Infertility treatment can make you feel like you’re Dorothy in The Wizard of Oz and your house just fell on a witch in a foreign land. From the moment of your first visit to the man or woman behind the curtain, otherwise known as the Fertility Specialist, there is a brand new language to learn mixed in with a flood of new emotions. And while you’re just trying to gain your sense of where you are, there are lots of directions on how you are supposed to get back home to Kansas. The yellow brick road to building a family can feel complicated! One of the best things you can do is start to keep a fertility treatment journal. Write it all down!

And I mean everything! What is the name of the person at the front desk who  makes your appointment? Make a list of fertility medications that  your doctor wants you to take, and in what order! Also, take the time to write down how you are feeling every step of the way.

Keeping a record is not only smart, it is also a great anxiety reducer. You don’t have to remember anything. You will have it in writing. You may also find that when you are writing down instructions, it will also help you understand the process better. And if you can’t understand what you are writing down, that is a red flag to ask more questions!

So write it down. Appointments, instructions, and your feelings. It will help you take things one tiny step at a time as you head down the yellow brick road to building your family.

The post Why You Should Keep a Fertility Journal appeared first on RMA of Philadelphia.

I remember when I was a young girl and getting my period for the first time was so exciting. There was even a celebration at my house and my mother took me to a special lunch with my sister.  How things changed when I wanted to have a baby, and my menstruation because something I dreaded and feared. It’s arrival marked another failure, and could set me down a spiral of grief and sadness. It took me a while to get back a healthy relationship with my period. And I wonder about how to make our menstruation during infertility less of a defeat, and more of a sign of another possibility that hasn’t happened yet.

 Recently in my google alerts a blog post from Babble.com caught my eye – it was called “Do or Don’t: Auntie Flo Gift”.

I had never heard of an “Auntie Flo” gift before…but for women who are trying to conceive or perhaps coping with infertility, maybe doing something loving for yourself at the first sign of your cycle might be a good idea. Why not buy yourself a gift in recognition of your efforts? Why not treat yourself with kindness instead of punishment?

For women who are TTC (trying to conceive) – it’s so easy to fall into the trap of hating our bodies and menstruation can feel like a failure or even a little death. Dreams can feel like they have ended with the first sign of blood.

I like the comments on the blog that I linked to above. Check them out. There are some women who are also trying to conceive who left their tips for how they cope. Many were giving themselves the gift of permission. Permission to drink wine or coffee – eat sushi – engage in activities that give them pleasure, but that they withhold from themselves when they thought that they might be pregnant.

Personally, I think that’s a great idea. If you have been withholding something because you think your body might be pregnant – and you are not – then drop the weights for a little while and give into those pleasures. Pleasure can be healing.  It’s also a great time go give yourself the permission to get extra support.

I hate that when we are trying to conceive that our menstruation becomes a marker of pain. Our menstruation ties us to a deeper connection to our own bodies – and I saddens me that this vital part of our being can be so associated with pain.

Maybe this idea of  bringing a gift of pleasure to an otherwise unwelcome arrival to the first day of menstruation while we are trying to conceive is not a bad idea at all.

So what do you think? I would love to know!

The post When Menstruation Brings Pain appeared first on RMA of Philadelphia.

It’s that feeling in our belly that can feel like butterflies or snakes. Free flowing anxiety that seems to come from nowhere. Only you know where it is coming from; it’s coming from not knowing what is going to happen next in your infertility treatment.

Sometimes when we’re trying to conceive we can feel a sense of panic. Maybe it’s the results of a test. Or maybe we were sure that we were pregnant this month and we got our period anyway. Maybe, we even got a positive pregnancy test, and we’re seeing signs of bleeding. Sometimes, in the midst of fertility treatment, feelings of panic and overwhelming sadness can literally take our breath away.

The thing about these feelings, is that they can actually support us, even protect us – even if they make us feel uncomfortable. They may make us call our doctors for help and information that might be very important to our outcome.

These feelings may encourage us to reach out to friends, fertility coaches, and therapists for support. They can also encourage us to do something different. Sometimes, the feelings of panic, sadness, and fear move us into action.

