Ep 90: Infertility 101
Fertility Forward Episode 90:
Struggling with infertility and trying to conceive can often feel lonely and isolating. If only there was a simple and practical guide for those on this journey. Well, now there is! Join us today for an intimate conversation about Rena Gower’s new book, Infertility 101: A Quick & Concise Guide to the Club You Never Wanted to Join, which touches on a diverse range of topics and materials that those struggling with infertility may be grappling with. In this episode, Rena shares how she channeled her personal experience into writing the book, how she hopes to destigmatize the topic of infertility by empowering those going through it to share, and why she is so wary of toxic positivity, as well as who the book was written for. She also offers some journaling prompts, practical mindfulness exercises, and resources to help you stay grounded and ease anxiety along the way. A useful tool for individuals, partners, friends, and family, Infertility 101 provides an inside look at what those on their infertility journey may be facing, so make sure to tune in today to learn more!
Rena: Hi everyone. We are Rena and Dara and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward podcast brings together advice for medical professionals, mental health specialists, wellness experts, and patients, because knowledge is power and you are your own best advocate.
Dara: Hi everyone. I'm so excited. We have a really interesting topic today. I'm actually interviewing Rena, my fellow co-host on Fertility Forward because she has just launched a book. She's written a book. It's pretty incredible. I was just telling her beforehand how in awe I am of her. It's, the book is called Infertility 101: A quick and concise guide to the club you never wanted to join. Rena; thanks for sharing with us today a little bit about this new baby of yours, so to speak.
Rena: Thanks for giving me the opportunity. And I always get a little bit uncomfortable talking about myself, so I will have to get over that and share. This was, you know, my pandemic project. When everyone else was watching Tiger King, I was writing this book at night and I'm super excited it's out there. And, you know, the, the impetus behind it was really, I just felt like, you know, I was having the same conversation over and over with people. And so it would just be, you know, more efficient to write a book with all the info. And so, you know, I just wanted to write something that would hopefully help people going through this and be a quick, easy read, not super dense, not super intense and that would be helpful both for patients as well as partners, as well as friends or family. So there's kind of something for everybody in there. And my hope was, you know, again, you read it and just have a better idea of what, you know, to expect for yourself or, you know, what a friend is going through, what a partner is going through.
Dara: Did you, like, in the back of your mind when you first started working in this field, so you were a therapist beforehand, a social worker beforehand, and then through your own personal fertility experience, this led you to this new specialty, I guess, in terms of working with a specific group of people, but was this something right from the get-go that you wanted to write? Or was this something that developed over time?
Rena: No, this totally developed over time. You know, I, as you said, you know, I was a social worker and then I went through treatment myself and spent the first year totally isolated, totally alone, and then was kind of like, okay, I'm trying to create a life and I'm no longer living one. So then I started getting very active with RESOLVE and advocacy and connecting with others and that was so helpful for me. And then after my daughter was born, I realized I wanted to stay counseling people in the field. And, you know, I blindly emailed the big New York fertility clinics and kind of pitched this role and, you know, right time, right place, Dr. Copperman was so amazing. He believed in this and the role. And so, you know, it's grown into what it is and I'm, you know, so grateful to him and RMA for believing in this and supporting it. And, you know, the book just came out of kind of both being quarantined during a pandemic and wanting to have an outlet and then sort of just feeling frustrated that I felt like I was having the same conversation a million times a day and so just wanting to write it down and be more efficient about it.
Dara: What a great outlet to write down all your thoughts and your experiences. And I love, I actually just finished a really good audible book called Maybe you should talk to someone by Lori Gottlieb and it actually reminded me of your book in many ways. She's a therapist, but she wrote it from the perspective of her being a therapist and also her being a patient. And I just love that, you know, in your book, you start off, first of all, sharing your own personal story and kind of what you experienced and the hardships that you experienced and kind of what you wanted out of it. And, also coupled from the perspectives of the patients you work with kind of, what were the common themes that you heard from you included them in the various chapters. It's great.
