The Type A Personality: What's a Great Grade for You?
I am not a Type A personality. Summing myself up, I believe that a 92, 94 or 96 is a great grade. It's an A plus even. If most of us (except for the super Type A personalities), got a 96 on a test, we'd feel we'd done well. Even very well.
Okay. Except it's not 100%. Ask my husband. I clean the kitchen, 94%. That means, invariably, that there is a dish or two not done, sitting in the sink. Or a glass or two still sitting on the dining room table. Or the napkins haven't made it down to the laundry room. Sometimes I clean the kitchen 98%. That's a pretty high percentage for me. Still, it's not 100% done. When Bill cleans the kitchen, it's scoured. Top to bottom. He's the one who earns 100%, plus 4% extra credit.
I learned at the American Fertility Association (AFA), as the Editor-in-Chief of inFocus magazine, that 92, 94 and 96% done with the magazine did not end up being delivered to our members mailbox. Ninety-six percent done meant that they weren't mailed and addressed and delivered. Even 99% didn't have them in the readers' hands. (Check them out: the content is available in AFA's online library and many of the articles are written by the top doctors, scientests, clinicians and mental health professionals in the field of infertility.)
Sometimes the only time you can say you've finished something is when it's 100% or more done. Finished. Complete. And sometimes, 96% is very, very good. Good enough.
During Infertility Treatment, How Do We Judge?
With infertility treatment, your clinical staff will guide you about what needs to be done, in terms of fertility testing, procedures that need to be done and more. They will let you know what foods and activities to avoid and embrace and to what extent. No caffeine or less caffeine? No sugar or healthier choices 94% of the time? Should you not exercise at all? What's a healthy heart rate? How many miles can you safely run, if at all? Listen carefully to your health care providers and ask the questions that you need to find out what you, as the unique individual that you are, need to know.
Make healthy decisions for yourself. How completely do you need to finish something today? Is it a work in progress so that 20% today is a great step forward? Will you allow yourself to feel complete, give yourself a high grade with a 96%?
I just finished cleaning the kitchen. It's bright and sparkly. The counters are wiped down, the sinks are empty and clean, the stove has no dirty pots.
I'm still me. I'm looking into my dining room. And sure enough, there are two water glasses on the table.
I give myself a 94%. And I'm good with that.
Dr. Mark Leondires, Medical Director of Reproductive Medicine Associates of Connecticut, talks about stress and infertility. Read below:
Stress and Infertility
It’s a hot topic among those who talk about fertility, as seen last month at the fertility field’s most prominent and prestigious professional group, the American Society for Reproductive Medicine (ASRM). Reproductive doctors from around the world – from Greece to Japan to several of the U.S.’s most respected institutions – made presentations about their recent studies concerning stress.
These clinical studies examined stress and infertility from nearly all angles: whether stress resulted from infertility and its complicated emotions, whether negative stress resulting from life-events impacts the success of in-vitro fertilization (IVF), even whether patients were able to accurately asses their own stress.
Fertility researchers have found both negative and positive correlation when they study stress and infertility. The real question is what marker does one use to study stress, as everyone’s stress response is unique. One study’s conclusion reads: “Logistic regression analyses revealed that [both] infertility-specific stress and non-specific stress were negatively associated with a pregnancy outcome after IVF. Psychological stress was negatively associated with IVF outcome, after controlling for biomedical variables. Fertility treatment protocols should consider including counseling interventions to potentially mitigate adverse effects of stress.” (The relation of psychological stress to pregnancy outcome among women undergoing in-vitro fertility and intracytoplasmic sperm injection; Gourounti, K. et al. ASRM Meeting 2011)
It is very clear that infertility increases stress on relationships between partners. In addition, as a couple enters treatment there are scheduling demands, anxieties about treatment options, financial stressors, and worries about potential for success. It appears to me that what my colleagues at ASRM were grappling with is what we know in our hearts versus what we can prove through science in a clinical study.
Our patients report benefits from learning to manage their life stressors. Whether patients are stressed as a result of infertility or if stress is one variable causing infertility is actually immaterial. My patients who manage their stress are more likely to get pregnant.
Since there is no downside to learning how to manage stress and improving overall health, there is no reason to resist recommending stress management options to patients. Although these interventions may or may not increase the likelihood of getting pregnant, there are two important known benefits: fertility patients have something to take control of and it improves their overall ability to manage stress in their lives.
