Fertility and Wellbeing
Your fertility doctors at Reproductive Partners Fertility Center – San Diego believe in holistic, whole-person care. We deeply want two things for you: to realize your dreams of fertility, and to have as much wellbeing on your fertility and life journey as possible. It is our mission to help you achieve both fertility and wellbeing through excellent, evidence-based medicine and compassionate, whole-person care.
We recognize that the journey of trying to conceive, infertility, pregnancy loss, and fertility treatment is one of the hardest experiences to go through in life
Infertility significantly impacts one’s dreams, sense of self-identity, personal agency, mental wellbeing, stress, and relationships. These are some of the most important things in our life, and so we find that many people facing infertility experience the diagnosis as devastating, a personal crisis, and have a perceived loss of control over their lives. Perhaps one of the hardest human experiences is the feeling of powerlessness and the suffering that comes with it. Depression and anxiety are doubled in women going through infertility and quadrupled in women who have experienced recurrent pregnancy loss.1-4 Medications from fertility treatment often elevate women’s systemic levels of both estrogen and progesterone, which may independently influence one’s wellbeing (through these hormones’ actions on serotonin).5
Your team at Reproductive Partners Fertility Center wants to empower and validate you on your fertility journey.
We want you to know that it is normal to be feeling what you are feeling – this feels hard because it is hard. We want you to know that every time you step through the door of our clinic, we recognize what courage and bravery that takes: to face infertility and fertility treatment and bravely go after what you really want – that is courage. We are here for you every step of the way.
One of the core values of your fertility doctors at Reproductive Partners Fertility Center – San Diego is Practicing Compassion.
Compassion means that we are deeply aware of suffering and we are profoundly motivated to relieve that suffering. Our whole team of fertility specialists at Reproductive Partners – San Diego want to help you have wellbeing in even the hardest times on your fertility journey. Helping and being there for patients through sometimes their darkest moments, into their greatest joys, is why I became a physician. I am extremely passionate about improving your wellbeing through helping you create intentional daily practices for peace and joy in your life, which are essential to help you face and overcome the challenges of infertility.
Creating Space for Peace and Joy on Your Fertility Journey
From the heart of Dr. Stanhiser
My patients teach me about Courage every day
As both a fertility specialist and a woman, I am deeply aware of how vulnerable it may feel during so many of our fertility evaluations, procedures, and treatments – like talking about one’s own intimate experience with infertility and experiencing transvaginal ultrasounds and pelvic exams. Pursuing your dreams in the face of this vulnerability is how my patients teach me about courage every day. Brené Brown has said that, “Vulnerability is not winning or losing; it’s having the courage to show up and be seen when we have no control over the outcome. Vulnerability is not weakness: it’s our greatest measure of courage.” Your team at Reproductive Partners Fertility Center – San Diego will do everything we can to help you achieve your fertility dreams and recognize your courage every step of the way.
In your fertility journey, and when facing any hardship or suffering, I recommend creating an intentional space of presence in your inner life.
This is how you will get through it, how you will have wellbeing in even the hardest times, and why suffering has been called a holy truth – because our suffering has the capacity to show us the path to peace and joy. We do this through mindfulness and self-compassion. These practices will improve your wellbeing on your fertility journey every single day.
Mindfulness is the energy of being aware and awake to the present moment. It is the continuous practice of touching life deeply in every moment of daily life. Many studies have found that mindfulness practices promote and improve wellbeing.6
Even when you have pain in your heart, you can enjoy the wonders of life through mindfulness. Mindfulness is a practice – to be entirely present in the simple wonders of everyday life: present to a sound, a sight, a touch. I recommend noticing simple things throughout the day – things that are always present in our life no matter what is going on – the sky, the plants and animals, the tree branches moving in the wind. Eckhart Tolle writes, “Many poets and sages throughout the ages have observed that true happiness – the joy of Being – is found in simple, seemingly unremarkable things.”
Kristin Neff is a researcher and one of the world’s leading experts on self-compassion. She explains that self-compassion involves three core elements that we bring to bear when we are in pain: mindfulness, self-kindness, and common humanity.
When life circumstances are challenging and feel difficult to bear, it is essential in practicing self-compassion to actively soothe and comfort ourselves, instead of attacking and berating ourselves.
The components of mindfulness and self-kindness within self-compassion have been called The Two Wings of the Bird that Free Us: we see what’s going on inside us, and we let it be there and we offer kindness.
