Fertility emotions

If you’ve experienced pregnancy loss, there may be a hard-to-ignore question in the back of your mind: what, exactly, causes miscarriage?

You may know that it’s common—as many as 1 in 4 pregnancies end in miscarriage, and the real number is, unfortunately, even higher when you factor in unknown pregnancies—but as frequently as it happens, many prospective parents still don’t know what actually causes it.

That giant question mark can make the miscarriage experience even worse. Grieving over your pregnancy loss is hard enough, but when you don’t know where to place the blame, and wonder if it could happen to you again, you end up facing fear, anger, and frustration on top of grief.

When miscarriage happens, it’s crushing. But the thing to keep in mind is this: miscarriage is not your fault, and there’s nothing you could have done to prevent it or change it. The universe has a pretty messed up way of working, huh?

So...what are the causes of miscarriage, anyway? And why do they happen to so many women?

Here are some common reasons why miscarriage can occur, and what you should ask your doctor if it’s happened to you.

Possible miscarriage cause #1: abnormal chromosomes

Biology may be a science, but it kind of functions like a delicate musical instrument: one wrong note and the whole thing goes out of tune. Translated to genetics, this means that if one teensy piece of the babymaking chromosomal puzzle doesn’t fall perfectly into place, the embryo may not develop properly, potentially causing miscarriage.

According to OBGYN Mary Jane Minkin, M.D., clinical professor of obstetrics, gynecology and reproductive sciences at Yale University School of Medicine, an embryo that’s genetically abnormal is the most common cause of miscarriage. She says sometimes this abnormality occurs at the very start of the fertilization process and other times it happens a bit later.

Either way, you can’t control the genetic processing that happens when sperm meets egg (unless you did in vitro fertilization and your doctor tested the genes of your embryo before transferring it, which many do!).

You can, however, ask your doctor to do some detective work for you if you’ve had repeated miscarriages: placental and fetal tissue can be tested for chromosomal abnormalities, giving you a clearer picture of what’s going on in your body when a fertilized egg ends in miscarriage.

Possible miscarriage cause #2: advanced maternal age

You know what sucks? Because women are born with all the eggs they’ll ever have, those eggs age right along with us...and can increase your chances of those chromosomal abnormalities we mentioned.

In a 2019 study published in the British Medical Journal, the risk of miscarriage rose sharply in women over the age of 30, reaching as high as 53 percent by age 45.

Even men, who generate fresh sperm all the time, are subject to chromosomal aging, says Minkin: “Guys keep making new sperm, although there is data to show that older fathers do have more genetic issues, too.”

If you and your partner are concerned about your genetic health—whether it’s because of aging or not—you can ask your doctor for genetic screening, which may alert you to risk factors you otherwise wouldn't know about.

Possible miscarriage cause #3: infertility or hormonal issues

This is going to sound like a chicken vs. egg scenario, but hear us out: infertility issues may actually cause...more infertility issues? Basically, your miscarriage rate can be higher if you’ve struggled to conceive in the past, possibly because there’s something up with your hormones at the root of your infertility challenges.

“Occasionally, a woman might not be ovulating well enough, [meaning] she is ovulating enough to produce the egg, but not enough to make the progesterone needed from the ovary to maintain the pregnancy,” explains Minkin. This might apply to you if you experience anovulatory cycles, irregular cycles, or if you have polycystic ovarian syndrome (PCOS).

Possible miscarriage cause #4: infection or chronic illness

No, we’re not talking about colds or stomach bugs here—we’re talking about more severe infections, like sexually transmitted diseases (STDs), cytomegalovirus (CMV), and pelvic inflammatory disease. We’re also talking about chronic conditions, many of which come with the one-two punch of increasing your risk of miscarriage and infertility issues.

Kecia Gaither, M.D., double board-certified physician in OB/GYN and maternal fetal medicine and director of perinatal services at NYC Health + Hospitals/Lincoln, says maternal illnesses like diabetes, thyroid disorders, autoimmune disorders such as lupus, and blood clotting disorders can contribute to the overall causes of miscarriage, too.

Possible miscarriage cause #5: reproductive or anatomical issues

There are a bunch of congenital abnormalities in the reproductive system that can a) make it harder for you to conceive and b) make it harder for a fertilized embryo to thrive after conception.

Some of these abnormalities include:

• a misshapen uterus (like a double- or half-uterus)
• uterine fibroids
• a uterus with a septum
• blocked or damaged fallopian tubes
• endometriosis scarring

You may know about these anomalies already if you’ve got ‘em; they may have affected your menstruation or caused other symptoms. Either way, many of them can be treated if they’re contributing to infertility, so talk to your doctor.

Possible miscarriage cause #6: substance abuse

According to Dr. Gaither, frequent drug and alcohol use may also increase your chance of miscarriage. No, we don’t mean the celebratory glass of champagne you had on your birthday before you knew you were pregnant. It’s the consistent consumption of alcohol—especially as you move past week five of pregnancy—that’s affiliated with miscarriage. (And any amount of drug use, at any point during pregnancy, is potentially a problem.)

Addiction is a debilitating mental health condition; if you’re struggling, consider seeking help—especially if you’re trying to have a baby.

What to ask your doctor

If this is your first miscarriage, it may not be necessary to ask your doctor anything just yet; Dr. Minkin says miscarriage is common enough that it doesn’t always mean there are overarching fertility issues that need to be addressed. On the other hand, if you’ve been trying to conceive for a while, have a known fertility issue, or received any kind of fertility treatment, you may want to investigate any underlying issues as soon as possible rather than wait.

It’s best to talk to your doctor about a miscarriage so they are aware it happened and can make a decision, based on your overall health, about how to proceed. If your doctor feels more evaluation is needed to determine what caused your miscarriage, Dr. Gaither says there are a few things your doctor can do in terms of getting your fertility prospects checked out. These may include:

• Having miscarriage tissue genetically evaluated
• Having diagnostic tests to look for uterine or cervical anomalies
• Managing any other medical conditions that could be contributing to your inability to maintain a pregnancy

If you’re grieving a pregnancy loss, we know this information is probably pretty overwhelming. You may not be eager to dig into the reason behind your miscarriage at this point — and that’s understandable. You should take the time you need to consider your options and move forward when you feel ready.

But you should also know that miscarriage doesn’t mean you can’t ever get pregnant. Many women go on to have healthy pregnancies after experiencing loss, sometimes naturally and sometimes with assistance from a fertility specialist. We’re rooting for you.

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Read more in Does Using Donor Eggs Decrease the Risk for Miscarriage?

Zika has been in the news a lot since it first came to public consciousness in 2016. And while it's definitely a very scary virus, there's some confusing information out there about how people get it and what the risks are to those of us living in the US and trying to get pregnant. We did some research to make sure you have all the facts before you plan your next vacay while you're TTC.

What is Zika?

Broadly speaking, Zika is a mosquito-borne virus, but there are other ways it can be transmitted: through sex with an infected person, or if a pregnant woman passes it on to her developing fetus. Symptoms in adults are similar to getting the flu: fever, rash, headache, joint pain, muscle aches and red eyes. However, many people won't show any symptoms at all, and those that do might not feel badly enough to go to the doctor.  

For most adults, the symptoms will pass without issue within a week. But the biggest danger is that Zika can get passed to a fetus if a person with Zika becomes pregnant, because the symptoms for a baby are far more severe, including a birth defect called microcephaly and other scary brain defects.  

I'm not pregnant (yet). Why should I worry about Zika?

Not to freak you out, but, "the fear is that Zika can stay in your system for several months," says Dr. Jamie Knopman, a reproductive endocrinologist at New York fertility clinic Colorado Center for Reproductive Medicine (CCRM). "So, let's say you went on a great trip and then got pregnant after you got back, it could still be living inside of you."

And remember, Zika can also be sexually transmitted. So if your partner traveled to an area with a Zika risk and caught the virus, it could continue to live in his or her system and then get passed on to you (and your future pregnancy) even months after.

So, if you're already trying to get pregnant, or you're thinking about starting to try, here is some info you'll need to make sure you conceive as safely as possible.

Where can I contract Zika?

The Centers for Disease Control (CDC) states on their website that there were no local mosquito-borne Zika cases reported in the US in 2018. That means there is no known risk of getting Zika from a mosquito bite in the States. But, if you have plans to travel out of the country while you're TTC, be sure to search for your dream destinations on the CDC's website to ensure you're playing it safe.

What precautions should I take when I travel?

The cold, hard truth: "don't go to places that may have Zika," says Dr. Knopman.

But if you must travel to one of these areas, you've got to protect yourself from bug bites. Wear an EPA-approved bug spray at all times, protect your skin with long-sleeve shirts and full-length pants, ideally treated with permethrin (an insecticide that keeps working, even after washing), and keep bugs at bay when you're indoors with screens on windows and doors and mosquito nets over your bed. Don't hate us for killing your travel vibe; we're just the messenger!

