I Didn’t Need a Different Fertility Treatment, I Needed Therapy

I’ve resisted writing this for 5 months. After sharing the news of my miscarriage in January, I wanted to continue updating you– all the wonderful people who showed us so much love and support– on our fertility journey. In the least overwhelming way possible, I wanted to share what I believe helped and didn’t help me and my husband, Rob.

Part of me resisted because I’m incredibly superstitious. I’m terrified that I’ll jinx our pregnancy by sharing, which sounds so silly to me as I write it because I know it’s not true! But, as I learned from my yoga teacher and friend, Regina Smith, just because something isn’t true doesn’t mean it doesn’t feel real. And my fear of jinxing remains very real for me.

I’m working through this form of self-sabotage because I want to happily accept that we’re pregnant. Plus, sharing my story is important. So often we brush over the uncomfortable parts of our lives to our own detriment and our community’s.

I also resisted writing this because it’s difficult to go back to the beginning of this year. I’m crying as I write this now. It feels as real and raw now as it did then and recalling the most emotionally taxing period of our lives takes a lot out of me.

All that aside, it’s time. I need to finally share the fertility update with you. Hopefully it will help you no matter where you are on your fertility journey and help me to release the pain and move forward.

At the end of my last article, I wrote about the importance of finding a medical team that you trust, like, and will listen to. After my miscarriage, I spent a month and a half improving some nutritional deficiencies (including B vitamins, magnesium, vitamin D). My integrative doctor put me on a strict diet and supplement protocol.

The hardest part of the protocol was having to eat some meat and fish. It was difficult even though I ate the highest quality from sources I trusted. I’ve never enjoyed eating meat and it doesn’t sit well in my body or mind. In general, the highest quality meat, in modest amounts, can fit in a healthy diet. However, I personally prefer a well-planned predominantly plant-based diet to provide all the necessary nutrients. Meat never seems to work for me.

But I tried it. After not eating meat for about 4 years, part of me expected that I’d feel an immediate increase in energy upon re-introducing it into my diet. I didn’t feel this lift at all and instead dreaded mealtimes.

On the other hand, injections of B vitamins, glutathione and vitamin D gave me that immediate lift. I left the doctor’s office buzzing. In hindsight, I think I could have skipped the protocol and just done the injections!

The 6-week protocol + injections solved my nutritional deficiencies, but my period didn’t return, my estrogen levels remained extremely low, and the medications that the integrative doctor initially villainized were back on the table. I wish integrative medicine alone would work for me.

Ultimately, I ended up back at a traditional fertility doctor, one that was more convenient to where I lived. For anyone just starting fertility treatments or looking for doctors, my first piece of advice is to go somewhere great AND convenient. Don’t underestimate the power of convenience. Some weeks I was at the doctor 3 or 4 times. When I saw a practitioner in New York City, it was more stressful to get to the doctor from Long Island than necessary. Sometimes the best option isn’t the most convenient. But, if you can, choose the MOST convenient option possible. 

For anyone just starting fertility treatments or looking for doctors, my first piece of advice is to go somewhere great AND convenient.

Choosing an amazing doctor nearby at a practice where I fortunately also had a family friend practicing (and looking out for me) made such a difference. I often spent the 20-minute ride to the doctor crying, but at least it wasn’t an hour and a half schlep on the crowded Long Island Railroad at 6am.

Back in a doctor’s office, I went through my entire health history again and was diagnosed with unexplained infertility– the most anti-climactic diagnosis– again. Because it had been 2 years without a natural period and 1 year of fertility treatments, I was much more receptive to the one piece of advice my doctor gave me when I asked, “is there anything else I should be doing?”

She advised me to gain weight. I was never underweight and was considered a “healthy” BMI. Nevertheless, my doctor explained that even though I was in that healthy range, maybe my body wanted to be heavier. Maybe my body perceived my weight and eating habits as restrictive even though we didn’t. And, when the body feels restricted, it’s constantly stressed, and the reproductive system can shut down.

