While not every woman wants to have children, those do, but struggle to conceive, face a unique and often isolating journey. Often, society tells us that if we cannot conceive spontaneously and naturally, or carry a baby inside us, we are not fulfilling our roles as women. Counseling can be helpful in helping to reconcile emotions of guilt and shame around having babies, and can be especially useful coming to terms with the decision to engage in the use of assisted reproductive technology, or ART. For those who want to become parents but have been unable to conceive on their own, ART presents a wonderful opportunity. It has provided many different paths to parenthood, and has created many families for people across gender, lifestyle choice, and family makeup. 62030357 L

While the decision to pursue ART is never taken lightly, it is also the first step in what can be a very overwhelming and sometimes frustrating process. Hopeful parents-to-be who come to see me here at the Center for Growth often struggle with the many aspects of fertility treatment that they could not anticipate. Sometimes coping with the financial investment can feel overwhelming, or sometimes the techniques feel invasive and triggering for women both with and without a history of trauma. Sometimes, couples are in disagreement about how many rounds of IVF is "too many", or they struggle to connect with each other during what can feel like an interminable wait for a baby. Finally, even a successful implantation does not always guarantee an uneventful pregnancy. Pregnancy can be easy for some, but others may struggle with morning sickness, or even face the heartbreaking decision to end a wanted pregnancy due to fetal anomaly. Other intended parents may struggle to connect with their babies as they are carried by surrogate mothers. If you are dealing with some of these challenges during ART, know that you are not alone, and here are a few tips to help you cope with the process.

1) Connect as a Couple. If all goes well, and you're currently part of a couple, you may soon be more than a party of two. So, now is the time to try to enjoy these last few months, or years, as a duo. While your entire relationship may feel focused on the goal of conceiving, it can benefit your marriage to continue to pursue different healthy ways to connect. Consider couples activities or outings, train for a 5k, or even go on a self-guided "foodie tour" of your city, discovering new and exotic places to eat. Stay home and cook together, or invest in some new board games involving strategy and skill. Another great way of exploring your relationship is by playing the couples version of the Pocket Ungame or Our Moments: Couples Edition to get conversations going. Now might also be a good time to have the harder conversations about your ART journey: are you both on the same page about ART, adoption, and/or surrogacy? When will you feel it is time to "call it" and find an alternative way of pursuing a family? Are you interested in adoption, or foster care? These conversations can open doors to being on the same page about family planning. On the creative side, you might consider making a scrapbook chronicling your journey together. You can also enlist family and friends to share stories and pictures to contribute to the scrapbook. Sometimes, this can be especially meaningful when a family member has died, but you want your future child(ren) to know about them. Including a space for loved ones who have left the earth can also be a healing piece of the ART scrapbooking journey, too. ART can sometimes feel like a never-ending process, and couples can lose sight of each other while waiting between mock transfers, implantations, and more. It can even be useful to attend a few sessions of couples therapy to open new channels of communication with each other. 

1a) Find Yourself! If you've made the decision to single parent, now is also a great time to invest in getting to know yourself even better. Find the time to take a new course, read a book on the Best-Seller list, or connect with friends and family. Many of the above recommendations can go for (future) single parents, too: scrapbook your journey or create a journal for your future baby, chronicling the process of becoming a parent. 

29626220 L

2) Know that You're "Marking Time". ART is not always a straightforward process. Sometimes, there are unexpected delays and roadblocks in the way of getting to a healthy baby. While attending to these is always necessary and in the best interests of getting you the baby or babies you are dreaming of, the wait can feel interminable and sometimes couples report feeling like they are living their lives by the numbers, counting days of their cycles, days until the next procedure, anticipated due dates, and more. Sometimes, the wait in between appointments (and important answers) can feel unbearable, and staying in the present can be so hard. My mentor gave me a useful metaphor to help make sense of this period, called marking time. In marching band, there are periods of practice where players continue to march in place, without playing their instruments. During this time, members of the band are getting ready for their part, and continuing to be productive, functional, and engaged, with the goal of creating fabulous music. Similarly, you may currently be marking time, feeling as though you're moving, but not necessarily feeling forward momentum. However, this is time that you, too, are getting ready. There are feelings to process, conversations to have, and elements of your life that must continue. It is perfectly reasonable to set other goals for yourself outside of ART, and working toward those. Know that when you become a parent, those goals will become part of the beautiful melody of your life, and these will enrich and contribute to your journey. While it can feel frustrating, this marking time period serves a valuable purpose, and the wait will make the end result all the more worthwhile. 

97344368 L

3) Be Mindful of Trauma and Mental Health. This is a special note for readers who have experienced prior sexual abuse or violence, as well as those who have felt triggered, invaded, vulnerable, or exposed, during the IVF process. Many different types of people want to become parents, and some feel especially affected during ART as they may feel that their bodies are no longer exclusively their own, or they may have painful reminders of past abuse. Please know that you are worthy of conceiving, and of being treated with the utmost care and sensitivity by your providers. A helpful website to refer to your team is Trauma-Informed Reproductive Endocrinology Directives (TIRED), a resource developed by one of my former students who also specializes in working with infertility. On this website can be useful resources for you, including links to support groups and more. You may find validation and recognition on this site, though please be gentle with yourself as you begin to uncover the discussion of ART and trauma. I highly recommend that you work with a trauma-informed therapist to process your own experiences as you go through IVF, as well as developing coping strategies to help you with the more triggering processes. Even if you do not have a trauma history, ART can contribute to symptoms of anxiety and depression, depending on your individual experience. Take care of your mental health and treat yourself to therapy during this time.

The journey to parenthood can have its ups and downs, and there are more than a few twists and turns along the way. It is also one of self-discovery, and, no matter the outcome, can create meaningful experiences. Good luck!