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Self-Advocacy During Infertility Treatments: Claiming What You Need From Your Doctors

By Helen Adrienne, LCSW, BCD
Published in Resolve for the future and beyond, Summer 2012

Let’s get one thing straight right away: It is normal to feel intimidated in any doctor’s office, and it is normal for your IQ to drop to zero when creating the next generation becomes an ordeal.   

That being said, how do you maximize the opportunity to minimize your stress with good self-advocacy?  How can you best facilitate a dialogue with your doctor so that the complications that go with treatment get clarified so you can make informed decisions?

It will help if you can organize your thoughts according to these questions:

  • Who is this person, your doctor?
  • Who do you become in the face of adversity?
  • Self-advocacy: What do you need?

Who is your doctor?

A skilled reproductive endocrinologist (RE) with a glorious reputation may not be a good match for you in the same way that you may not have enjoyed a teacher that everyone else thought was fabulous. 

Therefore you need to scrutinize if the doctor that you have chosen is right for you.  Ask yourself:

  • Do you feel (s)he is giving you the time you deserve? 
  • Does (s)he show compassion for your concerns, fears, upsets? 
  • How available is (s)he by phone or email when questions inevitably arise in between appointments? 
  • Does (s)he provide a back-up person, perhaps a nurse, who will know your case? 
  • Does (s)he inspire confidence that you can be helped even if you do not have a clear diagnosis?  

It is important to honor yourself with a choice of a doctor with whom you feel a connection. Unfortunately, there may be practical considerations beyond your control (such as insurance, location, etc.). Where choice is limited, accepting what is possible becomes your job.

Who do you become in the face of adversity?

It is just as important to know what happens to you when you are under duress. Infertility is capable of knocking Godzilla for a loop. No matter how empowered you feel in the world, it is common to feel at a loss with the thwarting of this goal.  

Anyone’s IQ is apt to disappear if they view their doctor as an “M Deity” instead of an MD. Doctors are authorities in Assisted Reproductive Technology (ART). You are the authority on you. Think of this as an equal partnership. Consider these details:

  • Your capacity to communicate and your capacity to feel entitled to getting what you need are crucial. If you have trouble communicating and if you do not feel entitled to your doctor’s time, you are in a battle with your own history.
  • Your motivation can boost you past your internal obstacles. Your needs belong front and center; it is not your job to be worried if the doctor has time for all of your questions. Presume (s)he does. And, no, this does not make you selfish. It makes you dedicated to getting to your goal.
  • If you have difficulty getting past whatever historical experiences have left you feeling that you cannot speak your mind, seek help in learning stress-reduction techniques. Thinking things through depends upon taming down the feeling of being overwhelmed so you can find your inner strength.  

Self-advocacy: What do you need?

Of the many infertility situations that require self-advocacy, how to get your needs met with your doctor is an unavoidable prerequisite for traversing the universe of ART. Once you scrutinize your doctor and yourself, you can utilize these practical considerations:

  • Ask for handouts so that you can be educated about your physiology and the treatment protocol(s).   
  • Many people use the internet or chat rooms to get or compare information. Be careful with this. I have seen women drive themselves crazy because they cannot help but gravitate toward the worst news. Make as much sense of the information as you can with your partner or a trusted confident, but always go back to your doctor with the information you get from other sources. If (s)he debunks your intuitive sense of things, consider another opinion.
  • Do not expect to remember your questions; write them down! Same goes for the answers. You might even request permission to tape record the conversation, especially if your partner cannot be with you. 
  • There will be many decisions. Do not be afraid to buy time so that you do not commit to any treatment until you are ready.
  • The realm of ART is complicated, especially for a lay person.  Do not be afraid to ask “Why?” or “Can you explain that in another way?”. 

I have seen many women develop a stunning capacity to understand the jargon of this hi-tech science. Have faith in your capacities to rise to the occasion. You could get to surprise yourself.

It is hard to believe that you are in this situation, never mind that you have to become a scientist when everyone else barely needs to know one body part from another. One of the most challenging aspects of dealing with infertility is the need to be your own best advocate when what you most feel like doing is crawling in a hole, hoping that a magical force will replace this unwanted reality with the idyllic one of your dreams. 

Understandably you are in a hurry to resolve this nightmare.  Lily Tomlin is famous for saying, “For fast-acting relief, try slowing down.” 

Helen Adrienne, LCSW, BCD, has been in private practice since 1979. She enjoys forming therapeutic alliances with women, men and couples who are struggling with a mental, physical or circumstantial log-jam. Helen is an expert in the issue of infertility. She runs mind/body stress-reduction groups for infertility at NYU Fertility Center. Her recent book is On Fertile Ground: Healing Infertility.  Helen has authored many articles for the infertility patient which can be found on her web site, http://www.mind-body-unity.com/. She is also a blogger for Psychology Today at www.psychologytoday.com/blog/fertile-ground