Doctors, dietitians, acupuncturists, and herbalists had told me this before– that gaining some weight might help– but I always dismissed it because, well, I didn’t want to gain weight. I knew my “happy weight” and didn’t want to veer.

When I got home, I told Rob, who always greets me with a genuine “Hi Gorgeous” regardless of how I look, the doctor’s suggestion. He was very excited. “Great, this is awesome. Let’s gain weight.” Much of the fertility process is out of our control– we’re constantly at the mercy of doctors and blood tests and exams. Rob was eager to do something on our own that might help. I remained open, but less than enthusiastic.

My best friend’s wedding was in a few weeks, so I declared that I’d gain weight after those festivities.

My best friend, Ruthie Friedlander, had a severe eating disorder and, post-recovery, started The Chain, a non-profit dedicated to supporting women in media and fashion with eating disorders. She posted something on Instagram before her wedding that changed my perspective on gaining weight. Three weeks before an important event, she usually severely restricted her eating. Not this time. Instead, she treated herself to manicures and massages to combat the urge to restrict. Here I was not wanting to gain weight prior to her wedding while she was demonstrating that all that matters is our physical and emotional health. Sometimes this involves doing things that we don’t want to do.

Ruthie and me at her wedding to Steven Chaiken at the Frick Collection.

This brings me to my second piece of advice. This applies to any time that you’re a patient and going to see a professional. Accept that you’re going to get recommendations that you like and ones that you don’t like. You don’t have to follow all recommendations, but you’re doing yourself a disservice if you shop around for a professional who’ll tell you exactly what you want to hear. If you had nothing to change or work on, you wouldn’t seek professional advice. Am I right?

This brings me to my second piece of advice. This applies to any time that you’re a patient and going to see a professional. Accept that you’re going to get recommendations that you like and ones that you don’t like. You don’t have to follow all recommendations, but you’re doing yourself a disservice if you shop around for a professional who’ll tell you exactly what you want to hear. If you had nothing to change or work on, you wouldn’t seek professional advice.

Some of the things recommended worked for me (i.e., gaining weight) and some things didn’t (i.e., eating meat). At a certain point, I opened my mind and realized that even when a recommendation didn’t work, at least I tried it and didn’t let my stubbornness win at my own expense. The only way we know if something works is by trying.

The only way we know if something works is by trying. 

This also applies to the solicited and often-times unsolicited advice you inevitably receive from friends, family members, and random people on the street. I lost count of the “All you have to do is…” and “My friend’s sister’s accountant’s wife did X so you should too,” and the most triggering comment, “just relax.”

The advice is overwhelming and hard to hear. I get it. But, people mean well and want to help you, especially when they see you hurting. Try to have an open mind and heart because you might hear something that will make a difference. And, as I reflect back, the “just relax” comment was the most triggering because it was what I needed to do.

Okay so I was trying to gain weight and back on clomid (a fertility medication designed to cause ovulation). Being on clomid is not fun. The first few days were fine and then by day 3, BAM. I noticed Rob and my family looking at me differently and leaving me alone more often to avoid my wrath. I felt depressed, moody, sad, anxious, and bloated. Not my usual #happyabby.

After feeling grateful that I was responding to clomid, which not everyone does, we decided to try our first IUI or intrauterine inception – a type of artificial insemination. I resisted this intervention because nothing was wrong with Rob, I prefer things to happen as naturally as possible, and the plastic involved in any procedure makes me cringe. However, I also hated being on clomid and anything that could increase my chances of getting pregnant and avoid more rounds of clomid seemed worth it.

The stars were aligned for our first IUI. I happened to have that particular Saturday off of yoga teacher training and was feeling great. I had a few bites of dried pineapple (one of my favorite ways to #snacknaked), did a Jody Shield self-mothering meditation in the waiting room, wore my favorite pajama-chic outfit by SVILU, and some of my favorite Taylor Swift songs randomly played on the radio. After the IUI, which took about a minute and was completely painless, I remained in a zen-like state for 10 minutes. Rob and I then enjoyed a lovely breakfast together, loaded up on #zerowaste sourdough bread, and had a relaxing Saturday.

