Psychological and emotional preparation for IVF brings numerous benefits

Psychological and emotional preparation for IVF brings numerous benefits including an improved likelihood of success -The Fertile Body Method

Authors: Sjanie Hugo Wurlitzer Hyp. Dip, HG Dip, B.A, Jane Evans NLP Pract, BSc, Sandra Znidar PhD, MA, MAS

Outline:

1.      Introduction

2.      Why we need mind-body approaches for fertility

3.      What is the Fertile Body Method (FBM)?

4.      How the FBM helps woman prepare for and cope with IVF?

5.      Some of the benefits of psychological and emotional preparation for IVF

6.      Summary

 

1. Introduction
Since the wonderful scientific advances that have happened in the field of reproductive endocrinology, fertility issues have become more widely recognised and more readily addressed.

The UK’s National Institute for Health and Clinical Excellence (NICE) defines infertility as ‘failure to conceive after frequent unprotected sexual intercourse for one to two years.’ According to the Fertility Society of Australia 1 in every 6 couples in Australia experiences fertility problems.  

In the UK, fertility problems currently affect about 3.5 million people.  The number of women treated in the UK has increased steadily since the early 1990s; over 2½ times between 1992 and 2007 (http://www.hfea.gov.uk/2585.html).

Infertility is often thought of as a female concern, but in fact approximately equal numbers of patients sought treatment for male (29.7%) or female (28.5% in total) factors. A further one in ten patients received treatment because of both male and female factors. Nearly a quarter of patients treated had unexplained infertility (HFEA, 2005).

IVF is one of many treatment options available and is normally recommended when a woman has blocked fallopian tubes, a male factor is present, other fertility treatments have failed or if the diagnosis has been unexplained infertility.  In the UK, over 50,000 In Vitro Fertilisation (IVF) cycles are performed each year.[i]

The IVF process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman's ovaries and letting sperm fertilise them outside of the body, in a fluid medium. The fertilised egg (zygote) is then transferred to the womb so that implantation can occur. Pregnancy will result if the implantation is successful.

We know that fertility problems can be really challenging on a number of fronts.  And going through fertility treatments like IVF can compound the struggle and stress of infertility. IVF is a very time consuming, intense and demanding procedure.  People put a lot of financial and emotional investment into it, and some believe that their happiness depends upon the successful outcome. Irrespective of the outcome, going through a cycle of IVF is likely to have a negative effect physically, emotionally and psychologically, the impact of which is likely to be magnified by treatment failure.

In this article we will introduce the Fertile Body Method (FBM), a mind-body approach for fertility and look at how this approach prepares women for IVF and how that preparation brings numerous benefits including an improved likelihood of success.


2. Why we need mind-body approaches for fertility

Fertility problems are caused by a combination of many factors. Often overlooked are the psychological and emotional factors that influence the hormonal system and the ability to have children.

We know that the mind and body are interactive and constantly influence and affect each other. After prolonged periods of unhealthy emotions like anxiety, the body’s natural hormonal balance becomes disturbed. Excessive stress can lead to complete suppression of the menstrual cycle, and in less severe cases will lead to anovulation or irregular menstrual cycles. Research has yet to fully explore the impact of stress on the IVF process however we do know that in order to create positive changes to health and fertility, thoughts and emotional responses need to be healthy too.

Fertility problems increase the pressure and strain on all areas of health and well-being. People who have problems conceiving may experience a reduced sense of mental, emotional and physical well being which may leave them feeling frustrated, angry, jealous, guilty, hopeless or anxious. Fertility problems can affect their work, friendships, family and relationships. People’s self esteem and worth are often affected by ongoing fertility problems and increased levels of stress and depression often results (Domar, 1992). Much of the above is exacerbated by IVF treatment, especially repeated IVF cycles.

Fertility problems are amongst the most challenging life difficulties that we can go through.  For many women, just the thought of starting IVF treatment can place them under huge mental, emotional and physical strain.  Their path to fertility has been far from straightforward, with many disappointments along the way.  And now they face a major medical procedure at a time when they may well feel extremely vulnerable.

As a result, women who are due to undergo IVF often have high levels of stress and anxiety, or present with depression.  In a study by Dr. Alice Domar, women who had been diagnosed with infertility were compared with a group of women who had a terminal illness.  Dr. Domar found that the depression levels were the same in both groups of women (Domar, 1992). Another study by Chen et al (2004) showed that of 112 infertile women entering an artificial reproductive therapy (ART) clinic, 30% had a diagnosable psychiatric disorder.  Most common was generalised anxiety disorder (30%), followed by major depression (17%) and a form of low-grade chronic depression called dysthymic disorder (9.8%).

