Coping with new restrictions which have temporarily postponed fertility treatment

Written by Melissa Stephens
02 Apr

For those of you who are struggling with this news, we wanted to offer support and share advice from Melissa Stephens, fertility counsellor.

Many women and couples this week will have learnt the news from the Government’s announcement (on 25 March 2020),that non-urgent elective surgery has been temporarily suspended, which means they aren’t able to start their fertility treatment.

For those of you who are struggling with this news, we wanted to offer support and share advice from Melissa Stephens, fertility counsellor at IVFAustralia. Melissa agrees, many of the feelings women and couples are experiencing right now are feelings of grief.

We know many will be heartbroken, many will have chosen 2020 as the year to have a baby, but now their treatment has been put on hold.

Putting their hopes and dreams on hold is tough and for some it’s a feeling of sheer disbelief. Particularly for those who missed out on treatment by literally a number of days, because they were waiting for their period to start and this month it started a few days later so they weren’t able to start their treatment.

Women in their late 30s and early 40s will be particularly struggling as they are already super aware that their biological clocks are ticking. They will have heard from various sources that they need to get on with treatment soon and now they are being told to wait.

The other factor increasing anxiety is not knowing how long these restrictions will last for; it’s the uncertainty and the lack of control of the situation that is escalating anxiety.

The situation is heightened because everyone is feeling emotionally affected by the pandemic. People are worrying that they might be losing their jobs, worried about their elderly parents, worried about their own health. Every aspect of life there are feelings of uncertainty.

The feelings being experienced right now are stress, anger, feelings that they have lost control and frustration. Everyone is asking: Why is this happening now? Why is this affecting my plans?

Some people see these emotions as negative but they are real emotions and we have to see them for what they are.

If you’re feeling overwhelmed, the advice is to try and take each day as it comes, don’t think too far ahead, try and keep things in perspective as much as you can.

Make sure that you are reading factual advice, try limiting the amount of time you are watching the news and make sure your news sources are reliable.     

Make sure you are taking care of your own health, so when the time comes to restart treatment, you’ll be in a good place to do that.

Take time to work on self-care, doing things that make you feel good and reach out to other people for support whether that’s a counsellor or close friend, or family.

Be careful with letting your fears escalate, with the current uncertainly it’s really easy to let your thoughts turn to catastrophe. Try to prevent your thoughts from escalating from, ‘well if I can’t fall pregnant now I will never fall pregnant’.

It’s better to try and live in the ‘now’ and see it as a temporary situation, and know that there will be a time when you can get back to your fertility treatment plan.

I would advise keeping busy and doing tasks that you can complete such as cleaning your home, puzzles, reading books, watching movies, cooking, things that have a beginning, a middle and an end are important. They make you feel like you have more control of a situation.

Reach out to friends, make use of Facetime, this is where you should be making use of social media. Connect with people that you care about.

Meditation, mindfulness, exercise are all important; lots of gyms and yoga studios are putting their classes online so try and get involved with these.

If you’re angry, it’s ok to be angry, anger is a normal response so don’t try and ignore it. My advice, just sit with the feelings and say I’m angry and it’s ok to be angry and in time, the wave of anger will pass.

Some people find it useful to journal their feelings, especially if you are feeling overwhelmed, sometimes writing it down helps.

There are situations where I would advise reaching out for professional help and these are if you’re experiencing feelings of hopelessness; if you’re mood is consistently quite low; if you’re not motivated to do anything; you’ve lost interest in things that you normally enjoy; you don’t want to speak to anyone; you’re not eating much and you can’t kick start yourself.

Or reach out for help if you feel like you’re family and friends don’t understand.

We’re here to help any patients with support and care during this challenging time. In addition to our specialist doctors, nurses and administration staff – who are all able to talk you through any concerns related to COVID-19, our team of counsellors are here for support and advice. Contact us on 1800 111 483 to learn about video or phone consultations.

 

 

Contact

Make an enquiry

Share this article


We hope this article was informative and useful to you. If you have any questions or feedback, feel free to get in touch at info@blogivf.com.au.



Related Articles

Post mortem sperm retrieval – a matter of life and death

Further to his interview on Channel 9’s 60 minutes programme, Dr Ben Kroon of Queensland Fertility Group discusses the topic of post mortem sperm retrieval.

Thankfully for the vast majority of people, post mortem sperm retrieval will never become a reality.