Rena: I'm definitely going to have to check out that book. It sounds fantastic, but you know, I think like so many therapists, many of us go into the field because of sort of needing to heal ourselves in some way. So, you know, I'm sure on some level, this book was therapeutic for me. You know, to be honest, I, when I think back, you know, I was in therapy kind of off and on when I was going through treatment, but I, myself never really worked through, you know, what really is the trauma of this. And then sort of, for me, my own story was kind of coupled with my daughter was born and then going through a divorce and kind of my life totally blowing up. And since spent a lot of time working through everything, but I don't know that I've really actually ever gone back and really, really worked through the trauma of fertility treatment just because so many other things had happened after that I needed to kind of like stop the bleeding on. But I think sure at some level it was probably therapeutic for me to write about it. And certainly that's what kind of led me to the work. I really will never forget what it was like to be in such a vulnerable position and going through something so scary. And so, you know, I can totally empathize with our patients, you know, all the time going through it. It's really scary.
Dara: Oh, totally. And you know, how lucky are your patients to receive all your insight in your knowledge, but you made a good point. I agree with you in that the work that we do, as much as we help other people and guide and support others, in a way it's also part of our healing process. And I, I specifically loved, you know, you went into many conversations, but you definitely always went back to grief and the fertility journey, no matter what it looks like, if it's short or shortish or what seems like to take forever, just that concept of loss and grief and the idea that it's a) normal and b) that it's an important thing to acknowledge.
Rena: Sure. You know, I think, and this kind of comes up a lot in my work with people, you know, when you're in therapy school, you know, whatever that is, I've done a bunch of different trainings, you know, beyond social work and psychoanalytic institutes, et cetera. But you know, you're really taught that you should be a blank slate for people and the work, you know, you're really not supposed to reveal much about yourself at all. And if somebody asks you a question, then you're supposed to process, well, why, why does it matter to you? But I've, I've really found that in this work, it really resonates with people to know that I went through treatment and it's not something that I ever bring up independently, but because it's in my bio, a lot of people will ask me about it at the beginning. And so of course, when they ask, I say, you can ask me whatever you want. I'm very open. And I find that that really resonates with people, I think, just to know, okay, you get it. You know, you're not another talking head and there's sort of, you know, we say this is the worst club with the best members, you know? And I always say, there's, you can have nothing else in common with somebody, but if you have a commonality of going through treatment or both having a loss, you know, you have that shared common bond. And it's very strong. And especially in a world, which today we're recalibrating from a pandemic and trying to figure out how to reconnect with people, having that to connect about is super powerful.
Dara: And it's interesting cause you, you mentioned it just now a little bit, but what I loved in your book, there's many forms of loss and you know, the initially people think of, okay, if they have a chemical pregnancy, a miscarriage, but the idea of the loss of control of something that we feel we have, or maybe the expectations that, you know, we can get pregnant. No problem. It's our right. And you know, when, when it doesn't come exactly the way we had intended to, that in itself is a loss. I found that was a very interesting thing that you mentioned.
Rena: Sure. Yeah. I love that you brought it up. I think that's something when I bring that up, it usually comes up with people in the first session about just intangible loss or the loss we can't see. And I think it resonates with so many people because oftentimes they don't realize that. And then when we talk about it, it makes so much sense. And so I think it's identifying that. And I think a big part of the work is being able to be authentic and be vulnerable and figure out that balance of how to share with other people that you're going through a hard time. And I think that that is hard, but I think that is what can be super therapeutic. Research shows that most people going through treatment don't share and then that same research also shows that the people that don't share have higher levels of anxiety and depression. So I do think it is quite important to share. And, and again, that was kind of, again, another driving force behind the book, which is okay, a lot of times people, they don't wanna have a conversation, you know, and if you come, if you’re counseling we’ll go through sort of how to have that conversation. How do you navigate that? But you know, the hope is, okay, you tell someone, you tell a friend or family member, well, read this book because you're gonna get a better idea of what I’m going through. Like, I don't wanna talk about it, but just give the book and then you'll at least have a better idea. And to sort of just broaden the general, you know, understanding of what someone going through treatment might be experiencing..
