Wellness Matters Webinar - What to Expect When You're Not Expecting: Managing Infertility

This Wellness Matters session, What to Expect When You’re Not Expecting: Managing Infertility, offers a compassionate and honest exploration of the emotional realities of infertility and pregnancy loss. Drawing from both professional training and lived experience, Megan Farnel creates space to speak openly about the often unspoken aspects of this journey, including grief, uncertainty, relational strain, and the impact on identity and community. This talk invites participants to better understand the complexity of infertility, feel less alone in their experience, and consider ways to navigate this path with greater self-compassion, connection, and support.

Facilitator: Megan Farnel

• What is infertility, and who can it affect?

  Infertility is more than just not getting pregnant after a certain amount of time. It can also include needing medical support to build a family, whether as an individual or with a partner. It can affect people of many different identities and situations and is not just a women’s issue.

• Why is infertility so emotionally difficult?

  Infertility can affect nearly every part of life, including mental health, identity, relationships, and future plans. People may experience grief, shame, anger, jealousy, anxiety, or depression, often while feeling isolated or misunderstood.

• How can infertility affect relationships and daily life?

  Infertility can place strain on partners, intimacy, friendships, family relationships, and day-to-day routines. Treatment can also take a physical toll, and the emotional burden often spills into work, social life, and a person’s sense of self.

• What can help when coping with infertility?

  Helpful strategies can include recognizing and validating grief, practicing self-compassion, setting boundaries, finding safe people to talk to, and seeking support from a counselor, support group, or infertility-informed care provider.

Watch the video

Transcript

Good evening and welcome to our wellness matters talk this evening with Megan Farnell. What to expect when you're not expecting managing infertility. My name is Nicole Immigrant. I'm the director of River's Edge Counselling Centre and I'm just going to give a brief introduction to Megan and then turn it over to her. Megan Farnell is a counseling practicum student whose path to River's Edge has been a winding one, including an MA in English literature as well as experience in teaching and curriculum development. Throughout all of it, a love story has remained at the heart of her work. Megan believes deeply in the powerful ways that sharing our stories can foster healing and connection, and she is honored to sit alongside clients as they make sense of their own experiences. Her interest in reproductive mental health is shaped in part by her own experiences with infertility and pregnancy loss, which have given her a deep appreciation for the complexity and weight of these journeys. She is especially passionate about supporting individuals as they navigate these challenges with care, compassion, and respect for the uniqueness of their stories. We feel really fortunate to have Megan on the River's Edge team this year, and I'm excited for her presentation. I'm going to turn it over to you, Megan.

Thanks, Nicole. All right. So, thanks for bearing with us while we sorted that out and welcome. I'm really grateful that that you're all here tonight.

I'm really thrilled to welcome you to to this talk and I'm very proud of the title. I feel like one of the things about the infertility community is that like we know funny stuff to call things. So, I felt like there was a lot of weight on the title and I'm very happy with it.

So a little bit more about me just in case you're not like sick of hearing about me.

I did want to give you a little bit of an introduction to myself kind of both personally and professionally.

I would normally stick much more just to the professional side of things, but one of the things about the infertility community kind of as a whole is that we tend to really like to know who's talking to us and what their kind of motives and their stake is to just to kind of know where people are coming from.

So some things to know about me personally, are that I have been there. Between my partner and myself, we've experienced both pregnancy loss and infertility. So that has included multiple rounds of IUIs and then IVF and numerous miscarriages including a second trimester loss. I have lived the special kind of misery that is the true weight. I have refreshed my Alberta Health app waiting for the results of blood draws. I've lost friends as part of this journey, which can be really common and is something that we'll talk about, I've devoted a lot of kind of every kind of resource you can imagine to trying to grow my family. We were lucky enough and there is a lot of luck involved in this - to end our journey with two living children.

But I was really really changed by this experience and I felt like I needed to do something with this weird collection of knowledge and insights that I had gained so that hopefully it was a little bit easier for the next person and the next person. So that kind of sparked some changes in my life and initially my aim was to gain certification as a fertility doula and I was fortunate enough to do so through Doula School Canada. But the more that I worked with families, the more that I saw statistics about how many people end up stopping treatment, not because of the financial burden of it, which is often the thing that is cited the most, but because of the toll that it takes on you as a person. the more that I became invested not just in making sure that people got pregnant but that they were okay regardless of the outcome because I couldn't guarantee them any specific outcome. Nobody can.