Managing stress can be accomplished in different ways; and for most patients there are many approaches that are effective. First, I believe in having a strong network – patients need to talk to their partners, family, and friends. And when this is uncomfortable (many fertility patients hesitate to share private details with someone who has not experienced infertility), then share your thoughts and emotions with a support group or a therapist.
Second, find a release such as meditation, yoga or exercise in general. This will also help patients optimize their health, which is important for achieving a healthy pregnancy.
That leads me to the third approach: reduce the outside stressors (e.g., unhealthy foods) on a patient’s body and mind which can be mediated by working with a nutritionist or an acupuncturist.
Over the past several years, my partners and I have incorporated adjunct services such as these into our practice at Reproductive Medicine Associates of Connecticut (RMA of CT). We started with Fertile Yoga, and based on positive patient feedback we added an acupuncturist to the staff. Then patients expressed other needs and we began peer-led support groups and added a nutritionist to our staff. There are four key services – Fertile Yoga, acupuncture, nutrition counseling and therapy for individuals and couples – as well as several related workshops and seminars. Some are free of charge, some are covered by insurance and some are paid for out of pocket. Patients rave about them all.
This month we launched the RMA of CT Integrated Fertility and Wellness Center. It marks a symbolic stand, as well as a practical one. Patients will have greater ease in finding a practitioner and a time for appointments. At the core of our fertility treatment remains advanced reproductive medicine – but our method is to treat the whole patient.
I have a tendency to procrastinate. Generally, this actually works fairly well for me and I have come to accept it. I find that when I wait, something slips into place that had I moved to action immediately, would not have been possible. So, although procrastination has gotten a bad reputation, I have made peace with the fact that this is how I do things, and that in fact, it's not laziness, but a realization that over-planning, for me, often, is not my best choice.
Infertility and infertility treatment is planned out exactly, in terms of medication, procedures and blood draws. Except. A great big, huge except. Except when follicles grow more quickly/less quickly; except when there aren't enough follicles; except when one's body reacts more/less to the medication than anticipated; except when bloodwork doesn't indicate what is needed; except when sperm count is not where it needs to be; except when ovulation comes earlier/later than planned; except when a treatment cycle needs to be adjusted from IVF to IUI; except when you need to reschedule work days off from Monday to Friday.
You get the idea. A fertility treatment cycle is planned and then things happen. You are an unique individual. Your body is unique as well. Sometimes things go exactly as expected; often they do not.
Here's an excerpt from an article from Yoga Journal, written by Sally Kempton. She's been meditating and writing about meditation for about 30 years and is the founder of Dharana Institute.
Put simply, it looks like this: You do your best to control reality, to make your life function smoothly and efficiently. You also strive to keep your mind and emotions under control. At the same time, part of you longs for flow. Somewhere deep down, you know that a crisis or a meltdown can serve to push you past the psychic barriers you erect against the unpredictable and lead you back to the roller-coaster-like sense of freedom that can arise when your plans are suddenly overturned. You've probably also felt how resisting life's flow nearly always seems to create suffering.
Whether consciously or unconsciously, we all are engaged in a pas de deux between our desire to keep things under control and our longing to ride with the unpredictable. On one hand, control is essential. Without it, we would never mature, never accomplish our goals, and never transform bad habits. Our safety and productivity—indeed, the social contract itself—depends on our collective ability to control our impulses, check our tempers, make plans, and keep our commitments. When we say that someone is out of control (unless we're talking about a rock star going into fourth gear onstage), we usually mean that the person is dangerous to herself and others.
At the heart of any control issue is the desire for personal power. Essentially, we measure our empowerment by how well we control our inner and outer environment.
Externally, we express our power by how well we're able to control and manage our time, work, reputation, finances, and—admit it!—the other people in our lives. Internally, we take power by controlling our bodies—think of how good it feels when you hold a Headstand a minute longer than usual or resist eating the extra cookie—as well as our thoughts and emotions. We try to think positively or take deep breaths, instead of lashing out at a family member. We get down to work when we secretly feel like watching a movie. In so many ways, control is good, necessary, and admirable.
But then there's the other side of the story. That useful, necessary control mechanism has a tendency to turn tyrannical. Too much control deadens the life force in you. And the line between too much and too little can be hairline fine.