But wait, there's more. after you or your partner return from your trip, you need to continue to be cautious, pushing your TTC timeline even further into the future, including:

• Continuing to fend off those mosquitos: For at least 3 weeks, the CDC recommends you keep taking all the same precautions to avoid bug bites. Sounds crazy, but better to be safe than sorry.
• Months of no unprotected sex or fertility treatments: if your partner traveled without you, doctors advise you avoid conception for at least 3 months after your partner returns from that trip. If you traveled with your partner, or if you traveled alone, the recommendation is to avoid pregnancy for at least 2 months. These periods apply even if you have no symptoms of having contracted Zika, and they're extended if one or both of you has caught the virus: you'll need to wait until 2-3 months from the date your symptoms first appeared or the date of your Zika diagnosis.

So, yeah...it's complicated. Really, if you're hoping to conceive any time within the next year, it's probably best to take Dr. Knopman's advice and avoid traveling to anywhere on the CDC's list of Zika risk areas. Even if you don't end up getting Zika, you're still going to be playing a waiting game to ensure the healthiest pregnancy possible.

Let's face it: infertility sucks. Whether you've always known you want to have children or have just recently embraced the idea, learning that it won't be easy—and may require months, or even years of invasive treatments—can cause a flood (and, to be honest, sometimes a fury) of infertility emotions.

According to Dr. Sheeva Talebian, M.D., a board-certified reproductive endocrinologist at New York fertility clinic Colorado Center for Reproductive Medicine (CCRM), "the underlying infertility emotions come from having a complete lack of control over the process," which comes from the shock of failing at something that we've been led to believe will come so naturally.  

Lindsay Liben, a licensed clinical social worker (LCSW) explains that so many of the people she meets have been successful in most areas of their lives. This is the first time they're experiencing this level of adversity that's so far outside their control, so developing survival skills for this bumpy ride is essential. Don't worry, we're here to navigate.  

Don't ride alone

When dealing with infertility, the highs and lows of your emotions have a direct and immediate effect on your relationship with your partner. Carolyn Berger, LCSW, says she sees over and over again that this journey either "brings couples closer together or further apart." Keeping the latter from happening will require a lot of communication and honesty.

• Get real: If you're dealing with infertility, you might be trying to get through it as quickly and painlessly as possible. If you don't talk to anyone (especially your partner) much about it, maybe it will just go away. The hard truth is that this isn't normally how it goes: you could be in for months or even years of treatment. It's no fun, but accepting that will help you and your partner move on as a team.  
• Reclaim your body: sometimes it can feel like infertility emotions and treatments have hijacked your body. "Your areas that used to be private are no longer private. It's like Grand Central Station," says Liben. In order to feel like your body is your own, Liben advises taking a "pleasure inventory." These may include super-intimate time with your partner, taking walks and listening to your fave playlist, trying different face masks, or eating that cupcake. Bringing your partner into these experiences will help you remember that you're riding this roller coaster together—wherever it goes.

Protect yourself

Self-care is one thing, but what about when you're out in the real world? Emotional hazards come at you left and right, so here are some tips to weather the storm.

• Set your boundaries: It's ok to lie. Seriously. If sitting through a barrage of oohs and aahs at a friend's baby shower makes you want to run headfirst into a brick wall, tell your pal you have other plans. If you feel like you just have to be there, let the host know when you arrive that you have dinner plans and have to leave early. Then, reward yourself for surviving that triggering social experience: go out to dinner with your partner or take yourself to a movie.
• Tell others where to get off: Ugh—those intrusive questions from nosy friends, family members, co-workers and even complete strangers. Berger advises us to remember that "this is your information and you have a right to talk about it or not." If someone asks when you're going to start a family and you're feeling super awkward, one suggestion is to just say, "we're keeping our options open and we'll see if we get lucky." Then, change the subject as quickly as possible. Save your thoughts on how you really feel for your inner monologue.
• Stop, look and listen: Going through fertility treatments can be an all-consuming hamster wheel of thoughts. Berger advises couples to avoid talking about fertility throughout the day and instead set aside a total of ten minutes each evening. During this time, each partner takes five minutes to share all of his or her feelings about fertility, while the other simply listens, without judgment.
• Step away from the needles: Berger also recommends that time away from the process can be helpful. Beyond that, a weekend away in another city, in a yoga retreat, or a couple of good day hikes can give you the time you need to reconnect with your body and your partner.

Ask for help

It can be hard to make time and room in your budget for one more weekly appointment, but finding a therapist who specializes in infertility and pregnancy loss can be extremely beneficial. You can't have too many people in your corner. It can make all the difference between feeling isolated and feeling that you have people to turn to when you need them.  

Above all, be kind to yourself. "These are probably not going to be your best moments," advises Liben. "The goal is just to get through and just preserve your relationship and the things that are important to you, while also tolerating this acutely stressful time."

You can search Psychology Today's database and narrow your selections to therapists with infertility and pregnancy loss specialties. Take the time to carefully interview each therapist to make sure they have worked with several clients with similar struggles, and also feel free to ask if they've experienced their own personal losses or fertility challenges.

Fertility issues are hard enough to deal with when you actually understand what's causing the problem. But if your infertility is unexplained—as is the case for 30% of infertile women or 50% of infertile men — not knowing what's keeping you from getting pregnant can get pretty damn frustrating.

For the sake of this post, we’ll be addressing unexplained infertility in females. Don’t worry, we talk allllll about the guys in other posts.

What the heck is unexplained infertility? 

Unexplained infertility means not only are you not getting pregnant, but also that the usual suspects don't seem to be behind your problem. According to Dr. Nataki Douglas, M.D., Ph.D., director of translational research for the Department of Obstetrics, Gynecology and Women's Health at Rutgers University in New Jersey, it's the diagnosis given to an individual or couple trying to conceive after a thorough evaluation already reveals normal ovulation, a normal uterus and patent fallopian tubes, and a normal semen analysis.  

That means you've probably already done a huge battery of tests (egg assessment, an ultrasound and hysterosalpingogram (HSG), and semen analysis), and basically only up with a big shrug of the shoulders. So that leads to hunting elsewhere for a problem, and dealing with a lot of uncertainty in the meantime. We know. Not fun.  

So, what's happening?

Unexplained infertility doesn't exactly mean that there's no explanation at all. You may have undergone all the routine tests, but there is likely some explanation for your infertility hiding somewhere. Here are some of the additional factors that could be at play:

Diet

Consider this the perfect reason to clean up your diet, if you haven't already. Recent research from the Harvard T.H. Chan School of Public Health and Harvard Medical School has shown that diet plays a role in conception.

For women, that means boosting your intake of folic acid, vitamin B12, and omega-3 fatty acids, along with following a generally healthy diet, while men need to follow a healthy diet and reduce their intake of trans fats and saturated fats. Bottom line: If you think your diet could be a factor, it may be worth seeing a nutritionist to see if you can find a fertility-enhancing diet that works for you.

Autoimmune issues

If you've been diagnosed with an autoimmune disease like lupus, your medical team has likely already weighed in on how your condition and your treatment could impact your fertility. But even milder autoimmune issues could be a factor in your fertility, according to the Oncofertility Consortium, either by attacking your ovaries, uterus and other tissues, or by interfering in the ability of a fertilized egg to implant.

However, the jury is still out on what role autoimmune issues may play in unexplained fertility—and some doctors aren't convinced. "Autoimmune testing is controversial amongst different leading reproductive endocrinologists today in the field," says Dr. Janelle Luk, medical director and founder of Generation Next Fertility in New York City. "But I say try anything and everything within your means to get pregnant."

Weight

Several studies have shown that being overweight or underweight can impact your chances of getting pregnant. A 2015 study found that obesity, for instance, can increase levels of chemicals called adipokines, which causes insulin resistance and impacts your fertility. There's also a link between being overweight and developing polycystic ovarian syndrome (PCOS), which can wreak havoc on your menstrual cycle and reduce your chances of conceiving.

On the other end of the spectrum, being underweight (a body mass index of 18.5 or lower) could cause your body to stop producing estrogen, which could keep you from ovulating.

Egg quality

The initial fertility workup may only look at whether eggs are present and ovulation happens, but unfortunately, won't be able to address egg quality. You may need to move into more aggressive fertility treatments like IVF to get a picture of whether your eggs are viable.

While [IVF] will cost you some change, it could be the most proactive way of figuring out what's going on.

Dr. Luk advises her patients with unexplained infertility to not make IVF the last resort. While it'll cost you some change, it could be the most proactive way of figuring out what's going on—and could uncover some egg quality answers.  

Stress

You've probably heard "just relax and it'll happen" so many times, you fantasize about punching the next person who suggests it (hey, just being honest). But there is some science to back up the idea that the impact of stress on your body could be a factor in your fertility. And yes, we totally get the irony that the stress of not getting pregnant could be keeping you from getting pregnant.

While research is conflicted about the effects of stress itself, some studies indicate that stress can impact your sleep patterns, your mental health, and other factors that may play a part in your fertility.  

If you're feeling stressed, a little me time can't hurt. Dr. Francis suggests investing in some yoga, meditation, or acupuncture to help you feel more zen.  

How to avoid freaking out

In many ways, unexplained infertility feels a lot worse than dealing with an actual diagnosis. The Type-A planners in us like answers and explanations. "Our psyche just does better knowing 'why,'" says Dr. Marra Francis, MD, FACOG, an OB/GYN in The Woodlands, Texas.