Dara: Well, you, you're great at providing strategies. You have a whole chapter on navigating social life, which is something that I wish I had read ahead of time when I was going through my own fertility struggles. Just like unfortunately there's natural progression of taught we get married. And often you go to an event, the next conversation amongst friends or family is, so when are you having a baby or are you pregnant yet? And I think just being able to have certain answers already prepared ahead of time, can help take away some of that stress or even just being able to open up the conversation. And, and I think as you mentioned, which I totally can understand that it can often feel like a very private topic and something that many of us, especially men, have a challenging time opening up about, but you really do help de-stigmatize, you know, this topic in that and really do emphasize the importance of being able to share and communicate and let things out.
Rena: I hope so. And I, again, that's probably, you know, again, one of my biggest regrets from my own experience, you know, I remember so many occasions where, you know, I would either not go and then me choosing not to go was causing a lot of problems in my marriage. So then I would go, but then end up crying in a bathroom because I saw somebody pregnant or someone announced that they were expecting. And it was so, so hard. And so I think it was interesting during the pandemic. A lot of people, I think actually found a lot of solace and comfort in that there were no social events, you know, or they were via zoom so people didn't have to deal with that. And it's been interesting as things have opened up, I see a lot of anxiety among my patients about going to things and sort of how to navigate that because now, you know, we're back doing things in real life. So I think it really is finding a balance between protecting yourself, but then also not isolating yourself.
Dara: Well, yeah. And I think you also have a great discussion on finding joy and finding things that excite you that is outside of the fertility process, because I, I think you mentioned something like 99% of our thoughts when we're going through infertility is usually on the process and the struggles and whatnot and really prioritizing some you time that is separate.
Rena: Oh, absolutely. Yeah. Figuring out how to make this a piece of your life and not the whole.
Dara: Which I think a lot of times we forget about that. So it's a nice reminder that it's okay and it's healthy to find other things and, but it can be tough. I, I feel like if anything, yeah. coming out of a pandemic where you're less social, I think trying to navigate something that's new can add another element of anxiety for sure.
Rena: Oh, absolutely. Yeah. It's been definitely hard for people.
Dara: The other, there's a couple other interesting chapters that I love. They're all great. But the two week wait, which is something that I definitely can relate to in terms of stress and something that I hear all the time with my patients. So explain to everyone what this two week wait period is.
Rena: Sure. Well, that's the time period between when you do your insemination and then get the beta test, the pregnancy test results. So are you pregnant? Are you not? And you know, it's that very, very stressful window of time where people don't know and they start to feel what are usually, you know, psychosomatic symptoms, cramping, or what have you. And you know, just really wanting to get the answers to know, you know, did all of this hard work that you've put in payoff?
Dara: But you grea,t give some great insight into ways to, to keep yourself occupied and busy. And I love, you've mentioned this a couple times. I think it's, and I, this can really apply to so many things in life. The idea that if you're going through a challenging time, it's not the best idea to fully deflect and keep yourself busy and occupied. But you gave that strategy of, like, setting a timer - could be five minutes, 10 minutes, whatever it may be. But a finite set of time to feel those feelings and then move on from then and I'll move on from it, but then do something else. But to actually honor those feelings, I think that's a great lesson for people, for many things in life.
Rena: Yeah, absolutely. It's that balance between, you know, you don't wanna repress them because then they're gonna come out in other ways, maybe, you know, crying or irritability or anger, but to also not let them consume you. So right. Set a timer. Tell yourself, okay, I'm gonna feel this right now. You know, journal it, whatever. Be uncomfortable, cry, all this stuff. And then when the timer goes off, okay, done. I'm gonna move on.
Dara: Yeah. You also have a great section in terms of journaling because that's something that I think a lot of people don't even know where to begin. So it's nice to know that you have prompts. So what if you're for all those listeners out there who have never journaled before, what are some great, easy prompts that people can kind of start with to get their thoughts flowing?