A sense of interconnectedness is essential to self-compassion. Dr. Neff writes, “Self-compassion honors the unavoidable fact that life entails suffering, for everyone, without exception. When we remember that pain is part of the shared human experience, every moment of suffering is transformed into a moment of connection with others.”
Daily Joy Practices for Wellbeing on Your Fertility Journey
When you are facing challenges, it is an absolute necessity to create moments of joy throughout your day. I recommend cultivating joy through intentional, daily practices. These practices are all a form of mindfulness, and will improve your daily wellbeing, emotional regulation, resilience to suffering, and your ability to persevere in fertility treatment to achieve your dreams. Doing these daily joy practices even for one minute will bring intentional joy into your every day, no matter what your day brings.
Dr. Stanhiser’s Daily Joy Practices
- Mindfulness – be entirely present as many moments as you can in your day, noticing simple wonders like water splashing in the sink, leaves moving in the wind, your in-breath and your out-breath.
- Walk Outside in Nature Every Day – walking in nature is a form of meditation and brings peace, energy, and equanimity to your day. Studies have found that happiness and wellbeing are substantially greater in natural environments.7 You will find that walking outside in nature every day is very healing for symptoms of depression and anxiety associated with infertility.
- Exercise – this is first line treatment for symptoms of depression and anxiety.8 Do something active that makes you feel connected and alive in your body every day.
- Create – anything. We are all artists. I highly recommend reading, “The Artist’s Way,” by Julie Cameron. The act of creating – the process – is where the joy is. Focus on the process, not the product. You can create anything – an environment, a feeling, an experience, music, art, growth. Viewing yourself as a creative being is part of healing.
- Learn Something New – each of us is learning something new every single day. The key is being aware of the new things we are learning, because in that awareness is the joy of growth. Bring that awareness to every moment you can in your daily life – you are constantly learning something new, progress is being made, and that is exciting. All of this improves your daily wellbeing.9
- Practice an Instrument – whether picking up an instrument again or for the first time, focus on the joy of the experience of playing in the moment itself, not on the end-product. Learning to make music in adulthood has been found to significantly improve wellbeing.8
- Garden – nurturing life nurtures our own sense of aliveness within ourselves. Helping things grow and having life around you is very healing. Whether it is gardening outside or nurturing potted indoor plants, studies have found that gardening improves our mental and emotional wellbeing.10
- Journal – this practice brings awareness of our inner life. Try stream-of-consciousness journaling or writing down five things that bring you joy every day.
- Bring Animals into Your Awareness and Life – whether it’s a dog or a cat, a bird, a fish, or a hamster – animals are healers: they bring us back to the present moment, again and again, and remind us of the joy of Being. Studies find that the presence of an animal in one’s life improves daily wellbeing.11 To be present and aware of the little things – the wonders of life – you need to be still inside; allow nature and animals to teach you stillness and the joy of Being.
- Read – learning something new through reading each day brings joy through growth, peace, and purpose and improves overall wellbeing.8 Just read one paragraph or one page a day and see where it takes you.
- Water Practices – water is a natural healer: the sight, sound, and feel of water brings peace and healing to us by reducing stress and increasing presence. Being around water physiologically and psychologically improves our wellbeing. Studies show that people living near water have a lower risk of premature death, obesity, and report better mental health and wellbeing.12 Introduce water into your life, throughout your day in many ways. Daily water practices include drinking 2-3 liters of water a day, and may also include baths, fountains in your living space, swimming, and visiting lakes and the ocean.
- Meditate – a formal or informal practice of meditation (quieting the mind with the breath, and then relaxing all effort, and simply resting in what is) brings space, peace, and joy into your daily life and improves wellbeing.13 I highly recommend Tara Brach’s guided meditations and talks which are offered freely:
Dr. Stanhiser’s Recommended Books for Wellbeing on Your Fertility Journey
- Radical Acceptance by Tara Brach
- Radical Compassion by Tara Brach
- The Artist’s Way by Julie Cameron
- The Mindful Self Compassion Workbook by Christine Neff
- The Power of Now by Eckhart Tolle
- A New Earth by Eckhart Tolle
- Man’s Search for Meaning by Viktor Frankl
- The Choice
- No Mud, No Lotus by Thich Nhat Hanh
- The Heart of the Buddha’s Teaching: Transforming Suffering into Peace, Joy, and Liberation by Thich Nhat Hanh
- Taking the Leap by Pema Chodron
- The Book of Joy by Archbishop Desmond Tutu and His Holiness the Dalai Lama
- The Joy Practice
Recommended Therapists Specializing in the Experience of Infertility and Pregnancy Loss
Your fertility doctors at Reproductive Partners Fertility Center recommend connecting with a therapist on your fertility journey. Speaking with a therapist can improve wellbeing, and mitigate the effects of depression and anxiety on your healing journey.