But what I really wanted was to just make sure that I could put them in the best possible position to be okay regardless of that outcome. And so here I am completing u my my master's of arts and counseling psychology. I don't only work with folks struggling with fertility. But it is a very special passion of mine, something very dear to my heart, and something that I'm really thrilled to get to chat with you about today. So, let's go. So, the first thing that we want to do, I mean, I'm an English person. I want to define the term, right? Probably not a huge surprise. so, what do we mean when we say infertility? The traditional definition, the one that you're going to hear still through a lot of major health organizations, is cisgender man plus cisgender woman trying to conceive via unprotected sex for 12 months or 6 months if the woman is over 35 and they're not successful. That is the definition that is kind of still used for the most part.

and that certainly captures what infertility looks like for some people. But the definition that I tend to really prefer and that I got so excited when it came out, you get excited about weird stuff when you work in this field. But I got very excited about this one. Um came from the American Society for reproductive medicine. And in 2023, they introduced an expanded definition of the term infertility. And you're seeing it on the screen in front of you, right? So a disease, condition, or status characterized by any of the following. The inability to succeed or to sorry to achieve a successful pregnancy based on a patient's medical, sexual and reproductive history, age, physical findings, diagnostic testing, or any combination of these factors.

And or the need for medical intervention including but not limited to the use of donor gametes or donor embryos in order to succeed to achieve a successful pregnancy either as an individual or with a partner. Granted, that's a lot longer. But what I love about this definition is that it's a lot more inclusive, right? It's capturing you know the experiences of 2SLGBTQIA+ folks is it is capturing what it is like to try to grow a family as an unpartnered person or as someone with a specific medical condition. It's capturing, you know, even something like HIV discordant couples, right? All of these populations who cannot conceive or who are going to struggle to succeed to conceive, sorry, succeed and conceiver are words that are very close together and apparently I'm mixing them up tonight.

But who cannot conceive without medical assistance or who struggle to do so. So that's the definition of the term that that I tend to work with and prefer.

Another definitional piece that I always like to add, get up on my soap box a little bit about this one, is that infertility is not just a women's issue, which is still sometimes a common attitude that that people have in heterosexual relationships. Typically, infertility is caused roughly 25% of the time. by factors related to the partner with internal reproductive organs, another 25% of the time by the partner with external reproductive organs, and the rest is that either combined factors, so both both partners are involved, or it's unexplained. No one quite knows what's going on. So, this is a topic that doesn't just affect people of all gender identities. It's one that is just tied to the overall health and wellness of many members of the population. So it's just a health indicator. It's not just a gendered thing.

It's not tied to just one type of person. Why is it important then? Why are we going to talk about infertility? Why does this matter? Right? What's the sort of purpose of this talk? Why are we here? There's a few reasons.

It's more common infertility than a lot of people think. Approximately one in six couples is the current figure are going to be impacted by infertility. And if you think about that expanded definition that I just offered to you a couple of slides ago, that one in six figure is almost certainly quite conservative because it is based on on that more limited definition of what counts as infertility. Infertility rates are also going up pretty substantially. There's all kinds of reasons for this. folks are tending to have kids later in life.

there's environmental factors going on that do impact reproductive health. Really, the causes could be like a whole separate kind of talk.

But for our purposes, what's important is that more and more people are either experiencing infertility directly or they're trying to support somebody who's going through this. So, there is a real urgency to understanding what this experience looks and feels like. Infertility is also still stigmatized. We talk more about it than we used to and that is fantastic. Because it used to be considered a super kind of private matter that no one was allowed to talk about or acknowledge in public.

That has started to shift, but there is still a lot of stigma and shame related to infertility. And one of the things that I've really noticed in my capacity as a fertility doula is that that has been made worse in the last couple of years by the ways that things like assisted reproductive technologies like IVF have kind of gotten really intensely politicized. That's in some ways brought that stigma back up again.

Ultimately it is my very firm belief that it is impossible or at least exponentially harder to heal from infertility. And I don't just mean have a baby or a pregnancy. I also mean recover from the myriad of effects that we're going to explore and chat about. It's so much harder to do that when the topic is something that's shrouded in secrecy and shame and misinformation. So that is a big part of why these conversations are just so important. And the last reason I'm going to share right is that infertility impacts every aspect of life.

