In this session, Sarah Banks, Fertility Coach and Mentor at Sarah Banks Coaching, author of ‘IVF Positivity Planner’ shared her own experience on how to cope with uncertainty and provided coping mechanisms that can help when you are trying to conceive.
Today’s topic was suggested by Sarah Banks because of her own experience of going through IVF. A lot of the time, she was uncertain about what was happening and felt overwhelmed with what was going on and, certainly, in the previous year and a half, there’s been much more uncertainty depending on where you were, what’s been happening with treatment, and how it affects you. For this reason, Sarah considered it important to talk about some tools that can help you cope with that uncertainty, and hopefully, some of them will be helpful to you.
She goes on by stating that she knows it causes a lot of uncertainty in life and that there’s so much more additional uncertainty, it’s worrying not knowing if your treatment’s going to be cancelled like it was the previous year in the UK, and coping with the restrictions you may be having. Therefore, the things that helped you as a coping tool and as a distraction, like seeing friends and family, were not able to do quite as readily depending on where you are in the world.
I know it’s causing people extra worry, and about what it’ll mean in terms of finances if you’ve been furloughed and if you’re not working at the minute (…) also in terms of depending on what age you’re worrying, if it has affected your chances of conceiving at all and I just want to let you know that it’s okay to feel sad about that and helpless about the situation.
Sarah emphasizes it’s understandable and normal, and that you won’t be the only one who’s feeling that. This, as well as uncertainty, makes people feel really out of control and really overwhelmed with things.
I just want to let you know that it’s okay and you’re not alone in going through it, but hopefully some of these things will help you.
A recommendation given by Sarah is allowing yourself to feel how you feel, meaning that you don’t have to feel guilty for feeling certain things. Sometimes, you feel you should be feeling a certain way, and people feel very different, it stirs up lots of different emotions, and it’s okay to feel however you’re feeling. You’re not alone, so be kind to yourself, allow yourself to feel how you feel, think about how you can feel better, and think about some of the things you want to talk through, and hopefully, that will help you.
You should also think about how you can look after yourself and make yourself feel better emotionally and physically while you’re waiting to start treatment, while you’re going through treatment, and after you’ve had a treatment cycle.
The first technique that Sarah talks about is something that can help when you’re feeling overwhelmed and uncertain about lots of things you don’t know what’s going on, you start panicking and feel them in your stomach.
For this reason, breathing is a really good way of controlling those emotions when you’re starting to feel triggered. Thus, whether that’s somebody announcing that they’re pregnant or you’ve got to ring the clinic to find out what’s going on with your treatment, and they tell you they’re not sure when you will start. If you’re feeling uncertain about these things, this technique will help you to control that uncertainty to feel clear-headed because when you start panicking, you start getting a brain fog that makes it hard to think clearly.
Breathe in through your nose, count to three, and exhale out through your mouth at the count of 6. You can also do it longer: Breathe out for double the amount that you breathe in. Breathe in through your nose and out through your mouth.
This will help you control some of those feelings and make it a bit easier to think about how you can rationally take control and some things you can do. Therefore, it just helps with some of those immediate emotions.
Sarah Banks considers herself a big fan of making a plan as it works and helps her. It’s something that she talks about a lot with people in her support groups and anybody she’s helping. She recommends making a plan when you’re feeling overwhelmed and when you’re feeling uncertain, start thinking about the things you can take control of.
Write down all the things that you’re worrying about whether that is starting treatment, telling work about treatment, confining to friends and family, and concerning about certain parts of treatment, like injections. Write down what’s making you feel overwhelmed; if it feels like you got too much on at the minute personally, work-wise, and going through treatment. If you’ve got too many things that are going on all at once, and you can’t think about where to start and what to tackle first, write down all of those things.