And it’s not just women who are negatively impacted by the prospect of IVF.  Men too suffer mentally and emotionally, often as a result of seeing their loved one in a high state of anxiety (Chiaffarino, 2011).

These studies illustrate the magnitude and the impact that fertility problems have on how women and men feel.  And if couples go into IVF without addressing their emotional health this vicious cycle is likely to continue.
Medical interventions can certainly help to address and take care of the biological aspects of fertility, but without the necessary psychological and emotional support these treatments are somewhat compromised.  An integrated approach to IVF, combining physical, mental and emotional interventions, is more likely to produce positive results and help make the procedure and outcomes much easier for people to deal with. The benefits are immediate and long term, helping people to undergo IVF feeling calm, empowered and well resourced.

 

3. What is the FBM

The Fertile Body Method (FMB) is a mind-body approach for fertility, developed by Sjanie Hugo Wurlitzer and described in her book The Fertile Body Method: a Practitioner’s Manual (Hugo, 2009).

The method offers 6 areas of treatment that include the vital ingredients needed for creating emotional well-being and enhanced fertility. These ingredients include; a solution-oriented focus, the restoration of balance and cultivation of inner and outer resources, the resolution of relevant problems/traumas, visualisation and guided imagery, adequate mental preparation and good emotional support. Refer to Table 1 for a description of the 6 stages of the FBM.

What makes this approach distinct is its emphasis on goal-orientation, psychological education and mind-body interventions. The method includes the use of all fundamental counselling skills like reflective listening, rapport building and reframing. It also uses hypnosis as a rapid means for creating emotional and physiological change and delivering meaningful therapeutic interventions of all kinds. Alongside therapeutic interventions the client is taught skills and mind-body tools for emotional health and enhanced fertility. The FBM can be used with men and women and is particularly effective when both partners undergo therapy. However for the purposes of this article we will be focusing on how the FBM can prepare and support women who are undergoing fertility treatment.

When it comes to IVF, the FBM can help women in two main ways; firstly it can help them to cope better with the IVF treatment and secondly it can help to increase the chances of success.

In our experience the optimum number of sessions to prepare and support a woman undergoing IVF is approximately 4 to 6 (Domar, 2001). The case study to follow covers 4 sessions with a client called Jo carried out before the start of IVF. Jo’s case is an example of how the FBM can be applied to help a woman prepare for IVF.  Although the focus of Jo’s case is to prepare for IVF it is important to note that ongoing support throughout the IVF procedure is highly recommended and encouraged as part of the FBM.[ii]

 

4. How the FBM can be used to help women prepare for IVF - a case example

The FBM                                                                     Case Example