Sally goes on to discuss the other side of control, the control freak side of control. One that many of us become familiar with in fertility treatment. We just want things to go the way they are supposed to, the way we were told they were going to, they way that they need to for us to become pregnant. And it is scary and upsetting when treatment changes course or timing is different than we expected.
Sally goes to on to say this in the Yoga Journal article:
However you slice it, the control freak has two big problems. The first is that, when you let her dominate, she'll try to eliminate everything unpredictable from your life and everyone else's. The second, more serious problem is that, since life is basically out of control, your attempts to control outcomes will often end in frustration. If you can't let go of your need to control when necessary, you'll be at the mercy of your stress hormones.
It's been a stressful week and I felt myself several times go into wanting to overplan, over organize, and decide things too early, before other things were in place. My inner control freak still wants to take over when there's a lot going on. I know when my control freak is taking over by the looks on the faces of those around me. Yep, time to settle into myself when I see that particular look on the faces around me.
So easy to say. Not so easy to do, find balance between control and letting go of control. I find it easier when I look at letting go of control as release. My release of myself and demands and my release of what I am demanding from others.
How're you all doing with this today?
Does stress cause infertility or does infertility cause stress? We’ve believed the second for a long time; we can see how much stress infertility and treatment create. In talking to patients or Fertile Yoga students, the conversation comes up quite a bit. We discuss that if stress “really” caused infertility, rape victims would never get pregnant. Nor would women in countries at war, nor would frantic 16 year olds. Yet, we all have a sneaking suspicion that it goes the other way as well.
I have to admit to a hidden agenda here as well. If stress does add to infertility, isn’t that just another way we can beat ourselves up about what we’re not doing right or well enough? And isn’t it so obvious? If stress does cause infertility, we add to our stress levels over and over again, trying not to feel stressed. A cycle is created that needs to be broken and can be, in many different ways. Read what the New York Times had to say today:
In a study published online in the journal Fertility and Sterility, the scientists reported that women who stopped using contraceptives took longer to become pregnant if they had high saliva levels of the enzyme alpha-amylase — a biological indicator of stress.
The authors say this is the first study to link a biomarker for stress with delayed conception in normal, healthy women, and they suggest that finding ways to reduce or manage stress may be a low-tech solution for some infertile couples.
You can actually read the abstract and specific results, although the New York Times does extrapolate most of the pertinent information.
I love what the article goes on to discuss. What I have found in the two years that I have been teaching Fertile Yoga is that my students disappear constantly. In a different type of yoga class, that would not necessarily be a good indicator; of the class or me as an instructor. In Fertile Yoga, it’s the best outcome possible. It means that my students are getting pregnant and moving onto pre-natal yoga classes.
New York Times article goes on below:
Women who have been treated for infertility say the process can be highly stressful — in fact, all-consuming. Amy Cafazzo, 38, of Framingham, Mass., said stress-reduction classes at Boston IVF taught her coping skills she uses to this day — now to cope with her active 19-month-old twin boys.
“When you’re going through this, people often say, ‘Relax, it’ll happen,’ and you just want to smack them,” Mrs. Cafazzo said. “You can’t just relax.”
The classes taught breathing techniques, yoga and other relaxation strategies and provided her with a support network of women going through the same experience. Did it actually help her conceive?
“I just don’t know,” she said. “But I’m a Type A personality that needs an actionable plan, and this gives you something to do, so you feel productive and aren’t caught in a downward spiral of stress.”
I had tea last weekend with a very special Fertile Yoga student. She is currently 26 weeks pregnant and yes, glowing. She was a big believer in Fertile Yoga; she even created a very special mantra for herself (inhale- peanut butter, exhale- jelly). She is a success story, not only for RMACT, but also for me, as the teacher of Fertile Yoga. She was a student who did not have fertility success quickly, but stayed with her convictions about how she wanted to progress through treatment. And one thing that she truly believed in was getting her “groove on” (paraphrasing her term, juju?) at Fertile Yoga.
Stress and infertility certainly are partners. Whether one truly causes the other, whether there is a much more intricate dance going on between the two, whether we will eventually find out something completely different, what we know right now is that reducing stress is the healthiest possible choice.
I know how I release stress. What do you do?