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Personal boundaries in your fertility journey: what are they, how to put them in place, and why you might need them

Professor Alan Thornhill
Fertility Expert & Coach, The Fertility Guy

Category:
Emotions and Support

Personal boundaries in your fertility journey_Alan_Thornhill-g
From this video you will find out:
  • What are personal boundaries in your fertility journey, and why are they crucial for emotional well-being?
  • How can planning before your fertility treatment help you establish and maintain personal boundaries effectively throughout the journey?
  • What is a simple and practical method for setting personal boundaries, and how can you adapt it to your needs?
  • What are the next steps to take if your boundaries are challenged, and how can you advocate for yourself in such situations?

Personal boundaries in your fertility journey: what are they, how to put them in place, and why you might need them

Embarking on the path to parenthood can be an emotional rollercoaster, but understanding and implementing personal boundaries can be your compass. Dr Alan Thornhill, Fertility Expert & Coach, Founder of The Fertility Guy, discussed the importance of personal boundaries in your fertility journey – what they are, how to establish them, and why they’re crucial for your well-being.

There’s no good definition for a personal boundary, but the clue is in the name. It’s personal to you, and that’s important. Just like the name in other parts of our life, like a wall or a fence, that kind of boundary, it’s a protective mechanism. It’s something that you put around yourself to protect you from whatever might come your way. In infertility treatment or on a fertility journey, there are a lot of things, a lot of stressors that are going to come your way, so it’s a way of protecting yourself through that journey.

Understanding the challenges

You need to keep in mind that fertility treatment is not always successful. And that’s a really important part of expectation management. That’s one of the reasons you need a boundary, you need to put in place boundaries to protect yourself.

Knowing that it’s not a guarantee and it’s not 100% successful means that some disappointment and possibly pain is coming your way.

Alan mentioned in his presentation that more than half of all IVF cycles, or indeed other types of treatment, are unsuccessful, and that’s largely due to female age. It’s not the only reason, but that’s the biggest reason. IVF can be very expensive, and the fact that most people require several cycles makes it even more stressful.

Before starting any treatment, it’s crucial to follow many steps, starting with educating yourself. You can’t set any boundaries if you don’t know how much things cost or what a treatment cycle is likely to involve. You must do this before you sign up for anything.

Find an advocate. This could be a coach, your partner, or a family member. Consider what protection they can offer you. If they are too involved in the journey with you, it might be hard for them to remain objective and independent. That’s for you to decide.

Be your advocate. You can’t be passive in this journey. I wish things were different, but they’re not. You have to take control of this journey, with lots of support, but you do have to be your advocate.

Set some personal boundaries. This has turned out to be one of the number one things people ask questions about, even though they don’t always use the term “personal boundary.” Do this before you do anything else.

I meet people who have already signed up with a clinic, parted with some money, and taken several steps. I ask them, “What planning and preparation, particularly what boundaries, have you put in place?” As we’ll see, some of these are important.

Examples of boundaries

Here are some examples of boundaries:

  • Emotional boundaries

We’re talking about emotional boundaries or emotional issues that may need a boundary because there’s a lot of stress in this journey. Stress on your relationship, just the medications alone, not just the choice of them but the effect they have on your body. It’s like having a massive dose of hormones that you would normally experience at a lower level, but at a much higher level. This can have a huge impact on your mood, your behaviour, and so on. Often, your partner doesn’t understand that. 

You should automatically start thinking of what you can do to relieve that stress, whether that’s yoga, getting away, reading, and so on.

  • Physical boundaries

Physical issues to consider when making a boundary include:

    • The number of cycles you’ll consider having – knowing that it’s unlikely you’ll be successful in the first cycle statistically allows you to plan for multiple cycles. You can always change your boundaries later on, but it’s worth not freestyling it right at the beginning. 
    • What medications are acceptable to you – some patients are happy to go with whatever the doctor says, and others want the least amount of medical or pharmaceutical intervention. Some don’t want to use medications labelled for a different purpose than what they were developed for. That doesn’t mean it’s dangerous and doesn’t work; it just means that’s a boundary and a red line they have.
  • Financial boundaries

Have a financial plan and budget. The cycle number is partly for physical reasons but also financial reasons. That’s all part of your financial boundary.

By planning and setting these boundaries, you can manage your expectations and protect yourself emotionally, physically, and financially throughout your fertility journey.

  • Ethical boundaries

When you look into some slightly different treatments, the ethical issues start to bubble up. There are certain questions you need to ask yourself before going ahead. For example, how long do you want to store your embryos? If your partner didn’t survive, would you want to transfer the embryos after their death? It’s not an ethical minefield, but it is stuff you wouldn’t normally have to think about but are forced to consider when you go through fertility treatment.

Egg and sperm donation are massively important ethically, as is the testing of embryos. What are we testing for? What could we find out about ourselves? These are some ethical boundaries to consider.