You can start thinking about what you can do to help you feel better about that, or what will give you more clarity and more certainty. Once you’ve got your list, you can see the following:
What can you take action on:
You can think about:
According to Sarah, in the UK, if it’s NHS funded, and you need to have a BMI of 29 or under, it might need research and things like that so you can start taking action if you’re not sure about them. Moreover, you should also think about your list because everyone does it, everyone adds things there and worries about things that may not be a priority at the minute. Possibly people worry about things that don’t need to be on that list, so think about what you can cross off your list, as it’s not important. You need to prioritize so you can prioritize things you’re worrying about rather than taking on everything.
Definitely recommend making a list so that you can start to feel more in control.
Following Sarah’s recommendations, you must use the time to make sure you’re in your optimum state for conceiving; for instance, if the treatment’s being pushed back or if you’re not able to start for a little while, think about what you can do to make sure you’re in the optimum state for conceiving.
There are a few ways of looking at that:
This way you can go to your appointments fully prepared.
If you’ve got to wait a month for your first appointment, start researching what goes on in IVF, and any questions you’ve got, and take a notebook with your questions. This is highly recommended by Sarah because when she went to her appointments, she forgot what she wanted to ask and what they told her because she’d be in tears through the whole appointment, she was too emotional to write and to take it in.
For this reason, Sarah advises to always go fully informed because if you need to start making decisions about the treatment, you’re fully informed to make those decisions, and you don’t forget when you’re in there. Thus, start researching the process of whichever treatment you’re having or, if you’re still earlier in the stage of trying to conceive, research things that may help you conceive and things to cut out.
This is related to things like:
You should follow the guidance of those and, the more time you’re following them, the better state your body will be in. This applies to both partners.
Sarah makes emphasis on being kind to yourself and not to judge yourself for how you feel. It’s normal to feel all those emotions, so take care of your emotional health, think about the things that work for you and how you can cope best.
One of the recommendations given by Sarah is to write a list of the things that help you cope best so that you can put some of those into each day.
According to Sarah, it’s very easy when people are struggling to get pregnant, and they’re going through treatment, to focus solely on the things that aren’t going well and the things that they don’t have in their lives. This can lead people into a bit of a negative spiral and leave them feeling down because they feel like nothing’s going right, they feel stuck in a rut, and that nothing’s moving forward for them.
I think it’s really helpful to create a thankful list. Think about something every day that you’re thankful for, and it doesn’t have to be big because I know sometimes it’s hard to think of things each day, it doesn’t have to be big, it could just be as simple as ‘I’m thankful that I was able to go and get a coffee today, and a decaf coffee’, I’m thankful that I was able to have a conversation with my friend over the phone or meet up with somebody’, and ‘I’m thankful for the support I get from my family around me.
It’s a really good idea to write these things down and then refer back to them when you’re having a bit of a wobbly day. Also, having that reminder can help people remember that there are lots of positives in their lives even though it doesn’t feel like that a lot of the time and that you need to celebrate them to protect your emotional well-being.
If you avoid that negative spiral and focus on the good in your life and the positives, it can help with that. Therefore, make a list of the good things in your life and all the things you’ve achieved which show how amazing you are and all the things that you have done and can do. This is not focused on what’s not happening in your life, which does tend to take over.
Similar to creating a ‘thankful’ list, Sarah also advises to start a journal. It has been found that it improves your emotional and physical health by reducing stress, boosting your mood, and improving memory function.
It’s also a great way of sitting down and just safely releasing some of those emotions so you don’t have to share it with anybody, you can keep it completely to yourself. If you want to, you can share it with people you like, but it’s also a time out that’s focused on you, where you can just sit and write down exactly what you’re feeling without the fear of being judged because you know it’s safe in there. Journaling gets some of the emotions off your chest.
It could be that people have written things down and probably rationalize them a bit more and realize that some of the thoughts they’re having may not be rational. Once people put those thoughts on the paper, it helps them see that it’s not like that, and they don’t need to be thinking like that way.
