Infertility and your mental health

With World Mental Health Day this month, it’s a timely reminder of the importance of prioritising your mental health when you’re going through infertility. 

“I’m sorry, but the container of embryos you shipped over from Australia is empty.” Words that still haunt me today. We were in Canada for our first gestational surrogacy transfer when our fertility doctor broke the news. An hour earlier, we were full of hope. An hour later, we were living a nightmare. There are a handful of days in your life you wish had never happened. This was one of them. 

When we returned to Australia, my mental health suffered. I was depressed and unable to sleep. I had also convinced myself that what happened was the universe’s way of saying we weren’t meant to be parents. Because transporting embryos is standard practice. People transport embryos, eggs, sperm all the time, whether they’re changing clinics or doing surrogacy. What happened was extremely rare. And we had travelled to Canada after years of failed IVF transfers and pregnancy losses, due to my thin endometrium lining. So I was already running on empty. Returning home, I realised how crucial mental health is. I’m not sure we would have continued with our fertility journey if we hadn’t started to prioritise it. 

Infertility is incredibly painful. It’s all consuming. It takes a significant toll you on your mental health. And it often feels like a full-time job. It took us six years to have our son Spencer, born through gestational surrogacy in Utah, USA. But it was only after Canada that my emotional and mental health became a priority. Here’s what helped me during our journey:

• Say no. Baby showers, gender reveal parties, first birthdays…These events can be torture. For me, baby showers always meant one thing: being surrounded by excited squeals and endless reminders of the one thing I didn’t have and desperately wanted. The one thing I was fighting so hard for. With my very good friends, I often went. But outside of those close friends, I didn’t. If you are not close to the person, I doubt they will miss you. They’ll have plenty of other people there to celebrate with them. And if you are close to them, as a good friend, they should understand.

• Goodbye Facebook. After our second pregnancy loss, I deactivated my account. My Facebook news stream was dominated with pregnancy announcements and baby photos. I would spend too much time scrolling through social media, feeling awful. Limiting my social media was liberating. 

• Advocate for yourself.  We’ve all heard it before, “You just need to relax.” It still amazes me that so people, with no medical expertise, continue to offer unsolicited advice. Comments like these are ridiculous and hurtful. It took me a while at first, but whenever someone would offer me “advice” I would point out the facts: Infertility is a reproductive disease, a medical condition that impacts millions worldwide. And if I was feeling extra bold: “I’m not sure how relaxed women in war torn countries are. These women fall pregnant every day” or “Relaxing is not a medical cure. Imagine telling someone who has cancer to ‘just relax’ and they would be cured. That would be hurtful and insulting. Infertility should be no different.”

• Therapy. I found therapy extremely helpful. My therapist used a mix of Cognitive Behaviour Therapy and hypnosis. Given the impact infertility can have on relationships, I also know of many people who have found couple’s therapy a lifesaver. 

• Self-care. Do some things just for you, things you love doing. If I ever I need a self-care kick, I go for a long walk, binge a reality TV show, read a good book or have a massage. 

And finally, it’s OK to not be OK. I think it’s imperative to acknowledge that infertility is incredibly painful. You will feel so many emotions like anger, frustration, jealously, sadness, and guilt…and that’s ok. It’s human to feel this way. Be kind to yourself. 

Also featured in IVF Babble.

I felt like just a number

I still remember the day one of our IVF specialists said to us, “I’m so sorry about your miscarriage. I believe it’s been about a month since you lost your pregnancy?” There was just one problem. I hadn’t miscarried. We were at our appointment to discuss my fourth egg collection. But clearly not remembering who we were, she had mixed us up with someone else. And given how deeply personal and emotional IVF is, I can’t really say it was an honest mistake to make.  

It made realise, there’s a severe lack of personalised care at IVF clinics. And while I can only speak to Australia, I’ve heard similar stories from people in the UK and the USA. And I’ve read stories in the news, and on social media, about the lack of personalised care and accountability with IVF clinics. I’ve also read several comments of people saying they “felt like just a number.” That’s not to say I didn’t have some fantastic specialists. In the end, we had two mediocre ones in Australia, a wonderful one in Australia and finally our fantastic doctor in America (Dr Russell Foulk, The Utah Fertility Center) who helped us have our son Spencer, born through gestational surrogacy. 

On reflection, our first IVF appointment was rushed. We were in and out within fifteen minutes and hurried to the finance department to pay our hefty bill. Not surprisingly, they didn’t rush us, and they made sure we signed all the paperwork and paid our bill. Once the finances were settled, we started treatment. When I went to the clinic for my monitoring ultrasounds for my first transfer, I had a different nurse each time. The lack of consistency was alarming to me. And it was impossible to speak on the phone to my IVF doctor. IVF is a huge financial, physical, and emotional commitment. Perhaps the biggest decision of your life. And yet, I probably had more attention, and consistency, with buying a car. 

As mentioned, this was not my experience with all my specialists but having some average doctors in the mix, it made me realise the things I needed to watch out for. Here’s my advice on what helped me navigate the IVF world: 

• Be prepared. Go to your appointments with a list of questions. For example: What are the success rates (and for your age)? How many embryos make it to Blastocyst stage? What are all the treatment options? And the side effects? What’s Pre-Genetic Screening (PGS)? There are so many questions you can ask.

