Author Archives: Admin

Claire’s Story

With the majority of those experiencing fertility struggles being actively employed, how is there so much silence about these issues within the workplace? I’m exploring what can be done to change this, drawing on my experiences from both sides of the fence…

From an employee perspective, I struggled to cope with the all-consuming nature of treatment and the prospect of not fulfilling my lifelong dream to start a family. The endless disappointments and devastating loss hugely affected my mental health and, whilst I desperately tried to maintain focus and still give 100%, it left me feeling like a burden to my employer and that I was struggling to be the person they initially hired.

From a Human Resources perspective, prior to my own fertility struggles, I had zero understanding of the impact fertility treatment can have on an individual. Of course, I would have shown empathy to the situation, but I most definitely wasn’t aware of the reality – the time-consuming nature of frequent short-notice appointments, the impact of hormones pumped into the body, the invasive procedures involved and the inevitable emotional turmoil. In the 12 years I’d dedicated to HR, I never once had anyone ask about time off entitlements or employer support for fertility treatment. To me, the silence speaks volumes and is no doubt caused by the lack of awareness and apparent ‘taboo’ nature of this subject. With one in six couples experiencing fertility issues (the majority within the working population), how could I have worked in an area with such focus on people whilst never coming across this all too common problem?

Using both my experiences in HR and facing infertility, I wanted to share how I believe employers could better support those going through treatment. Not only because it’s the right thing to do to be a compassionate employer, but because it would inevitably lead to a more engaged workforce, attracting and retaining top talent as an ‘employer of choice’. By getting it right, it can help to avoid losing good workers and to negate the need (plus huge cost) to replace them. It’s about facilitating and supporting short term adjustments to promote longer term engagement.

Employees are often reluctant to disclose to their employer about the need for treatment, mainly because they’re unsure whether they’ll be supported and fear discrimination for the admittance that they are actively trying to get pregnant. Having a dedicated policy in place (or an explicit mention of fertility treatment within an existing policy) allows them to firstly know that what they’re going through is valid and recognised. A policy encouraging openness with managers (whilst maintaining confidentiality) could significantly reduce stress levels for those who may otherwise feel the need to hide their struggles, fearing that they are ‘imposing’ by asking for time off for this very valid reason.

There are three elements I believe are key – awareness, flexibility and support. The starting point for each of these sits within a written policy. I’ve never been a fan of a policy for ‘policy’s sake’ – we can sometimes become too prescriptive and limit a manager’s freedom to ‘manage’, but with so many misconceptions and implications that infertility can cause, we cannot simply leave it down to the hope that each manager would make a compassionate judgment on what is considered fair and reasonable. We also need employees to know that it’s OK to disclose this information and not suffer in silence.

From my experience across a number of organisations and many HR contacts, I’ve discovered a range of approaches.

  • Those with no policy or mention whatsoever.
  • Those with a mention of fertility treatment within another policy, but classing it as an ‘elective procedure’ – ignoring the fact that infertility is classed as an illness (by World Health Organisation) and fuelling the notion that IVF bears resemblance to a cosmetic procedure, for example.
  • Those who mention discretionary entitlement within another policy. This tends to be within absence or flexible working policies but I’ve also heard of it being within a maternity policy (ironically a cruel reminder of what we desperately want).
  • Those who have a dedicated fertility policy.

In fact, in my (not so scientific) recent Instagram poll only 17% said that they believed their employer had a fertility policy.

So, from my experience, what would I suggest goes into an ‘ideal’ policy?

  • Firstly, recognition that fertility treatment is not a choice – it isn’t an elective procedure but something many have to go through either due to illness or social reasons – all outside of our control.
  • A summary of what might be typically involved in IVF treatment as a way to raise awareness with managers about the reality of what to expect e.g. numerous scan appointments and their ad-hoc nature and the need for invasive medical procedures requiring recovery time.
  • Guidance as to what might be covered as paid / unpaid leave and how it would be recorded, with reassurance that this type of absence (with proof if required) wouldn’t count towards attendance ‘trigger points’. Employees are only ‘protected’ by maternity legislation once they have had an embryo transferred, and so often employees can feel particularly vulnerable throughout fertility treatment. Workplaces will need to consider what is reasonable, but by giving employees an idea of what might be provided they can go a long way in removing the stress of the unknown.
  • Allowances for flexible working, enabling the employee to still perform their role working around their treatment. For example, temporary adjustments such as working from home, lighter duties, adjustment to start / finish times to accommodate appointments – all around treatment cycles.
  • The rights and potential flexibility for partners to attend appointments.
  • Any reasonable adjustments that might be considered for a role if it is physically demanding during treatment and post embryo transfer.
  • Recognition of the link to mental health – with suggestions of emotional support to consider such as Occupational Health and access to counselling services through Employee Assistance Programmes.
  • Recognising miscarriage as an experience that qualifies for compassionate leave and emotional support – another taboo subject that can leave employees unsure of their entitlements in a hugely sensitive situation.