If you're going through infertility, you might feel like a train stuck between stations. Definitely not a good feeling. Communication is key to getting through this; you're not a mind reader and neither is your partner. "Check in with each other," says Crystal Clancy, MA LMFT, PMH-C, owner of Iris Reproductive Mental Health. "Don't assume that you know what the other is thinking and feeling."  

As you're working through your feelings—you've got a lot of 'em—and your action plan, it may pay to get a little professional help, too. Don't hesitate to seek out a mental health professional who understands infertility to help guide you. A strong support system is always a good thing.

One in eight. That's the startling statistic of how many couples trying to conceive actually struggle with some sort of fertility challenge. Whether it's PCOS, low sperm count, endometriosis, or (ugh) "unexplained," infertility takes many forms, and is so much more common than we all think when we—with innocent, almost-naïve hope—begin to think about starting a family.

Even in busy reproductive endocrinologist waiting rooms, there seems to be an unwritten rule: avoid eye contact at all times, and don't you dare utter a word to another patient. Infertility affects so many, but oftentimes, we don't talk about it with anyone other than our partner and maybe our family. But why?

Opening up is hard to do

We're not going to lie, taking that first step is intimidating AF. There are tons of reasons why we might choose not to talk about our fertility struggles, like:

• They just won't understand: Before opening up about infertility, you might think nobody else could possibly understand, let alone empathize with your situation. I mean, how could they, if they haven't been through this themselves? They might say the wrong thing—and to be honest, they probably will at one point. But keep in mind, this doesn't mean they don't care about you, your infertility, or your overall well-being. Remember that.
• You're not picture perfect: It's super tough to come to terms with the fact that your life isn't the rainbows-and-butterflies false reality that social media often portrays. If you're actively trying for a baby, chances are your Instagram feed is filled with photos of babymoons, birth announcements and "X-months-old!" blocks. It's hard enough to accept that you're not there yet, so opening up to others? Yeah, that feels damn near impossible. Just know that you might not see what's behind the screen—for all we know, that birth announcement came years after trying for a baby.
• It'll make you upset: You cry enough in your alone time. So, we totally get wanting to skip the emotional breakdown that might happen if you open the floodgates and talk openly about your infertility. We've taken a totally uncensored, unfiltered approach to fertility, though, and we've got to say…it feels really good.
• It's really (really) personal: Let's face it: you might not exactly want to share that you don't ovulate or that your husband has poor sperm motility. These are super intimate topics that most people usually save for the bedroom. So, it's totally okay to pick and choose who you open up to and make sure it's a judgment-free zone.
• There could be repercussions: Being worried about getting held back at work because your coworkers know you're undergoing fertility treatment is a legit concern. For this reason, many choose to not share their fertility struggles with coworkers. But be kind to yourself. Prioritize your health. If the daily monitoring and hours spent on the phone with insurance are taking a toll on you, talk to your manager or an HR rep at your company. Or maybe a vent sesh in the bathroom with a trusted colleague is enough to do the trick.

No pressure

We get it. There are lots of reasons we don't talk about our fertility struggles. Your comfort zone is determined by (a) the type of person you are and (b) the type of people in your circle.

If you choose to open up at all, choose the recipients of your news wisely. We all have that person in our life who might shrug off an emotional conversation, or someone who may come off as judgmental. Maybe go ahead and skip over those people. While they might love you, that shoulder for you to lean on is precious real estate. You don't owe your story—or trust—to anyone.

That said, while we are firm believers in breaking the stigma around infertility, if talking about it with others makes you upset or super uncomfortable, take the pressure off. Do you. Just make sure to take care of yourself and find some kind of outlet for the emotions you're most definitely feeling around this time.

Something else to consider? Talking to a therapist with experience in infertility. You'd be surprised; sometimes, it's easier to talk to a professional than your closest friends. There's so much value in having someone who just "gets it." In the meantime, we'll try to be that for you here at Co.  

We've got the power

We were so surprised that there wasn't a fertility resource out there that kept it real and honest, and didn't bury fertility information among pregnancy or motherhood content. So, we decided to build it.

The more we talk about fertility, the more attention the issue of infertility will receive. And that, my friends, can actually affect real change. Like:

• Better medical coverage and benefits for infertility
• More scientific research
• Actual legislation, like state mandates for fertility coverage
• General openness and more emotional support for those with fertility challenges

So, let's talk—no, SCREAM—about infertility. Cause a commotion. Start that uncomfortable conversation. Say "hi" in that waiting room.

Get ready, because Co is here to talk about fertility. A lot. And we aren't going anywhere.

Ever heard of the “two week wait”? That refers to the period of time between your, IUI, or IVF embryo transfer and that ever-nerve-wracking blood pregnancy test. Depending on certain factors, like your average cycle length, your clinic’s protocol, or how many days after retrieval your embryo was transferred, the two week wait might not be exactly two weeks. That being said, whatever the actual length of time, you may spend it feeling like you’re going a little crazy! 

The two week wait = basically more of the same

The two week wait can be tortuous. Not only have you likely already been waiting for months, or even years, to become pregnant or have a pregnancy go to term, but you’ve also probably been in tons of other holding patterns throughout this journey.

In other words, even outside of the two week wait, if you’re trying to conceive you’re basically always waiting. Waiting for test results to evaluate your fertility. Waiting to ovulate for timed intercourse. Waiting to get your period so you can start a new cycle. Waiting for your doctor to determine your treatment plan. Waiting for your medication to arrive. Waiting to see how your follicles are developing. Waiting to see how many eggs were retrieved. Waiting to see how many fertilized. Waiting to see if any embryos developed to blastocyst and then, if you’ve opted to test your embryos, to learn how many are chromosomally normal. The list goes on and on.  

It’s draining and exhausting to constantly wait for the next piece of information to arrive, anticipating what you might hear. You’ll probably feel anxiety in advance of the actual news, and then, of course, disappointment if it doesn’t meet your hopes and expectations.

The ultimate culmination of this particular brand of purgatory is the final wait to learn if you’re pregnant after a treatment cycle. You’ve likely already invested mightily in this process—financially, emotionally, physically, and mentally. You’ve postponed and cancelled plans, changed your whole life around to accommodate this challenge, and generally been a slave to the process. You’ve been to hell and back, and probably already feel like a human pin cushion by the time you arrive at this point.

What the two week wait actually feels like

One of the hardest parts about the two week wait is trying to read your body for clues as to whether or not this cycle worked. “Are my breasts tender? What was that twinge in my abdomen? If I actually felt it, is it good or bad? Do I feel nauseous? Has my appetite changed? Could that bloat mean I’m pregnant? Is that blood? If it was, is it my period or could it be implantation bleeding? Should I do a home pregnancy test? Will that better prepare me for the news? What does it all mean?!”

During the two week wait, minutes can feel like hours, hours like days, days like weeks, and weeks like months while you wait to have your fate delivered to you. The second week often feels harder than the first, as the reality of finding out whether or not there will be a return on this massive investment looms even closer. Sometimes, you can feel very alone during this wait: perhaps you’ve chosen not to share with certain friends or family to avoid all those awkward questions or having to deliver bad news.

And if you have a partner, that partner might not fully understand what you’re experiencing during the two week wait. Or maybe your partner is able to compartmentalize his or her own feelings more effectively, because your partner is not the one whose body has become a barometer of success or failure. No matter how you slice it, the two week wait is brutal.

15 ways to survive the two week wait

So, what can you do to cope with the anticipatory anxiety and stress of the two week wait? Especially when many of your go-to coping mechanisms, e.g., heavy exercise, an occasional alcohol beverage, or certain foods you may like to indulge in, aren’t currently available to you? Glad you asked—here are our tips:

