Rescripted _Ep5_Relationship Challenges: Audio automatically transcribed by Sonix

Rescripted _Ep5_Relationship Challenges: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Kristyn Hodgdon:
Hi, I'm Kristyn Hodgdon, an IVF mom, current IVF patient, and co-founder of Rescripted.

Ali Domar:
And I'm Dr. Ali Domar, a thirty-four-year fertility industry veteran, psychologist, and expert in the mind-body relationship between stress and infertility.

Kristyn Hodgdon:
Welcome to Dear Infertility, the first-ever podcast that doubles as an advice column for those dealing with the daily stressors related to infertility and pregnancy loss.

Ali Domar:
We're here to answer your real-life questions related to the mental and emotional toll of infertility, while providing research-backed tactics and strategies for overcoming these dilemmas.

Kristyn Hodgdon:
Now, let's dive in and help you find calm on this stressful journey.

Kristyn Hodgdon:
Hi, everyone, welcome back to the Dear Infertility podcast, I'm Kristyn, your host, and I'm here with Dr. Ali Domar. Hi, Ali!

Ali Domar:
Hey, Kristyn.

Kristyn Hodgdon:
How are you?

Ali Domar:
I'm just dandy. Happy to be here with you.

Kristyn Hodgdon:
Yes. Happy to have you. So today we are going to be talking about relationship challenges, which I think is something anyone who's struggling with infertility has dealt with at some point or another. And our first community question is, as a woman, it's difficult bearing the bigger physical burden of fertility treatments. How do I avoid feeling resentment towards my husband, who complained about doing a simple semen analysis?

Ali Domar:
Oh, I only hear that one every day. I mean, it comes up with everybody, I think probably, especially if the woman is undergoing treatment because of male factor, and yes, I've had many, a male partner complain about doing his thing, and I have to say I don't have a lot of sympathy. I mean, I understand it probably is embarrassing and awkward to have to masturbate in a little room and to have to then take your little cup and hand it usually to a woman who knows what you just did. So yeah, I get that, but I also know exactly what my patients go through physically, mentally, and psychologically on a day-to-day basis. So I probably spend half my time in counseling talking about relationship issues. I think that the core concept is the way you are responding to infertility is the right way for you, and the way your partner is responding to infertility is the right way for your partner. And so you need to stop trying to get your partner to act like you and your partner need to stop getting you to act like your partner. And so, you know, in some relationships, one member wants to talk about it a lot more and the other partner doesn't want to talk about it at all, so there needs to be compromise. It does feel unfair that the physical burden of infertility falls on the female partner, however, same with pregnancy, you know, to create a baby in nature, a man has to have sex, a woman then has to be pregnant for nine months. And so nature has kind of set it up to be unfair. So it makes sense, then, that the vast majority of infertility treatment feels unfair. So I say to my female patients, OK, clearly the physical burden is going to be on you, there is nothing I, as a psychologist can do about that, you know, you're the one that needs to have the bloodwork and the ultrasounds and the injections and everything else and all. Yes, all he needs to do is to jerk off on a little cup, and that feels completely one-sided. So let's think about how can we try to even it up as much as possible? So can he deal with all the insurance company phone calls? Can he keep track of the calendar of what you need to do when= can he order the medications? Can he, whatever you don't need to do physically or psychologically, maybe ask your partner. I shouldn't say ask your partner to do. There's also, you know, there, there are ways of improving communication. You know, when you when I ask a couple, so you know, how are you guys communicating about your infertility? The female partner, if it's a heterosexual couple, will say, we never get a chance to talk about her infertility. And the male partner rolls his eyes and goes, Oh my God, it's all we ever talk about.

Kristyn Hodgdon:
Yeah.

Ali Domar:
So, you know, I suggest that they every night set aside like ten minutes where she gets to talk about her infertility and he has to just listen and vice versa. And that, that's the amount of time they spend. But they have to recognize whether it's a heterosexual couple or a same-sex couple, people are going to react to infertility in different ways and in different times. I've never in my career seen a couple who are in the same place at the same time. And I think you just have to accept that you're going to be in different places and have different reactions and try to work from there. Communication is key.

Kristyn Hodgdon:
Well, to that point, someone wrote in asking, how can my partner and I best communicate our grief and frustration without getting upset at each other?