Information Gathering A pre-appointment questionnaire is sent to the client to complete before the first session.  The questionnaire covers ·        Fertility history ·        Physical health history ·        Sexual relationship ·        Family history ·        Mental health history ·        Lifestyle During the session: the client is asked to give a brief overview of their life from birth to now highlighting anything that they think is relevant to their fertility and upcoming IVF treatment. The ‘birth to now’ question along with the completed questionnaire is a time effective way to gather enough historical detail to work safely and effectively and allows for the majority of the first session to be spent on goal setting. During the information gathering the therapist makes note of any fears and concerns that the client has as well as their skills, resources, strengths and achievements.	Jo came to see me after her and her husband had been trying to conceive for 2 years. They had been diagnosed with unexplained infertility and by the time we had our first session she had undergone 3 unsuccessful rounds of Clomid. She had done all the necessary tests and examinations needed to determine her suitability for IVF. Jo is fit and healthy and all tests indicate that she is fertile and statistically likely to be successful with IVF treatment. Although Jo has no history of mental health problems, she presented with anxiety. She said that felt like she was constantly worrying about her situation and at times that escalated into panic. She had lost a lot of weight over the past few months, experienced ongoing sleep disturbance and digestive complaints. She said she felt overwhelmed by the prospect of IVF and felt reluctant to put her body through such an ordeal. However after much consideration she and her husband felt they should go ahead with it as it may be their only chance at having a child. She was feeling very anxious about the financial and emotional investment in IVF and the possibility that it may not be successful. The IVF process itself frightened her because she didn’t quite know what to expect, was anxious about having to inject herself and that ultimately the outcome was completely out of her control.
Setting a healthy goal The majority of the first session is spent determining the outcome that the client wants from therapy and creating a smart healthy goal. Solution Focused Questions (SFQ’s) are an effective way to create a clear, concrete and observable goal that can be measured and when it is achieved it will be obvious to both the therapist and the client.   To successfully prepare for IVF, SFQ’s need to be asked to help the client identify: ·        what changes they need to make to be in an optimum mental, emotional and physical condition for IVF (before IVF) ·        how they would like to think, feel and behave throughout the process (during IVF) ·        how they would like to think and feel if the IVF is unsuccessful (after IVF)   Some typical examples of SFQ’s to ask a client who is preparing to undergo IVF include: ·        If you were mentally, emotionally and physically prepared for this treatment; how would you know? ·        What needs to change in order for you to feel prepared for this treatment? ·        What would help you to feel more ready and prepared for this treatment? ·        What healthy mind-set would you like to have about this IVF cycle? ·        How would you like to think and feel if this cycle of IVF is unsuccessful? ·        What past experiences have you had that show you that you can cope with IVF? ·        What are some of the advantages of your situation?	Jo wanted to feel calm and relaxed about the upcoming treatment. She wanted to give it the best possible chance of working and felt it was important to improve her sleep and return to a healthy weight. Other areas of her life had suffered over the past few months of fertility treatment and she longed to revive her friendships and social life. We discussed the stages of IVF treatment and she described how she would like to be thinking and feeling at each stage. She wanted to take the treatment step by step and trust the doctors and nurses to do their job so that she could focus on taking care of herself. She knew she wanted to create a lot of time for rest and pleasure and at the same time thought it would be helpful to keep her mind engaged in something positive, like a good book.   Jo mentioned that her and her husband had already discussed all their options and both felt willing to try a variety of paths to parenthood. If the cycle was unsuccessful she wanted to remember that it isn’t their last hope for having a baby and there are many other options they can explore.   We unpacked these goals in great detail and together built a very clear picture of what success would look like for her. In doing this she started to hold a new idea of success that was not connected to the outcome of this IVF cycle.
Activating resources Identifying and developing the client’s inner resources is an essential part of preparation for IVF.   Typically a ‘resource’ is anything that will help a person reach a desired state or transform a problem state (Dilts & De Lozier, 2000). Inner resources may come in the form of behaviours or actions, inner states, capabilities, skills or tools, empowering beliefs or spiritual values. Resources can be accessed from personal history, by modelling others or by acting as if something is already true.	From our conversations a number of resources became apparent. ·        Her care and sensitivity for her body (reframe of her concern about the effects of IVF) ·        The strength of her relationship ·        Overall health and fitness ·        No known fertility issues and statistically favoured for IVF success ·        Advantage of never having undergone IVF before and therefore being able to approach it anew (reframe of her fear about the process being unknown) ·        She has a good imagination (people who worry a lot tend to have very good imaginations that can be put to good use) ·        She experiences great success in her work life, has many friends and a supportive family ·        They are both open to various paths to parenthood which means that this IVF cycle isn’t her last resort. ·        During our work together Jo has taken many positive steps and made changes that will give her the best possible chance of success   These resources were activated through; the ongoing subtle reframing that I offered throughout treatment, re-enforcing them during trance sessions and deliberately mentioning them at every opportunity.
Reducing stress and  increasing relaxation Many clients are aware that feeling stressed and anxious is unlikely to help their situation and yet they struggle because they don’t know how to go about reducing stress. Restoring mental and emotional balance can have a positive effect on the hormonal system and also help to create greater emotional resilience.	As a part of Jo’s goal she wanted to worry less about the IVF treatment and feel calm and relaxed before, during and after.   I taught her how to interrupt worry and challenge her irrational thoughts. The 7:11 breathing technique provided her with a fast and effective way to induce the relaxation response and decrease emotional arousal.    A huge source of anxiety for Jo was that the outcome of IVF was out of her control. We looked at what aspects of the process she could control and named the things that were not within her control.   I used sailing as a metaphor and described how even the best skilled yachtsman with the best equipment could not control the weather. This helped to normalise her situation and she could see that there are always aspects of life that we cannot control. And if she focuses on doing what she can, she can relax knowing that they rest of it is not up to her. Jo felt great relief and realised that it is not all down to her.   Using SFQ’s Jo also identified the necessary changes she wanted to make in her day-to-day life that would help her reduce stress. We used hypnosis and positive mental rehearsal to support her to initiate and maintain these changes.
