Corona canceled my fertility treatments — now what?
As you all know too well, over the past few weeks states have been imposing tighter and tighter restrictions to try to control the spread of Covid-19 and ensure that the healthcare system remains able to meet the needs of those who fall ill. As part of this effort, the Centers for Medicare and Medicaid Services (CMS) issued guidelines to cancel all non-essential medical procedures. In addition, the ASRM (American Society for Reproductive Medicine) issued practice guidelines recommending the cancellation of all new treatment cycles and cancelation of embryo transfers and egg retrievals for many.
While these are certainly important measures to reserve much needed resources for the care of patients with Covid-19 and protect our hardworking healthcare providers, they raise significant concerns for many patients. For those struggling with infertility, they also bring great sadness, confusion, and even anger.
Over the past few weeks, I’ve spoken to many fertility patients about this news. All have expressed great sadness and anger at having their treatment cancelled or delayed. Some feel that they have been racing against the clock and now feel beaten by an invisible, intangible foe. Others are asking what now? When you’re struggling with infertility, fertility treatments tend to become an all consuming focus. But now those treatments are on hold with no clear re-start date. How do you handle this time in limbo?
This post will address these feelings in the context of answering the question, “What do I do now?”.
Step 1, acknowledge and allow space for your feelings. Almost all of the fertility patients I’ve spoken with have expressed sadness and anger at the current situation but then qualified their statement with things like “but I know this is just me being selfish” or “but nothing really happened — no one died”. But, here’s the thing, something did happen. You had a loss.
The experience of infertility is full of losses: the initial realization that building a family will involve much more than yourself, your partner, and the right mood followed by failed treatment cycle, perhaps you’ve had a miscarriage, or needed to adjust your idea of family building to include the use of a donor or surrogate or adoption. Each of these events represents a kind of loss. So does the cancelation or delay of your treatment due to Covid-19. And, since each loss compounds the next, your response to this latest setback may reactivate feelings from previous losses making it seem out of proportion.
It is important to take time to grieve each loss. Otherwise, the feelings associated with them go “underground” and, unrecognized, can impact all aspects of our lives and our relationships. This is explained more here. The article also describes the process of grieving a previously unrecognized loss. The key is to acknowledge the loss and let yourself feel and process whatever emotions come up for you. Don’t judge the emotions as good or bad, selfish or just. They are just emotions that you have in the process of grieving. Eventually, you will find your way to acceptance and feel ready to move forward.
Step 2, reframe this unintended pause in your fertility journey as an opportunity. I know, you’re thinking, “f-you lady”. And I get it. You’re not through Step 1 yet and that is totally fine. But, once you are, you’ll naturally be looking for the opportunity.
Perhaps this pause offers you the space to grieve your losses — or at least start the process. You may want to consider engaging a coach or therapist who specializes in infertility. You can also take other steps to fortify your emotional reserves like starting a mindfulness practice, joining a (virtual) support group, or reconnecting with nature on (socially distanced) hikes.
Pauses in treatments can also be great times to empower yourself for your next cycle. If you have questions about your care or need to make a decision about how to proceed, this is a great time to do some research whether that is reading up on your treatment protocol or consulting a new doctor for a second opinion. (Although clinics aren’t offering treatments at this time, all do continue to offer virtual consultations and some are offering diagnostic testing.) If you have been considering using a donor or surrogate or moving forward with adoption, right now is a great time to learn more about all of these routes to parenthood. You can call agencies to start to get a “lay of the land” or join a virtual support group to hear from other people who are pursuing those routes.
Finally, some women I work with start to feel “not right in their bodies” as their treatments progress. This sense of your body feeling foreign can come from the side effects of the fertility medications as well as changes in your physical activity and may be heightened by a feeling that your body is failing you. This pause may be a great opportunity to focus on feeling good and proud in your body again. Start an exercise routine or think about how you might optimize your diet. After all, regular exercise and maintaining healthy eating habits can help you stay sane while hunkered down at home, and exercising and grocery shopping are basically the only ways to get out of the house these days.
What you choose to do to reframe this loss as an opportunity doesn’t really matter. Simply by seeing the opportunity, you take back control and feel empowered.
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