IVF and Mental Health (From Motherdom Magazine)

This is an article I wrote for Issue 3 of Motherdom Magazine. This is a publication about the mental wellbeing of parents of small children. Trigger Warning: this piece contains some potentially upsetting details if you are on your own fertility journey. Please take care when reading it. The views expressed in this piece are mine, based on my own experience.

For some women the road to motherhood was straightforward. They got pregnant without any intervention. I was not one of those women. I put in time. A lot of it. And money. And heartbreak. And anxiety. It took me 6 IUI’s (Intrauterine insemination) and 3 IVF’s (In vitro fertilisation) to become a mother to my beautiful twins. And I was one of the lucky ones.

I had to be very vigilant about my mental health on my fertility journey. It was such a harrowing experience and I suffered many setbacks, including miscarrying my first IVF pregnancy at 12 weeks. An anxious person by nature, I found that the whole process really tested my ability to keep my anxiety at bay. Several years before my fertility journey began I had done an intensive course of Cognitive Behavioral Therapy (CBT). It was truly a lifesaver and I used those techniques as much as I could in this new chapter.

What I learned through CBT is that my issue has always been “catastrophising.” I would immediately jump to the worst-case scenario in my thinking. For example, as a child, if my mum was running late to pick me up from a playdate I’d imagine that she’d been in a terrible car accident and that I would never see her again. Although CBT taught me to recognise these kinds of inaccurate and unhelpful thought patterns, whilst attempting to get pregnant I would tend to look at every failed attempt as further proof that I was never going to be a mother. It was a constant effort for me to try to identify unhelpful thoughts and to understand that worry did not equal premonition. To imagine a negative pregnancy test was not an omen that it would be so. I worked very hard to change patterns of thinking by practicing the mindful meditation I learned as part of my CBT (especially during scans and embryo transfer procedures) and looking at what was actually happening and not focusing on what I was afraid might be happening. All of that, it turned out, was great practice for pregnancy and parenthood – where the struggle continues!

Infertility is a psychological minefield. Coming to terms with the concept of needing medical intervention can be an extremely difficult thing to do. For many of us, the realisation that we cannot get pregnant naturally is devastating. And depending on the reason we need Assisted Reproductive Technology (ART) to get pregnant, the emotional toll can be even higher. I felt like I was at fault for my inability to achieve a natural, spontaneous pregnancy.

My twins are three and a half years old now and I am still so aware of how lucky I was to have them. I have been surprised to find that, even though I have come through the other side of infertility, I still notice a reflexive pang of envy when I see a pregnant belly. Every Mother’s Day has been an emotional experience for me as I reflect on all the years I yearned to be a mother but wasn’t able to be. I try to give myself permission to feel my honest feelings about it.

Like mental ill-health, infertility can be soaked in stigma. I hate the idea that needing assistance to become a mother is something to feel shame about. I’ve come full circle with this. When I was going through IVF I didn’t really tell anybody but now I’m now extremely proud of what I went through. One day I will explain to my children how much they were wanted. They’ll hear about how their father and I worked so hard to bring them into the world because we wanted to meet them and love them with all our hearts. Even though it was the toughest thing I’ve ever been through, and I still feel emotional about it at times, I now know that I will always feel present and grateful in my role as a mother because of the lessons learned during that journey. My kids are a constant reminder to me of what I was lucky enough to overcome.

I run a support group in Dubai for women who are struggling to become mothers. I can see from our membership activity that there are a lot of women who choose not to publicly disclose their infertility status. While I can certainly understand why people want to keep this information private, I wish it could be more socially acceptable. In my experience, once I started telling people that I had to have ART to get pregnant and that I had suffered a miscarriage I was astounded by how many of my friends had gone through the same thing. Each of us privately and alone. I can only image the comfort and the sense of normalcy I would have felt if I truly understood how many people I knew were going though the same thing. I don’t think I would have struggled as much with the idea that I wasn’t “good enough” or “woman enough” to have a baby. I can now see that what I endured made me exactly the kind of mother I was meant to be.

If you had to take a different path to motherhood than you thought you would, whether it be through IVF, egg or embryo donation, surrogacy, or adoption, the experience you had on the journey will end up holding so much value for you. To overcome that kind of adversity to achieve the goal of parenthood is an incredibly beautiful thing and your children are so lucky to have you.

For those of us still on the path of infertility please remember to take care of yourself in your journey. It’s so easy to focus all our attention on trying to create new life and sometimes we can forget to nurture ourselves. I would encourage you to maintain a connection to the things that make you feel happy and complete, whether it be a yoga class, a walk in nature, or a long chat with a good friend over a cup of tea. You are loved and you are always enough.

Cassie and her twins