It's often referred to in research as a biocschosocial crisis. Which just means if we break it down right the bio it impacts the body that's the bio. It impacts the mind that's the psycho. And it impacts our relationships that's the social. Right? If that sounds like a lot to take on on your own, it is. I agree. So we're going to work together for the next half hour or so to kind of identify what's happening when someone's going through infertility and how to help. All right. So, so far we've established what infertility is and why we should care about it, why we should talk about it. So, now we're going to start digging into, you know, what this experience is actually like. And we're going to start with some of the mental and emotional challenges that are involved in dealing with infertility. The first one is grief. Grief is a really really big one in infertility. What are people breathing? The most common one, the one that probably is coming to your mind right now is loss, right? So many many individuals who are struggling with infertility have experienced some form of loss. Whether that's miscarriage, still birth, embryo loss, there's all kinds of things that can that can happen in terms of loss as part of this journey. That's what we might think of.

But there are so many other ways that grief can show up during a struggle with infertility. Right? A person who is going through infertility might be grieving the journey to parenthood that they thought they were going to have, the self that they were before infertility, their identity as a parent, dreams and hopes that they had for the future, relationships with friends or family, and the view that they had of the world before infertility. Again, it can touch so many aspects of our life. And because that's the case, we can end up grieving a lot of aspects of life that don't feel the same anymore. That's not even a comprehensive list, by the way, not to be frightening.

But part of the reason I wanted to kind of name some of these sources of grief and give us an opportunity to just kind of sit here and spend time with them is that the grief that is associated with infertility is often something that is called disenfranchised grief. meaning that it's a form of loss that doesn't tend to get the same kinds of social recognition that we give to other losses.

So on top of the fact that people who are dealing with infertility are grieving, they often feel like that grief is completely invisible to the people around them. Sometimes it even feels like it's being actively dismissed, right? So think about comments like, "Oh, you can try again. At least you can get pregnant. Just think positive. Or my personal favorite, have you tried, right? Folks experiencing this also lack the social supports that we might associate with other forms of loss, right? So it can be rare for instance for people to have the opportunity to take time off work after a miscarriage. It can be really hard to try to persuade a medical practitioner to do any kind of investigation until you've had three or more losses. So this disenfranchisement that I'm talking about is not just a kind of personal or interpersonal thing. It's also a structural something that plays out at the structural level and that impacts people's lives in really kind of material ways. Right? So, a huge part of managing this grief is therefore to kind of re-enfranchise it, to take it seriously, to give it space and time to be recognized.

We'll talk a little bit later about what that can look like, but I will kind of plant that seed now. for now I wanted to spend some time on other emotional reactions that can come up with infertility because while grief is a big one, it's definitely not the only one. Infertility can bring up super intense feelings of anger. Anger that you know your intended timeline for your life is so far off track. Anger that you are doing all the right things to try to build your family and it's not working. Anger that it doesn't feel like your doctor is taking you seriously or communicating with you as clearly and compassionately as they might about next steps with anger. I want to note two things. First, it is so legitimate to be angry about this process.

especially for people who identify as women, there can be this tendency to kind of avoid or repress anger.

And while we certainly don't want to be sort of consumed forever with rage,

I do want to make a case for the value of letting yourself be angry. And honestly in this journey anger can be kind of handy because anger can also be sometimes what is called an organizing emotion which just is a fancy way to say it can make you do stuff. So in the example of the doctor that I gave, right? Being angry might be the thing that drives you to advocate for yourself with that doctor and have hard conversations where you kind of make a case for what you want and what you need in this journey and try to you know be more assertive about making sure that that medical practitioner is helping you meet those needs. Right? Anger can also be what is called a protective emotion. essentially kind of shielding some of our softer, squishier feelings that are underneath it that we might not be able to face often because they make us feel too vulnerable in one way or another. So with infertility, these might be feelings like jealousy. So this is a really common one with infertility, right? It's hard to see other people growing their families while we're trying so hard and not getting there. Especially if it seems like you know that person is not having to work very hard, right? That is hard and it's a hard feeling to accept. Especially if the person that or the people that you are jealous of are close friends, if they're loved ones, or in my case, if they're Beyonce. Yes, that's right. My slightly ridiculous experience with jealousy and infertility is that briefly Beyonce and I were pregnant at the same time. And even though I like Beyonce, but I've never felt like a deep soul connection to her music, I found this very meaningful.

So when she went on to have a successful pregnancy resulting in twins and we experienced a loss, I remember feeling just like irrational rage about this outcome. And jealousy can feel like a really ugly emotion, right? Because Yeah, it just it does. It feels ugly. It can feel bad. It's not something that we often kind of think about wanting to experience. But the thing to remember with jealousy is that we're not actually wishing other people didn't get to grow their families, right? I was not actually wishing any kind of ill beyond.

