If you are new to the concept of infertility or infertility treatment, this post is for you.  Infertility is defined as a disease characterized by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a person’s capacity to reproduce either as an individual or with their partner.  Infertility can also refer to a person’s inability to sustain a pregnancy to term.  Not all couples have to wait the full year before seeking treatment, as there are other factors that can decrease that timeline.

It’s important to understand that infertility is something that is far more common than most people think. 1 in 8 couples have difficulty getting pregnant or sustaining a pregnancy to term.

One of the reasons that it feels so uncommon is because many people choose not to talk about their infertility diagnosis and experience; however, it really is more widespread than most imagine.  A couple ages 29 to 33 years old with a normal functioning reproductive system has only a 20-25% chance of conceiving in any given month (National Women’s Health Resource Center). After six months of trying, 60% of couples will conceive without medical assistance (Infertility As A Covered Benefit, William M. Mercer, 1997).

Infertility is something that no one is ever really prepared for in their lives.  Most have learned what needs to be done to prevent pregnancy, but there is very little readily available information about difficulty getting pregnant or difficulty sustaining pregnancy to term.  One of the most helpful websites I have found for learning about infertility is Resolve.org.  If you are concerned that you may have undiagnosed infertility, you can use their Personal Assessment Tool.  If you have already been diagnosed with infertility, you can learn more through Infertility 101. 

How would you go about learning if infertility is something that you are experiencing?  The first step would be to talk with your OB/GYN or primary care doctor.  They should be able to provide you with a guideline of what would need to happen before you can be referred to a Reproductive Endocrinologist (RE).  An RE is a doctor that specializes in treating infertility.

Infertility treatments can be covered by insurance, but are not always, so it is important to know what your coverage happens to be before proceeding.  The following states have mandates in place to make insurance cover infertility treatment: Arkansas, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, New Hampshire, New Jersey, New York and Rhode Island.

Beyond the actionable considerations for infertility, it is important to consider the emotional impact of this diagnosis. For many individuals, this is a long process with many ups and downs along the way.  It is normal to feel very emotional during this time.  Emotions may also be heightened if one is taking hormonal medications, which are common in most infertility treatments, making managing emotional responses even more difficult.

So, the big question is, how can you and your partner navigate this turbulent time?  Below you will find some suggestions.

1. Openly communicate with your partner.  Don’t expect that your partner will automatically know what you need.  They won’t, no matter how long you have been together.  You don’t know what they need every second of every day and neither do they.  Share with them your thoughts and feelings, as well as any needs that you may have.  If one or the other of you is going through treatment, make sure you are communicating openly with what is happening.  It is vital that you and your partner are on the same page about what you are open to and what is happening.
2. Openly communicate with your medical team.  Don’t be afraid to ask questions and verify information.  This is something they are used to.  It is also important to know what hours your office is open, as they may not be open on weekends.  Leave messages and follow-up, if needed.
3. Take notes.  Taking notes is always helpful when you are in a doctor’s office, but especially when you are doing something brand new.  You may be getting information from your doctor during an appointment, but it is also common for communication to happen over the phone.  There are times when information is coming very quickly and things are changing fast.  Don’t force yourself or your partner to remember all of the information.  You have enough stress, take notes and refer back to them.  Using a calendar is also vital for many people.  Put any medications, treatments, or appointments on a calendar; especially if you can add reminders.  It doesn’t hurt to have this information in multiple places.  This information can be very important to keep somewhere so you can refer to it later in life.
4. Slow and steady.  The whole process of infertility treatment can move much more slowly than many people expect it to.  Many times there is extensive testing that happens prior to any medical interventions for fertility.  Just note that this is a common experience and that patience is required.
5. Find support.  Talk with your partner and decide who you are comfortable talking with and how much you’re both comfortable sharing.  Not everyone is able to be supportive in the ways that you need, so consider if you think someone is capable before you open up to them.  This support doesn’t always come in the most likely places, such as close friends or family.  Sometimes it can come from unexpected areas.  If you or your partner are not comfortable sharing with others in your lives, it may be beneficial to seek out a professional to talk to or find a supportive community online.  You are not alone.
6. Be gentle with yourself.  No one chooses infertility treatments because it’s a fun time.  No one wants this.  You are here and the only way to get to the other side is through it, but it’s important to be gentle with yourself on this journey.  The infertility process can take a toll on our mental, emotional, financial, and physical resources.  Allow yourself to be aware of what you need and to be nice to yourself about it.
7. Find what helps you cope.  What can you think of that makes getting through the day a little easier?  What makes you feel happy?  From the small everyday things to the once in a while things, consider what helps you feel better.  If you feel like you’re not sure where to start, consider looking through the list below for suggestions (Covington & Burns, 2006).  You may choose to do only a few or all of them, it’s up to you and how you feel.