As weird as it may sound, I am not encouraging you to numb your uncomfortable feelings away. These feelings may be very important. But learning how to cope with your discomfort in a way that allows you to tolerate being uncomfortable is a survival skill, so I have some tips, so that you can learn ways to handle that feeling of infertility panic.

Tips For Coping with Fertility Panic:

1. When we have feelings of panic, fear or deep sadness the first thing that most of us do is stop breathing. So my biggest tip is BREATHE! Check out this article on WebMD for wonderful exercises on deep breathing and why it works! http://www.webmd.com/balance/stress-management/stress-management-breathing-exercises-for-relaxation.
2. Close your eyes and think of your support system. Take three clearing breaths. And then lift the phone and start reaching out. Maybe you need medical answers. It may be time to get a second opinion. Call in the troops. This is the time to surround yourself with people who love you and will support you.
3. Eat and drink something. Sometimes, having something to eat and drink can be very grounding and calming. Try a calming tea blend. Keep them in the house!
4. Cancel what you do not have to do. Make room for baby making! Sometimes, it is stressful. Cancel your regular day if you need to and go for a walk. A gentle walk can bring down feelings of stress and panic.
5. Take your mind away from the panic. It’s okay to distract yourself with television or reading a book. Take a break from the panic after you have done whatever needs to be done around it. Go shop! Cook a great meal. Take a calming bath. Do something to help yourself take the focus off of the panic.

My favorite saying about emotions is that it changes like the weather in San Francisco. Just wait five minutes. Panic, fear, sadness all come and go. Allow yourself to float with it knowing that these very uncomfortable feelings will fade a bit. Be compassionate to yourself. Remember panic can be our friend. It can point us in the right direction, create a change, or put us on alert. And then we need to learn how to ride the wave so that we can land safely.

And if you need a second opinion, why not call us?

The post Tips For Coping When You Are Hitting The Infertility Panic Button appeared first on RMA of Philadelphia.

By: Pamela Madsen, The Fertility Advocate, Guest Blogger for RMA

When the conversation turns to the links between infertility, conceiving a baby and stress – frankly I find it all very stressful!

Infertility treatment is stressful. My life in general is stressful. It’s not good for our heart, or even our weight. We know this. But the advice about stress and conception changes as fast as the weather in San Francisco!

And fertility centers like RMA are all trying to do the right thing, such as  bringing in acupuncture, and speaking to patients about exploring meditation and yoga. All good things!

So does it help? Does it matter at all? Can you conceive a baby while you are stressing out over it? Or do you need to strike a yoga pose and learn to OHHHM?   Let’s look at couples that are undergoing fertility treatments at a clinic. There is a recent report which is based on a review of previous studies, which investigated whether anxiety or depression affect the chances of becoming pregnant after a single cycle of fertility treatment, such as IVF. In this review, they looked at 14 studies in 3,583 women from 10 different countries, and combined their results to draw their conclusions. What the results of this analysis showed was that women who became pregnant after the treatment cycle did not differ significantly in levels of anxiety or depression before their treatment than women who did not become pregnant.

Does that mean that all yoga program and efforts to reduce the stress for infertility patients should stop?

I don’t think so. I think we should look at it another way – this study is reassuring in that all of the emotional upset of fertility problems, and the stress of treatment itself should not damage our chances, of becoming pregnant on a given cycle.  But that by adding in all of these additional support systems we are simply helping our bodies and our minds survive the infertility experience (which is huge) outside of the added benefit of it maybe helping us to conceive. Fabulous!

This study carried out by researchers from Cardiff University and the University of Thessaloniki, Greece (and which didn’t receive any funding) was published in the peer reviewed British Medical Journal – and is in my opinion very reassuring to most people trying to conceive.

Let’s face it. Anxiety and its kissing cousin Stress are simply uncomfortable feelings to walk around with all the time and, generally speaking, are not very good for our overall health. As far as baby making goes, I also know that I conceived both of my boys during the most terrifying part of my life – facing infertility.

I love this study. It will help some of us stop stressing over whether or not our stress is hurting our chances of making a baby! I also think that reducing the stress levels in our bodies through fertility yoga, guided meditation, and getting additional support through support groups and or patient organizations, while trying to conceive can also be very helpful in coping with uncomfortable stress of infertility.