Which is good on a number of levels, including the fact that this is being recorded and I don't want the beehive coming after me. But that jealousy right that's coming from this deep sense of yearning that I had that was unfulfilled and that many people including yes Beyonce they got to have that thing I wanted. It's a hard feeling to cope with. Another one that can come up is feelings of betrayal. Infertility can make us feel betrayed by our own bodies. And especially if you've never sort of had cause to doubt your body or its abilities, this can be a really hard one to encounter. And it can even lead to, you know, negative feelings about our bodies or a sense of real disconnection where our body doesn't feel like it's ours anymore or like it's something that we recognize in the same way as before.

Infertility can also bring up some issues around gender.

for a lot of people, their sense of, you know, what it means to be a man, what it means to be a woman, however they identify, that's often going to be tied in some way to ideas about fertility. So, not being able to conceive can really impact this aspect of how how they're viewing themselves and how they feel like they're viewed by others as well. kind of in the same light.

Our cultural identity can be impacted. Right? I am speaking in a Canadian context, but one of the things that I love and value so much about being here and being Canadian is that we are not a monoculture. People are coming to the infertility journey with different ethnic and cultural identities. And these can really influence, you know, how they might respond to and understand the challenge of infertility. For example, some groups or communities might have really strongly held beliefs about whether or not it's acceptable to make use of assisted reproductive technologies.

So that can kick up a lot of intense feelings for people who are trying to navigate making that decision for themselves and their families while that's the sort of cultural context that they're working from. kind of the undercurrent of a lot of these pieces. And I think by far the biggest thing that anger tends to be protecting us from when we're talking about infertility is shame for all kinds of reasons. Because of stigma, because we often experience infertility as a kind of personal failure, because it's wrapped up in all these things that we just talked about like our sense of embodied and gendered and cultural and relational identities. Infertility brings up a ton of shame. I would actually venture to say that I've never encountered anyone who has struggled with infertility who has not at some point in some way had to wrestle with shame. So, this is a big one that we want to be kind of thinking and talking about when we're preparing or when we're in the midst of this journey and trying to figure out how to manage. All right.

So I wanted to spend a little bit of time upfront on some of the maybe less expected or understood emotional responses to infertility.

But there are also two kind of major and more widely known reactions that I still do want to kind of discuss and note. So the first is anxiety.

As I said on the slide, infertility for me felt a lot like just a high stakes game of chicken. Almost everything about the experience is designed to like promote anxiety. There's so much waiting. There's so much uncertainty, so much that is completely out of your control. You don't know when or if there's going to be a positive pregnancy test. And that impacts everything from, you know, whether or not you take a vacation and where you go to what your financial situation is going to look like and how you kind of prioritize and budget to, you know, whether or not you sign a new lease on your apartment or take the chance and move into a house that might have a lot more space than you need. So that's anxiety. The other kind of really common emotional response is of course kind of depression or depressive symptoms, right? So that's things like our lowered mood, our decreased motivation, those reduced feelings of kind of pleasure and joy and interest in doing things that used to make us feel good. Again, this makes a lot of sense. No one who's been through infertility in my experience is surprised that depression is something that comes up because it's hard to feel pleasure and joy and to find those opportunities when it feels like you're fighting for your life and for the life of the family that you envisioned, right? All right.

I also wanted to note, I'll get up on my high horse again, that one thing that makes anxiety and depression really hard

In the context of infertility is that sometimes people will tell you that anxiety and depression make treatment outcomes worse, which first of all, even if that were true,

even if evidence supported this, how is it helpful to share that and to kind of make people feel worse about the way that they're feeling as part of this journey.

But second, there actually is no conclusive evidence that this is the case. And actually, the study that I've cited there for you on the slide seems to indicate the reverse. It seems to indicate that you are not infertile because you're anxious or depressed. You are anxious or depressed because you're struggling with infertility. That doesn't mean that there's nothing you can do to kind of support yourself or try to reduce these experiences. But the idea that like just relaxing or cheering up is going to mean that you magically get pregnant or are in a position to to grow your family.

That tends to intensify these feelings. It doesn't make them better. We feel worse when someone tells us to just cheer up, right? And it has, in my opinion, that advice. It has a lot more to do with making other people comfortable, right? versus actually changing any of these feelings. All right, I know this talk has been a downer so far. I promise that we are getting we're getting to some hope.

