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Written by:  Sandra Gordon
Date: July 1, 2011

If you're among the roughly 3 million women of childbearing age estimated to be affected by secondary infertility (infertility following the birth of one or more children), you're no doubt exhausted by it all. From the blood tests and sonograms to the do-it-yourself hormone shots and strategically planned doctor's appointments to the actual procedures — whether it's as low-tech as intrauterine insemination or as advanced and invasive as in-vitro fertilization (IVF) — the world of infertility is an emotional and physical wild ride. And that's even before you've waited for and received that phone call telling you whether treatment was successful, or not (or simply gotten your period). Besides the psychological and physical toll infertility treatments can take, appointments for blood tests, sonograms and related procedures can cumulatively consume hours, days and weeks of your life. But as all-consuming as it is, infertility treatment doesn't have to disrupt your entire life. Here are sanity-saving strategies for managing responsibilities during this particularly challenging time.

Seek support from others

With secondary infertility, you may be less inclined to confide in others about your situation than if you were trying to conceive for the first time. And for good reason. "Secondary people often don't get the understanding they need from coworkers, friends and relatives. The sense is, 'What are you complaining about? You already have a child,'" says Harriette Rovner-Ferguson, clinical social worker, co-author of Experiencing Infertility and a support group leader for RESOLVE, a national infertility organization. But as a result, you're apt to feel even more disenfranchised than those with primary infertility.

But getting others' understanding and empathy can be helpful, especially through a secondary infertility support group of those going through a similar experience. Studies show that the emotional support these groups provide may even improve pregnancy rates in infertile women. (To find a support group, preferably one that specializes in secondary infertility, visit www.resolve.org.) Online support communities and discussion boards such as www.fertilethoughts.com are available, too.

You may wish to seek individual psychological counseling, especially if you're depressed because of your infertility or if it's creating marital conflicts and other deeply personal problems a support group can't really address, says Linda D. Applegarth, director of psychological services at the Center for Reproductive Medicine and Infertility in New York City.

Choose a doctor with job-friendly office hours

If you travel for business, it's tough. Your whole month can be ruined if you're away when you need to be at the doctor's office for baseline hormone tests and other procedures, such as ultrasound exams to monitor ovarian follicle development—not to mention the actual infertility procedure, all of which track with your menstrual cycle. In which case, the best you can do is to coordinate your business travel schedule with your cycle, if possible. Otherwise, try to seek an infertility specialist with office hours before or after the traditional workday.

Confide in colleagues, selectively

At work, keeping your infertility a secret can jeopardize your career. For example, unexplained frequent absence can make your boss think you're out job hunting. But the other extreme — using your boss and colleagues as a sounding board — can also backfire.

Besides risking not getting the empathy you need, "coworkers can grow weary of hearing about your treatment and become resentful of the fact you're out so much," says career coach Laura Berman Fortgang, president of InterCoach Inc. and author of Living Your Best Life.

Or your coworkers may start tracking your treatment cycle and know exactly when you should be pregnant, which can feel eerily invasive, especially when treatment isn't successful.

Your best bet: Don't give your coworkers the play-by-play, but do brief your supervisor on why you'll need to be out the office frequently (unless, of course, your medical appointments don't interfere with your workday). If they do bleed into company time, emphasize that you'll stay late, work through your lunch hour or take work home, if necessary, to get your job done.

If you aren't comfortable mentioning your treatments to your supervisor, you don't need to disclose even that much. "To legitimize your absences, you can justsay, 'I'm having female troubles.' That catch phrase buys you a lot of privacy," says Mary Casey Jacob, Ph.D., professor of psychiatry and obstetrics and gynecology at the University of Connecticut School of Medicine. She suggests then saying something like, "It requires treatment and it's hard to predict because it's based on my menstrual cycle. I'm going to have to pop in and out of the doctor's office for a while and I'll do my best to keep you informed. How can we work this out?"

Know your baby limits

When undergoing infertility treatments, you're sensitive to anything about babies. "Seeing pregnant women or babies, or holding babies, can make me depressed," admits Donna Williamson, 33, a legal administrative assistant who underwent treatment to conceive a child with her second husband. (Williamson has two daughters from her first marriage.) "And going into the baby department is a big no-no," she says.

Whether or not to attend baby showers may depend on what's best for you that day, Rovner-Ferguson says. The same applies to visiting friends and relatives with babies and anything else in your life in which babies are involved.

You can't just blow off important events, however, or you risk harming relationships, says psychologist Casey Jacob. "If it's somebody you want to maintain a good relationship with, you either need to just pop into the shower briefly or privately take her a gift and say congratulations," she says.

Polish your comeback

Throughout the infertility process, you're bound to get your share of intrusive, albeit innocent, questions and comments, such as "Do you want more children? Are you trying?" Even, "You should just be happy with one (or the number of children you already have)." To keep from losing your cool, develop an arsenal of short answers that curtail the topic.

When are you going to have another child? "Well, gosh, I wish I knew" or "Still practicing." Do you want more children? A simple, "Yes, we do," is sufficient.

Keep a journal

Throughout your infertility treatments, keeping a journal (either daily or weekly) can help vent any negative feelings that can cast a shadow on your life. To keep it in perspective, also write down at least three things you're grateful for at the end of each journal entry, such as the wonderful events and milestones occurring in your children's lives. Otherwise, they're easy to overlook because you're so involved in your infertility treatments.

Give back to your body

Because infertility treatments can be so physically and emotionally demanding, it's important to pamper yourself throughout the process. Manicures, facials or pedicures and/or stress management techniques, such as meditation, exercise and yoga, can also give you a much-needed emotional boost.

"When I was going through in-vitro, I had to give myself injections of progesterone, which made my muscles sore. So I gave myself permission to get massages during that part of the in-vitro cycle. Even though it felt extravagant, the massages really helped my muscles," says Shelli Fidell, a psychologist in private practice who specializes in helping women deal with infertility and other pregnancy-related issues. "The fact that I was taking care of myself helped me get through it."

Sandra Gordon is a mother of two and the author of Consumer Reports Best Baby Products.



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