  • Communication boundaries

Communicating across the globe to millions of people at the same time is very easy. How much do you want to share your story? These stories are very personal, sensitive, and can be very painful. Consider who, what, when, and how much you want to share. These are all things worth thinking about before you start, rather than trying to switch it on the fly once you’ve already begun.

  • Time Management

Do you have a good work-life balance? This process is going to put more pressure on an already tricky work-life balance, and it might include your partner as well since they will be part of this journey. Additionally, consider not just how much time you’re spending working versus living your life and incorporating this fertility journey, but also how many hours per week you’re spending on it. This includes appointments and reading up on the topic. Becoming a little obsessed can feel necessary when you need to get educated quickly, it might be better for your sanity and mental health.

  • Trusting the clinic

There’s a lot of trust that goes into fertility treatment, you need to trust the people helping you on this journey. Make sure you’re asking the questions: What are the risks, benefits, costs, and limitations? The clinic needs to provide that information. This isn’t a nice-to-have; it’s a need-to-have.

Another aspect is that once you have that information, unless doing procedure X or taking drug Y is mandatory, you are allowed to say no. You are allowed to say that unless the clinic says it’s an absolute requirement, they should respect your decision. That’s about putting in place your boundary.

  • Decision-Making

Decision-making is critical because it could involve deciding to have another cycle, spend more money, or choose which embryo to transfer. Seek objective, independent support. People very close to this, like a partner, obviously have a stake in it. If somebody’s going through the treatment with you, and they’re a gamete provider (sperm or egg provider), they have a significant stake in it.  You might want someone independent to help with that decision-making.

Setting personal boundaries

Here’s a simple set of steps:

  1. Start with a very long list – be specific (physical, financial, social media, etc.).
  2. Do a self-audit – use a 1 to 10 scale.
  3. Prioritize low-scoring issues
  4. Put a plan in place (perhaps with some support from a coach, another advocate, or someone in the clinic, etc.).
  5. Communicate that boundary
  6. Ensure you get the support you need – this is a combination of having someone to speak to and looking after yourself.
    • Regaining control – the fertility journey and treatment are characterized by losing control—you’re handing over something exquisitely personal to other people to try and help you with it. However, it’s never too late to start putting in place some boundaries.
    •  Be firm, but flexible

Communication is key

Good communication is clear, specific, and transparent. When communicating with a partner or loved one, it’s crucial to be clear and explicit about your needs and wants. Expecting others to intuit what you mean can lead to misunderstandings. Be direct.

Similarly, with your clinic, be clear, specific, and transparent. They need to know exactly what you’re asking for. Avoid ambiguity and put everything in writing to ensure there’s a record.

Anyone involved in your fertility journey—friends, family, clinic staff—can help set and support boundaries. However, these people are not mind readers and might have different opinions from yours. Be assertive and communicate your needs. Learn to say no, especially to the clinic, when something doesn’t align with your boundaries.

Address problems as soon as they arise. Delaying action can lead to festering issues and missed opportunities for others to respect your boundaries.

Support can come from various sources, such as friends and family, professional support, online communities and support groups, etc. Identify who is best suited to support you in different aspects. Not everyone needs to be involved in every part of your journey. For instance, your mother might be great for emotional support, while a friend might be better for logistical help. You might also consider a professional, such as a counselor, coach, or mental health professional. They bring objectivity, independence, and a compassionate distance that can be invaluable. Support groups and online communities can provide emotional support and a sense of community. However, manage your expectations and be cautious about the advice you receive, as it may not always be factual or helpful.

Your partner should be on the same page as you, given their significant stake in the journey. However, they might be too close for certain boundaries. Have honest discussions about which aspects you need them to be involved in and where you need them to step back.

Seeking support is crucial for navigating your fertility journey. It ensures you’re not alone and can help you manage the emotional and logistical challenges you face.

Benefits of support

What are the benefits of support? As we’re talking about boundaries and particular issues that need addressing, decision-making, dealing with grief, and disappointment following an unsuccessful cycle, establishing, articulating, and maintaining your boundaries with support is important. Sometimes you’re going to feel weak and want to look at social media for an hour a day.

Prioritizing self-care is important. Other people can take care of you, but you know how best to take care of yourself. What things can you do? Find stress management tools, exercises, and activities to develop your resilience because this could be a long and difficult journey. Find space to reflect because, if nothing else, that’s going to allow you to review your boundaries and what your new needs are. These needs do change over time. Your core values don’t change, but if you have a cycle that you expect to work and it’s unsuccessful, you may not feel the same way after that cycle as you did before, even though you still have the same goal.

- Questions and Answers

During family gatherings, people often ask when we’re going to have kids or share their opinions on our fertility choices. What are some strategies to handle these questions gracefully without feeling pressure to disclose more than I’m comfortable with?