Rena: One of my favorite, favorite initial exercises with people is sort of this idea of who you were before, who you are now and who you wanna be. So how you interpret that is open. But the point of that is that so many people really fight against what's going on with treatment. Right? You know, like before I was a marathon runner and now my exercise is restricted or, you know, maybe I put on some weight from the medications or the stress or before I was happy and now I'm really depressed. And it's the idea that this is situational and to meet yourself where you're at. Life is dynamic. It's always changing, right? If life is stagnant, than that's a problem. So, how do you meet yourself where you're at, give yourself some grace and figure out how to get comfortable with the uncomfortable. Right? And I think that also is helpful because it sort of lets people know that there's a timeline, there's an end game to this, right? You know, this isn't forever, but okay, right now I need to make these adjustments to my life. You know, this is who I was before and I'm going to mourn that loss, but now I'm going to accept who I am now. And then these are my goals for the future. So I always love that as an initial journal prompt.
Dara: I think that's great. It reminds me of, did you ever hear of Chuck Yeager? He was the guy that broke the sound barrier. And so he was, you know, the first guy in an airplane that like pushed past that shaky part, where at first pilots would go and feel that unsteady aspect and retreat. And he was the first person to go through that and come out to the other side in the smooth sailing altitude or whatever. And I think it's a great analogy in terms of life that sometimes, you know, what we resist persists and the notion of pushing through some of those uncomfortable feelings, writing it out. And then often that could be so cathartic and it could help you work through some challenging moments.
Rena: What we resist, persists. I love that.
Dara: It's something I've been thinking about lately. And I think, you know, it's tough going through some of those hardships can teach you so much. And, you know, I was thinking a lot because you mentioned a lot, especially in the beginning about the power of positivity and positive psychology, and that's part of how you practice, which I think is brilliant, but just, you know, the idea of reframing and shifting the way we see things and working through some of the gunk to get to the good stuff. I think it's hard when you're going through something so challenging to really see that light, but it's amazing, that small reframe or that change in thinking can make a huge impact in our day to day life.
Rena: Totally. Yeah. And, and I am very into positive psychology and reframing, but I think it is also important to point out that toxic positivity is also something to really be wary of. And that is sort of this idea in our culture to be positive, be happy, smile. And you, if you look at half the clothing young kids are wearing, it's all toxic positive.
Dara: They’re all happy faces.
Rena: It drives me crazy. Cause you know, we're not letting people feel their feelings. And the reality is none of us can be happy all the time. That's not reality. And so again, it is important to let yourself have those moments, you know, feel those feelings, but then yeah, figure out instead of being a victim, you know, so like, why is this happening to me? You know, any sort of statement that ends with, to me, flip that to what is this teaching me? What can I learn from this? So, you know, again, feel the feelings you don't have to smile and be positive and be grateful that you're going through fertility treatment. I mean, that sucks. But let's be real, but don't be a victim. You know, again, figure out, okay, what is this teaching me? What can I learn from this?
Dara: Very Edith eager from The Gift, which I saw was one of your resources.
Rena: Well, that was you. You gifted me The Gift, which was an amazing, amazing present.
Dara: She's the ultimate survivor story of, you know, seeing yourself, you could see yourself as the victim or you can flip it and see yourself as a survivor and see how far you've come. So it's not acknowledging all the struggles, but also seeing how those struggles can actually be used towards your personal growth.
Rena: Right. So I, I was listening to a podcast a long time ago and it turned me onto the stoic philosophy, which is very dark.
Dara: It’s a little heavy
Rena: It's super dark, but it's this idea that the universe or the world, you know, it doesn't, it throws you challenges because it's trying to prepare you for the ultimate challenge, which is death. So I realize that's very dark, but I like the idea.
Dara: But it’s real.
Rena: Well, right rr just accepting the sort of, I find it very comforting to believe the spiritual practice, you know, of sorts, but just sort of this idea that, okay, the universe doesn't give me what I can't handle. And it's giving me things to prepare me for the next challenge. And, you know, as I sort of look back on my own life and certainly I had a very challenging period of about seven years, which really started with fertility treatment and then, you know, through divorce and rebuilding my life. I really do feel like the universe, each challenge is preparing me for the next. And sometimes it's easier said than done, right? I certainly have dark days where, you know, I just wanna be a victim and feel like life is unfair and duck and all of that. But then when I can zoom out of that, I find it very comforting.