When I got my period 2 weeks later, my heart sank. Even in my most zen, calm state, clomid plus IUI didn’t work. Plus, insurance didn’t cover the IUI.

I hate to bring up finances because it’s uncomfortable, but the financial pressures of the fertility journey are often not discussed and a HUGE source of stress. I wanted a baby more than anything, but it’s incredibly frustrating to spend money, a lot of money, on something that should be FREE (or, at max, the cost of a nice dinner and a bottle of wine 😜)!

Each failed cycled meant more money spent, more stress, more unknowns and still, no baby.

I get antsy for results about one and a half months into any treatment. And like clockwork, I started thinking of my other options and everything else I could and “should” be doing. I scheduled appointments with other acupuncturists and herbalists.

This was when I had two profound turning points in my fertility journey. One I came to on my own and the other came unsolicited from another one of my best friends.

With the itch to see a new practitioner and start a different treatment, I remembered a particular moment with the integrative doctor I saw months prior. In that moment, I was noticeably on the verge of breaking down. It was toward the end of the session and she brushed past my comments and emotions and wrapped up.

I wanted to, and needed to, talk through what I was feeling with a professional. Instead of having a very important conversation, she dismissed me. Recalling that moment, I realized that I didn’t need a different fertility doctor to diagnose me with “unexplained fertility.” I didn’t need another integrative doctor to tell me that my hormones were off or that I had adrenal fatigue or that I needed to eat meat. I didn’t need an acupuncturist to tell me that I needed acupuncture. I needed to talk. I needed therapy.

I realized that I didn’t need a different fertility doctor to diagnose me with “unexplained fertility.” I didn’t need another integrative doctor to tell me that my hormones were off or that I had adrenal fatigue or that I needed to eat meat. I didn’t need an acupuncturist to tell me that I needed acupuncture. I needed to talk. I needed therapy.

Luckily, I was already in therapy– the exact type I needed. My superpower is attracting the most amazing people into my life and I attracted Regina Smith, Morgan Rose, and all the students in my yoga teacher training into my life. The Life Enrichment and Yoga Teacher Training program at Gritty Buddha was my therapy. I needed to be surrounded by powerful women (plus one man!) three days a week. I needed to breathe with them, to absorb their love and positivity, and feel their support. I needed to let them see that I was struggling and I needed to listen to their advice. Small things, like when Regina and Morgan corrected me every time I said, “IF I ever get pregnant,” by immediately saying “when, Abby, when” made a difference. Even if I didn’t believe it would happen, I needed to be surrounded by people that did.

Through talking and listening, I started to figure out what healing myself meant for me. Social media can make it seem like we’re supposed to heal ourselves by ourselves. Every day we read stories of this one curing herself by listening to herself or by eating a plant-based diet or by eating meat or by dancing in the moonlight.

Maybe it’s just me, but these stories made me feel like a complete failure. How come I didn’t know how to heal myself? (This was a theme in my first fertility post and continued to be a stressor for me). These stories usually mention the many different diets/protocols/supplements the individuals tried. But, we (or maybe just me) fixate on what worked and ignore that others also tried different treatments with different practitioners before “healing themselves.”

Through talking and listening, I started to figure out what healing myself meant for me.

What I learned and, most importantly, finally accepted was that I didn’t have to heal myself by myself. I didn’t have to find all the answers myself by finding the secret science hidden in the secret library in the room of requirement that no one else has yet discovered. I had to listen to those who loved me most and had to sit with their suggestions.

What I learned and, most importantly, finally accepted was that I didn’t have to heal myself by myself. I didn’t have to find all the answers myself by finding the secret science hidden in the secret library in the room of requirement that no one else has yet discovered. I had to listen to those who loved me most and had to sit with their suggestions.

Morgan told me to wear red and get red sheets to support my hormones. Because red just isn’t my color, I purchased blush pink sheets and Rob and I redid our bedroom to make it fresh and bright. After Morgan’s advice, Heather gave me a magical red crystal to support hormonal health that I carried around with me (and still do!). And, my sister knit me a beautiful red blanket. These “woo-woo” things actually made me feel better. They reminded me of how much I was loved and supported. And, “woo woo” things are FUN.