The absolute ideal would be the introduction of initiatives to support the written policy, raising awareness and starting some conversations within the workplace. The only way we can make positive change is to open up the dialogue, encouraging education and understanding.

I’d love to hear your experiences and thoughts – through the power of sharing we can help others feel less alone and encourage positive change!

 

 

Becky’s story

With the majority of those experiencing fertility struggles being actively employed, how is there so much silence about these issues within the workplace? I’m exploring what can be done to change this, drawing on my experiences from both sides of the fence…

From an employee perspective, I struggled to cope with the all-consuming nature of treatment and the prospect of not fulfilling my lifelong dream to start a family. The endless disappointments and devastating loss hugely affected my mental health and, whilst I desperately tried to maintain focus and still give 100%, it left me feeling like a burden to my employer and that I was struggling to be the person they initially hired.

From a Human Resources perspective, prior to my own fertility struggles, I had zero understanding of the impact fertility treatment can have on an individual. Of course, I would have shown empathy to the situation, but I most definitely wasn’t aware of the reality – the time-consuming nature of frequent short-notice appointments, the impact of hormones pumped into the body, the invasive procedures involved and the inevitable emotional turmoil. In the 12 years I’d dedicated to HR, I never once had anyone ask about time off entitlements or employer support for fertility treatment. To me, the silence speaks volumes and is no doubt caused by the lack of awareness and apparent ‘taboo’ nature of this subject. With one in six couples experiencing fertility issues (the majority within the working population), how could I have worked in an area with such focus on people whilst never coming across this all too common problem?

Using both my experiences in HR and facing infertility, I wanted to share how I believe employers could better support those going through treatment. Not only because it’s the right thing to do to be a compassionate employer, but because it would inevitably lead to a more engaged workforce, attracting and retaining top talent as an ‘employer of choice’. By getting it right, it can help to avoid losing good workers and to negate the need (plus huge cost) to replace them. It’s about facilitating and supporting short term adjustments to promote longer term engagement.

Employees are often reluctant to disclose to their employer about the need for treatment, mainly because they’re unsure whether they’ll be supported and fear discrimination for the admittance that they are actively trying to get pregnant. Having a dedicated policy in place (or an explicit mention of fertility treatment within an existing policy) allows them to firstly know that what they’re going through is valid and recognised. A policy encouraging openness with managers (whilst maintaining confidentiality) could significantly reduce stress levels for those who may otherwise feel the need to hide their struggles, fearing that they are ‘imposing’ by asking for time off for this very valid reason.

There are three elements I believe are key – awareness, flexibility and support. The starting point for each of these sits within a written policy. I’ve never been a fan of a policy for ‘policy’s sake’ – we can sometimes become too prescriptive and limit a manager’s freedom to ‘manage’, but with so many misconceptions and implications that infertility can cause, we cannot simply leave it down to the hope that each manager would make a compassionate judgment on what is considered fair and reasonable. We also need employees to know that it’s OK to disclose this information and not suffer in silence.

From my experience across a number of organisations and many HR contacts, I’ve discovered a range of approaches.

  • Those with no policy or mention whatsoever.
  • Those with a mention of fertility treatment within another policy, but classing it as an ‘elective procedure’ – ignoring the fact that infertility is classed as an illness (by World Health Organisation) and fuelling the notion that IVF bears resemblance to a cosmetic procedure, for example.
  • Those who mention discretionary entitlement within another policy. This tends to be within absence or flexible working policies but I’ve also heard of it being within a maternity policy (ironically a cruel reminder of what we desperately want).
  • Those who have a dedicated fertility policy.