It simply makes good sense for us to pay attention to our stress levels. Not only for conception, but for our overall health. It’s a beautiful thing to be able to keep our sanity, and to emotionally survive infertility. If we burn out, we will not be able to continue in treatment long enough to conceive.

So…release the guilt and self blame AND strike a meditative pose!

The post Is Stress a Fertility Buster? appeared first on RMA of Philadelphia.

Women have been talking about fertility and making babies since there have been women on this earth. We do it privately, and in groups. And when infertility blocks our path to motherhood, we create a lot of stories about why this happens. Let’s face it, infertility sucks and it’s a medical problem. Yes, stress doesn’t help, but it’s not caused by stress or bad karma. You are not being punished  for something you did in your past.  This isn’t because you had sex with your best friend’s boyfriend in college or because you cheated on a math test. Infertility  is not in your life because you don’t deserve to be a parent.

Infertility is not a spiritual problem. No one is punishing you.

There is always a medical reason why a pregnancy doesn’t occur. I took this straight from a fact sheet on female infertility, it’s a great overview of what can go wrong medically on the female side of baby making.

Causes of Female Infertility:

• Defects of the uterus and cervix (fibroids, polyps, birth defects)
• Hormone imbalance or deficiencies, often related to age
• Ovarian cysts and polycystic ovary syndrome (PCOS)
• Pelvic infection or pelvic inflammatory disease (PID)
• Scarring from sexually transmitted disease or endometriosis
• Tumor
• Long-term (chronic) disease, such as diabetes
• Autoimmune disorders
• Clotting disorders
• Obesity
• Excessive exercising, eating disorders or poor nutrition
• Exposure to certain medications or toxins
• Heavy use of alcohol
• Advanced maternal age

There can also be egg-related problems, such as egg production in the ovaries, movement of the eggs from the ovary to the uterus, attachment of the eggs to the uterine lining, and survival of the egg or embryo once it has attached to the lining. No bad karma here, just human issues that happen to good people who are trying to have a baby. There can also be sperm related problems  such as poor sperm quality, or the lack of sperm.

Every single one of the issues listed above has solutions and different types of fertility treatment.

And while it is true that not every woman who has female infertility will end her treatment with a baby -a great many will.

The best path to parenthood when confronting female infertility is with a board certified reproductive endocrinologist. Sometimes, it is just about taking the next step and calling for an appointment. Sometimes, it’s about changing treatment plans. Sometimes, it is just about finding patience and giving things a chance to work.

It’s never about bad karma. Promise.

The post Infertility Is Not a Spiritual Problem appeared first on RMA of Philadelphia.

Very few us wait for very much anymore in our lives. If you have enough money, you get express lines, and advanced seating. We live in an instant society. We can get our movies on demand, pay our bills online, and there is an app for everything. We have lost our ability to wait. And the waiting is the hardest when it is for something that we want more than anything – like a baby.

In fact, baby making is one of those things that you just can’t hurry. It depends on cycles, and procedures, and responses to medications. There is a lot of starting and stopping. It is the way of medical treatment and bodies.

I get it. The hardest thing for me to do in life is wait. And when you are trying to conceive, life can seem like it is full of waiting. The waiting for an appointment, for your period, for the results of blood tests, the waiting room, waiting for the doctor, the list is endless. All capped off with the dreaded two week wait. That’s right – more waiting!

Waiting can feel like an active process of doing nothing. Sometimes it can feel like it can take all of our conscious effort and it can be exhausting. 
And yet, there is a part of me that believes that patience is power. That the doing of nothing, the actual process of waiting is not an absence of action; rather it is about perfect timing. It’s about really getting clear on the right time to act, for the right reasons and in a right thinking way. Infertility can feel a bit like a spiritual practice  of exploring your relationship to patience, and waiting in uncertainty. It can be a self-enforced time of doing nothing. And for me it can be like fire burning me to the ground. It consumes me and leaves room for nothing else. There is nothing left to do but be fully in it.

I get it.

I’m burning with you.