It is an extremely complex and challenging area of reproductive medicine, involving retrieval of sperm after a man’s death so that it can be used by his surviving partner.

While new assisted reproductive technologies are allowing more people than ever to fall pregnant and start the family they desire, the law, at times, does not keep pace with these developments.

In Australia, the law does not specifically address the issue of retrieval and use of sperm after a man’s death. So, while a partner may be sure she knows what her partner ‘would have wanted’, without supporting legal documents explicitly stating those wishes, the question of retrieval and use of sperm is not clear.

In most cases, an urgent court order is needed to retrieve sperm. This is a problem because while the judge is coming to a decision, every hour that the sperm lies in the body after death decreases the chance of finding live sperm.

While 24 hours is the accepted time period for successful retrieval, there may still be a small chance up to 36 hours after death.  However, while retrieval might be medically successful, the court may never permit a woman to use the sperm.

I co-authored a paper, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, in which we surveyed 28 IVF clinics across Australasia to test attitudes towards posthumous sperm retrieval and use.

It appears that directors of IVF units are generally supportive of the practice, given the right circumstances, but that the lack of clear laws makes the response to requests for sperm retrieval very difficult.

Myself, and the papers co-authors, believe that ‘clear, accessible and consistent law in this area would benefit everyone involved, including the medical, legal and societal stakeholders’.

It is not only the law that needs to catch up. In the same way that people discuss organ donation, I believe that couples should discuss post mortem sperm use.

Men should consider and discuss with their partners whether they would want to father a child after their death, bearing in mind that they could not raise the child, and that the child could conceivably be raised by another man.

I need to be clear that I am not suggesting that more people should have their sperm collected and used after their death.

Personally, I wouldn’t want my sperm to be retrieved and used if I died suddenly, and my wife knows this. But, if couples don’t have the discussion and document their wishes, it is seldom clear what one would have wanted if one dies.

Have you considered discussing post mortem sperm retrieval with your partner?

Melissa Stephens
02 Apr

Children of IVF parents as healthy as those conceived spontaneously

In 2007 a local Melbourne paediatrician approached me curious about whether girls conceived through In-Vitro Fertilisation (IVF) and other Assisted Reproductive Treatments (ART) enter puberty earlier than those conceived spontaneously. With the first babies born through IVF now reaching their mid-30s, this query was my early motivation and the catalyst to initiate a study on the effects of IVF and ART on the health and wellbeing of children conceived through these technologies.

How healthy are IVF children?

This project was the largest of its kind ever attempted, worldwide.

We found that children conceived by IVF grew into healthy, normal adults when compared to children conceived spontaneously.

The collaborative study initially funded by Melbourne IVF prior to a National Health and Medical Research Council (NHMRC) grant involved researchers from Murdoch Children’s Research Institute, Monash IVF, the University of Melbourne and Monash University. Interviewing 656 mothers who used ART and their 547 young adult offspring aged between 18 and 29 years, and compared this to reports from 868 mothers and their 549 young adult offspring who were conceived spontaneously.

Self-report of their health and wellbeing for the first 18 years of life found the ART children had a normal body mass index and similar history of pubertal development to those spontaneously conceived. Educational outcomes, including tertiary admission ranked scores and completion of tertiary education, were also similar.

Were there differences in the health of IVF-conceived children?

Mothers did report a higher rate of hospitalisation, as well as a higher rate of asthma and hay fever in ART children. We found this to be in line with what we already know as a common mild condition in the whole community. The rate is not much higher at 23% of spontaneously conceived children experiencing allergies, compared to 30% of ART children.

These problems are more common in premature babies and we know a higher proportion of ART babies are born prematurely for reasons still largely unknown. Premature births may be because of the age of IVF mothers, as having a baby in your early 40s is generally harder than having a baby in your late 20s or early 30s.

ART parents might take their children to the GP more often and consequently they are diagnosed at a higher rate. We found ourselves speculating if parents of IVF-conceived children are more protective reducing their baby’s exposure to dust and dirt in turn increasing their risk factor for later allergies.

The finding of increased hospitalisations, including in the secondary school years, has not been examined in other studies to date and the reasons for hospitalisation varied, with no consistent set of conditions. Again, we wonder if this is due to parental vigilance.

What will be done to investigate further?