I think there are several different ways of dealing with this, and I’m not saying I have all the best answers. It is probably very specific to the situation and particular to the family. Here are some strategies that might work, though they won’t all be right for everyone. Depending on the size of the gathering, you might consider talking to the organizer in advance. You could say something like, “You’ve invited everyone. Would you mind letting them know we’re having some issues with this at the moment and would rather not talk about it?” This way, they can inform everyone beforehand to avoid the topic. Another approach is to not shut down the conversation, but to say something like, “I’d prefer if we don’t talk about this today.” This way, you make it clear what you want without getting emotional or upsetting anyone. You might say, “We’re just here to enjoy ourselves today,” or “We’re taking a break from thinking about it,” even if that’s a little white lie. Dealing with unsolicited opinions can be more challenging because people often can’t help but share their thoughts. One way to handle this is to have a third party, like your partner, say in advance, “We’re not looking for any opinions right now. We’ll share what’s going on, but that’s it.” When people ask questions because they don’t have all the information, it can be helpful to provide that information in advance through a designated person, like the organizer. However, I understand this might feel artificial. If anyone else in the room has suggestions, please share them in the chat. I hope these ideas are helpful. You can also find valuable advice online. When looking online, you can read other people’s opinions and choose the ones that work for you. Googling the question or using ChatGPT can yield interesting answers. I’m not giving one definitive answer because there are probably many ways to approach this, and some will be right for you while others won’t. If you try a suggestion and find it doesn’t work, you can always try another approach. You might even test out a strategy with a friend before the gathering to see if it sounds okay. Your question emphasizes handling this gracefully, which is important. You don’t want to upset anyone, and you hope they consider your feelings in the same way. Unfortunately, people can be clumsy. I hope these strategies are helpful. Everyone has to find a way to handle these situations.

I am trying to juggle work, personal, and everything to do with getting organized. No one knows apart from me and my partner about what we’re going through. Any tips?

It seems to me like you need quite a lot of boundaries in place. They don’t solve the problem, but they do mitigate some pain, anxiety, and uncertainty. You can say, “I know how far I can go with this. I know who I can tell here.” You’ve put down that no one knows apart from you and your partner. That’s fine. Again, it’s not for me to judge, and there is no right or wrong answer about who should know and who should be told. But I suppose I would ask: has that happened by default, that nobody knows apart from you and your partner, or did you agree on that? Are you both on the same page? Did you say, “We’ll only tell people when something happens”? The only reason I ask is that sometimes the uncertainty of just falling into that position, where no one else knows, might not have been planned. One of you might have thought, “I wanted to speak to my mom about it or my best friend,” but now you don’t feel like you can because of this unspoken agreement. That’s where a good conversation with your partner could come in: “Are we still sure that we don’t want anyone to know? Is that our boundary?” In many cases, no boundary has been put in place; it just evolved that way, and maybe one or both of you aren’t happy with it. You may well be, but I’m just trying to make a point about how boundaries relate to the situation you find yourself in. All I would probably do there is ask: is there a time or circumstance under which we would change that boundary? Of course, the answer might be no. If you were successful and had a baby, people will know. But there could be a spectrum of events that might lead you to tell somebody. You might think you’re not getting enough support from each other and might need someone else to talk to. In that case, I would probably suggest someone completely independent. It’s not someone in your social circle who might accidentally tell someone else; it’s a professional for whom it’s completely confidential. You’re getting support and someone to talk to and bounce things off. I’m not trying to undermine what you’re doing; it’s fantastic if it’s working for you. But if it’s not, or if the cracks are showing, or if it’s a lot of stress, you’ve got a good boundary in place, but maybe you need to expand that boundary to include another person.
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Authors
Professor Alan Thornhill

Professor Alan Thornhill

Professor Alan Thornhill is a fertility expert with over 25 years of experience and more than 100 scientific publications in IVF. Specifically, he’s a clinical scientist (specialising in embryology and genetics). Uniquely, he’s worked in IVF and diagnostic laboratories, research, clinical and business management, and even with the UK’s fertility regulator. Working in US and UK-based IVF clinics and consulting globally, he’s been involved in the IVF journeys of thousands of couples (both professionally and personally). He’s helped and advised patients, friends and strangers with issues including low sperm count, sperm and egg donation, genetic testing, surrogacy, treatment overseas and more. He currently works in the biotech industry, and his personal mission is to provide his unique brand of fertility coaching to people in need of help.
Event Moderator
Caroline Kulczycka

Caroline Kulczycka

Caroline Kulczycka is managing MyIVFAnswers.com and has been hosting IVFWEBINARS dedicated to patients struggling with infertility since 2020. She's highly motivated and believes that educating patients so that they can make informed decisions is essential in their IVF journey. In the past, she has been working as an International Patient Coordinator, where she was helping and directing patients on their right path. She also worked in the tourism industry, and dealt with international customers on a daily basis, including working abroad. In her free time, you’ll find her travelling, biking, learning new things, or spending time outdoors.
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