Creating an optimum state To empower, build confidence and ensure the best possible chance of success we work alongside the client to create an optimum state of mental, emotional and physiological balance before starting IVF.   This may include physical preparation, such as diet and exercise changes as well as lifestyle changes that will improve overall health and wellbeing.   Central to restoring balance is to establish a healthy mind-set for IVF and address any limiting beliefs. A healthy mental attitude for IVF includes acknowledging the possibility that the treatment may not work, but giving all their thoughts and attention to the possibility that it could work.	Along with the diet and lifestyle changes that Jo wanted to make, we discussed what a healthy mental attitude towards IVF would be. I asked her how she knew it would be okay even if the treatment didn’t work. This prompted her to name all the things in her life that were good and why this cycle is not the ‘be all and end all’ for her.   A wonderful technique called Out the Box (Berland, 1998) based helped her to feel this acceptance and see her situation from a new, healthier perspective.   Being able to accept the possibility of the treatment failing created a lot of ease and relief for her and allowed her to more easily give her attention to the possibility of the IVF working.
Healing past disappointments Past failed fertility treatments and other disappoints can cast a shadow over upcoming IVF treatment and affect mind-set and ability to cope.  SFQ’s can help to reframe past experiences and build resources. Below are a few examples of questions that Jo was asked   Looking back on your Clomid cycles -        what did you do that you feel proud of/ pleased with? -        in what ways has that experience prepared you for IVF? -        in what ways will this upcoming IVF treatment be better than the Clomid cycles?   There are many ways to help heal past disappointments including techniques like EMDR and EFT. Metaphors and visualisation techniques like the Primal Image (Hugo, 2009) used with Jo can also be used to great effect.	Jo’s experience with Clomid, to a large extent, undermined her belief in her body and her capacity to see herself as healthy and fertile. She did however discover that her body was very resilient as she suffered no side-effects and bounced back after treatment. She felt pleased about how the experience had brought her and her husband closer together and recognised the strength of their relationship. She knew that the success rates for IVF were higher than Clomid and by undergoing treatment she was more likely to have a baby. I asked her to allow an image (Primal Image) to come to her mind that represents how she feels about her fertility right now. She imagined an intricate electrical circuit that was faulty and in disrepair. Using SFQ’s I asked her to imagine how that image would be different when she, once again, trusted and believed in her body and remembered that it IS healthy and fertile. In response to these questions she imagined a delta with many rivers and rivulet’s, all connected and flowing with fertile banks and abundant life flourishing all around. I completed the visualisation by re-enforcing what she had shared with me about her learning’s during the Clomid cycles and reminded her of all the ways it had prepared her for the upcoming IVF.
Developing skills and coping strategies   Preparation for any future event requires that you have adequate information about the event so that you know what to expect and that you are equipped with all the tools and resources that you may need to handle that event in a way that you feel comfortable with.   The FBM includes a wide range of self help tools and strategies for coping including: ·        self hypnosis ·        breathing techniques such as 7:11 ·        creative tasks ·        visualisation/mental rehearsal ·        mindfulness ·        self talk SUDS (subjective units of disturbance scale) ·        cognitive restructuring	Two concerns for Jo were how she would manage the injections and how her body would handle all the drugs and medication.   We used the Emotional Freedom Technique (EFT), well known for its ability to reduce fear and phobia. Jo learnt how to do EFT on her own as a strategy to prepare for the injections and reduce all anticipation and fear about administering them. EFT provided a simple coping strategy that she knew she could apply to any other frightening situation that arose during IVF.   The process of healing her past disappointments helped her to remember that her body had in fact responded well to the Clomid and she had experienced few side effects. To help her to cope with the drugs and other medical interventions along the way, I taught her how to use visualisation to support her body to cope well. For example, she could imagine the medicine as being very intelligent and high functioning, knowing exactly what to do and how to do it. She could see her body taking only what it needs and easily discarding the rest. Feeling her body as very responsive and well resourced to adapt to the drugs in the best possible way.
Mental rehearsal and visualisation Mental rehearsal and visualisation is used throughout preparation for IVF in a variety of different ways. Mental Rehearsal of an upcoming event can be used to help clients to change their expectation of themselves and their future and to rehearse new behaviours. The process of imagining by using our internal senses can create changes in the mind, body and behaviour. There is an intimate link between what we imagine and what becomes ‘real’. There have many experiments and studies done to investigate the relationship between thoughts/imagination and physical/behavioural changes. An article published in the Journal of Neurophysiology demonstrated the effects that mental rehearsal alone had on developing the neural networks in the brain (Pascual-Leone, 1995).	While setting Jo’s goal for therapy she described how she would like to be thinking, feeling and behaving during each stage of IVF. As a part of the process I weaved in practical information about IVF to help her have a better idea of what to expect.   We spent a full session during which she mentally rehearsed herself going through each step of IVF, thinking, feeling and responding in the best possible way. I reminded her of all the skills and resources she had to do this and she rehearsed drawing on them. This hypnosis session was recorded so that she could listen to it repeatedly in the lead up to her treatment.
·        Managing the outcome of IVF ·        If the client feels equipped and able to handle and tolerate the IVF failing they will be much more likely to feel relaxed throughout treatment. It can be useful to ask questions to identify what will help the client to cope with a negative outcome and to find out where they draw their strength from. It’s important to prepare for IVF failure and equally vital to prepare for success too.	The Sailing metaphor helped Jo to find acceptance about the things that she can’t control. And yet she still felt that her happiness depends on a positive outcome from the IVF.   Using SFQ’s and direct suggestion in hypnosis I helped Jo to keep the whole of her life in focus and see the IVF cycle as just one small part of her life. She started to see the many areas of her life that fulfil her and bring happiness and that it isn’t dependant on this one thing alone.   She saw herself coping well with a negative outcome and started to feel more confident in herself and her inner strength. From this centred perspective she was able, for the first time ever, to visualise herself holding her baby in her arms.  I asked her to make the image bigger, brighter and clearer and suggested that she keep that image and all the positive feelings that go with it at the forefront of her mind through each step of IVF and beyond.