Then, my best friend, Lisa Hayim, called. I wish we could remember the exact date of this conversation, but I’m pretty sure it was right before we got pregnant (me and Rob, not me and Lisa 😜). 

I was blathering on and on about how our planet is drowning in plastic and we are doomed and the Earth is dying. She said, quite strongly, “Abby, you’ve got to chill about this plastic stuff. How can you expect a baby to want to come into the world when you’re constantly thinking about how horrible it is here?”

Lisa said, quite strongly, “Abby, you’ve got to chill about this plastic stuff. How can you expect a baby to want to come into the world when you’re constantly thinking about how horrible it is here?”

As soon as she said it, I knew she was onto something. When I wasn’t thinking about fertility, I was researching the sorry state of Mother Earth and our health.

I sat with her comment and thought about what it meant for me. I was always so focused on the stress that came with the fertility process that I neglected to deal with the sources of stress outside of fertility.

Lisa and me at her bachelorette party.

All of this combined, the realization that I needed to treat yoga teacher training as therapy and Lisa’s observation that I needed to be more positive about the world, forced me to “just relax.” Relaxing for me meant ACTUALLY dealing with stress of fertility treatments and the regular stresses of life productively.

Dealing with stress is deeply personal. It requires more than an infographic perfectly suited for Instagram. Yoga and meditation helped, but I had to make other changes.

Dealing with stress is deeply personal. It requires more than an infographic perfectly suited for Instagram. Yoga and meditation helped, but I had to make other changes.

First, I started to focus on the positive news in the worlds of nutrition and the environment. One of my favorite bloggers, Kathryn Kellogg of Going Zero Waste, posts positive news every Friday. I read her posts religiously to keep my spirits up about the environment.

Second, I identified the little things in life that really annoyed me. You know those pet peeves that get under your skin day after day? These little things add up and leave us feeling depleted. I took note of them and took action to eliminate as many as possible.

For example, I constantly received Explanation of Benefits (EOBs) forms from my insurance company. This really frustrated me; I wanted them emailed to save the paper! Every time I received them in the mail (which was about every day!), it brought up how the fertility process was leading me to create more waste.

Instead of getting worked up about how wasteful this was, I took action. I asked Rob to find out if there was a paperless option and we learned that there wasn’t. Even though I continued to receive the wasteful packets of paper, at least we tried to avoid it. This sounds silly, but it actually reduced the stress I experienced every time I received the EOB in the mail.

Additionally, the number of Band-Aids I used at the doctor’s office bothered me– so. much. waste. We had many Band-aids at home that we’re using up before getting a more sustainable bandage option and yet I wasn’t using them; I came home with more band-aids every week! So, I brought my own to the doctor’s office. Sometimes I forgot to ask to use my own, BUT having the intention me feel better. I took steps to live my low waste life throughout the fertility process.

Here’s one last example. I usually cried on the way to the doctor’s office in the morning out of frustration and sadness. Unsurprisingly, this wasn’t a great start to the day. During yoga teacher training, a guest teacher told us that Disney researches the musical notes that make us the happiest and uses those notes in its songs. He said, “just try to get angry with Moana songs on…just try!” In thinking about this, I decided to belt out Disney songs during the ride to the doctor. Sounds totally crazy, but it helped. It distracted me and put me in a better state of mind.

I couldn’t control the fertility process as a whole– I couldn’t control how many times I had to go to the doctor or how many exams I needed or when we’d get pregnant. But, I could control some stressors. In doing so, I felt better.

I couldn’t control the fertility process as a whole– I couldn’t control how many times I had to go to the doctor or how many exams I needed or when we’d get pregnant. But, I could control some stressors. In doing so, I felt better.

Before we knew it, it was time for our second IUI. Even though I was productively dealing with stress, the lead up to this cycle was the most stressful we’d experienced. For a few days, we didn’t think I was responding to clomid, so we were at the doctor even more than usual. And, we were both exhausted. I was convinced that we missed the window for IUI (I blame clomid for messing with my logic!) and the morning of the procedure, I pleaded with Rob to skip the cycle because “I just knew this wasn’t going to work.” I cried all the way to the doctor and in the waiting room– no Disney song could help me.