But first, let's talk about more things that are hard. You know what else is hard? Being a body going through infertility. That's hard. So the emotional aspects of infertility are important. But they're also not the only thing to consider, right? Infertility takes a tremendous toll on the body. So if a couple is, you know, undergoing assisted reproductive tech of any kind, this might involve things like hormone treatment, injections, procedures like egg retrievalss, intraunerate insemination or IUIs, or embryo transfers. You can wind up covered in bruises, struggling to regulate your emotions through really intense hormone surges, preparing for and recovering from a surgical procedure, all for a cycle that's unsuccessful, right? And all of this can also either provoke or activate medical trauma, right? So for instance, individuals who struggle with needles, right? The frequent injections that can be involved in some of these forms of treatment can be tremendously difficult to cope with, especially again if the provider is not trauma-informed or compassionate in their approach. And another physical aspect of infertility is that a lot of folks will end up making changes to their kind of physical habits and routines, right? They might exercise more. They might try to eliminate or increase intake of particular foods. they might start taking a lot of vitamins or supplements or using acupuncture or other holistic treatments. None of these are an inherently bad thing of course.

And there is evidence supporting the value of certain nutritional movement-based and holistic changes. But but the thing that sometimes happens is that because there are so many other aspects of this journey that are out of our control, the emphasis in this area can become super super intense. So all of a sudden, you know, someone's diet has completely changed. And they're maybe even leaning in the direction of, you know, being too restrictive. They're maybe leaning in the direction of overexercising.

Kind of everything about their body, what they're putting into it, what they're doing with it, everything has changed. And especially if all these changes are happening at once, that can place actually a tremendous amount of stress on the body, right? Not to mention the kind of emotional stress that you start to feel if it seems like the future of whether or not you have a family or not depends on whether you eat this cookie. It's a big feeling. It's a lot to put on a cookie and it's a lot to put on yourself. The last kind of set of challenges that I wanted to talk about before we get to the what do we do about all of this is the relational aspect because we've been talking so far primarily about you know how infertility is going to affect an individual. But fertility is also something that even if we're talking about someone who's going through it not as part of a couple it's still going to impact that person's relationships with others. So for people who are going undergoing infertility as part of a couple we know that infertility places a tremendous strain on relationships especially when couples don't end up with a successful outcome. Rates of divorce and separation really skyrocket in those situations. So I want to kind of unpack why that is.

Obviously there's the huge factor of stress, right? And the way that any form of stress can kind of expose or worsen or weaken, you know, any existing sort of cracks or or issues in a relationship. There can also be a very negative impact on intimacy, which is one aspect of, you know, how we nurture our relationships with our partners. So for instance, you know, if sex is becoming not an act of love, but or attraction, but something that's kind of primarily dictated by a carefully managed and pretty unforgiving schedule, it gets a lot less fun. One thing that I've even seen and commented on in the past is that for some infertility starts to make the very concept of enthusiastic consent a little bit murkier. And even for those not trying to conceive via intercourse things like hormone treatments and other kinds of procedures can very much impact you know one's level of kind of desire for an interest in intimacy. I also want to note too that another challenge that I see a lot and that I wish we talked about more is the labor of infertility because it's often falling really heavily on one partner and that can produce a lot more additional strain. Right? So if it's one person who's responsible for attending all those early morning appointments for tracking cycles and medications undergoing you know physically invasive testing and procedures tracking potential symptoms while the other partner is largely uninvolved. That unevenness can produce, you know, feelings of resentment, frustration, and ultimately that that disconnection, feeling like you're not going through the same journey. And as I noted before, it's not just our relationships with our partners, if we have them that are affected. People going through infertility often withdraw. They do that because of shame, because they're depressed, because they have less time to spend with others during treatment, because people keep saying, you know, well-meaning but kind of insensitive things that make it hard to be around them. There's all kinds of reasons, but it does tend to happen. And sometimes others are going to be the ones pulling away from you, right? We as a culture are not always great about sitting with the feelings of others, especially grief. grief makes people really uncomfortable.

I feel like the number one thing that that people kind of hear as part of an infertility journey is some variation on the phrase I can't even imagine. But I would challenge that.

And I would, you know, if you're coming to this talk or watching the video, you know, from the role of someone trying to support others, I would ban this as much as you can from your language because you can't imagine.

We don't want to imagine because nothing scares us more than thinking about, you know, the death of a wanted child.

