WHILE OUR ANCESTORS MAY HAVE THRIVED IN VILLAGES OR TRIBES, these days we tend to live more isolated, often separated from close family and friends by a long drive or a plane flight. While there may be pros and cons to tribal living, there’s no denying that one thing lacking in many modern lives is a sufficient support system.
Because of this common disconnect, we recommend building a strong network of support—via friends, groups, experts, and health practitioners to help to lift and guide you from preconception through parenthood.
Cultivating Emotional Support 
Women going through fertility challenges often complain of feeling very alone and isolated. Many feel as though they cannot talk about their woes with friends who already have children, or they feel judged and fussed-over by family members. They find little in common with their younger counterparts who aren’t yet at the baby-making stage of life.
The longer it takes to become pregnant, especially if miscarriages or other complications come your way, the more likely you are to withdraw from friends, avoiding things such as kids’ birthday parties, baby showers, and family functions where young kids are present. While the compulsion to hide out is totally understandable, finding the right kind of support can make the process a lot more bearable.
For many, finding a group of women going through similar challenges can be like finding an oasis in the desert. Suddenly, a world full of people who can truly relate to your experiences become accessible and are usually more than willing to offer you the kind understanding and support you’ve been missing.
While online chat groups may seem like the easiest place to meet other women experiencing similar fertility struggles, these groups can also be filled with false, misleading, and secondhand information. Regardless of whether you find them to be helpful, we actually discourage spending too much time in these forums unless you can find one moderated by a medical professional.
Resolve is a national organization offering peer-led infertility support groups. The benefit of in-person support groups is the important element of human connection. Many women find great comfort in meeting and connecting with others who are facing challenges similar to their own. Still, like online forums, peer-led support groups where medical advice is dispensed can be confusing and even detrimental, so please be aware of this when participating in these meetings.
The best choice, in our opinion, is a professionally led group facilitated by a therapist or other well-trained health professional. These meetings will often also incorporate the teaching of stress-busting techniques such as mediation and provide an objective perspective that might be missing from peer-led groups.
Given what we know about the impact that fertility challenges have on women and their partners, it’s no wonder there are plenty of therapists who specialize in this important topic.
If you’ve never been in therapy before, it can feel scary to start, but it’s worth overcoming your fear. Fertility issues can take a big toll on relationships, and a good therapist will facilitate keeping the channels of communication open between you and your partner, helping to guide you toward honestly discussing the impact of this process on each of you, both as individuals and as a couple. During this, or any other serious life challenge, seeking the support of a qualified professional is a worthwhile investment of time and money.
Calling on Chinese Medicine Practitioners of Chinese medicine learn a vastly different way of viewing the human body and supporting health. This medicine treats the whole person, not just symptoms, and as such can bring a refreshing perspective and effective approaches to fertility. In many cases, Chinese medicine can also find hope and solutions where Western medicine is empty-handed.
For those acupuncturists who wish to be successful in treating infertility, it is essential to acquire a thorough understanding of Western diagnosis and treatments, in addition to the Chinese medicine side, so as to avoid leading patients down the wrong treatment path. When choosing your Chinese medicine practitioner, be sure to ask about their training and experience with infertility.
Training in Chinese medicine is very broad, and most people leave with a degree that enables them to go in just about any direction they choose. This can sometimes pose a problem when it comes to fertility, as this specialty requires a unique skill set, beyond what is taught in a typical Chinese medicine curriculum. Just because an acupuncturist says they treat fertility issues doesn’t mean they have the scope of knowledge required to really help someone if things get complicated.
If you are seeing a reproductive endocrinologist, asking him or her for a referral can be a good place to start. Chances are they won’t recommend someone who isn’t familiar with the ins and outs of their world. Friends who’ve been through fertility treatments while using acupuncture can also be a good choice. Finally, The American Board of Oriental Reproductive Medicine (www.aborm.org) has a list of board certified fellows who have demonstrated competency in the field of integrative reproductive medicine, through a board exam and ongoing continuing education requirements.
Deciding When to Get Medical Support While virtually every hopeful parent wishes to achieve pregnancy the old-fashioned way, it’s important to know when to seek diagnostic care and possibly medical intervention. Doing so can often save you valuable time and resources in the long run.
Making a baby technically takes two people (or, more specifically, one sperm and one egg). If you are having health issues, are “older,” or are encountering challenges, it’s a good idea to get support sooner than later.
As a general rule of thumb, a couple is considered to have fertility issues when they are:
Under 35 and have been trying to conceive for more than a year unsuccessfully
Over 35 and have been trying to conceive for more than six months unsuccessfully
Over 40 and have been trying to conceive for more than three months unsuccessfully
While these parameters are reasonable for many individuals, it is also important to consider family history and personal medical history in deciding when to go in for a workup. For example, if your mother and grandmother experienced early menopause and you are in your early thirties, you might consider getting evaluated after three to six months of trying, rather than a year. If you have very irregular periods, struggle with weight management, and/or have to manage hair on your body in typically male areas (such as your chin or chest), you might want to go to the doctor to rule out PCOS (a condition we cover on page 170).
CAN MY GYNECOLOGIST BE MY FERTILITY SPECIALIST?
Sadly, in the United States, most fertility services are not covered through insurance, and many people turn to their regular providers to try to get some of the lab costs and procedures billed. While it is quite common these days that OB-GYNs (obstetrician-gynecologists) offer fertility services such as IUI cycles, it is our experience that this is not always the best route to take.
We often see a number of issues arise when a patient opts for using an OB instead of a reproductive endocrinologist including:
• INSUFFICIENT MONITORING through ultrasound can sometimes lead to inseminating on the wrong day.
• LIMITED AVAILABILITY. Unlike fertility specialists, OB-GYNs typically don’t hold office hours on the weekends, which can leave a woman who is ovulating on a Saturday completely out of luck.
• OVERUSE OF THE DRUG CLOMID (Clomiphene Citrate) without sufficient workup to determine if it is the best drug for the patient. Clomid is often used by OB-GYNs as a first line of defense for just about anybody having trouble conceiving, even when they have symptoms that would make its use ill advised (such as low estrogen levels or a thin uterine lining).
On the other hand, board certified reproductive endocrinologists/infertility specialists (RE) spend their days implementing fertility protocols, are generally more focused on finding the right medications for their patients, monitor their patients’ progress carefully throughout the cycle, and inseminate at the exact right moment—even if it’s a Sunday.
In the world of fertility medicine (at least in the United States), you get what you pay for, and in this case, it’s worth the investment. If your case is complicated, or if you’ve been through more than two or three unsuccessful IUIs under your OB-GYN’s care, please consider seeing a specialist.