I think some of that just helps with getting down on paper, and as I say you don’t have to show it to anybody (…) when you start writing things down you can start to notice patterns of things that you maybe need help with the areas where you feel like you want to take more control back and you can start to create a plan to do that. It’s also really good to look back on. For instance, in a year’s time, maybe you can look back and see how far you’ve come, so it’s really good to show that and a really good activity to start doing.
Social media, according to Sarah, is a big topic and it’s kind of a bit balancing because social media is great for support, but when you’ve got a lot of uncertainty in your life and don’t know what’s happening with treatment, like all the pregnancy announcements on social media, can make it even harder to accept and see.
Sometimes, especially if you’re feeling wobbly and you’ve got a lot of uncertainty around, moving forward, and what’s happening with treatment, maybe you should take some time off social media. It can be hard when you’re overwhelmed and struggling to see everybody’s perfect lives, which is never like that, but it’s very hard to rationalize that they’re not what’s being shown in social media and how different they are from what you’re living through.
For this reason, maybe take a break from social media or certain platforms and think about the support you get, if you do get support from them. In addition to this, Sarah runs online support groups, and it’s very difficult when people come off social media, they will say ‘Well if I come off, I don’t have the support group’. So, it might be worth not going on social media other than the support groups or only keeping Instagram and following people who have infertility accounts who you find supportive.
If you don’t feel you can fully come off social media because it’s a bit of a lifeline and it offers that support, then maybe think about if you could unfollow certain people, if you could come off certain social media platforms (the ones that you find more triggering), and just go on the ones that do support your emotional well-being. Thus, it’s worth considering this option, especially when you’re feeling a little bit vulnerable and wobbly.
It’s also good to think about the things you’d like to do and achieve. When you’re struggling to get pregnant and then you’re going through treatment, it can feel like you’re stuck in a rut. Sarah herself mentions having felt like that her life wasn’t moving forward and nothing else was happening while everybody around her was moving forward.
Unfortunately, you don’t have any control over what happens with treatment and when you can start it, but one of the ways that you can kind of help with that is get yourself in the best place for it. You should think about other areas of your life you could start taking action in and taking control of, like some of the things you might have put off.
I used to put off so much stuff because I was thinking ‘Well, in case I get pregnant I don’t want to do it’, but think about things: Have you wanted to start a new hobby for a while? Have you wanted to change jobs? Have you wanted to redecorate somewhere in the house? I mean, I know various lockdowns that we’ve all been in, you may have decorated everything in your house, but think about some of the changes you maybe want to make, some of the things you’ve been holding off doing in case you get pregnant.
You may also create a plan which doesn’t mean throwing yourself into it because that can feel a bit overwhelming if you suddenly start throwing yourself into doing something different., but maybe create a plan about what you could do.
For example, if you wanted to start learning a new language, it could just be a case to start researching places you could do that, think about the languages you’d like to learn and think about how you could do that; would you want to do a course? Would you want to get a podcast or some kind of online learning? So, consider some of the things you’d like to do and achieve so you can use this time while you’re waiting to start treatment or while you’re going through treatment.
Sarah advices to start doing something to help you take control and move forward with things and, even if they’re small steps towards those things, it makes a difference.
Coming back to something related to journaling and planning things, you should spend time doing things that help you relax. According to Sarah, sometimes people get so focused on the fact that they’re trying to get pregnant, or they’re going through treatment, that they forget that there are a lot of things they enjoy doing, there’s a lot of things that can help them relax and forget momentarily about what they’re going through.
For instance, people that help you laugh, people who helps you to distract, people who make you feel really good about yourself, and hobbies that you love and maybe you’ve had to put on hold.
I had to stop dancing while we were going through treatment, and for me, that was a big thing that helped me feel relaxed and happy.
You should consider things that make you feel good and happy and recharge your batteries. Also, think about what will distract you, how can you plan in time to do them, and plan in time for self-care and something small every day because once you’ve got it planned in, it’s much more likely to happen, and it just gives you something to look forward to each day. It gives you something, every day, that makes you smile, and sometimes people forget to put those things in, but they’re really important.