Dara: I love that zooming out. Zooming in and zooming out, seeing life as like waves that it's nice to think that every day is gonna be sunshine and butterflies, but that's not life. And, but I think it's hard when you're in that dip period to recognize that it will come back up.
Rena: Oh, for sure.
Dara: I think I've never heard of that. The toxic positivity. So that's an interesting way to see it too. And it's something that I've never heard of and actually didn't even recognize, but you're right. There's a lot of happy faces these days. That's the, a typical trend.
Rena: It drives me crazy because then people say, oh, I'm, I'm sorry, I'm sad. I'm sorry, this I'm. And you know, I say my one role is to not be sorry. You know, your feelings are valid and it doesn't matter if you're sorry about, you know, what, you're deeming valid, you know, something like a loss or a failed treatment, or you're sad because you ordered a sandwich with whole wheat bread and they gave you white bread. Like your feelings are your feelings and it's for nobody else to judge
Dara: Amen to that. You mentioned in the beginning that the book really is for many different people. And I wholeheartedly agree. You had a whole section on male infertility, which I'm really hoping all you male listeners or maybe female listeners that have men in their life and their families that can really read this book because you touched upon a topic that really isn't discussed a lot. The idea that men are going through something challenging as well, many men, but it's not something as discussed as, as much. Why do you think that is?
Rena: Sure. Yeah. I mean, you know, as much as women struggle, again, really struggle. There's just lack of resources, so much more shame and stigma surrounding it. And again, as much as we try to get women to open up and share, it's just sort of that much more challenging for men. I think we've had a couple of podcasts where we've had doctors come on and talk about these new at home kits that are available for sperm testing and sort of now this new push for, to start testing men in tandem or way, way sooner than before. So I think hopefully as the field changes and people really recognize infertility is one third female, one third male, one third unexplained. And so hopefully, you know, as the field changes and more people understand that and sort of the onus is taken off so quote unquote women's problem that will also change as well.
Dara: It's great that you're involving them in the game. And hopefully by having this, this resource, more men will be able to speak up and also seek the support that they may need throughout their journey as well. And we mentioned journaling, which I think is great that you provide some prompts at the end to help people kind of get thinking or get starting on, you know, maybe a gratitude practice or writing down thoughts and feelings. But what I really think is remarkable throughout the book you add in some exercises for people to do. And I know Rena and I, you know, we've spoken quite a bit over the years on our podcast about mindfulness practices and meditation, but I would love - couple of things - I would love for you to chat about what the 4 7, 8 breath, which is one of my favorites! You wanna kinda share with people really quickly what the 4, 7, 8 breath is maybe something that they can do on their own time?
Rena: Yeah. I love that one. That's one of my favorites, you know, that's, where you breathe in for four, hold for seven, exhale for eight, and you do that a couple of times, and it really is shown to reduce anxiety, reduce sort of any super uncomfortable feelings that you're having. And so I love, love, love that one. You know, I think a lot of times people think of breathing isn't gonna help me, but it does. And I, myself practice breathing when I'm feeling really anxious or out of control, I do a lot of breathing and it does help. You know, you have to just let yourself do it and sit with it
Dara: And it's free. It's free. We all could do it free. The hardest thing,
Rena: No one needs to know you're doing it, you know,
Dara: But the, I think the hardest thing people start out is the idea, can I really hold my breath for seven? Can I really exhale for eight? And of course it takes some time to get into that routine, but you can get into a flow. And that's where, like she also mentions the four, the box breath, which is, I believe like four breaths in hold for four exhale for four, breathe out like hold for four. And that could be an easy, perhaps start to get into the 4, 7, 8 breath, which takes a little bit more finesse I would say maybe
Rena: No, I always say one, just breathe in and count to 10 and exhale and count
Dara: Or single breath.
Rena: And just really be in tune to your breath and it, and it really, I mean, what's most recommended set a timer and just give yourself, it's really only a couple minutes a day and just make it a daily part of your practice. Don't wait until you're feeling anxious or stressed just every day. Make sure you have some time for deep breathing.