The post The Infinite Patience of Waiting For Your Baby appeared first on RMA of Philadelphia.

By: Pamela Madsen, The Fertility Advocate, Guest Blogger for RMA

Louise Brown, the first IVF child conceived, is now an adult and a mother. So much has changed since her conception and birth – and yet so much has stayed the same. When it comes to human reproduction and medical science the physicians and scientists have helped couples conceive children through incredible breakthroughs in reproductive medicine – but the one thing that they have not been able to crack is how to “fix” a broken egg!!

Why is this important?  It is important because egg quality one of the most important determinants of embryo viability.   And, until very recently, distinguishing a healthy embryo from one that is not viable has been an educated guessing game, where most embryos are judged by it’s good looks rather than what is inside.

It’s amazing to me as the founder of The American Fertility Association,  guiding thousands of potential parents on their path to parenthood that I have seen almost every kind of breakthrough there is – except one that helps women with aging eggs or multiple miscarriages, use her own eggs to have a child.

After all, we have been able to take one single sperm and make a baby – but still – we cannot help a woman with eggs that are not healthy become healthy enough to make a baby. That is rather incredible,  isn’t it?

In fact, other than checking ovarian reserve or expensive genetic tests, we have been very limited in our ability to tell if an egg is normal or not. This, coupled with inability to look inside a seemingly normal embryo and know if it is a viable, has  been one of the biggest hold backs in success for many couples.

So while we still can’t fix a broken egg, or can now crack the code on which embryos are healthy, and most likely to result in a baby. Pretty amazing stuff.

This new technology developed at RMANJ, and now available to patients at RMA Philadelphia and RMA Central Pennsylvania may be what is the pin in the needle stack for so many.

It’s a unique, rapid and scientific method to improve the embryo selection process, called SelectCCS (comprehensive chromosome screening).

This one-of-a-kind 24-chromosome screening platform identifies whether embryos are euploid (normal number of chromosomes or 46 with 23 obtained from each parent) or aneuploid (abnormal number of chromosomes).

Embryos are complicated, and errors can occur with all 23 pairs of chromosomes.  Patients who opt to use SelectCCS  are able to have their embryos screened at the molecular level which is more effective than previous testing processes that only count a handful of chromosomes. This can be especially helpful to women who have experienced miscarriages or are older as the current data suggests that 50-70% of miscarriages are due to embryos with too few or too many chromosomes.

Taking that extra step and using SelectCCS during the embryo selection process can improve the safety and success of your IVF cycle.

In addition to reducing the anxiety of not knowing if your embryos are healthy, the SelectCCS process allows patients to also take advantage of single embryo transfer (SET), which is a huge advantage as this allows patients the ability to avoid complicated twin pregnancies and deliveries.

It works like this, Select CCS allows the doctor to know if he/she is transferring a healthy embryo which is more likely to result in a healthy pregnancy. Therefore is no reason to transfer more than one embryo at a time. There is no compromising of success rates to avoid multiple birth pregnancies.

So if you are a patient 35 or older, or with multiple unsuccessful in vitro fertilization (IVF) cycles or miscarriages, please check out SelectCCS.  It truly might be the answer that you are looking for.

The post The Newest Fertility Treatment Breakthrough: Select CCS appeared first on RMA of Philadelphia.

Mother’s and Father’s Day can be grim dates on the calendar when you’re going through infertility. It’s a hard one to parse. You may long to feel a sense of belonging with family, and it can also feel like a great big day of mourning for what you don’t have yet in your life. In the infertility blogging community, you will find all sorts of blogs on how to cope with Mother’s and Father’s day. Explore the internet, see what’s there for you.

At RMA, we want to acknowledge your courage on these days, and let you know that we feel the sense of sadness that many of you feel.

What we can tell you is that it is just simply predictable that many emotional issues will come up if you are in the midst of infertility and everyone else is celebrating motherhood and fatherhood.

The best strategy is to plan ahead and be prepared for your feelings. You may not be able to take control over your IVF cycle, but you can take some control about how you are going to deal with your sister in law! So, plan ahead. How much time are you going to spend at the brunch? Do you have to be the first to come and the last to leave? Perhaps making the brunch will give you a different kind of role, and keep you busy enough not to bother around all the questions?