 

5. Research to support psychological and emotional preparation for IVF

Develop good coping skills

Often by the time couples start-out on IVF, their coping skills are at an all-time low.  So it’s vital that these are strengthened, ideally before the IVF treatment even starts.  There’s a wealth of research to show how developing a wide range of coping skills can positively impact the fertility journey.

In a study by Emery et al (2003, p. 2647-53), significant benefits were reported by couples getting pre-IVF counselling in areas of psychological assistance, education and discussing relationships. Domar et al found that women receiving some kind of psychological intervention fared better than those receiving none.  In particular, women participating in a mind-body group which focused on relaxation, cognitive restructuring and fertility-relevant education had significantly better scores on psychological outcomes than women who focused only on discussion and emotional support.  (Domar et al, 2000, p. 568-575).

And Terzioglu et al (2001, p. 133-141) showed that couples who had received psychosocial intervention with assisted-reproductive treatment (ART) had lower depression and anxiety levels and higher life satisfaction than the control group.  

 

Improved outcomes of IVF

Stress and anxiety can have a profound impact on the outcome of IVF treatment.  So powerful is the mind-body connection that when stress and anxiety is experienced before IVF, the body is less able to respond positively to the IVF procedures.

Research presented in two separate studies Li et al and Gurhan et al (2011)(2009, p. 786-806) showed that baseline psychological stress and anxiety negatively influence the clinical pregnancy rate of IVF treatment in women.  Li et al’s (2011) study also highlighted that increased levels of the stress hormone norepinephrine (noradrenaline) were negatively associated with the percentage of good quality embryos.

Stress, anxiety and depression are also the most commonly reported reasons for dropping out of IVF treatment.  Verberg et al (2008, p. 2050-5) studied a cohort of 384 couples planning to undergo IVF treatment, of which 17% dropped out of IVF treatment.  They found that the physical or psychological burden of treatment was the most frequent cause of drop-out (28%). In a study by Dr Alice Domar (2011) participants suggested that more information on how to deal with infertility-related stress would help to increase patient support and reduce drop-out rates. So we can see that women who are better equipped to cope with the stress of IVF are more likely to continue with treatment.

 

Benefits after IVF results

For all women going through IVF, their ultimate intention is to have a baby.  Psychological and emotional support aimed at reducing stress in IVF has been shown to be shown to have a positive effect on pregnancy rates in a number of studies.