1. Brace yourself. Head into your two week wait knowing it may be incredibly difficult. Acknowledging this will help you feel more prepared to process it.
2. Get your crew on board. Prepare your loved ones who do know where you are in your #ttcjourney for the likelihood that the two week wait will be a challenging time for you, complete with instructions or feedback as to how to best support you. Help them help you, even if that means asking them to give you space or not ask you questions about it.
3. Make plans you can flake on. If you’ve found in the past that you do better with distractions when dealing with a stressful time, make loose plans during your wait. Just make sure they’re the type of plans that you can easily cancel if you find you aren’t up for them.
4. Or...don’t. If, on the other hand, you know you do best without commitments, clear your schedule as much as possible.
5. Check yourself. Know that your moods will go up and down and keep in touch with your needs. If you feel like you need a quiet day, give yourself permission to lie under the covers and binge your favorite show. If you feel like you need air, movement, or company, go ahead and take a walk with a friend. Whatever works for you. The two week wait is a highly personal, individual, and customizable experience. Just listen to your heart, head, and body for what they’re telling you they need at any given time.
6. Step away from the internet. We know you might be looking for reassurance. However, Googling during the two week wait typically can often lead you down a number of anxiety-ridden rabbit holes, supporting many of your worst fears about what may happen, or providing conflicting “information” that just creates confusion.
7. Prep for test day. On the day you know you’ll be getting bloodwork results, think about where you might be, who you’ll be with, and what you might be doing—and prepare accordingly. If there’s a way to orchestrate whatever scenario would feel most helpful to you (whether the result is positive or negative), such as taking the afternoon off of work, try to do it.
8. Stay skeptical. Remember that whatever physical sensations you experience during the two week wait aren’t indicative of cycle success or failure. If you’re undergoing fertility treatment, you’re probably on numerous meds that can create changes to your body, and it could be too early for you to actually be symptomatically pregnant. Know that whatever you’re feeling or not feeling, or think you may be feeling, is normal and doesn’t tell you whether or not you’re pregnant. Use this information to comfort you, e.g., “That twinge neither confirms nor denies a pregnancy,” not to create fear, e.g., “Oh no, that definitely means I must not be pregnant!”
9. When in doubt, skip the home pregnancy test. Holding up a pregnancy test to the light to see if the faintest line came through? Is the uncertainty killing you yet? Keep in mind, the only way to absolutely know for sure if you’re pregnant at this stage is to do a blood pregnancy test with your doctor.
10. Treat yourself. Indulge yourself as much as possible during the two week wait, with whatever works for you (within clinical parameters, of course). The word, “selfish,” doesn’t exist right now. Read what you want, watch what you want, do what feels like it might de-stress you without guilt.
11. If there are things that make you feel empowered during the wait, be proactive. There may be certain actions you choose to take during the two week wait that support your emotional needs, and foster a sense of control and agency. If you feel like more of a participant in the two week wait by, for example, eating certain recommended foods, engaging in meditation, regularly doing acupuncture, etc.,go for it. If your doctor has said they are safe, and they help you to feel involved in your process without a sense of obligation, embrace your chosen program.
12. Acceptance is key. Validate WHATEVER feelings you may have, and try to love and nurture yourself in ways that feel beneficial and helpful. You’ve already been through so much—you don’t need to feel unnecessary negative emotions! The sadness, fear, sense of loss/grief, anxiety, and disappointment you may have already experienced are enough. If you can, remove guilt by accepting that at this point the outcome is beyond your control and you aren’t to blame if the cycle doesn’t work. Release yourself from self-blame and guilt. There is no such thing as “fault” here.
13. Let go of control. During the two week wait, it’s important to remind yourself that you won’t affect the result by feeling certain emotions or doing certain things. You might want to feel in control of the process, so would rather beat yourself up for what you did or didn’t do than accept that the outcome is out of your control. Trust that you’ve already done everything you could possibly do, whatever that looked like for you (there’s no one prescription for making this work!).
14. Live in the now. The two week wait can be an anxiety-inducing spiral full of scary stories we tell ourselves, like, “If this doesn’t work, I will be that person who can never get pregnant.” You may want to be emotionally prepared for disappointment, but trust that you’re already well aware of that possibility. The goal is to maintain as much emotional equilibrium as possible during the wait, for YOUR well-being. You deserve it and have earned that right; you are more than just a potential vessel for pregnancy.
15. But make a backup plan. Even if you’re taking things one day at a time, feel free to at least plan your very next steps in the event of an unsuccessful cycle. Just as long as you give yourself permission to reevaluate them as soon as you actually know where things stand.

Remember that the two-week wait will inevitably end. It may feel like an eternity, but you will get through it! And you will survive it, because you are even more resilient than you know—just make sure to show yourself lots of love, no matter what the outcome.

You’ve probably just received the worst news of your life—that you’re no longer pregnant. And we know just how shocking and upsetting that can be. We’ve been there, too, asking the same horrible question: How could you possibly feel so pregnant, but not be?

According to your doctor, you’ve had a missed miscarriage (also known as a blighted ovum). But you’re not alone. About half of the first trimester miscarriages are due to blighted ovum, according to the National Center for Biotechnology Information.

What is a "missed miscarriage," anyway?

Whether it’s called blighted ovum, anembryonic pregnancy, early pregnancy loss, or missed miscarriage, it all amounts to the same awful thing. Your body has started growing placenta for a baby, but a baby isn’t growing inside it. It occurs when the fetus either dies or never grew, but the placental tissue and sac are still there, according to Dr. Marra Francis, MD, FACOG, executive medical director at EverlyWell.

You’ll likely try to search out the reason it happened, and you might even place the blame on yourself for it. But your miscarriage didn’t happen because you drank a glass of champagne or you cleaned out the cat’s litter box before you knew you were pregnant. Repeat after us: it was. not. your. fault. In most cases, actually, a missed miscarriage happens because of a chromosomal abnormality, a problem with the genetic code of the embryo.

In fact, there was nothing you could do to cause this miscarriage to happen—and there was nothing you could do to stop it from happening. No matter how well prepped you are (modifying your diet and exercise routines, limiting stress, taking prenatal vitamins), unfortunately, that won’t stop chromosomal abnormalities from happening, says Dr. Stephanie Zobel, MD, an OB-GYN with Winnie Palmer Hospital.

How it's diagnosed

There’s a reason it’s called a “missed” miscarriage, and that’s because all the common signs of miscarriage, like heavy bleeding and cramping, are missing. Your levels of hCG (human chorionic gonadotropin), the pregnancy hormone that the placenta produces, may rise just as they should—leading to the breast tenderness, nausea and other symptoms common in early pregnancy.

In fact, the only unusual symptom women might experience is a bit of brown spotting, says Dr. Francis. A missed miscarriage is only caught when you go in for an ultrasound, and there’s no baby.

What happens if you're diagnosed with a missed miscarriage?

Once it’s been confirmed that you’ve miscarried, you and your doctor can decide the best course of action to deal with your miscarriage. You might decide to simply wait for your body to expel the placenta and other tissues on its own, or you may opt to take a medication like misoprostol to help remove the remaining tissue.

In some cases, it might make sense to have a dilation and curettage (also known as a D & C), where the doctor will dilate the cervix and surgically remove everything. That’ll be helpful if you’d like a pathologist to investigate what happened—which might be important for you if you’ve multiple miscarriages.

But the grief, anger, and myriad of other emotions you’re feeling in the wake of the miscarriage can be much more challenging for you and your partner to handle. Take time to grieve, seek out supportive friends and family members (or even a support group), and be kind to yourself. Remember that you’re not alone. According to the March of Dimes, 15 to 20 percent of all recognized pregnancies end in miscarriage—so odds are, you have some friends who have dealt with this themselves.

How soon can you try again?

Most doctors recommend waiting at least one to three menstrual cycles before you try to get pregnant again after a miscarriage, but you should check in with your own OB/GYN to see what she recommends for you.

It can be scary to try again after a missed miscarriage, but keep in mind that the odds are in your favor that the next time will, hopefully, be a success. We're keeping our fingers crossed for you. In the meantime, take all the time you need to grieve.

Religion can be a great source of comfort and solace during the most difficult of times. Religion has been implicated in reduced mortality, expedited recovery from illness, and improved mental health. It can encourage healthy lifestyles, provide social support, and provide meaning to life. But it can also impact help seeking behavior, especially when it comes to fertility treatment. Religiosity has been associated with greater concerns about infertility treatment, which, in turn, decreases the likelihood of help seeking (i.e IVF, egg donation etc).

Religion and assisted reproductive technology (ART)

The use of donor gametes to create embryos can ignite some serious debate in many faith circles. Some faiths say fertility treatments go against their beliefs and should not be used, even if it means someone will never become a parent otherwise. Meanwhile, other religions have no issues with it at all, as long as certain “rules” are followed. 

A Pew Research study conducted in 2013 asked people living in the United States about the moral acceptability of using in-vitro fertilization to have a family. One-third said it is morally acceptable, 12% said it was morally wrong, and 46% said it was not even a moral issue. The survey found modest differences in opinion among social and demographic groups, including religious groups, about the moral acceptability of IVF. 

But for many religious people their religious beliefs strongly inform their understanding of fertility and parenthood. Procreation can be an important tenet of a religion along with prescribed roles for the male and female partner when it comes to parenthood. So what if you want a family and the only way that family can be created is through egg donation? And what if you are someone who holds strongly to their faith - a faith that carried you through troubled times - only to discover that very faith does not give you its blessing to have the family you have prayed for? 

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What if you are someone who holds strongly to their faith - a faith that carried you through troubled times - only to discover that very faith does not give you its blessing to have the family you have prayed for?

How do I navigate making a decision?

You want to adhere to the teachings of your religion and at the same time you also have a very strong desire to have a child.  What should you consider when deciding how you want to proceed so you can feel good about your decision? How can you find a way to remain connected to your beliefs even if your choice is different from what is taught by your religion?

Give yourself permission to imagine different options

Play your life tape forward and really imagine how it feels to go against your beliefs in order to achieve pregnancy. Now imagine how it feels to stay strong in your beliefs and never be a parent. Discuss these options with your partner. Write them down in a journal and come back to them in a few weeks. Does one evoke a bigger emotion? Does one feel better than the other? There is no right or wrong and there is no judgment - you are allowed to imagine and really think through your different options. 

Speak to trusted members of your community.

Speak to respected and trusted members of your faith community. Ask questions to fully understand what your religion’s expectations are regarding parenthood and regarding ART and IVF and donor eggs. What are your expectations? Do they match or are they very different? 