This study fills an important gap in our knowledge about the long term health outcomes of children conceived via IVF and ART. Our results indicate that the perceived physical, mental health, social and environmental quality of life reported by the 547 ART-conceived adults is very similar to that of their non-ART conceived peers.

We have a responsibility to continue this research and gather further clinical review in long term follow up of those conceived through IVF and other ART. Further research will evaluate their health status and follow up to determine if there are any important lifelong medical or other legacies of IVF.

What does this mean for those considering IVF?

This study provides reassurance to those requiring IVF that there are no apparent substantial negative long term health and wellbeing effects on young adults compared to those spontaneously conceived.

This study is published in Fertility and Sterility. 

Learn more about IVF in Queensland, Victoria and New South Wales.



 

Melissa Stephens
02 Apr

15 years of IVF patients – how have women changed?

The media is increasingly full of stories showcasing the latest 50 year old mum, or the celebrity who has undergone IVF. Even women who have used donor eggs are increasingly more comfortable discussing their medical history.

But, do these sensationalised stories really reflect the changing face of the IVF patient we see every day at our fertility clinic?

At Queensland Fertility Group Toowoomba we decided to assess the reality of these changes. In order to do this we conducted a retrospective study of 1587 women who had undergone IVF between 1998 and 2013 at our clinic in Toowoomba (based in the Darling Downs, west of Brisbane). We know that during this time there has been considerable social change, and we were interested to see how our patients may correspondingly have changed during this 15 year period.

Older women

Studies carried out by the Australian Institute of Health and Welfare informs us that the average age of women receiving treatment using their own eggs or embryos, is 36 years. We know too that over the last 20 years the average age of women giving birth has increased by 7.5%.

What did our study of 1,587 women show? The average age of women undergoing IVF treatment in Toowoomba has significantly increased by 6% - from 33 years in 1998 to 35 years in 2013.  Interestingly, the major shift has been the marked increase in the number of women aged over 39 completing treatment - which 15 years ago was just 3% and by 2013 had grown to 18%.

Rising obesity

The number of overweight and obese Australians has been gradually increasing for the past 30 years across all demographics – from wealthy, metropolitan suburbs to rural and disadvantaged communities.

An Australian Bureau of Statistics Australian Health Survey identified that between 1995 and 2011/12 the average adult woman’s weight had increased by 4kgs. The report likewise stated that in 2011/12 27% of all females aged 18 and over were overweight with a Body Mass Index (BMI) of 25 to 30.

Toowoomba is no exception to this trend. It’s therefore not surprising that the average IVF patient has become heavier. Women undergoing IVF treatment in 1998 at QFG Toowoomba had an average weight of 66kgs, and this had increased up to 77kgs by 2013. More significantly, their BMI (which also takes into account their height) moved from normal at 24 to overweight at 28 in 2013.

Single Women and Same-sex Couples

Shifts have occurred in the structure of families and as a result, we have seen a considerable increase over the past five years in single and same-sex couples accessing donor sperm to start their families.

Looking at the subset of patients where female cause was the sole reason for them having treatment, the proportion of single women and same-sex couples undergoing IVF increased from 2% in 2008 to 22% in 2013.

15 years later

Women attending our fertility clinic in 2013 are significantly older, heavier and have an increased BMI than they did in 1998. However, as women delay child bearing, by choice or circumstance, we need to ensure that there isn’t an unrealistic expectation that medical science can undo the effects of age.

What would you advise?

Unfortunately, we still cannot reverse the aging process, but we can ensure women are given the correct information to help them make informed decisions earlier. For example, the increasing use of the Anti-Mullerian Hormone (AMH) test or as it's more widely known, the egg timer test, can help a Fertility Specialist better assess a woman’s fertility and guide the direction of her fertility treatment.

Many women still remain unaware of the effect of weight on their fertility. We advise weight loss with simple lifestyle changes and, if necessary, dietician support. In addition to boosting a woman’s natural fertility, this can also have a beneficial impact on pregnancy and the health of the child.

This data was presented by Leita Fien, Fertility Nurse, Toowoomba at the 5th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2014) in conjunction with the Fertility Society of Australia Annual Conference held in Brisbane April 4-6, 2014.  Leita would like to acknowledge and thank her co-authors and colleagues Susan Lax, Julie Logan, Jeremy Osborn, and Dr John Esler, Clinical Director QFG Toowoomba.

Melissa Stephens
02 Apr

Receive our quarterly e-news with free advice from the fertility experts.