Patricia Gilbert Fertility Counselling Service ni 3 rd October 2015

Patricia Gilbert

Fertility Counselling Service ni

3rd October 2015

*The Two Week Wait

All those considering Fertility Treatment…

• It is likely to be stressful

• Emotional needs can be different at different stages of investigations and treatment

• Within relationships you may have different needs to your partner.

Waiting for…

• appointments• tests• test results• phone call• treatment• period (maybe not need

treatment)

• pregnancy test• review appointment.

Waiting

• It takes two weeks from the time a fertilised embryo implants in the uterine

wall to start emitting enough of the hormone hCG (human chorionic

gonadotropin) to be detected accurately.

• hCG may still be in the body’s system as it is also used as a “trigger” hormone to

mature eggs prior to egg collection

Why Two Weeks?

Once embryo transfer takes place, all hospital visits likely to stop…can feel like being “cut loose”

Why is Waiting Stressful?

Lazarus & Folkman (1984)

Uncontrollable

Meaning

• In tune with what is going on in body

• Bargaining• Day 10• Bracing

Under the Magnifying Glass

Its not that I’m anxious when I think about it – it’s deeper than that. Its there in my very core, with every waking moment

Quotations

I took time off work. By the third day I was climbing the walls. There’s only so much day time TV you can watch

Life goes on during TWW. I couldn’t control the treatment so I tried to control everything else. I have the cleanest house in the street

I’ll definitely stay away from the chat rooms. They made me believe their pregnancy symptoms were mine too. They weren’t. It was too much like living off someone else’s experience, rather than my own.

Time off work definitely. Stay away completely. Don’t want the guilt of “if only I’d looked after myself better”

Two weeks is too soon. I want to enjoy the possibility we are pregnant

I got a really good embryo, they said it was the best. I thought, if they can be positive, I can be too…it didn’t work. They made me believe it would work

Men Wait too

“The roles are reversed, and it can be hard to sit back and watch; to care rather than control, to pamper rather than provide”

Swimming Upstream 2006

To document the course of anxiety, depression and positive effect and coping during the active treatment time and the waiting period before a

pregnancy test result in fertility treatment Boivin & Lancastle 2010

Research

Anxiety- tense, nervous, worried

Depression- angry, frustrated, sad

Positive affect- happy, content, tolerant

Emotional Reactions

* Anxiety, depression and positive affect during the stimulation, waiting and pregnancy outcomes

stages of IVF

S1 S2 S3 S4 S5 S6 S7 W1 W2 W3 W4 W5 W6 W7 P1 P2 P3 P40

0.2

0.4

0.6

0.8

1

1.2

1.4

AnxietyDepressionPositive Affect

Mean

Em

oti

on

al

Reacti

on

s

IVF Day

Active Stage Waiting Stage Outcome Stage

FEAR

HOPE

• May wish to limit the number of people you tell about your current treatment?

• Decide in advance how you will handle questions from those who don’t know

• Create menu of things that give you delight (music, waltz)• Daily structure (get up to something pre-arranged)• Relaxation techniques (progressive muscle relaxation, deep

breathing, meditation, imagery)• Resist “Consultant” named “Google”• To work or not to work• Journal• Protect yourself emotionally (family gatherings, parties)• Be energy efficient• Plan for the pregnancy test• Talk to each other about what you may need

(mind reading is not an option)

Some Survival Strategies

*Mindfulness

“paying attention in a particular way, on purpose, in the present moment and non-judgementally” Jon Kabat-Zinn, Univ of Massachusetts

What does this mean? Paying attention – focussing on one thing

In present moment – what is happening NOW

Non-judgementally- accepting thoughts as they are

Walt Whitman

Paying Attention to what is happening Now is likely to be a Challenge

“Conception is so uncertain: make sure to continue to live

and move on in your day,day by day”

THANK YOU for LISTENING

• Boivin,J & Lancastle,D. (2010) Medical waiting Periods: imminence, emotions and coping. Women’s Health 6(1)

• Jensen,J. (2013) The Incredible power of Self Talk

• Lazarus,R,S,& Folkman,S. (1984). Stress, appraisal and coping. New York: Springer

• Rawlings,D & Looi,K. Swimming Upstream. Peacock.2006

• Wenzel,A. (2014) Coping With Infertility

References