If they are different, would you ever make a decision to pursue donor egg IVF that isn’t sanctioned by your religious teachings? If yes, how would your community support you? Would you be ostracized? What does it mean to be against these teachings?  If you would never go against the teachings, then how can your religion provide guidelines about living child free? Would you be able to find peace regarding infertility from your religious teachings? Studies have shown that infertile women with higher levels of spiritual well-being reported fewer depressive symptoms and less overall distress from their infertility experience because of the support from their religious community.  

Summing it up

Faith can be an essential aspect of a person’s life. Sometimes it is possible that not all  tenants align. But that does not necessarily mean that you forsake your faith, nor does that necessarily mean you give up your desire for a family. It may mean digging even further and leaning even stronger into your faith.  It may mean exploring all your different options by researching, talking, asking questions, and praying. All of these things can open doors and create alternative paths to parenthood that you may not have ever considered.

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Being told you can’t have a genetic child can be heartbreaking. At the same time, knowing that there is still a possibility of being a parent and caring for a child and growing your family with the help of a donor, can bring relief. Still, that grief needs to be honored and given space and time to heal before moving forward. 

Stages of grief

Elisabeth Kubler Ross came up with five stages of grief that a person moves through when they suffer a loss. Researchers have found that these stages can be generalized to losses across the board - such as the grief of infertility. The stages aren’t linear and people may find themselves moving in and out of the different phases at different times. Some stages last longer  than others and some stages can be skipped over. 

Denial

It makes sense that after the initial diagnosis of infertility, a person might not believe it. Especially if they feel healthy, are ‘young’ by conventional standards or have never been sick. They can be quick to assume it is a mistake or can be quick to jump into another cycle of treatments because denial is at play. Denial is a method of self-protection as it can be painful to admit that your life plan may go in a completely different direction than you had ever imagined. One way to move on from this stage is to give yourself permission to feel the pain and sorrow and to dig deep to understand what this diagnosis means to you and what you think it means about you. Many times we have distorted beliefs about what something like this means about us. 

Anger

Once you get that second, third, or fourth opinion… or once you can no longer endure the treatments, anger may erupt. Anger can come in many forms; anger at self, anger at partner, doctor, or even random pregnant strangers. Sometimes this anger drives away those who can actually help and provide that very important emotional support. 

Bargaining

Anger is typically replaced by bargaining or what is sometimes called “magical thinking.” Meaning, a person in this stage might think that perhaps by dramatically changing their lifestyle, their doctor, their medical protocol, anything - with the hope that the changes will somehow have an impact and change the result of their diagnosis. 

Depression

Hiding from the world, lethargy, hopelessness, and intense sorrow describe this stage. It is important to note if this mood lasts most of the day, nearly every day for two or more weeks with a diminished interest in activities along with:

• Significant weight loss, weight gain, or decrease or increase in appetite 
• Fatigue or loss of energy 
• Feelings of worthlessness or excessive or inappropriate guilt 
• Diminished ability to think or concentrate, or indecisiveness, 
• Recurrent thoughts of death

Then it is time to speak to your doctor. 

Acceptance

There comes a point during this time that your heart beat slows down, that pit in your stomach goes away and you feel as though you can breathe again. Whether you decide to adopt, use a donor or be child free, something inside finally says, “I am okay.” When this acceptance occurs, doors open, and options become available.

Acknowledge and accept your feelings

It is okay to not be okay. It's important to acknowledge and accept your feelings of loss, sadness, anger, or any other emotions you may be experiencing. Allow yourself to feel your emotions and understand that it's okay to grieve.

Seek support

You don't have to go through this alone. Seek support from family, friends, a therapist, or a support group. There are many online communities and support groups for people who are facing similar challenges.

Focus on self-care

Take care of yourself physically, emotionally, and mentally. Give your mind and body its best chance to heal by engaging in activities that bring you joy, practicing mindfulness, exercise, and eating healthy.

Find meaning and purpose

Focus on finding meaning and purpose in your life beyond having a genetic child. This can include volunteering, pursuing a career, or cultivating relationships with friends and family.

Explore other options

Although you may not be able to have a genetic child, there are other options available such as donor eggs. Sometimes processing means moving forward with Plan B. 

Does it matter if my child is not genetically related to me?

We live in a world where adoption, step and foster families and blended families are the norm. 

Research shows that in general, there are no differences in the bonds created between parents and children born naturally, through surrogacy or donation. 

Does the pain of infertility ever go away?

It doesn’t ever completely go away but you learn how to manage it and not let it impact your daily life. You learn that grief is part of the human experience. Everyone at some point or another will go through some type of grief. But you will be okay. 

First comes love, then comes marriage, then comes… how does that song go again? Our world has so many cultural rules and norms in place that we forget that in reality everyone’s experiences, needs, and realities are very different. We say we are open and tolerant to difference yet, we let society dictate how we live, love, and feel. So when a woman is diagnosed with infertility and told that donor eggs are required to have a baby, instead of being grateful for the opportunity to be a parent, different fears can kick in. One of the fears includes not being supported by family or friends. But what happens when that non-support comes from your partner? And what if despite his not wanting to use donor eggs, you still do? What happens then?

Understanding your options: the pros and cons of using donor eggs

The positives are obvious: you get to be a parent. And for some, another positive can be that  the husband's sperm can be used, thereby keeping some genetic connection. Negatives can include cost and finding the ‘right’ donor may take time. And in this scenario, conflicts with your partner about moving forward with donor eggs. 

Read more: I'm Considering Using Donor Eggs. What are the Pros and Cons?

Communicating with your partner: how to have a productive conversation

When this topic first came up, you both most likely had your own private reactions. You both may have needed time to truly digest and process the situation. But sometimes, one partner moves through the process a lot quicker and immediately decides what to do while the other partner needs more time to figure things out. 

So if you want to move forward with donor eggs and he doesn’t, what comes next? First, he needs the opportunity to spend time really digesting and processing this on his own terms.  He needs to sit and put himself in both situations (using a donor vs. not using a donor) and being honest about how that would look and feel. Has he had time to talk to someone without you? Maybe a friend, the REI, or even a therapist? He needs to talk to someone about his biggest worries, his biggest concerns, and his biggest issues with using a donor and sometimes that person is not you. 

You can’t force anyone to get on board just because that is something you really want. You also can’t let your feelings invalidate his feelings either. But what you can do is both get educated on the process, you can both speak with a therapist, you can both read the literature, and/or attend groups with other couples in your exact same situation. These are things that can help you make informed decisions, decisions that you can feel good about, even 20 years from now. 

Can I pursue donor eggs without my husband knowing? 

Surprisingly, this isn’t a joke. This question has been asked -  a few times. If you have this thought, then you need to work with a couples therapist. Starting a family is a huge endeavor, regardless if you use a third party or not. It is a life changing event that triggers a lot of stress and can be very challenging. If you are not on the same page regarding donor eggs you need to find a therapist who specializes in fertility. This is important so you aren’t spending time explaining the details of infertility, they will already understand and be able to flush out the issues with you.  

A fertility psychologist can help you  explore different parenting options. Options such as adoption, fostering, or maybe even living child free. It gives you the opportunity to create a safe space for you both to voice your feelings but also a safe space to learn more about each other's feelings, needs and wants. It can open space for understanding and a deeper connection. 

Coping strategies and how to manage your emotions during this time.

You can’t change the past and you can’t control the future. But you can learn how to be in the here and now by practicing mindfulness. Mindfulness can help regulate emotions, decrease stress, anxiety and depression. Practice self-care by doing things you enjoy and being with people you love. Talk to someone. Find a therapist, a friend or join a group, don’t bottle it up.

Conclusion

At the end of the day, there is no wrong decision. Navigating the complex world of infertility and exploring options like using donor eggs is a journey filled with challenges and emotions, particularly if you and your partner are not on the same page. It is essential to maintain open, honest, and compassionate communication throughout the process, granting each other the space to process feelings and come to a decision at your own pace. This is not a decision to rush, and sometimes the assistance of a fertility specialist or therapist may be needed to guide you both through this journey.

Remember, your feelings are valid and it is okay to feel a multitude of emotions. You are not alone in this journey and there are many resources available to you – from literature on the subject to support groups for couples facing the same situation. Lastly, self-care is vital during this time. Practice mindfulness, enjoy activities that you love and surround yourself with supportive individuals. Most importantly, no matter the outcome, it can lead to a deeper understanding of each other and potentially a stronger connection as you face these decisions. Together as a couple, you need to make a decision that is right for you and your family.

Social media's incessant flow of perfectly filtered life updates and photos can be a double-edged sword. For those who are dealing with infertility, a simple scroll through a feed can sometimes turn into a painful reminder of what we are struggling with. An ad for diapers, pregnancy announcements, gender reveals, or family vacation photos can all trigger feelings of sadness and loss. 

These digital fragments, seemingly innocuous to others, can become acute pain points, echoing the unfulfilled desires and dreams of those grappling with infertility. In a space designed for connection, sharing, and joy, the unintended emotional toll can be heavy. 

If social media is bringing you daily triggers, I wrote this guide for you. It’s a guide to help tailor your social media environment, and serves not just as a practical tool but as a necessary aspect of self-care and emotional wellbeing. This guide aims to provide clear instructions and support, enabling you to create a more controlled and comforting digital experience.