Dara: It's, I'm telling you, well, it'll change your life and it is a great segue into a meditation practice. I think it's a great first step into that world. And then I really enjoy that closer to the end, you have not only did you, you mentioned a little bit about egg freezing and the importance of a community. You also mentioned ethical and cultural dilemmas, which I think is very timely. I love how you started and ended the book very similarly, in terms of the concept of patient advocacy, how you mentioned, how not only do you advocate for your patients, but you also empower them to be their own best advocates.
Rena: Hmm. That sounded like the intro of our podcast. I think that is part of our intro. Sure. You know, because really the powers with you, right? Not relying on somebody else to do something for you, but sometimes, you know, you need tools, you need help, but right. You know, we're all our own best advocates. We're all in charge of our own voices. And sometimes we just a little bit of help to sign the,
Dara: A little handholding. But I think you have really given people the tools you're helping people have their own voice in their own experience. And really it's something that's easy to read. I'm all about short chapters and also like practical exercises that you can really take with it. And I think it's very well rounded. Is there anything you hope, like for the future, in terms of, next book? I mean, granted this just came out or anything you’d like to share about this process?
Rena: I will say, well, for the second edition, I will certainly make a shorter title.
Dara: I loved this title.
Rena: It's it's mouthful, but no, I really hope, you know, is my goal just to help people. So I hope that it is helpful, a helpful tool, a helpful guide, something you can sort of just share and that it will just be something to ease the, the burden of this journey a little bit.
Dara: Where are we able to purchase it? I know I purchase my coffee on Amazon, the best place to get it.
Rena: Yeah. Amazon, I mean, where I buy my like, so why not?l Yeah. Amazon. Yeah. I think there's a link. There's a link in my Instagram, which is at renamg_fertility, or my website, which is Renamgfertility.com
Dara: I am so happy that we had you on to really delve deeper into this. You've also shared other resources that you really believe in other books, which I feel like we just should do another chat down the road of maybe our favorite reads in general.
Rena: Good idea.
Dara: Yeah. That are related to our personal experience at work and personal journey experience as well. As always Rena. I love to talk about gratitude as you do you. What are you grateful for today?
Rena: Well, let's see. I knew that was coming. So I started thinking about it. Then I got distracted answering your questions. I feel like I always say the same things. Today I'll go with grateful for, and especially cause it's May - mental health. I've had a really tough winter, you know, I, I love the word languishing, cause I feel that really describes kind of my winter. It's just been quite difficult mentally and physically, I just haven't been feeling very good. So I am going to go with, I'm grateful for health and I'm grateful for the ability to talk about things and you know, people share their struggles and just kind of keep it real. You know, I think life is hard and just cuz I'm in the field, doesn't mean I'm immune to, to struggles. So, you know, I'm just grateful to be able to share that and, and also, you know, come back. We’re in the time of new beginnings. And so I'm really grateful for that. And I'm grateful that every day I, I wake up and I say, okay, today's a new day. And that I have hope because I know that that hope is hard to come by then that's a really, really different place. So that was many gratitudes in one.
Dara: So beautiful. So pretty.
Rena: What are you grateful for?
Dara: I was also thinking about like, what am I gonna say today? And I, I dunno if I've already said this, but it feels right now. I'm grateful for recognizing that I need to slow down a little bit and like, breathe in life. Have that pause, take that breath in both of our, I mean, probably more so in what I do than you do. It involves a lot of talking and education. And I recognize, I mean, you've taught me this too, that sometimes it's in the silence. Sometimes it's in the pause. Sometimes it's in the listening where you get the best meat. Where you really can learn so much about yourself and learn so much about others. I’m grateful for remembering to pause and take a moment and enjoy the sense.
Rena: I love that. Well, I love that you're always so self-aware and always, so, you know, looking to better yourself and learn and grow and then in turn, you know, that ripples out to sort of everyone that you touch. So I think wonderful.
Dara: Well I think this is why we do what we do is to learn from each other and grow, share that with others. So everyone, thanks for listening today and we will be back.
Rena: Yep. Thank you so much.
Dara: Thank you so much for listening today and always remember: practice gratitude, give a little love to someone else and yourself, and remember - you are not alone. Find us on Instagram @fertility_forward and if you're looking for more support, visit us at www.rmany.com and tune in next week for more fertility forward.