But we do want to kind of try to make those connections, try to make this imaginable for us if we're in that supportive role. So overall, infertility can be just a very lonely experience.

so part of what we're going to be looking at now when we're thinking about coping is thinking about how do we nurture the connections that do bring us, you know, that comfort, that security, that support. Okay, one more thing before we get there. I want to talk about men. I really, really want to talk about men. Because at the same time that, you know, I've worked to make this entire presentation pretty inclusive and general in a way that could apply to people of any gender identity, it is also important to recognize that there are aspects of infertility that are unique for men and which are under represented in both kind of research that's done about infertility and in sort of popular discussions about its effects.

so just like people who identify as women can experience infertility as kind of an assault on what it means to them to be a woman, men go through the same thing. Masculinity has long been associated with things like verility and the responsibility of carrying on the family name, all of these kinds of things, right? So especially research has found that when there are male factors involved in the causes of infertility, this often leaves men feeling like they are really failing to live up to the kind of gendered expectations in their in their kind of society. Right? These feelings also tend to intensify when they're looking at potentially not sharing a genetic relationship with a future child. you know, in discussions about using donor gametes, surrogacy, adoption, that kind of thing, those feelings get really intense. Emotionally,

masculinity has also kind of come with these expectations of being a protector, a source of strength,

and comfort when others are struggling. And because this is still an expectation that a lot of men have of themselves, there can be a tendency for men to kind of neglect or repress their own pain as part of this infertility journey. And this is made worse by the fact that people often don't ask men how they're doing. This happens not only at the level of like friends or family who might reach out to a woman but not neglect to kind of check in with her male partner about how he's doing. It also takes place again at that structural level. Men report that they're frequently left out of conversations being had with care providers about treatment for instance. So there's overall in moving forward what we really want to do is kind of be thoughtful and conscious in expanding our view of who infertility affects and what those effects might look like. Okay. All right. Let's talk about coping because that was a lot of really dire sounding stuff and I get that and I did consider a kind of different organization to the presentation to sort of sprinkle the hope in throughout.

but I ended up deciding against that in part because it felt really important to kind of validate and name and sit with those negative aspects of the experience to acknowledge that they're real and model the fact that we can sit with them and make space for them without drowning in them. Okay. But yes, there is hope to be found here.

and we're going to spend the entire rest of this talk

kind of discussing things that people going through infertility

can do when they run up against some of these challenges.

so let's talk about grief first. I kind of hinted about this already, but a huge part of what it looks like

to process grief related to infertility is that re-enfranchising piece, right? So we want to give it that recognition and that validation. So that can look like just acknowledging the loss and doing it without comparing is such a big thing, right? So going from well, it was only the first trimester to just this hurts. I'm devastated. This can also look like creating some personalized rituals around grief. So if you've had losses, you might have already done some of these things before, right? but marking significant dates, you know, a potential due date.

the date of when you learned about the loss.

folks often like to plant a tree or have some kind of like growing thing symbolizing their their loss. And there are also some meaningful dates within the community that you can kind of mark and take part in.

so National Infertility Awareness Week as well as the International Wave of Flighter are just a couple of examples of those. And then we also want to kind of express and externalize grief in some way. That might look like talking with other people. But that's not the only option, especially if it doesn't feel like right now you have someone who's, you know, safe that you can chat with about this. So it can also take the forms of things like journaling or those creative outlets. It's just in some ways being able to kind of express this pain is is really key to kind of being able to move forward. We also got to think about how to deal with that really pesky shame that keeps wanting to show up.

empathy and self-compassion are the biggest kind of antidotes to shame. Empathy is something that people tend to be familiar with. So, I'm going to skip right to the self-compassion piece.

self-compassion essentially involves kind of regarding yourself as someone worth the same

connection and compassion that you would try to give somebody else, right? So if shame is saying something like I don't deserve to become a mother because my BMI is too high which by the way is a super super common thing that people hear from doctors and is actually not rooted in a lot of evidence. So that's part of why I chose this one. But so shame is saying that that's the shame message right there are three kind of elements to self-compassion that we can can kind of embody to try to work through that. The first one is is sort of self- kindness, right? Being kinder to ourselves versus that harsh judgment. So instead of that shame message, something like, I've been working really hard to improve my relationship with food and with movement, I also still deserve to have both nourishment and joy on this journey. So we're coming back to the cookie in some ways, right? That common humanity piece is another one because often shame makes us feel alone. So thinking about a lot of people struggle with infertility. I'm not alone. BMI is also influenced by a whole range of factors and many people struggle to make lasting sustained changes in these areas. And then the last element is just that kind of mindfulness being able to acknowledge what's happening without making our feelings either too big or too small, right?