How the algorithms works against you 

Algorithms are the unseen force shaping what we see and interact with online. Social media platforms leverage sophisticated machine learning and data analysis to create a feed tailored to our interests, behaviors, and interactions. However, for those grappling with infertility, these algorithms can inadvertently contribute to emotional distress. 

The algorithms work by tracking your interests and behavior. Platforms like Facebook, Instagram, and Pinterest analyze your clicks, likes, shares, and time spent on specific content to understand your interests. If you've ever looked at baby products or followed pregnancy-related accounts, the algorithm remembers. This informs personalized advertising, where advertisers target you with specific content. Algorithms also suggest posts, accounts, and hashtags to follow. While this usually helps discover content that aligns with your interests, it can backfire if you're trying to avoid specific triggers.

Simultaneously, “cookies” record your visits to other websites, such as online stores looking at baby products or blogs about parenting. These digital crumbs allow advertisers to follow you back to social media, serving ads that align with your browsing history. The integration of algorithms with cookies means that a casual glance at a baby stroller can transform into a series of targeted ads on your social media feed.

Despite the overwhelming influence of these invisible algorithms powering our online experience, the reality is that you have the ability to take control and change the way these algorithms affect you. You can transform your social media experience into one that supports rather than undermines your emotional well-being. 

You're not entirely at the mercy of the machines. You have tools at your disposal, and the agency to shape a better online experience. In the sections below, we will explore specific strategies and methods to do just that. 

How to reduce triggering posts and ads on social media 

Let’s dive into the strategies for changing your social media algorithms. 

Unfollow or mute those who tend to post triggering content

You know those friends and influencers who continually post content that might be triggering. Their posts are not ill-intended, but they can still sting. If they aren’t a friend, you can simply unfollow them as a necessary step in self-care. But if they’re someone you can’t simply unfriend without some drama, try muting them. 

Muting someone is a feature that allows you to temporarily hide their content without unfollowing or unfriending them. 

• Instagram: Allows you to mute posts and stories from specific users without unfollowing them. Just tap the three dots in the top right corner of the post, and select "Mute."
• Facebook: You can "snooze" friends for 30 days, which is akin to a temporary mute. Click the three dots at the top right of a post and select "Snooze for 30 days."
• X (Twitter): You can mute accounts, meaning you will not see their posts in your timeline. Click on the three dots next to the Tweet, then click "Mute @[username]."
• Pinterest: Pinterest does not have a specific mute feature, but you can unfollow users by clicking on their profile and hitting the "Unfollow" button. If you want to give feedback on a particular pin, click on the three dots and choose "Hide Pin."
• TikTok: Allows you to mute users. Just go to the profile of the person you want to mute, tap the three dots in the top right corner of the screen, and select “Mute.”
• Threads: Allows you to mute users. Go to the profile of the user you want to mute. Tap the three-dots-in-a-circle icon in the top right corner and select “Mute.”

Change your advertising settings

It is not just posts from friends that can be triggering; targeted advertising related to pregnancy and babies can be equally distressing. After I lost my twins in the second trimester, I could avoid the baby aisle at Target but I had to manually shut off the pregnancy and newborn ads on social media platforms. 

Advertisers know how to utilize sophisticated algorithms and user data to target individuals with specific content. This results in ads for baby products or parenting services being presented to those who have recently engaged with related content. For someone grieving a loss or grappling with infertility, these ads can be more than mere marketing messages; they can become haunting reminders of dreams unfulfilled and hope deferred, reinforcing a cycle of emotional distress that one might be striving to overcome. 

• Instagram: Allows you to change ad preferences. Go to “Settings and privacy,” then “Accounts Center,” then tap on “Ad preferences.” There, you can manage ad topics and remove interests related to pregnancy or babies. 
• Facebook: If your Instagram and Facebook accounts are tied to the same phone number, you don’t have to do this again as ad settings for Instagram will automatically apply for Facebook as well. 
• X: Click on “Privacy and safety,” then “Ads preferences.” Turn off personalized ads, so you get generic ads instead of those tailored to your activity. 
• Pinterest: Allows you to turn off personalized ads. Click on “settings,” select "Privacy and data," and uncheck personalized ads.
• Google: With My Ad Center and About this Ad, you can block ads you don’t want to see. On any ad itself, select “More,” and then drop down to select “Block ad.”
• TikTok: Go to “Settings and privacy” and tap “ads” to see how your ads are personalized. You can turn off any interests that TikTok may have added. It can also be helpful to switch genders to confuse the app. 

Improve the algorithm by setting content preferences

The algorithms that govern your social media feeds aren't immutable; you can actively tailor them to suit your needs. By hiding certain words, phrases, or even emojis that might be triggering, you can create a more personalized and considerate online environment. Here's how to do that on different platforms:

• Instagram: Go to “Settings and Privacy,” then go to “Hidden Words” and choose the words or phrases you don’t want to see on your feed or in your DMs. 
• Pinterest: Go to “Settings” and “Tune your home feed” where you can add/remove interests, boards, and pins. 
• Facebook: You can see and adjust your Facebook Feed preferences by going to “Settings and privacy” then clicking on “Feed.” 
• Twitter: Allows you to mute words, phrases, or hashtags. Go to "Settings and privacy," click on "Privacy and safety," then click "Mute and block” where you can choose muted words that won’t show up in your timeline.
• TikTok: Limit content by going to “Settings and privacy” then “Content preferences.” There you can filter keywords that you don’t want to see. 

Refill your feed with content that makes you happy

Okay now that you have removed a lot of accounts, ads, and keywords that could be triggering, it’s time to add back in some content that will make you happy. Find joy in funny animal videos? Love food tutorials? Following accounts that focus on interests rather than personal life events can provide a welcome distraction.

Avoid social media when you're feeling especially down

The online world will always be there, but sometimes a break is necessary. If you’re feeling particularly sad one day, step away from the apps and find solace in the real world.

The bottom line

In a digital era where our lives are intertwined with social media, navigating the online world can be both empowering and perilous. The very platforms that offer connection and inspiration can also become minefields of triggers and distress, especially for those dealing with infertility or pregnancy loss.

Your virtual environment can and should be a sanctuary, reflecting your needs and nurturing your emotional health.

Through the conscious and intentional modification of settings and preferences, you can reshape your social media experience. From muting and unfollowing content that triggers pain to fine-tuning advertising settings, the power to create a safe and supportive online experience rests in your hands.

But this journey is also about mindfulness and introspection. Knowing when to embrace the virtual world and when to seek refuge in the tangible one is a subtle art of balance. Replacing the triggers with content that resonates with joy, humor, and personal interests can breathe fresh air into your digital life.

Ultimately, the algorithms, the advertisers, and the endless stream of posts don't define your online experience—you do. With the tools and insights shared in this guide, you're well-equipped to turn social media into a space of comfort rather than conflict.

In the end, social media is not just a reflection of what algorithms think we want to see; it's a reflection of who we are, what we value, and how we choose to engage with the world around us. The control is yours.

Gestational surrogacy involves a woman agreeing to carry and give birth to a baby for someone else. After the baby is born, the gestational carrier (GC) gives custody and guardianship to the intended parent or parents via a legal document. This document states that the baby is not hers and that she has zero claim over the baby and surrenders all rights. The baby may have all, partial or none of the DNA from the intended parents. Due to medical reasons, carrying your own baby may not be a possibility and that may create some very strong negative feelings. Feelings of guilt, anger, loss and failure are very common. 

The grief of not carrying your child

Grief is something that is experienced after a deep and meaningful loss. We usually think of grief in terms of a death. However, grief in surrogacy is also very real, as the death of the dream of having and carrying a child of your own, may no longer be a reality. 

During the surrogacy process, grief can be felt after failed IVF attempts or miscarriages. There may be grief about the loss of a biological connection if donor gametes need to be used. There may be grief about missing out on the pregnancy milestones such as feeling the baby kick. There may even be anticipatory grief of believing that one may be unable to bond with the baby after birth. 

Stages of grief and how they manifest

Grief during surrogacy can manifest itself in many ways. It doesn’t always manifest as sadness as we would expect. During surrogacy, the intended parent(s) may go through stages of denial, anger, depression, and even guilt. 

Denial

Denial is typically the first way grief manifests during surrogacy.  Unless you have always known that you will not be able to carry your own child, that realization that you will not be carrying and birthing your own child, can be a difficult pill to swallow. Because you may look or feel healthy, you may not believe what you are being told.  You may refuse to believe that this is true. 

Anger

Anger can be aimed at self, partners or doctors. Even at random pregnant women walking down the street. Since this all seems very unfair, you may be easily set off by the most minor things. Your reactions may vary from minor irritability to intense rage. 

Depression

When the sadness just doesn’t go away. When it becomes more and more difficult to engage with life, depression may be setting in. There may be a sense of hopelessness and a loss of interest in things that used to create joy and happiness. There may be sleep issues - too much sleep or not sleeping at all. There may be a lack of appetite and social isolation. 

Guilt

Surrogacy guilt is real. The feeling that it is your fault and that maybe you are a bad person or are doing something wrong can start to appear as you go through a surrogacy. It may manifest as embarrassment, shame or a sense of inferiority. 