In another of Dr Alice Domar’s (2001) studies, 97 women undergoing their first IVF cycle either attended a mind-body group or a control group.  After the second IVF cycle, when 76% of the mind-body group had been to 6 out of 10 sessions, significant differences in pregnancy rates were seen – 52% in the mind body group versus 20% of the controls.  Women in the mind-body group also reported improvement in their psychological symptoms.

Similar positive effects on pregnancy rates were seen in studies by Levitas et al (2006) where 53% of women receiving hypnosis achieved pregnancy, while only 30.2% in the control group did and Terzioglu et al (2001) where 43.3% in the psychosocial group achieved pregnancy compared with only 16.7% in the control group.  

 

Recovery after IVF

But what about those women and men who have to deal with the impact of failed IVF treatment?

A study by Pasch et al (2012) looked at the impact of IVF failure on psychological distress.  Unsurprisingly, failed IVF was associated with increased levels of post-IVF depression and anxiety.  And as we are suggesting Pasch et al recommended that time should be taken to help women prepare for and cope with both treatment and treatment failure.

Only with coping strategies in place will couples have the strength to continue on their fertility journey, whether that means further IVF cycles or perhaps pursuing a different path.

 

Benefits if pregnant  

The education, skills and coping strategies that are learnt before IVF and developed whilst undergoing the procedure form a robust grounding for the ongoing management of worry, stress and anxiety. This is especially invaluable when there has been a history of miscarriage, loss or birth trauma. A study conducted by Teixeira, Martin, Prendiville, and Glover (2005, p. 271-6.) during pregnancy supports the findings that relaxation methods significantly reduced cortisol levels, which has a positive effect on both endocrinological balance, pregnancy rates and reducing antenatal maternal anxiety which has adverse effects on the fetus and the child.

And it’s also been shown that reducing anxiety during pregnancy can have a positive impact on the birth experience.  In her book, HypnoBirthing, Marie Mongan (Mongan, 2011) highlights how fear can have a negative impact on the proper functioning of the uterus during birth. But when fear is reduced, you can achieve a relaxed state from the very onset, facilitating an easier birth.

 

Benefits for the IVF clinic  

So far, we’ve only considered the benefits of physiological and emotional support the couples trying to conceive through IVF.  But what about the IVF clinics themselves?  Although the evidence is much more anecdotal, it’s clear that couples with lower stress levels make much easier patients.  And while there is no conclusive evidence that lower stress levels result in better fertility treatment outcomes, reducing stress prior to treatment may reduce the number of treatment cycles needed before pregnancy is obtained, may prepare the couple for initial treatment failure or even make more invasive techniques unnecessary.  

In his article Should fertilization treatment start with reducing stress? Daniel Campagne (2006) suggests that medical professionals consider stress as both a cause and a consequence of infertility.  He even suggests that the ever-growing economic costs of IVF treatment could be reduced by using less invasive methods, such as stress reduction, first in treatment protocols.

Summary
 

The Fertile Body Method offers a robust and effective framework for offering mind-body interventions that can benefit psychological and physical health, wellbeing and fertility. Using this approach to help women prepare for IVF is vital and of great benefit to them; both in terms of how they cope with the treatment as well as its effectiveness. 

 

Biography:

Sjanie Hugo Wurlitzer is a psychotherapist and hypnotherapist, author and founder of the Fertile Body Method (FBM). She has developed a unique approach to treating fertility problems combining hypnosis and other mind-body techniques. During her years in practice, both privately and as part of an integrated medical team in London, she has successfully treated many couples with fertility problems.

Since developing the Fertile Body Method, Sjanie has trained a worldwide community of Fertile Body Therapists. She continues to contribute to the growing field of fertility and mind-body medicine through writing, teaching and most recently co-founded of the new Blossom & Be online fertility support community.

Sjanie was the managing editor of the European Journal of Clinical Hypnosis, has lectured internationally for the London College of Clinical Hypnosis (LCCH). Over the past few years she has developed her work to acknowledge the menstrual cycle as the foundation for women's wellbeing at all levels. Sjanie is co-founder of Women's Quest, pioneering a ground–breaking approach to women's physical, psychological and spiritual wellbeing based on the menstrual cycle and the journey from menarche to menopause.

Email: info@thefertilebody.com

 

References

Berland, W. (1998) Out of the box for life. New York: Harper Collins.