In fact, in my (not so scientific) recent Instagram poll only 17% said that they believed their employer had a fertility policy.

So, from my experience, what would I suggest goes into an ‘ideal’ policy?

  • Firstly, recognition that fertility treatment is not a choice – it isn’t an elective procedure but something many have to go through either due to illness or social reasons – all outside of our control.
  • A summary of what might be typically involved in IVF treatment as a way to raise awareness with managers about the reality of what to expect e.g. numerous scan appointments and their ad-hoc nature and the need for invasive medical procedures requiring recovery time.
  • Guidance as to what might be covered as paid / unpaid leave and how it would be recorded, with reassurance that this type of absence (with proof if required) wouldn’t count towards attendance ‘trigger points’. Employees are only ‘protected’ by maternity legislation once they have had an embryo transferred, and so often employees can feel particularly vulnerable throughout fertility treatment. Workplaces will need to consider what is reasonable, but by giving employees an idea of what might be provided they can go a long way in removing the stress of the unknown.
  • Allowances for flexible working, enabling the employee to still perform their role working around their treatment. For example, temporary adjustments such as working from home, lighter duties, adjustment to start / finish times to accommodate appointments – all around treatment cycles.
  • The rights and potential flexibility for partners to attend appointments.
  • Any reasonable adjustments that might be considered for a role if it is physically demanding during treatment and post embryo transfer.
  • Recognition of the link to mental health – with suggestions of emotional support to consider such as Occupational Health and access to counselling services through Employee Assistance Programmes.
  • Recognising miscarriage as an experience that qualifies for compassionate leave and emotional support – another taboo subject that can leave employees unsure of their entitlements in a hugely sensitive situation.

The absolute ideal would be the introduction of initiatives to support the written policy, raising awareness and starting some conversations within the workplace. The only way we can make positive change is to open up the dialogue, encouraging education and understanding.

I’d love to hear your experiences and thoughts – through the power of sharing we can help others feel less alone and encourage positive change!

 

Fertility Education Project Report

Working to help preserve fertility, improve awareness and educate young people

Fertility Education Project

Aim

The aim of the project is to tackle the problem of a lack of awareness of issues surrounding fertility and infertility in Scotland.   It was agreed that this would be achieved in a variety of ways i.e. by working with universities, health professionals; GP’s and employers across Scotland to introduce ways of ensuring people are better informed about how their fertility can be conserved. To reduce the instances of infertility through improved outcomes in terms of health and lifestyle both of which can be factors in preserving fertility.

The project provides open sessions within Scotland’s clinics where patients access fertility services. F N Scotland staff hold regular events at clinics and work with staff there to ensure that patients are aware of the information and support services the charity can offer and how they can make use of those and benefit from them.  It is widely recognised that those who do have ready access to such services are informed and empowered enabling them to better manage their illness.

Another area where better health outcomes may be achieved through education of fertility issues is at GP level and within family planning clinics. Through this project we work with GPs to encourage them to include a conversation about fertility as part of their general gynaecological checks such as smear tests or when women attend for contraceptive advice and to explain both the effect of lifestyle factors on their fertility and the decline of female fertility with age. We similarly work with family planning clinics where we encourage them to include these same discussions as part of their system.

 

A schedule of visits is established to Universities/Colleges in Scotland and F N Scotland liaise with the faculty to request that we have an open day where F N Scotland staff  present  information on fertility and infertility. As part of these events F N Scotland also request that we were able to address the students and give a presentation on facts related to fertility education and preserving fertility. Through this approach we believe could improve health outcomes for our young students.

It is widely recognised that there needs to be a change in people’s attitude towards the whole area of fertility, career and family. Young people in higher education/working with other organisations to gain qualifications are the employers and health professionals of the future and through the multi targeted approach of this project, we believe that we are creating a more knowledgeable fertility population and reduce infertility in future years.

Over the course of 2018/2019 the need for education surrounding future fertility has continued to be highlighted by Clinical Professionals and the media with it being widely reported for example obesity and eating disorders are on the increase in Scotland.

The Project – 2018/2019

During 2018/2019 the project distributed approximately 7558 “your future fertility” leaflets which are aimed at giving an informative overview of lifestyle, eating disorders, age, weight, smoking, STI’s etc. which are often issues many people do not consider until they discover they have a fertility problem.