It is important to understand that all these feelings and emotions are normal. It is also important to understand that with the right help, these feelings can be processed and managed. You can get to the other side. 

How to deal with questions from nosy people

Sometimes questions that we consider to be personal are unavoidable. If you are using a gestational carrier to have a baby and you ask for maternity leave or tell people you are expecting when you’re not visibly pregnant, you can only expect people to be curious.

Luckily you have options. You are never obligated to tell anyone anything. It is afterall a personal matter and you are in charge of who gets to know what information. You can decide to share and tell your story while leaving out some information. You can do this by crafting an answer that you feel comfortable with. Write out some answers and start testing them - how does it feel when you say it? 

Coping strategies

The path through grief is winding and often disorienting. But equipped with coping strategies and the validation that your emotions are to be honored, not ignored, you are better poised to traverse this emotional landscape. Here are some coping strategies to try:

Find support through counseling or support groups

Navigating the emotions when using a gestational carrier often necessitates external assistance for emotional equilibrium. The act of consulting a therapist or joining a support group can serve as a respite from the mental weight one is carrying. Therapeutic interventions have been shown to improve emotional well-being and reduce symptoms of depression and anxiety). In the company of a trained therapist or a community of people sharing similar experiences, you are granted the space to explore your emotions and thoughts candidly. The collective wisdom found in these gatherings might provide unanticipated insights or coping strategies that you hadn't previously considered.

Communicate with your partner, friends, or loved ones

Solitude might offer a temporary refuge, but enduring support often lies in meaningful dialogues with those who share your life. Quality communication fosters emotional intimacy and provides a backdrop against which you can more fully understand your own feelings and concerns. By confiding in someone you trust, you externalize your emotions, creating room for insight and understanding to settle in.

Spend time with people you love

In the abyss of grief, companionship can be a lifeline. While the impulse to isolate may be strong, seclusion seldom serves the healing process. Human interaction releases oxytocin, a hormone proven to reduce stress and create feelings of well-being. Time spent with loved ones offers a reprieve, however brief, from the emotional turmoil you're enduring.

Spend time doing things you love

When enshrouded in grief, it's all too easy to forget the activities that once elicited joy. Though it may require a conscious effort, engaging in a beloved pastime can redirect focus and uplift spirits. Whether it's reading a treasured book or painting a canvas, these activities serve as emotional anchors, grounding you in a reality that still contains elements of pleasure and fulfillment.

Listen to your body

Grief can be visceral, a physical ache that demands your attention. If you feel the urge to cry, let the tears come. Emotional tears have been found to contain stress hormones and are thought to be a way for the body to achieve emotional release. Denying your body's signals to grieve can delay healing, whereas acknowledging them can pave the way for emotional relief.

Give yourself compassion

Self-compassion is not merely an emotional indulgence but a psychological necessity. Self-compassion is often linked to better mental health outcomes and resilience. It provides you with the psychological space to accept your feelings without judgment. Offering yourself compassion means acknowledging that grief is an inherently human experience, worthy of patience and understanding.

Keep a journal

Writing down your thoughts and feelings is akin to speaking them out loud but in a more introspective manner. By committing your feelings to paper, you're not only creating an emotional release valve but also establishing a written record that can help you track your emotional journey and healing progress over time.

Maintain a healthy lifestyle

A robust mind is often housed in a robust body. Regular exercise, balanced nutrition, and adequate sleep can have a profound effect on emotional health. It may be tempting to neglect these basics when grief strikes, but maintaining a healthy lifestyle provides the physiological support needed to cope effectively with emotional strain.

As you journey through, remember, the path is not to be walked alone. Seek and extend support; empathy and understanding are companions you need not leave behind.

Conclusion

Surrogacy can be an emotionally challenging journey. One fraught with many ups and downs. Aside from the complex medical procedures and legalities and costs, there needs to be an acknowledgement of the grief that also accompanies the process. 

Seeking support and resources before embarking on the journey, during and even after are important to managing emotions and the psychological impact of surrogacy. So prioritizing support is vital for the well-being of everyone involved. Cofertility is here to guide you every step of the way. 

Read more:

• What Should I Know Before I Get Serious About Surrogacy?
• Can Someone Break Down the Costs of Surrogacy?
• What Do I Need to Know About Surrogacy Laws?

You already know how difficult it can be to select the right egg donor match for your family. That is why once you have found a potential match, meeting her (either in person, over video, or on a call), can be a great way to finalize and feel confident about your decision. 

Since starting work in this field as a Fertility Psychologist in 2011, I have facilitated many egg donor match meetings. Sometimes the first few minutes are a little awkward and uncomfortable. That is completely normal. That is why having a facilitator can be great as they can help guide the conversation and keep it moving. 

Below are some questions you can ask during your meeting to get to know your egg donor. When preparing for your meeting, it can be a good idea to write down your questions and also write down hers. These can be placed in your child’s book (if you are making one). 

Also, remember, she will likely ask you questions as well. So think about what you want the egg donor to know about you and your family. 

10 questions to ask when meeting your potential egg donor

1. When did you first learn about egg donation and why did you decide to donate?
   Why are you donating to us? Understanding her reasons for wanting to donate can give you an inside look at her thought process, and understanding why she wants to donate to your family, can create a stronger bond and understanding between you.
2. Who will be your primary support person during the medical procedure? Make sure she has a support system during the process, and ask how you can help. 
3. Have you told your family? Not everyone wants to tell their family and friends, and that’s okay. 
4. If she has donated before, it is okay to ask her questions related to previous donations such as: What went well? What do you wish could have been different? 
5. What are your thoughts about the type of relationship you want to have with our family? Depending on your egg donation agreement, the relationship you have with the egg donor can be anywhere on the spectrum, from no involvement at all to attending birthday parties. There really is no right or wrong. It all just depends on what works best for you, your donor and your respective families. It is also important to keep in mind that like all relationships, this one too will evolve. Some end up drifting apart and others become closer over time. Again, there is no right or wrong here. 
6. Although questions about medical / family medical history are already in their profile, you can still use the time to ask them to clarify anything.
7. Questions about education and career: what are you studying? What about that interests you? What are your career goals? 
8. What do you love to do when not working or going to school?
9. Tell me about your typical day, how does it look?
10. What are your expectations of us during this process? How can we help make this process as smooth as possible?

When asking questions, be respectful and kind, and if you feel she is getting uncomfortable, move on to the next question. 

The emotional and relational dynamics of meeting your egg donor

It is normal to feel all sorts of emotions when meeting with a potential egg donor— from gratitude to being completely nervous. So be prepared to feel. Just remind yourself why you are doing this. Typically at the end of a meeting, most parents and egg donors are even more ready and excited to move forward.   

Meeting your egg donor in-person or virtually is a great way to finalize your decision to use egg donation to grow your family. Bringing that profile to life helps to create a more personal connection with your donor.  

Find an amazing egg donor at Cofertility

At Cofertility, our program is unique. After meeting with hundreds of intended parents, egg donors, and donor-conceived people, we decided on an egg donation model that we think best serves everyone involved: egg sharing.

Here’s how it works: our unique model empowers women to take control of their own reproductive health while giving you the gift of a lifetime. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family.

We aim to be the best egg-sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:

• Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
• Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
• Diversity: We’re proud of the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
• Baby guarantee. We truly want to help you bring your baby home, and we will re-match you for free until that happens.
• Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.

We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive. Create a free account to get started today!

Read more:

• Should I Meet My Potential Egg Donor?
• Should I Pick an Egg Donor Who Looks Like Me?
• 10 Facts You Need To Know About Using Donor Eggs
• Five Parents Share What They Wish They Knew Before Using Donor Eggs

One of the first things a woman may think about after learning that an egg donor is required in order to have a child, is the worry of attachment. Specifically, will I have issues attaching to my baby because we are not genetically related? The reason for this train of thought may stem from common misconceptions or stereotypes that all mother’s immediately bond and connect with their child and that a genetic relationship is required for that attachment to even take place.  

Social media definitely loves to show that “perfect” moment after a woman gives birth where the mother looks lovingly into her healthy child’s perfect round face - with her hair, makeup and lighting fully on point - proclaiming this to be her greatest love of all. But rarely do we get to peek at what is happening behind the curtain. 

Whether an egg donor is needed to create a baby or not, many parents do not immediately connect, attach or bond with their baby. This lack of attachment has nothing to do with a lack of genetic connection, but everything to do with this new found responsibility, the shock of a new identity and purpose, hormones, lack of family support, lack of sleep, and just trying to survive those first few months. The purpose of this article is to examine attachment between mother’s and their donor conceived babies and to give a better understanding of attachment and how it works. 

Attachment theory and parent-child bonding

Psychologist John Bowlby described attachment as the emotional connection between an infant and their primary caregiver. The parent-child attachment lays the foundation for the child's life choices, overall behavior, and the strength of the child’s social, physical, mental, and emotional health. According to Bowlby, attachment develops  through interactions between infant and caregiver that evolves and grows deeper over time. This attachment typically occurs when a child is about six months old. 