Chen TH, Chang SP, Tsai CF, et al. (2004) Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Hum Reprod. 19(10):2313-2318

Chiaffarino F et al (2011) Prevalence and incidence of depressive and anxious symptoms in couples undergoing assisted reproductive treatment in an Italian infertility department.  Eur J Obstet Gynecol Reprod Biol  Feb, 154 (2)

Campagne, Daniel (2006) Should fertilization treatment start with reducing stress?  Hum. Reprod. 21 (7)

Dilts, R., & DeLozier, J. (2000) Encyclopedia of systemic NLP and NLP New Coding. Scotts Valley: NLP University Press.

Domar, A. et al (1992) The prevalence and Predictability of Depression in Infertile Woman. Fertility and Sterility, 58, 1158–1163

Domar AD, Clapp D, Slawsby E, et al. (2000) The impact of group psychological interventions on distress in infertile women. Health Psychol. 19(6):568-575.

Domar et al, (2001) Impact of a group mind/body intervention on pregnancy rates in IVF patients, Fertil Steril , 95 (7), 2269-2273

Domar AD, Prince LB, (2011) Impact of psychological interventions on IVF outcome, Sexuality, Reproduction and Menopause, Vol. 9, No. 4, 26-32

Emery et al (2003) Results from a prospective, randomized, controlled study evaluating the acceptability and effects of routine pre-IVF counselling, Human Reprod. Dec;18 (12: 2647-53)

Gurhan et al (2009) Association of depression and anxiety with oocyte and sperm numbers and pregnancy outcomes during in vitro fertilization treatment, Psychol Rep, Jun, 104(3), 786-806

HFEA. Human Fertilisation and Embryology Authority  (2005) The HFEA Guide to Infertility and Directory of Clinics 2005/2006 London: HFEA; 2005

Hugo, S. (2009). The Fertile Body Method: A practitioner’s manual. Crown House Publishing.

Levitas et al (2006) Impact of hypnosis during embryo transfer on the outcome of in-vitro fertilization – embryo transfer: a case-control study.  Fertil Steril. 85(5), 1404-1408

Li et al (2011) Baseline psychological stress and ovarian norepinephrine levels negatively affect the outcome of in vitro fertilisation, Gynecol Endocrinol, Mar 27 (3), 139-143

Mongan M, (2011),  HypnoBirthing - The MonganMethod, London.  Souvenir Press  

Pascual-Leone, D., et al (1995) Modulation of muscle response evoked by the transcranial magnetic stimulation during the aquisition of new fine motor skills.

Pasch et al (2012) Psychological distress and in vitro fertilization outcome, Fertil Steril., Aug 98(2).459-464

Teixeira, Martin, Prendiville, and Glover (2005) The effects of acute relaxation on indices of anxiety during pregnancy, J Psychosom Obstet Gynaecol. Dec;26(4):271-6.

Terzioglu et al, (2001) Investigation into effectiveness of counselling on assisted reproductive techniques in Turkey.  Psychosom Obstet Gynaecol,22 (3), 133-141

Verberg et al (2008) Why do couples drop-out from IVF treatment? A prospective cohort study. Hum Reprod. Sep;23(9):2050-5.

 

 

Table 1 - An overview of The Fertile Body Method six stage therapeutic framework   1.  Outcome: the focus of this stage is to develop an orientation towards change. During this stage of treatment we build rapport, gather information, access the clients resources and create a clear, detailed therapeutic goal. We can then agree the strategy for change.   2.  Balance: addresses the client’s current mental, emotional and physical state by restoring balance to internal and external factors which may be affecting overall wellbeing. This may include addressing negative self talk, stress levels, diet, lifestyle and other environmental factors. The main aim of this stage is to stabilise the client, build ego strength, develop inner resources and increase feelings of wellbeing.   3.  Resolve: once greater psychological and emotional wellbeing has been established, the third treatment stage addresses any unresolved issues or limiting beliefs. Important issues may include addressing fears, resolving past traumas, or dealing with sexual or relationship issues.   4.  Enhance: visualisation, guided imagery and mental rehearsal to help enhance fertility and/or the effectiveness of medical treatment.   5.  Prepare:  for pregnancy, birth or parenthood. This stage also includes mental, emotional and physical preparation for medical treatments like IVF.   6.  Support: the client and help them to maintain the changes that they have made. This stage also includes supporting them once they receive the results of the IVF treatment.

Endnotes:

Author: Sjanie Hugo Wurlitzer
Website:
Copyright © 2023 Sjanie Hugo Wurlitzer. All rights reserved

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