And speaking of questions, do you know how you are going to answer them? You can count   on questions about your family-building quest. So decide ahead of time how you are going to handle this in advance of the quite onslaught of curiosity.

Do you feel like talking about your treatment or adoption plans? Decide ahead of time and don’t break your boundaries! Stick to the plan. Come up with polite, friendly pat answers like, “We love that you care so much, we will let you know when we are ready to share”.  And then move on to “How about more dip?” Know where you are and what you can expect. If you are dining in a restaurant, they may ask you if you are a mother, so they can pin a pink carnation on you. How do you want to respond?

Spend time with your parents, aunts and grandparents. Celebrate them. Remember that this is special time for many of the people in your life that have been in the role of parent for you! How can you enjoy celebrating them?

Get extra support! Plan on it! If we know that an especially difficult time is about to happen, put the support in place now. Reach out to your support group, a therapist, or even go on-line and see what virtual support is available there. Research it out ahead of time, so that it’s there right when you need it.

And then there is always the ditch and run. You don’t have to celebrate Mother’s and Father’s Day this year. You can see your parental loved ones on a smaller scale. Plan a dinner before the big day or after. Do something special and smaller together. And then grab your sweetie and do something completely different on Mother’s or Father’s Day! Create it for yourself. Go to the movies, take a mini holiday, hide in bed all day and read the paper. It’s okay. It’s just Mother’s or Father’s Day, this too shall pass!

The post Celebrating Mother’s and Father’s Day While Going Through Infertility appeared first on RMA of Philadelphia.

By: Pamela Madsen, The Fertility Advocate, Guest Blogger for RMA

So much has changed since I was an infertility patient. Back in my day, in vitro fertilization in the U.S. Was little more than an optimist idea. We’re talking more than 25 years ago. Oh yes, there were a handful of babies conceived in petri dishes in a very few centers around the country. But the science and techniques were still so new, IVF was an all-or-nothing crap shoot with the odds decidedly not in the patients’ favor.

It was the Pleistocene Age of assisted reproductive technologies – full of rapid developments but still primitive. In 1979, when the Jones Institute in Norfolk, Va., opened its doors it was the only IVF center in the U.S. At its inauguration, the Institute already was scorched by controversy – busloads of protesters, poison-pen letters, volatile newspaper editorials both for and against and a suspicious fire.

By 1980, there were no “Island of Dr. Moreau” monkey-men, but there were no IVF babies either. Groundbreaking work had been done in England, where in 1978, Louise Brown debuted as the world’s first IVF infant. The great, late scientist Dr. Robert Edwards, brought Ms. Brown about by relying on the natural ovulatory cycle, trying to anticipate when the egg would be ripe, ready to extract and fertilize outside the body.

Dr. Howard Jones of the Institute named for him, notes, “When we had worked with Dr. Edwards in the 60s at John Hopkins, we tried ovarian stimulation and it didn’t work. We tried about 100 times. So he went back to the natural cycle.”

By the 1979, when Drs. Edwards and Jones had long gone their separate ways, Dr. Jones stuck with that protocol, with the “objective of obtaining the single egg that was characteristic of the normal ovulatory menstrual cycle. In 1980 we attempted to use that natural cycle in 40 cases and didn’t have any success.”

Then during the Christmas break between 1980 and 1981, Dr. Jones wife, Georgeanna Jones, a noted reproductive endocrinologist, suggested using ovarian stimulating drugs. “She had a great deal of experience using gonadotropins in treating anovulatory patients and saw no reason why we couldn’t use it in IVF,” said Dr. Jones. EUREKA!

In 1981, using Pergonal in a normally menstruating woman, Jones and team succeeded in recruiting more than one normal egg. By May of that year, Elizabeth Carr, the first child conceived using ovulation stimulation and IVF, was born.

Now we come to my piece of this Homeric saga (every single patient who undertakes IVF, even today, has got to have a heroic strength).