Research and findings: attachment in donor egg families

Evidence from the attachment literature focuses on the importance of parental responsiveness as to what differentiates the type of attachment formed between parent and child - not whether they are genetically related. From the perspective of attachment theory, what is important for secure attachment to occur is not genetics but the consistency, availability and love that is shown to the child by the caregiver. It is parental responsiveness, rather than biological relatedness, that is considered to be important for the development of secure attachment relationships between a parent and a child. Meaning genetics does not play a role in secure attachment. 

It is parental responsiveness, rather than biological relatedness, that is considered to be important for the development of secure attachment relationships between a parent and a child.

Further insights from the adoption literature suggest that overall, parents who adopted their children reported few differences in the attachment behaviors between them and their adopted children versus parents and non-adopted children. Further adopted children and adolescents did not report feeling less secure in their relationships with their parents compared to non-adopted children. 

It appears that the caregivers' behaviors played a more important role when it comes to attachment. For example, Bowlby found that children whose parents were sensitive and responsive were likely to view themselves as loveable and have a positive sense of self. Whereas children whose parents were emotionally unavailable or rejecting, were more likely to develop a lack of self-worth. 

So the question of “will I have attachment issues to my baby because we are not related?” is not the question to ask, rather, “am I ready to be emotionally available to a child? Am I ready to be a parent?”

Existing research on attachment in families with donor egg children found that families with no genetic link between mother and the child showed more positive outcomes than families where the mother was genetically related to the child. The authors posed the possible explanation that perhaps this was true because these parents took the extra steps required to intentionally choose to raise a child who was not genetically related to them. Since that strong desire for parenthood was more important to them than genetic relatedness and since they had to move mountains to become parents, they found parenting to be more satisfying than those who become parents through “traditional routes.” Remember, this is just a hypothesis and it is definitely not implying that genetically related parents love their children less than parents not genetically related to their children. It could mean that the parents using donor eggs were perhaps more prepared - as they may have spent years planning for this baby. And finally having that dream realized makes them not take having this baby for granted. 

What does genetics have to do with attachment? 

Not much. A longitudinal study compared 46 donor insemination families and 48 egg donation families, with 68 natural conception families on the child’s second birthday. The results showed gamete donation mothers to have more joy towards parenting and more positive maternal feelings towards their child by the time the child had reached two years of age. Adding further evidence to the growing body of literature that genetics do not play a role in  the development of a positive relationship between a gamete conceived child and its parent. 

Social perceptions and stigmas

Societal views on donor egg conception vary with differing social perceptions and stigmas. Depending on your culture, your religion, your sexual orientation, your age, your belief system, your fertility journey, your level of education and understanding of gamete donation, and even your socio-economic status, your views on egg donation will be very different.  So depending on all those different variables society's views may potentially impact a mother-child relationship in a negative or positive manner. 

It seems as though everyone has an opinion on how we should raise our children from what they should eat, watch on television, ipad or no ipad, which school they should attend, and how to get that constipation resolved. It really never ends. It is very easy to say “don’t let people’s opinions impact you and your relationship with your child.” But it is never that easy, is it? 

We have evolutionarily evolved to want to be a part of a tribe, a village if you will. And their opinion matters. Because guess what? If you fell out of favor with your tribe thousands of years ago, you wouldn’t be able to survive. Things are a little bit different today than our caveman times but people’s opinions and views of how we live our life, can still negatively impact us. This is where the role of a mental health professional and support groups can be of tremendous benefit. 

Counseling and support

A healthy attachment style starts from the day you take your first breath. But what if you did not have a healthy secure attachment with your own parents? How is that now informing your relationship with your child? What if you don’t have a positive sense of self? What if you don’t  feel cared for by others? What if you don’t have a sense of closeness with other people? These are just some possible indicators of not having had a secure attachment to your own caregivers. Working with a therapist to work on your own attachment issues can really inform how you end up attaching to your own children, regardless if they are genetically related to you or not. 

Working with a mental health professional, you can learn how to self regulate your emotions, build your self-esteem, learn how to effectively communicate your needs, and how to set boundaries. Learning some of these skills by working with a mental health professional can be an important way for you to learn how to become more self-aware, how to stop self-sabotage and even how to get over that imposter syndrome you may be feeling when it comes to parenting. And learn how to deepen and securely attach to those you love. 

Summing it up

To sum it up, do moms of donor egg babies have attachment issues? Sometimes. But then again so do most parents, regardless if they are genetically related to their child or not. Attachment can take time, it doesn’t happen overnight. If you don’t immediately fall in love with your baby the second you lay your eyes on them, you are not alone. Every single relationship in this world takes time. Learn to cut out the outside noise, learn to listen to your own voice, and just go with what feels right.

Read more:

• Nature vs. Nurture: What Parents Via Egg Donation Need to Know
• Five Parents Share What They Wish They Had Known Before Pursuing Donor Eggs
• How Do I Navigate Telling Others My Child Is Donor Conceived?
• The Parent-Child Relationship in Families Created Using Egg Donation

As someone who has been working as a Psychologist in the field of fertility for many years, egg donation is a common topic of conversation that I have with my clients. Many who come to see me are working with egg donors and they express the high level of stress they feel and want to learn how to manage all the emotional challenges involved in seeking and working with an egg donor.

Understanding the stress factors in egg donation

Making the decision to work with an egg donor to start your family is a major life decision. A major life decision that can cause a lot of stress. Stress due to uncertainty, financial costs, failure…. the list goes on. 

Stress is your body’s response to something you perceive to be difficult. Your body responds to this by going into fight or flight. Meaning your body is ready to do what it needs to feel safe again. Everyone experiences stress differently. It may cause you to experience physical, emotional, or mental distress or pressure. But one thing is common, the feeling of overwhelm. It can just feel like too much.  Some start to feel emotionally detached and even start to feel numb to the whole process. On the other end of the spectrum, some may become overly hyper-vigilant. Obsessively checking their emails from their clinic or wanting every single piece of information to ensure an informed decision. Stress can also show up as irritability, heart palpitations or shortness of breath, and even panic attacks. 

All of this is normal. Your body and mind are doing what they think is right to protect you from harm. But there are ways you can cope with stress.

Setting realistic expectations

When potential intended parents tell me they are stressed out about working with an egg donor, inevitably we discover that they have very unrealistic expectations about timelines and outcomes. The thing is, even the best laid plans can go awry and this is especially true with third-party reproduction. Think about it, there are a minimum of 10 people involved with one egg donation cycle. The chance of all 10 being synced up at the same time doesn't always happen. Being realistic means being flexible and adaptable. Knowing that this journey is not a linear progression. There will be delays, cancellations, and obstacles. These things are given. Those rigid expectations need to be loosened up.

Emotional preparedness and support

Having a solid support network can help build resilience and help manage stress. One of the best ways to be prepared is to prepare your network of friends and family. Many keep this journey to themselves for a myriad of reasons and that is fair. At the same time knowing that you can lean on someone can alleviate some stress. Communicate what it is that you need from them and allow them to help.

Support groups that focus on egg donation can be a shining star, especially in times of darkness. You can find people that are going through similar things and can understand how you are feeling. These are great places to learn coping skills that have worked for others in your same situation. 

Staying informed and making informed decisions

You cannot underestimate the power of information. Yet, this is also one area that also causes extreme stress. Yes, please understand the egg donation process thoroughly. But you do not need to understand it at the same level as your REI or embryologist. Take that burden off your shoulders and put trust into your team. Understand the basics, ask questions, read reputable journals if you wish, but once you have chosen your team, trust them and let them do their job. 

Stress-reduction techniques

• Mediation and mindfulness. These are definitely two buzzwords we hear all the time in popular literature. But honestly, they aren’t for everyone and contrary to popular belief they don’t necessarily reduce stress. In fact, some research shows that they can increase stress. This is because you are so focused on your thoughts or physical sensations that your stress increases. If you find these tools to be beneficial then by all means go for it.

• Organize your time. If you know you only have 15 minutes to get to your appointment before you need to get back to work, then don’t schedule your appointment for that time. Don’t schedule appointments back-to-back either. Give yourself some breathing room. Many times parents are sitting in my therapy room, staring at the clock because they need to be at their doctor's appointment so they can’t focus on anything, only increasing their stress. 

• Make a list. Write down all the things that you need to do. Organize them in order of importance. 
• Set easy to reach goals. Setting smaller, more achievable goals can help us feel more satisfied and in control. For example instead of: go to the gym 5 days a week for 1 hour. Write: go to the gym on Monday at 3pm and ride the stationary bike for 20 minutes. 
• Be honest. Things that seemed easy and no big deal before you started this journey can feel a lot more difficult. That is because they are more difficult. You have a lot on your mind and a lot going on. So, If you can’t go to that birthday dinner after your blood tests, then don’t go. If you take on too much during this time, you will feel even more stressed. 

Summing it up

While you are seeking an egg donor just expect that you will feel stressed, overwhelmed, and tired. Now is the time for self-compassion, patience and self-care. Lean on your people, take a break and be kind to yourself. 

Read more:

• Six Reasons Why Egg Sharing is a Better Egg Donation Model for Intended Parents
• Coming to Terms with Using Donor Eggs
• My Doctor Suggested Using Donor Eggs. Now What?
• Building Your Family Through Egg Donation After Infertility: Navigating the Emotional Rollercoaster