Think about what things you can do and start planning them, even if it’s writing them in your diary or planning them on your phone calendar for every day, try and make them happen just to give you something to make you smile.
Sarah recommends spending time away from treatment as a couple. When you’re going through treatment, trying to get pregnant, there’s so much focus on trying to get pregnant and timings of things that it becomes very regimented. The focus is on discussing treatment, trying to get pregnant or perfect times, taking temperatures, things like that.
People tend to forget that before they started trying for a baby, they were a couple in love and that there was a reason they got together. They forget that they’re not defined by their infertility and not everything between you must be related to trying to get pregnant. It’s always good to remember what you love about your partner, what they love about you, and remind them of that.
I think we get so caught up in this bubble that we don’t do that, so have a go at writing down a few things and swap them over and enjoy reading, maybe have a think about 10 things you love about your partner and swap over. It’s bound to make you feel good, try and keep them positive, things that you love about your partner and your favourite feature about them, how they’ve supported you through what you’re going through, how they support you through other things, what attracted you to them in the first place, and what they do that makes you feel special.
According to Sahra, you can do the following:
Therefore, you should spend time away from treatment as a couple and time away from talking about it, set it aside, have an evening where you go out or you have a meal in, and you don’t talk about treatment. The focus is on other things so that you don’t feel like your whole relationship is focused on trying to get pregnant because it puts a lot of pressure on both of you and it’s good to have that separation from it as well.
Sarah mentions the topic of rest because she considers that not many people do this enough as everyone is very busy all of the time. It’s also important to take into account the pandemic when everything was all about the enforced lockdowns, social distancing, and a lack of being able to do as much and see as many people, which forced everyone to slow down a bit and rest more. Some people may like that, and others might be quite happy to get back to being busier because it’s more distracting, but it’s just a reminder to take the opportunity when you can to recharge your batteries and reduce the stress when possible.
It’s also essential to know what you’re going through that brings additional stress, but just try and slow down if you can, and certainly when you’re going through treatment, as Sarah would say as a caveat to this, is if you are somebody who likes being busy and distracted, and if you are resting and sitting down doing nothing and your mind wanders and you’re more likely to google, then maybe take that into account and think of ways you can rest and recharge your batteries.
However, Sarah advises to also be a little bit distracted so you’re not fiddling on your phone, looking at social media, reading things on Google, and thinking about how you can do it in a way that works for you.
This is something really important as you should get support. When you’re struggling emotionally with the uncertainty of starting treatment, your chances of success or coping with a loss, and everything that you’ve been through, Sarah highly recommends speaking to a fertility counsellor or somebody who can support you. For this reason, reach out to have a chat, even if it’s just to find out if it’s right for you, and it’s not for everybody.
Most clinics have access to a fertility counsellor depending on where you are, but there are also websites like BIKA, which is a British Infertility Counseling Association, where you can find the names of counsellors and the sessions online wherever you are in the world. You may access that, but there’ll be similar things in every country where you can find a fertility counsellor who is specially trained and can help and talk you through some of these things.
You can use the time when you’re waiting to start treatment, and it’s a good opportunity to feel emotionally stronger while going into treatment and certainly, if you’re struggling with the emotional side of the uncertainty and the lack of control. Thus, it can be really helpful, and they are completely confidential, so information isn’t shared with the fertility clinic if it is linked, and unless there is a major problem you can speak confidentially to them.
Sarah suggests not to wait until you reach a breaking point before you seek support, as it can be really helpful to speak to them at any point during treatment. You should get there and find that since there may be delays in appointments, you could have the support sooner. If you’re struggling, reach out and find out how you can speak to a fertility counsellor.
In addition to the previous point, Baker believes that emotional support is, so important in lots of different ways. There are many ways and many different levels that you can get support, thus, there is something for everybody, and it doesn’t have to be as intense as fertility counselling. If you don’t feel like you need that, then you don’t have to do it because there are other options, and it’s really important to think about what’s helpful for you and what would work for you.