First a bit of background. My older sister became infertile after developing a near-fatal infection using the Dalkon Sheild contraceptive device (subsequently taken off the market). I was in high school when this trauma unspooled and it terrified me. But I remember her doctor telling her, “Today you can’t have a baby. But they’re working on this thing called in vitro fertilization and I believe you will be able to have a baby tomorrow.” My sister and I got married around the same time. She had some surgeries to correct tubal scarring and then began making pilgrimages to the Jones Institute because that was it.

Couples lined up and the waiting lists were huge. My sister and her husband would go to a hotel for two weeks, give up their lives and money for a shot at very low success rates. At the time she was hauling down to Virginia, I discovered I was a 24-year old unable to get pregnant. The diagnosis was unexplained infertility and to say I was freaked was to put it mildly. I had done everything humanly possible to protect my reproductive self precisely because of what happened to my sister. My self-image as this great fertile woman deflated faster than a punctured balloon. So did my self-esteem and confidence. The next year was one of inject-able medications and intrauterine insemination and picture perfect cycles that went nowhere. I saw the possibilities of motherhood being taken away. When my doctor brought up IVF, I couldn’t believe I was going to be doing this last ditch thing to have a kid, just like my sister. IVF was the final frontier and I was terrified.

As I was beginning treatment, my sister became pregnant on her third try. What a relief. And, a few IVF centers were slowly springing up in other places, meaning I was spared the trek to distant places. I was one of the first IVF cycles in New York City. My husband still didn’t get it. He thought the whole “IVF thing” was an unnecessary drama. I was crazed. After the first cycle, during that two-week wait for results, I was convinced it wasn’t going to work. The morning of my pregnancy test, I was possessed –cheerful Pamela had been replaced by an evil twin. I left the lab, went to teach my kindergarten class and routed calls from the IVF center to my husband. I couldn’t handle any more bad news.

At 2 pm I got summoned to the school office. There were two-dozen roses with a note that said, “My love to both of you.” I burst into tears because we had done it. My sister and I each have two sons.

So many eons have passed so rapidly it seems like a time-lapse film of history. Now there are hundreds of IVF centers throughout the country. Patients no longer has to give up their lives for weeks to travel to an IVF center. In fact, RMA Philly just opened up a new center in Central Pennsylvania.  Treatment has never been so convenient. Those Pergonal injections that I used to take with huge needles have now been replaced with better fertility drugs with tiny insulin needles.

Success rates at programs like RMA Philadelphia are in most cases (depending in diagnosis and maternal age) higher than fertile individuals trying to conceive the old fashioned way. Back in the day, is so over! While no one wants to experience infertility, if you are traveling on this path – it has never been a better path, and the possibility of family is likely today than it has ever been before.

The post Back in The Day of Infertility: A Brief History Lesson appeared first on RMA of Philadelphia.

Studies have clearly demonstrated that children of same-sex parents are as well adjusted and happy as children of heterosexual parents. Same-sex parents have the ability and freedom to create parenting roles that are not gender bound nor  tied to stereotypical behaviors. Same sex parents are able to create families of choice that encompass all of the many facets of love, stability and support.

Same sex-couples also have the wonderful opportunity to examine their basic beliefs about parenting, family, values, and decide in a conscious way about what they want to bring to their children.

It’s also important to all prospective parents, whether they are same-sex or not, to discuss basic beliefs prior to baby making, including religious beliefs, discipline, parenting roles, education, communication, and how they speak about the child’s conception to family and friends.

Prospective parents should also use the time before a child is conceived to talk about expectations of each other – not forgetting to consider the stuff we all bring along to the party (our baggage!). It’s also important to talk with members of your extended families  and friends with whom you and your child will engage.. What will those relationships be like after the birth of your baby?   Are there any conversations that should happen now?

The path to parenthood, is filled with lots of twists and turns for every prospective parent, including LGBTQ individuals and couples. But once that baby is in your arms, you simply become parents, with all the thrills and obligations that everyone else has.  Children are one of life’s greatest pleasures and a lifetime commitment of hard work. The best way to get ready for your greatest life pleasure is to have these important conversations while that bundle of joy is still a twinkle in the sky.

The post LGBTQ Parenting Dreams appeared first on RMA of Philadelphia.