Ali Domar:
Maybe express your grief and frustration to somebody else. You know, I think that, I had one woman in my whole career whose husband had male factor, and she said to the group, you know, if I don't get pregnant on my first IVF, so I'm going to divorce him and marry a fertile man, which I remember thinking, I think there's been twice in my whole career that I've hoped someone didn't get pregnant because I just thought that was an awful thing to say, especially to a group of people. Infertility is never anybody's fault. You know, it's really hard to make yourself infertile. I mean, yeah, you could smoke for a long time or whatever, but it's most, the vast majority of people with infertility didn't do anything to cause their infertility. And so I think blaming your partner for the infertility that the two of you are experiencing might be misplaced frustration or anger. So I'd say, either see a therapist to do a couple of sessions, a couple of counseling, independently meet your needs, you know, there are there are ways for women and their partners to, you know, have the woman join mind-body fertility, and then she, when she hears other people in the group complaining about their partners, she'll realize her partner may not be so bad. You know, in the 10 me mind-body program, we have in Boston IVF, the partners come to three of the sessions. And one of those sessions, the partners go off with a different therapist to sort of talk about how they're doing. And it's, you know, it's ninety-five percent a male partner. And once in a while, I will lead those sessions and some of the time it turns into a bitch session like, well, the men would go, oh my god, my wife, like all she talk about, is baby, baby, baby, baby, baby. She won't, you know, she won't go to barbecue, she won't do this, she won't do that, I can't stand it. But more recently, and I'd say most of the time, the men are talking about how hard this is for them and how much they are suffering because they can't have a baby, how much they are suffering seeing their wife so miserable, if it's a male factor, how insanely guilty they're feeling about what their wife has to go through to compensate for their male factor fertility and how miserable they are. But they feel they can't tell their partner how miserable they are because one of them has to be strong. And so they kind of have to pretend they're OK because otherwise they're afraid the relationship will fall apart.

Kristyn Hodgdon:
Yeah, we definitely don't see that perspective enough, so thank you for sharing that.

Ali Domar:
Yeah. I mean, guys are taught to be stoic. And I think these days, you know, when I got into the field a long time ago, you just weren't seeing distress levels in men. And the most recent research shows most men have clinical levels of anxiety, a third of them are depressed because they want to have a baby too.

Kristyn Hodgdon:
Right.

Ali Domar:
And they love their partner, and it's it's awful to see their partner be so miserable.

Kristyn Hodgdon:
Yeah, I remember my husband saying he felt so helpless because, you know, I bore the bigger physical burden and then, you know, had to go to appointments by myself and not because he didn't want to be there, but because, you know, sometimes logistically it just was hard and a lot and a lot of it fell on me.

Ali Domar:
Well, and think about COVID, you know, for, the first, I don't know how many months after clinics reopened, partners weren't allowed, you know, they were allowed to come in to do a semen sample, and that was pretty much it. And until relatively recently, a lot of partners couldn't be there for the first prenatal ultrasound. And so women were truly alone.

Kristyn Hodgdon:
Yeah. So someone wrote in, my husband and I are not on the same page emotionally after our miscarriage, do you have any suggestions?

Ali Domar:
So I would say I have never seen a couple after miscarriage be on the same page because it's just a completely different experience for them. For a woman to be pregnant and have a pregnancy loss, it's a very concrete experience. She got pregnant, she felt different, you know, her boobs hurt or she had to pee all the time or whatever, she knew she physically was pregnant. For her partner, it was completely abstract, they're told your partner is pregnant, but maybe they saw a prenatal ultrasound, but it was completely abstract. It's very hard to mourn something that doesn't feel real to you.

Kristyn Hodgdon:
Yeah. Well, after our early pregnancy loss, my husband said, I feel like it just didn't work, like I don't feel like we lost a baby, but I took a pregnancy test, it was positive, I felt pregnant. I, you know, had a lot of the same pregnancy symptoms as I had with my twins, and that went on to be successful. So it just all felt so real. And to him, it was like he was excited, but then it all happened so quickly that.

Ali Domar:
Right.

Kristyn Hodgdon:
It would just kind of a blip.

Ali Domar:
Because he was told you were pregnant, you felt different. And so it's a completely different experience. And I think expecting a partner to feel the same way you do is unreasonable because, you know, it's a theoretical loss. You know, I think until a partner, you know, sees a baby on ultrasound and might feel the baby kicking, it's really hard to mourn something that's abstract. And you know, it's just a different, it doesn't mean that your partner is not sad and it doesn't mean your partner didn't want the baby and your partner also might be really worried about you. You know, when a woman has a miscarriage, you know, she can, you know, have a lot of bleeding, and it can be kind of scary for her, and it can be really scary for the partner. And she might be physically miserable and a total psychological mess. And so the partner may be much more focused on taking care of her, then even acknowledging what their own feelings are. Isn't that the man's role is to take care of his partner? Yeah.

Kristyn Hodgdon:
So I love this question. Infertility took all of the fun out of our sex life, any tips for how to get the spark back?