Our team of fertility specialists are here for you to answer any questions about your fertility journey and wellbeing.
It is our honor to help you in any way we can. We look forward to continuing to empower you on your fertility journey, and to help you thrive in the face of both infertility and any hardship in life.
Yours in Courage,
Jamie Stanhiser, MD MSCR
- Stanhiser J, Steiner AZ. Psychosocial aspects of fertility and assisted reproductive technology. Obstetrics & Gynecology Clinics of North America, 2018; 45(3):563-574.
- Hoff HS, Crawford NM, Mersereau JE. Mental health disorders in infertile women: prevalence, perceived effect on fertility, and willingness for treatment for anxiety and depression. Fertil Steril. 2017;104(3):e357. doi:10.1016/j.fertnstert.2015.07.1113.
- Holley SR, Pasch LA, Bleil ME, Gregorich S, Katz PK, Adler NE. Prevalence and predictors of major depressive disorder for fertility treatment patients and their partners. Fertil Steril. 2015;103(5):1332-1339. doi:10.1016/j.fertnstert.2015.02.018.
- Kolte AM, Olsen LR, Mikkelsen EM, Christiansen OB, Nielsen HS. Depression and emotional stress is highly prevalent among women with recurrent pregnancy loss. Hum Reprod. 2015;30(4):777-782. http://dx.doi.org/10.1093/humrep/dev014.
- Williams KE, Marsh WK, Rasgon NL. Mood disorders and fertility in women: a critical review of the literature and implications for future research. Hum Reprod Update. 2007;13(6):607-616. doi:10.1093/humupd/dmm019.nces
- Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. Journal of personality and social psychology. 2003 Apr;84(4):822.
- MacKerron G, Mourato S. Happiness is greater in natural environments. Global Environmental Change, 2013;23(5):992-1000.
- Carek PJ, Laibstain SE, Carek SM. Exercise for the treatment of depression and anxiety. The international journal of psychiatry in medicine. 2011 Jan;41(1):15-28.
- Perkins R, Williamon A. Learning to make music in older adulthood: A mixed-methods exploration of impacts on wellbeing. Psychology of Music. 2014 Jul;42(4):550-67.
- Clatworthy J, Hinds J, Camic PM. Gardening as a mental health intervention: A review. Mental Health Review Journal. 2013 Nov 29.
- Janssens M, Eshuis J, Peeters S, Lataster J, Reijnders J, Enders-Slegers MJ, Jacobs N. The pet-effect in daily life: An experience sampling study on emotional wellbeing in pet owners. Anthrozoös. 2020 Jul 3;33(4):579-88.
- Foley R, Kearns R, Kistemann T, Wheeler B. Blue space, health and wellbeing. Hydrophilia Unbounded, Routledge, London. https://doi. org/10.4324/9780815359159; 2019.
- Keune PM, Perczel Forintos D. Mindfulness meditation: A preliminary study on meditation practice during everyday life activities and its association with well-being. Psihologijske teme. 2010 Dec 31;19(2):373-86.
Recommended Therapists Specializing in the Experience of Infertility and Pregnancy Loss
Center for Infertility Counseling and Support
Karen Hall, Ph.D.
12625 High Bluff Drive Suite 104
San Diego, CA 92130
Tel: (760) 443-5425
Fax: (858) 793-1124
The Center for Human Infertility and Reproductive Psychology
Sylvia Marnella, Ph.D.
9765 Birch Canyon Place
San Diego, CA 92126
Tel: (619) 379-6012
Fax: (858) 693-4387
Kelly Engleson, LCSW
1050 University Avenue Suite E107 #715
San Diego, CA 92103
Tel: (619) 500-1268
UCSD Maternal Mental Health Clinic
UCSD Outpatient Psychiatric Services
8950 Villa La Jolla Drive Suite C101
La Jolla, CA 92037
Tel: (858) 534-7792