So we don't want to repress and we also don't want to kind of make ourselves feel totally hopeless. So, this can just look like it is so painful to not have been able to grow my family. It hurts. I don't know what the future holds. And part of what I really like about this versus like affirmations, which is another kind of common approach in the community, and all the power to people who do respond to affirmations, but what I like about self-compassion is that we're not necessarily trying to put a positive spin on things. We're just kind of trying to provide a more accurate description of what's actually going on, right?

So what's the overall effect of self-compassion? Why give it so much time? in this discussion about shame, research tells us that shame helps to mediate the relation between this need for parenthood and subjective well-being. So in other words, when people have compassion towards themselves when they're going through this, they're able to situate their fertility as part of their well-being rather than the only measure of their health and their worth and their value. Okay, I realize we're getting near the time I promised I'd be talking and I lied, but I'm I will speed things up a little bit.

There's a lot of wonderful voices in self-compassion right now, but I did want to highlight Kristen Nef in part because her website which you you're seeing a screenshot of here has so many amazing free resources on them, including a bunch of guided self-compassion sort of exercises. So if you're looking for a place to start with it, I would always always start there. Another super practical form of self-compassion can just be taking some of those smaller and more manageable steps with lifestyle changes. Right? So rather than trying to like restrict entire food groups, move multiple hours a day, plus still trying to, you know, get work done and be a human, I often just encourage people to start with one thing, one thing that they want to focus on and change. And making those smaller adjustments can feel sort of counterintuitive because we want to get results as fast as we can. But at the same time, I really try to encourage people to kind of think about how to make this process sustainable. You don't know how long you're going to be on this on this ride.

so we really want you to emerge at the end of the journey, whether with a child or not, in an okay position, right? as healthy and sane and okay as you can be. All right. Relationally, we also want to think about, you know, connections with others. We can come at this a few ways. One of them is boundaries, right? I don't prescribe a sort of wholesale do or do not talk to people about your infertility because that is such a personal thing and everybody's needs are going to be different. So instead of saying do or do not talk about it, I really encourage people to think about who's safe to talk about this with, right? folks who are going to get uncomfortable, folks who are going to provoke that shame or frustration by giving, you know, uninformed advice or judgment. We don't need to be talking to them about this.

these are the folks you want to have some pretty strict boundaries with. Just because infertility can kind of make in some ways reproduction like a more public thing than we sometimes think about it, that doesn't mean that you have no right to privacy. You absolutely have a right to set these boundaries.

boundaries might also look like taking some space, you know, from friends who are pregnant, from friends who have children.

this is a hard one for some, and again, your boundaries need to be personal to you.

but if it feels really bad or activating to go to a baby shower or answer the door on a child- centric holiday like Halloween, it is okay to take that time and space for yourself. And it's also fine if things like that feel fine sometimes and terrible other times, right? And the other thing that I always like to kind of add in there is that if you yourself are pregnant and you're aware that a family member or a friend is going through infertility, don't surprise them with pregnancy announcements. If it is at all possible, reach out ahead of time, ideally by text, and let them know that you'll be sharing this and when you'll be sharing this. And that just gives them a little bit of time to process privately to maybe grieve and have some of those negative emotions so that then they can show up for you the way that they want to show up for you. Okay. All right. Other ways of finding connections, especially if you're feeling like your circle is kind of small or non-existent. I know mine certainly was. Or yeah, it was small. It was not non-existent. But there are options for reaching out and for forging connections with those who've had similar experiences. So there's a small but mighty community of folks online dealing with infertility and my experience is that they are a welcoming bunch who are really eager to share knowledge and tips to cheerlead for each other and just kind of be there and sit with you.

There are also support groups available in the area both in person and online and without being too on the nose. Counseling is also of course an option, right?

There's not sort of one recommended modality or approach that that I recommend when we're talking about infertility. So I won't say, you know, go to someone who does A, B, or C. But I will say that there are folks in the area, including myself, but certainly not limited to myself, who do provide kind of specialized support for infertility and who have a lot of that knowledge and experience.

and at least one clinic in the Edmonton area does also have an in-house psychologist that they can direct you to as well. And there's also some really great reading and resources on the topic. I've showed you a few of them here at the bottom of the slide. I told you infertility people are so good at coming up with titles. How to make love for to a plastic cup. Come on. So good. Uh, all right. How do we nurture our relationship with our partner?