I would say emotional support from somewhere is important, so one thing that I will always say to people as advice, please seek support from somewhere.
There are a lot of support groups on various platforms, and Sarah also has a free Facebook support group called ‘TTC Support UK’ which everybody can join wherever you are in the world, it’s a great place to seek support and advice from people who fully understand what you’re going through. Moreover, everybody in there is either going through treatment or has been through treatment, they will fully understand and won’t judge you; therefore, this is great for peer support, and whenever you need it, it’s there 24/7. There are a lot of other groups around that you could join, such as the Instagram community, which is great for that, and you can be anonymous in both of those.
I think the Instagram community is great for seeing different platforms and lots of different places where they share advice, so I recommend checking out some of those.
Also, you don’t need to post on the groups or Instagram, you can be silent and just read everybody else’s posts, but just hearing what other people are saying is reassuring. Even just being part of the groups to understand that you’re not alone in what you’re going through is great. There are fertility charities and fertility networks as well in the UK, RESOLVE in the US, and there will be the same equivalents around the world; so, wherever you are you’ll be able to find fertility charities that can offer support. They often have lots of advice and blogs, thus they’re great and you can contact them for support.
There are also fertility blogs. On Sarah’s website, you can find lots of blogs on there that you can try and use people that are reputable if you can. If they’re giving medical advice or if you read blogs that give medical advice, then Sarah always recommends consulting with your fertility clinic.
Furthermore, the blogs around coping emotionally and what people have been through are great because they show that you’re not alone, as well as give tips and advice that might be helpful. In addition to this, not everybody’s comfortable with telling friends and family what they’ve been through or what they’re going through, but they can be a good source of support, and you can tell them how you like to be supported. Therefore, you might find that within your friends and family, there are a lot of people who are very supportive and who give you the support that you need.
Sarah reiterates that she has a free Facebook group where anybody’s welcome to join. People can freely join the TTC Support UK and if you’d like to know about it you can always contact Sarah. This is a closed group so that nobody outside of the group can see that you’re in it or what you’re writing in it as well. and it’s just a great source of support.
Firstly, the fact that you’re on here to learn more is amazing, that shows how supportive you are, so thank you for being such a good friend to her, it’s really difficult, I think, when you haven’t been through you don’t necessarily understand what it’s like to go through and know the best things to say, and a lot of people do worry that they’re going to say the wrong thing, and I think it’s just really important to let her know that you’re there for her. She might not want to talk sometimes, and she might want to talk other times, but letting her know that you’re there for her, just saying ‘I’m sorry for what you’re going through, and I don’t fully understand, but I want to help you in any way that I can, so please tell me anyway I can help’.
Things like researching what happens with treatment as well can be really helpful because then you understand a bit about the process and the times when she might be struggling, so certainly things like after the egg collection and after embryo transfer might be that she wants more or less support around those times. But at least you’ll understand what she’s going through and what happened. If she talks to you about it, ask her how she wants you to help her, is it when she’s been through the egg collection, it might be that she just wants you to come around and sit with her and chat or plan things with you when she’s had an embryo transfer so that she can be distracted. Don’t push if she doesn’t want to talk about it and I know people tend to want to give advice, but it’s hard if you don’t understand what the right advice is. So, try and avoid advising if you can, but just listen to what she says.
I’ve got a blog on my website, so if you have a look at www.ivfpositivityplanner.com, in the blog section there’s one ‘how to help’, it’s about how to help your friend who’s going through IVF. So, there are lots of different things that you can do there, it’s meant for people like you who want to support their friend who’s going through treatment. The main thing is just being there, letting her know you’re there for her and that you’ll help her in any way. I’d check out the blog because there are lots of different things on there that might be helpful for you.