• Listen/watch relaxation videos or audio.  (I recommend Headspace: Unwind Your Mind which is an interactive video on Netflix to start.)
• Take treatment holidays.
• Learn and use self-hypnosis or guided imagery.
• Engage in healthy amounts of exercise and/or massage (as directed by your doctor).
• Eat nutritious and balanced meals.
• Abstain from alcohol, tobacco/vaping, or other recreational drugs.
• Cut down on caffeine.
• Sleep 7-9 hours per night.
• Use relaxation music before or during medical procedures.
• Reduce stressors in other areas, as much as possible.
• Find and engage in activities that you enjoy.
• Seek information on coping with stress from infertility through books, blogs, or other knowledgeable sources.
• Engage in with your spirituality.
• Talk with your support system.
• Go out with loved ones and do something enjoyable.
• Learn and practice meditation, progressive muscle relaxation, or other appropriate relaxation techniques.
• Do some yoga.
• Do something or watch something that makes you laugh.  Laughter is good for you.
• Spend time with your pet or with animals.
• Spend time in nature (gardening, hiking, visiting a park).
• Volunteer somewhere that is meaningful to you and that you will have time to engage with.
• Do something for yourself every day.
• Take frequent days/weekends to relax and enjoy life and your partner.
• Create a budget for finances, as this can help from feeling overwhelmed financially.
• Notice how your body reacts to stress and find what works for reducing that stress.
• Accept that there are some things that you cannot control.  You are only human and you can only do so much.  The rest is out of your hands.

References:
The list above has been edited for clarification and brevity. It is originally sourced from Infertility Counseling: A Comprehensive Handbook for Clinicians, Second Edition, by Sharon N. Covington & Linda Hammer Burns, found on page 187.

First, I want to say, Congratulations! Completing your college degree is an amazing accomplishment. In addition to the regular stressors of getting through college, you managed to do so in the middle of a pandemic! Give yourself credit for the result of your hard work and dedication. 
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As someone who regularly works with college students, my guess is that you are experiencing a mixture of emotions in light of your graduation. Excitement, pride, fear, and sadness tend to top the list. It is common to experience all of these emotions! While people are congratulating you and patting you on the back, you may be worrying about what to do next or whether you will get a job.

​Here are some encouraging statistics for graduates. As Thier (2022) summarizes in Fortune, every year Monster produces a “State of the Graduate” report which provides information on the current job market. According to the latest report, companies will hire 26.6% more college graduates from 2022 than in 2021. Additionally, 72% of employers have increased entry-level salaries in the last 12 months. While many job-seekers assume the employer has the upper hand, 57% of hiring managers indicated that job candidates have the power. Currently, it is estimated to take an average of 4 weeks to fill an entry-level role. This has increased 57% since 2019. Whether you already have a career plan or you are in the process of figuring out your next step, here are some things to keep in mind. 