we want to continue to spend meaningful time connecting with each other on topics that are not related to infertility. This one is so much harder said than done, and I can say that from experience. But truly the more it feels like your relationship is kind of consumed by fertility, the more it feels like the harder it gets to kind of weather unsuccessful attempts, right? Go on dates, support each other in pursuing shared hobbies. And maybe the biggest one, particularly those for those attempting to conceive via intercourse, make space and time for non-baby making intimacy. And that doesn't just have to mean sex. There are a lot of ways to feel kind of physically close to our partners. And especially if sex is not feeling like something that's truly kind of connecting you at certain points, that's fine. But do still try to find ways to kind of share space and time with one another that do promote that sense of connection. So we don't want to talk about it all the time, but we still need to talk about it right at the same time. So we want to check in with each other. We want to validate each other's feelings, even if we're having different feelings. And one of the things that I really wanted to highlight here is that it becomes especially important if you're starting to differ in terms of what you think next step should be. It can be really terrifying and frustrating and a million other things to realize that maybe you're reaching a point where you want different things, right? One of the most common ones given the sort of cost and time commitment of it is IVF. Partners often will will differ on whether they feel like that's an option or not. Yet at the same time as these positions are sometimes not reconcilable I do find that the big defensive reactions that they often kind of provoke right away are sometimes about whether what we're reading into what the other person is saying right so in the example that I gave about IVF right the person who doesn't want to pursue IVF might be really hurt by their partner being in favor of it because that might feel to them like their partner's choosing you know a chance at a baby over financial security or other shared goals that they used to have. So, it feels like hearing you're not important. Our life together is not worth having if it doesn't have a child in it. My role as your partner means less to me than my role as a potential parent, right? That would be hard for anybody to hear. So if we can approach these conversations as much as possible with curiosity, with less judgment, that can go a long way to kind of supporting shared understanding. Okay, going to try to wrap things up here. So for another connection that I really always try to make a brief mention of is advocacy, right? So one thing that makes infertility even harder in Alberta than in several other provinces is that almost all of the costs are out of pocket. So insurance rarely covers art. There's no provincial health coverage for IVF, which is typically going to cost around 15 to $20,000 if you're paying totally out of pocket. So especially if you have a lot of that anger floating around and you don't know what to do with it, one way you can let it organize you is by helping support others kind of going forward. So, I always suggest throwing some attention and or resources to organizations like Fertility Alberta, which is a group that is trying to increase public funding for fertility support in our province. Okay, that was a lot.

If it feels like you're coming away from this with the sense that infertility, you know, impacts everything, touches everything, you're kind of right.

but I want to stress that at the same time as we're, you know, aware of and I talked about some of these general trends or commonalities across the experiences, it's also the case that everyone's journey is specific to them. Your experience of infertility is just that it's yours. And so too should your path to coping and healing be your own and not someone else's. So, what I've provided today is very much not a guidebook or a manual for surviving infertility. Although, in some ways, man, I wish that existed. What I have hope I've been able to do instead is give you kind of a series of invitations, opportunities to better understand this journey and better understand yourself. Do whatever you like with these invitations. Hold tight and explore anything that might have resonated today. release anything that didn't with no guilt or no obligation. And one more invitation that I want to leave you with. Infertility is a series of contradictions. It is despair and its hope. It's loss and its growth. It's pain and its resilience. Rather than kind of simplifying your experience or yourself to fit someone else's version of what you might be going through, I really want to encourage you to acknowledge and even embrace those contradictions and nuances to sort of live and grieve and cope and grow in whatever ways feel truest to you. All right, so thank you again for being here tonight. whether you came because you're related to me or because you're in the thick of infertility or taking first steps to kind of understand your reproductive health or supporting someone going through this experience.

We have a saying in the infertility community that it's the worst community in the world to be part of but or the worst team in the world to be part of but we have the best team members in the world and that is very much true. So thank you for being part of the team tonight.

I really welcome any of your questions if you have them now. And I've also included my contact information on this slide as well. So if you want to reach out if you would like, you know, the references that were used for this presentation. If you want less academic resources, you could check out like some of those books. If you want to reach out, please feel free to do so.

Thank you so much, Megan. What a what a helpful presentation. I really appreciate you sharing all of your knowledge and also just out of your own lived experience too added to the richness of that and just the compassion and understanding that you bring to a topic that's dear to many people and very difficult road to walk on. Yeah.

And thanks for all the resources too. We're going to put the presentation on the website along with the video. you're welcome to share the video with others then and also to circle back to pick up some of those resources that might be helpful as well. We we have time for a few questions if there are any. So feel free to put them in the chat or the Q&A for those of you that need to leave. I want to say goodbye and thank you very much for joining us and you are always welcome to join us for a wellness matters talk. Take care.