When they’ve been for treatment or generally doing tests, I know if people have been through treatment sometimes there might be a temptation to test before the test date and sometimes there’s a reason they say not to do it before the date because it can be too early, and it can mean that you get a negative which can cause just additional anxiousness. You think it hasn’t worked when maybe it has, it’s causing you additional worry, so I would say try and hold off and just reason with yourself about why it’s best not to check before the official test date.
If it’s a case of just every month you’re checking, I know it’s hard because every month it’s that waiting to find out, and it’s hard to wait until your period comes to know or not. It’s then almost like the hope when you’re doing the test, but it’s a constant up and down and what I’d say is just try and keep distracted, try and think about the reasons why it’s best to not keep checking because it could just be causing you unnecessary anxiety. After all, if it’s a negative, it could just be that it’s too early in the month for testing. It could be that if you tested in a few days, it would be a positive, so I think testing too often can cause unnecessary worry and anxiety, I know it’s hard, and it’s easy to say that because I was the same, but it’s trying to almost rationalize that by doing this, I could cause myself unnecessarily worry thinking it’s a negative when fact I’m just testing too early. So, I’d say try and keep distracted.
If you’re struggling to keep distracted then try and plan around the time that you know your period’s due each month and that it’s the right time to test, and maybe plan more things. If you know that you are more likely to test regularly, then maybe try and plan days out with people or that you’re busy at work or things in the evening after work, if you can. Keeping in line with everything that’s going on with the restrictions where you are but try and plan things even if it’s a case of planning a call with somebody, try not to go to a supermarket, things like that, just try and make it harder for you to buy a test and do the test, easy to be distracted is what I would say. I know it’s hard because we all want to know as soon as we can, but I would say that it causes unnecessary worry, so try and plan things if you know you might wobble under pressure to buy another test.
Good luck, I’ll keep everything crossed for you. I think it’s just trying to keep distracted because you don’t know if you test too early, it could just be that it’s too early to test, and it’s very easy, once you see that negative, to go into a spiral that it hasn’t worked, and it might just be too early, and it’s better to try and hold off if you can as hard as it is. So, just try and plan lots of different things and keep away from the supermarkets if you can.
There isn’t enough support around for men going through it. Men and women tend to cope quite differently and that’s just a generalization, and they do cope differently, but as with everybody I think it’s finding what works for you and that’s for men and women. Finding coping mechanisms that work for you, and if you cope by being distracted by seeing people, by going and doing a certain form of exercise, by writing things down with your male or female, then do that. Find what works for you as a coping mechanism. I find a lot of men like to take on the practical and the logistical side, so if you’re uncertain about what’s going on, then doing things like researching treatment is something that they can get involved with because obviously, they’re less involved from a medical point of view.
Their side of treatment is less involved as in the female side, that’s just the nature of fertility treatment, but they could be researching things like treatments, different types of treatments so that they’re fully aware and can ask informed questions, things like add-ons. It could even be when you’re going for treatment, planning the route, planning the timings, if you are going to stay somewhere. I think they can get involved in a lot more of the practical side and maybe sort of make the appointments being there as support whilst going through the appointments with their partner, but also making sure that their voice is heard, and their questions are answered in the appointments with consultants.
I’d also say it’s really good for them to have a support outlet and, again generalizing, but the men don’t tend to seek out the support like women do and in my support groups, I would say it’s about 95% female, 5% male. There were a few men in there when I was doing the face-to-face meetings when we could see people face to face, and when men came to the group once they started talking, I found that they opened up, and then it was very difficult for them to stop talking because they just felt safe and not judged, so they could talk. Having an outlet for them to talk, whether that’s their friends, whether that’s a male-only support group, so they can get support and advice from other men in similar situations.
There are Instagram accounts that are run by men and who are kind of talking about the male side of things which is fairly new, and it’s good if they can maybe follow them because then they can see what they’re doing and any advice they’ve got and how they’re coping. I think them knowing that it’s normal to feel these things is important, but just finding coping mechanisms that work for them and helping their partner be in the best state for conceiving, taking charge of the things they can do in treatment, and helping cope with the lack of control that they have through treatment.