Ali Domar:
Ha! So, you know, Liz Growl, who co-wrote the effort to come with me, she's actually a certified sex therapist, and so it's always interesting to talk to her about sex and infertility. Infertility can have a huge hit on one sex life because it, you know it takes the fun out of sex. People start to associate sex with failure, a lot of women then only want to have sex mid-cycle, because why bother having sex any other time? A lot of people, once they move on to IUI or IVF, why have sex at all? Because, you know, this doesn't work. And men, you know, for a lot of men, making love with their wife is the way they express their love or their affection, et cetera, and they start to feel like they're a sperm manufacturing machine. And so it's really common for people, in fact, far more common than not for people going through infertility to say this is having a real big hit on our sex life. And so there are a number of suggestions. One is, if you have this opportunity, you now have one bed for baby making sex. So that's your days, what 10 through 16 and then use a different bed for fun sex or, you know, just to take the, you know, so you don't associate the same bed with both kinds of sex. Try to think about things that really turned you on early on in your relationship. You know, maybe having sex in the kitchen or going to a hotel or things like that, you can be creative. I remember when the with the Shades of Grey books came out, my patients found those very helpful because, you know, it sort of takes you out of your own self and you can use some imagery and fantasy and it's OK, you know, I tell patients, if you guys both want to watch porn together, watch porn together, there's nothing wrong with that.

Kristyn Hodgdon:
Right.

Ali Domar:
So be creative and also think back, you know, one of the things we teach our patients in general is mindfulness. And, you know, learning to be in the moment and the way I teach mindfulness is I give each patient a Hershey's kiss and I tell them to peel and eat the kiss mindfully. And then I say, for homework, I want you to do something mindful, you know, take a shower mindfully, you know, take a walk mindfully, make a salad mindfully. And one patient years ago didn't really realize you'd have to tell the whole group what she did mindfully. But when she came back was that she had made love mindfully, and she said, you know, she and her husband at that point had been married for like five or six years, and so they had had sex thousands of times, and so they sort of knew each other's bodies. And, you know, she didn't want to say to the group was boring, but you know, you sort of got that impression. But she says that she chose to make love mindfully, which was to be in the moment and to, you know, feel and hear and smell and taste and to really focus on her sensations in that moment, and she said it was a very, very different experience for her.

Kristyn Hodgdon:
Wow, that's a really great piece of advice. I think one of the silver linings of IVF, and this might be an unpopular opinion, but is that it sort of takes the sex out of trying to conceive, which can be a hard pill to swallow at first. But then it kind of makes sex feel like less of a chore.

Ali Domar:
Yeah.

Kristyn Hodgdon:
Which is nice, because when you're doing timed intercourse and IUIs it feels like such a chore and feels like, you know, we don't want to do it, we have to do it. And so IVF can kind of take that out of the equation, which is a small silver lining.

Ali Domar:
No, I think it's not a bad thing, you know, to separate trying to get pregnant with making love. And I think that's really important. And, you know, to have sex not during mid cycle is really important. And, you know, also think back, I mean, when you first started having sex with your partner, it was really exciting and really erotic and really amazing, hopefully. And you know, you can go back to saying, oh, you know, remember, we used to do this or we used to try that or this felt good or that felt good, you know, go back to those early days.

Kristyn Hodgdon:
Absolutely. So, you know, I love to ask my favorite question of the podcast. How would you rescript the way people think about navigating relationship challenges during infertility?

Ali Domar:
There's a lot of data, or there's some data to show that people who go through infertility have lower divorce rates than people who don't.

Kristyn Hodgdon:
Wow!

Ali Domar:
And I think that for most couples, infertility is their first crisis, and it's really hard to be in a crisis with someone who's not responding the same way you are, in a sort of, the idea is, if this person loves me, we should be feeling the exact same way at the exact same time. And that's never going to happen during a crisis because you're never going to react exactly the same way as your partner. Just like the example you gave of a miscarriage. And so I think infertility can be a learning experience to teach the two of you to respect the fact that you're not going to be in the same place at the same time and hopefully will force you to learn how to communicate and express your feelings and your needs and your expectations. And I kind of feel, if you can get through infertility together as a couple, you can get through anything.

Kristyn Hodgdon:
I wholeheartedly agree with that. Well, thank you, Ali. This is so helpful and thank you all for tuning in and we'll see you next time.

Ali Domar:
Bye!

Kristyn Hodgdon:
Thank you for tuning in to this episode of Dear Infertility. We hope it helps you find calm during this incredibly stressful time. Whatever you're currently struggling with, Rescripted is here to hold your hand every step of the way. If you like today's episode and want to stay up to date on our podcast, don't forget to click Subscribe. To find this episode, show notes, resources and more, head to Rescripted.com, and be sure to join our free fertility support community while you're there.

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