• Career indecision may be more common than you think. It is estimated that anywhere from 10-30 percent of college students should be classified as “undecided” (IResearchNet). Many consider career indecision a normative phase that is closely related to an individual’s age and education level. This experience may extend beyond graduation. 
• For those of you who are still feeling undecided, The Occupational Outlook Handbook located at www.bls.gov is an excellent resource. 
• Limit support or advice-seeking to a few trusted family members or friends. Without meaning to, many people may project their own fears and insecurities when giving career advice. I found that when I told people I wanted to be a psychologist, the common response I received was how much time and money it would take to make it happen. 
• Networking is important. Consider creating a profile on a professional networking site such as LinkedIn. You can gain a lot of information about different career avenues and the qualifications that are needed. You might also try contacting someone to ask whether they would be willing to answer questions about their profession. There are people who enjoy mentoring young professionals in their field.
• It’s great to dream big and to try to find a career that feels like your life’s purpose. However, not everyone ends up in a job for which they are passionate. What might be more realistic is to find a job that feels manageable and allows you time and resources to pursue hobbies, relationships, or volunteer work that makes you feel inspired. Do the best you can with the opportunities that present themselves now and this may lead to a job that feels more meaningful down the road. 
• Remember that your goals and aspirations may change over time as you gain new experiences. Allow yourself grace and flexibility as you continue to learn and grow. 
• Look for organizations that align with your goals and values. This will impact the workplace culture and could make the difference between a job that feels manageable and one that does not. 
• Do your homework on companies before interviewing. It helps to demonstrate specific reasons you are excited to work for that particular company. 
• No matter how certain a job offer may seem, never assume you have the job until you officially get the offer! 
• After an interview, jot down specific topics that were discussed. Write a thank you card or email that you can send promptly after you’ve finished your interview. Include some of these specific items. This can help keep you in the employer’s mind. 
• Lastly, mindfulness can be helpful with life transitions. Try to focus on the present moment as you graduate or celebrate accomplishments with family and friends. I still remember my last day at my undergrad school. I took one last long jog around campus and allowed myself to think about many of my positive experiences. It is a memory I enjoy to this day. 

References: 

Bring on Gen Z: Hiring the Newest Workers. Monster. https://media.monster.com/marketing/2022/US_BringOnGenZ.pdf 

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, OOH FAQs, at https://www.bls.gov/ooh/about/ooh-faqs.htm 

Career Indecision. Career Research. https://career.iresearchnet.com 

Their, J. (2022, April 26). 2022 grads are set to outlearn last year’s cohort-and the year before that. Fortune. https://fortune.com/2022/04/26/2022-grads-set-to-outearn-last-years-cohort/

May 4th is World Postpartum/Maternal Mental Health Day; therefore, I felt it is important to shed light on this area. 1 in 5 new mothers and 1 in 3 mother's of color will experience to some symptoms of Perinatal Anxiety or Depression. It is also important to mention that approximately 10% of fathers struggle with postpartum symptoms as well.

To start I will briefly explain what Postpartum Depression (PPD) and Postpartum Anxiety look like. Anxiety is something that causes avoidance as it provokes a flight response. When you become anxious you may notice that your heart begins to race, your muscles tense, you may feel sweaty and/or faint. PPD is sometimes mistaken for what people call the “baby blues.” However, the symptoms for  PPD are more intense, last much longer, and may interfere with a parents ability to care for their baby. PPD symptoms can present during pregnancy, but most often occur within the first couple of months after birth. Some symptoms of PPD include but, are not limited to:  depressed mood, mood swings, withdrawing from family and friends, thoughts of harming oneself, difficulty bonding with your baby, intense irritability, and/or intense anger/agitation. 
  
As I mentioned above, symptoms can appear at any point during pregnancy as well as up to the first year after childbirth. An Acronym that might be helpful to remember in combating and coping with Postpartum Anxiety and Depression is SNOWBALL. I know, you're probably thinking what?!, But hang with me here, as this word can be important to remember when taking care of maternal mental health. 
 
Sleep- It is important that new moms get enough rest. There are a multitude of negative consequences associated with not getting enough sleep, some of which include difficulty thinking clearly and low distress tolerance.
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Nutrition - Consuming foods that are not only healthy but that will also promote a speedy recovery is extremely important, and more so if breastfeeding.

Omega 3 - Research has shown that consuming fish oils may help reduce anxiety and depression in new moms. 

Walking - Getting out for a short walk can be incredibly beneficial.

Baby Breaks - It important to make sure that new parents take time away from baby if at all possible. Whether it be a trip solo or with our partners to go grocery shopping, taking time to visit with family or friends, or engaging in self-care activities such as getting hair or nails done. 

Adult Time - Making sure we pencil in quality time with other adults can be a protective activity.

Liquids - It is important to make sure we are drinking enough water daily. This is especially true if a new mom is breastfeeding, as this will help compensate for the water their body's needs in order to create breastmilk.

Laughter - It is important to remember that we need to find humor in situations and cut yourself a break.
 
References:
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https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617
 
https://www.mindfulmamasclub.com/bloghub/postpartum-anxiety-is-real-carina-devi