together. Couples therapy can be a wonderful thing at this point.
This is the hardest bit, you are in the tough bit, but you are doing this, and you are doing it well. Don’t bring yourself down thinking that you’re easily triggered to tears. That’s completely normal, and it is okay for you to just step back for this very short window of time from your family or from anything around you that might trigger you off. You need to build the surrounding environment that’s going to support you right now, and that needs to be as positive as possible. And sometimes those comments that are made, whether by a stranger or your family, can cut you right down, and you don’t need that right now. So don’t worry. You can do this, and it’s okay to just control your boundaries.
You said that meditation and exercising help. Well, that is a wonderful thing you already know some of the tools that work for you so just keep doing them. Also, I would recommend journaling. Getting some thoughts out. Moving your body may be through some yoga as well, which combines almost meditation and exercise. And possibly even adding in something like gratitude to think and have some gratitude, for whatever happens that day when you are in the process. Try and bring in the things that you are grateful for right now. But this waiting period is so hard, so tough and very tricky, but just do your best to what you need at this moment.
It’s a really important point you raised because it’s something that I often end up talking to people quite a lot. About that mindset peace around thinking “This is not going to happen for us” and drawing that line between being realistic about that, and staying positive. So, what I recommend is that you have that dose of realism. That sense of “yes, it is possible that this may not work”, but you leave it there. You don’t need to catastrophize your thinking. Don’t go down that road in terms of “I will be the only mom, the only person not being a mom” Just let those thoughts go. What I’d like to do is to just have that sense of realism, let’s say 5% is “yes, I’m realistic that it may not happen”, but then spend 95% of your thinking time, the 95% of your day thinking about that it will happen, that you are going to put everything into this to make this happen. And putting your mindset onto that. It doesn’t mean that you’re not recognizing that there is a realistic chance. It just means that you’re putting all your energy, which you say you are, into this process of working.
So, don’t let yourself spiral into those really scary thoughts, terrifying and not serving you. If it gets to a point, and there will be a known point, where you say, “I can’t do this anymore”. The reason that people stop IVF is emotional strain. It is emotional and financial strain. It is when they say no more and close the doors to IVF. But I also want you to know that closing the IVF door also opens other doors. So, it opens the door to conceiving naturally after IVF, which is a possibility. I know many people will not believe that in this forum tonight, but it is opening the doors to other routes to parenthood. So, don’t jump automatically to going to “I’m not going to become a mum” because there are lots of ways of becoming a mum.
You might want to listen for example to episode 37 of our podcast where Bianca talks about going through IVF, I believe it was 13 years she went through infertility before finally going on to conceive her boys through international surrogacy. And now she writes on that journey she’s called Where’s my stalk. That’s just one really small example and by no means the timescale that you will have to go through. But it’s just an example of how she didn’t give up the hope of becoming a mother through that process. So, it’s okay to be realistic, and I think that’s an important part of it. But I just wouldn’t spend your time in that too much. Again, it’s about controlling. You’re the boss of your emotions. Control where you want to spend 95% of your thinking time in that you are going to make this happen.