• Don’t be rushed. Ask all your questions and ask for clarity if you don’t understand something. Don’t feel pressured to be rushed out the door. 

• Arm yourself with knowledge. Speak to others going through IVF. Online communities and magazines like IVF babble are invaluable in helping you expand your knowledge. The Instagram community, and also fertility podcasts, are also a fantastic way to get all the insights you need before seeing a specialist. 

• Get a second opinion if you feel you need it. If we didn’t get a second opinion, I doubt Spencer would be here today. Our doctor took a step back and did some vital investigation work. He diagnosed me with having a very thin endometrium lining and explained how gestational surrogacy was our best chance of having a baby.  

• Find an IVF doctor who is supportive, patient, and empathetic. Dr Russell Foulk and his team at The Utah Fertility Center were the perfect examples of this. At our first consult, Dr Foulk took his time, acknowledged what we had already been through and greatly empathised with us. His caring and dedicated approach was a huge comfort and gave us the reassurance we deserved. 

IVF is a big business. It can be easy to get caught up in it all and trust the medical specialists. But unfortunately there are too many clinics who don’t have personalised care and where you feel like ‘just a number’. Infertility is incredibly painful and all-consuming and so much of it is outside your control. In my experience, it’s important to advocate for yourself and be as proactive as you can.

Also featured in IVF Babble.

Why the Pope’s call for a ban on surrogacy made my heart sink

Our son Spencer was born through international surrogacy in the USA in 2019. This was after a painful six-year infertility journey. Due to my thin endometrium lining, we had several failed and cancelled IVF transfers and three pregnancy losses. It was our second fertility specialist in Australia who told us that surrogacy was our best option to have children. And while it felt overwhelming at first, surrogacy was an amazing and life changing experience. Because without surrogacy, we wouldn’t have our beautiful son. Without surrogacy, we wouldn’t have children at all. So I’ll admit, when earlier this year I stumbled across a video on Instagram of Pope Francis proclaiming surrogacy as “deplorable”, my heart sank.

In the video, he described surrogacy as “an abuse of human rights” and something that should be banned globally. Bewildered yet intrigued, I searched for the news coverage. There were countless articles of Pope Francis saying how surrogacy turns a child into “an object of trafficking.” My sadness was quickly replaced with anger. His sentiment was also supported by the US Conference of Catholic Bishops who argued it’s a “grave injustice to everyone involved.” The Catholic Church has always regretfully been opposed to surrogacy, IVF, and abortion on the grounds that they violate the natural law. So the Pope’s declaration isn’t a surprise.

My first thought: What would a bunch of old men with no children know what it’s like to not be able to have children? Why should they get a say in who should - and shouldn’t - have a family? My second thought: How disappointing and tragic that they don’t understand how surrogacy is a gift for so many people. I wonder if they have talked to anyone who has a family through surrogacy. I doubt it. Without surrogacy, we wouldn’t have Spencer. Without surrogacy, tens of thousands of people wouldn’t have their precious children.  

It’s not the first time I’ve heard people be so vocal about surrogacy. Although it’s usually not been from people in high positions of influence. Only last year, I was scrolling social media when an Instagram post caught my attention: “Surrogacy is a mortal sin.” I laughed. Until I read the comments. There were so many negative comments. Most were complete rubbish. But there was one comment - and the replies in support of it - that angered me: “Anyone who has a baby through surrogacy is selfish. It’s incredibly selfish to the poor child. You shouldn’t be a parent. You will damage your child for life.” It was those final two sentences that made my heart race.

I would do anything for Spencer. We fought so long and hard to have him. He is the love of our lives. The accusation from a stranger that we were selfish and damaging Spencer, enraged me. I wanted desperately to reply and tell her she was wrong. But my rational husband convinced me otherwise, “If you reply back, they win. They’re trolls. And nothing you say will convince them anyway.” He was right. I didn’t reply. I blocked her account. But I was seething with anger for hours. And unfortunately that fury revisited me this year when I heard the Pope’s comments.

Like so many things in life, surrogacy is nuanced. Do I think there needs to be tighter regulation on surrogacy in some countries and fertility clinics? Yes. Are there stories of women being exploited? Yes. There are some countries that have very poor protections for surrogates. And that’s just not good enough. But for every awful story, I’ve heard of so many more positive ones. I’ve connected with several surrogates and intended parents over the years who have had incredible and beautiful experiences.

We had an amazing experience in the USA through the Utah Fertility Center and Dr Russell Foulk. And we have a beautiful and special relationship with our surrogate Leigha and her husband Josh. We even lived with them for a few weeks after Spencer was born. They are like family and despite the distance, we know they will be in our lives forever.

As for Leigha’s view? She often tells people how surrogacy was a gift for her as well and something she personally got so much out of. A surrogate twice, she says: “I now have two beautiful families that complete my family. One in Spain and one in Australia. They will always be a part of me, and I’m so blessed to have to sisters through motherhood.”

Infertility is indiscriminate and outside your control. It’s not your fault. And from what I’ve seen, the strength, resilience, and determination that people go through to become parents is astounding. To have a universal ban on surrogacy, would be ridiculous and hurtful and it would rob so many people of their dream to have a family. I hope that this call to ban surrogacy is just that. A request that goes nowhere. And that many more people will go on to experience the wonderful gift of surrogacy.

As featured in IVF Babble