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Round Two


a blog by Traci Shahan, RN, WHNP-BC, Doctor of Nursing, Albrecht Women’s Care: A Center for Reproductive Endocrinology and Infertility, March 20, 2011

So here you are. Financially poorer and not pregnant after your fertility evaluation cycle.

Perhaps your period started, or, like me, you took hourly home pregnancy tests long before the test could have picked up the tiniest mote of hCG, and they were all negative. What do you do?

(By the way, for you lucky ladies who were or are pregnant as a result of such a cycle, kudos and best wishes to you — we need women like you to give us hope!)

For the rest of you, there are no pat answers, and I am not an devotee of cookie-cutter anything — whether it’s medicine or grieving — but I can share what helped me and what I have seen help a lot of patients in my many years of working in reproductive endocrinology. Here are some ideas for short term coping with not being pregnant.

  1. If you feel like crying, please do so with complete, snot-filled abandon. I really mean this — cry, already! We are wired as human beings to feel and emote in relation to situations. And this one, sister ... not being pregnant is sad and way unfair. Sit with a giant box of tissues, and if your used tissues fill up the waste can, fine. If you think you can’t possibly cry anymore, then you do some more — go at throttles up! It makes me really sad when I see patients put on a brave face or even belittle themselves for weeping. This is one of the most effective ways that we can grieve the loss of a dream, a life that we envisioned. Some days I would pull the curtains closed, unwire myself from any electronics and communication with the outside world and simply cry. Under the covers. Into the nape of my Samoyed’s neck.
  2. Avoid what makes you feel worse. I avoided my mother’s well-meaning letters about how my five-year-younger, newly married sister, whom I love by the way, conceived precisely thirty atomic clock seconds into her honeymoon. I have a super mom, don’t get me wrong, but her alacrity for being a grandmother was too much for me when I was years into infertility treatment.
  3. ExerciseI I sometimes walked, and I always ran even when my fertility doctor told me not to (cut me some slack, reader, it was my only vice!). Many of our patients love yoga, riding bikes, and working out in a gym, but talk to your health care team about what amount is healthful. We’ve all heard and read about endorphin release after exercise ad nauseum, but I will say that exercise seemed to realign my thoughts toward hope.
  4. Be proactive and find information. Do not settle for gossip, and do not believe everything your find online or hear from others. Make fertility a discipline. Grill your doctor; if he or she seems the slightest impatient or gritchy, find another doctor post haste. The great news is that there are far more fertility doctors now than when I went through infertility, so put the law of supply and demand to work for you! I went to the library at the University of Colorado, my alma mater, and read mind-numbingly boring journals and wafted through the stacks like some apparition. One time I ate a whole bag of Cheetos as I sat at midnight in the stacks, investigating my unusual diagnosis. I found experts on the east coast, at Baylor, and on the west coast, and I called them all. If they wouldn’t take my call, I went to the next person on my list. Yes, some might consider my method too much work, but for me, I wanted the very best surgeon in the country and, as I’ve said in earlier blogs, a physician with a team who would support my emotional and physical health. Not an easy find.

As far as what happens next in the realm of your fertility care, it depends on what your diagnosis or lack thereof is. For instance, most women will conceive without in vitro fertilization (IVF), using oral fertility medications such as Clomid. Some fertility doctors will recommend another oral medication called Letrazole or Femara. Other fertility doctors will consider injectable medications called gonadotropins. All of these medications work differently on your body but are used to induce ovulation of one or more eggs in a cycle. During such a cycle, you will undergo ultrasounds and probably blood tests.

Other tests that may be performed are a semen analysis if you don’t have a recent result, imaging of your Fallopian tubes and uterus (check out the newer non-radiating types), additional blood tests. Take all of these tests and appointments one step at a time. Do as little or as much as you are capable in any one day. Ask for help from others. And for Pete’s sake, take advantage of all the awesome online groups, such as FertileThoughts. They are a godsend.

I will be out of the country next week and look forward to writing about IVF in my next blog.

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Comments (2)

Yes, financially poorer, jobless and not getting pregnant. That is my current situation. And Thank you so much for the cry-out-loud advice.
I'm due for an IVF this cycle. just hope all goes well. wish me luck!

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