Rob convinced me to go through with the IUI because we were there and “why not?” The nurse told us not to take a pregnancy test for 10 days and Rob and I sat in a sad silence for about 10 minutes after the IUI. Then we went to work.

I’m not usually good at putting things out of my mind, but during the 2-week waiting period between ovulating and pregnancy test time, I’m a pro. At the end of the day, what I wanted more than anything was to enjoy my life. I didn’t want to wallow because who knows how many more cycles were ahead of us.

On day 9, I took a pregnancy test during a break in yoga training. Rob advised that I should wait until day 14, but I couldn’t. I saw “not pregnant” and my heart sank…again. I wasn’t pregnant and I wasted another stupid plastic test wrapped in more plastic.

Back to yoga I went and I secretly cried when we were practicing.

Thirteen days after the IUI, I still hadn’t gotten my period and I got home late from yoga teacher training. I took another test with absolutely no hopes, put it on my nightstand and drifted off to sleep. A few minutes later, I rolled over to read it.

Much to our surprise, it read “pregnant.” Neither of us knew what to do. We were stunned and so happy and then, quickly thereafter, the fear of another miscarriage set in.

Much to our surprise, the test read “pregnant.” Neither of us knew what to do. We were stunned and so happy and then, quickly thereafter, the fear of another miscarriage set in. 

I nervously confided in both my yoga teachers. When I told Regina, I remember saying “I’m not getting too excited, I’ve been here before.” Regina hugged me so tight and for so long and said “Abby, this moment right now, this is pure joy.” And it was. She reminded me that I needed to stay in the present moment and the present moment was full of joy.

On the final night of yoga teacher training and after 4 months of incredibly hard work to become a yoga teacher, we all each took turns hugging each other. With each hug, I let the love and support from this amazing community seep in and channeled it all to my baby. I said to myself, “baby, please stick. There’s so much love here for you.” This was a huge change from my thoughts a few weeks prior about the horrible the state of the world.

I continued to repeat Regina’s words- “this is pure joy”- and said “baby, please stick” as mantras. No matter what happened, I didn’t want to rob myself of feeling any joy. I wanted this baby to know that it was entering a world filled with love (not only an excess of greenhouse gases…).

For the next six weeks, we had weekly visits with our fertility doctor. At each appointment, I clutched the magical stone from Heather, braced myself for bad news, and was pleasantly surprised when everything progressed “beautifully.” When we saw the sac, which wasn’t present when we were pregnant in December, we exhaled a huge sigh of relief. Then we saw a heartbeat. And, as the heartbeat grew stronger, I started feeling sicker and sicker.

Rob and I embraced each doctor’s appointment and each pregnancy symptom with such gratitude. When I could barely lift my head from the nausea, Rob looked at me with the biggest smile I’d ever seen.

I took it really easy during my first trimester and, as often as possible, redirected focus away from my nausea to how grateful I was for the support Rob, my family, and my closest friends provided me.

In the end, do we really know what worked? Was it one thing or was it a combination? We’ll never know and for every person, it differs.

I identify treating yoga teacher training as therapy and productively dealing with my stress as huge contributors. I needed to listen to people (professionals, friends, strangers) with an open mind, I needed to talk, I needed to feel love and support, I needed to lean on my friends and family, and I needed to take control over what I could control.

We all want that quick fix, those immediate results. But anything worth having takes time and quick fixes are a waste of our time and energy. And you know I hate waste.

We all want that quick fix, those immediate results. But anything worth having takes time and quick fixes are a waste of our time and energy. And you know I hate waste.

I’ll be sharing more about the details of my first trimester and how I am continuing to deal with stress productively in future posts. For now, to close, I’m sending love and support to anyone going through this fertility journey. You’re not alone. And if you’ve been practitioner hopping, consider that maybe what you really need is a type of therapy.

We all get our happy ending eventually in some form. I believe that now more than ever.