Presentations were given throughout the year which had been updated to present to GP surgeries, Midwives, Family planning, Universities, Voluntary Organisations and Employers.

Universities/Colleges

In 2018/19 F N Scotland secured a place and attended the following Universities/College Fresher’s and Health event weeks.  Presentations have continued to be presented to GP surgeries, midwives, student nurses, Mental Health nurses, voluntary organisations and  universities. The charity secured places and attended 41 university/college Fresher’s, Health event weeks and Sports groups across Scotland giving presentations and supplying information.

We attended the following educational establishments:

  • Dumfries and Galloway college
  • Napier University, Edinburgh
  • Fife College Stenton Campus
  • Fife College St Brycedale Campus
  • Gardyne Campus college
  • Arbroath
  • Perth College
  • Kilwinning
  • Irvine Royal Academy College Campus
  • Abertay University
  • Napier University
  • Stow College
  • Kelvin College
  • Glasgow City
  • St Andrew’s
  • Kilmarnock College
  • Dundee  University
  • Stirling University
  • Aberdeen  University
  • Dumfries University
  • Hamilton College
  • Ayr College
  • Robert Gordon
  • Paisley University
  • Glasgow University
  • Strathclyde University
  • Caledonian University
  • Alloa College
  • Falkirk College
  • Dundee College

During Fresher’s within the Universities and Colleges F N Scotland conducted a survey of student’s knowledge of what could affect their future fertility.  1529 Students took part in the survey.

To ensure the survey gave more detailed information about the participants whilst still allowing the survey to be anonymous participants were asked to indicate their age.  52% were aged 16 – 21, 26% were aged 22 – 30 and 22% were age 30 or over.

Overall results

Males Participated      –           400

Females Participated –           1122

Other Participated       –           7

Prior to approaching the F N Scotland exhibiting area 74% of participants indicated that they were not aware of lifestyle factors that may affect their future fertility.  The remaining 26% indicated they were aware of the following factors:

  • Smoking                      –           (7.2%)
  • Eating disorders          –           (1.3%)
  • Alcohol                        –           (7.9%)
  • Illegal substances       –           (1.9%)
  • STI’s                            –           (3.5%)
  • Age                             –           (1.7%)
  • Steroid Use                 –           (2.1%)
  • PCOS                          –           (0.3%)
  • Early Menopause        –           (0.1%)

391 (98%) of participants from the 400 males who take part indicated they would give more consideration to present and ongoing lifestyle choices they make which could affect their future fertility with 9 (2%) indicating they would not give more consideration.

1026 (91.4%) of participants from the 1122 Females who take part indicated they would give more consideration to present and ongoing lifestyle choices they make which could affect their future fertility with 96 (8.6%) indicating they would not give more consideration.

6 (85.7%) of participants from the 7 Other gender who take part indicated they would give more consideration to present and ongoing lifestyle choices they make which could affect their future fertility with 1 (14.3%) indicating they would not give more consideration.

Overall 1423 (93.06%) participants indicated they would give more consideration to present and ongoing lifestyle choices they make which could affect their future fertility.

F N Scotland are currently aiding 3 students in research to help complete dissertations on Fertility.

16+ Not in Further Education

F N Scotland have continued to work with the voluntary sector to give presentations to 16+ age group.  Providing practical help to those most in need, such as the long-term unemployed, vulnerable of homelessness, young offenders and care leavers, supporting the hardest to reach young people.  We have continued to deliver Presentations to new groups of young people whilst working with the following organisations:

  • Enable
  • Street Soccer
  • Kibble
  • Sexpression, (Student LED Charity) St Andrew’s
  • Girvan Youth Trust
  • Quarriers
  • The Great Steward of Dumfries House Trust
  • LGBT Youth
  • Beat the Blues Wellbeing
  • City of Glasgow College Mental Health Team
  • North/South/East Ayrshire Social Care Team
  • Move On
  • FareShare Glasgow
  • YIP World
  • Chill and achieve awards
  • Versus Arthritis
  • Rankinston Strong Connection Community
  • Health and Social Care Alliance
  • Women Liberation Group

There were workshops presented to voluntary organisations who work with more vulnerable groups of young people.  There were 113 education fertility workshop questionnaires returned with the following out comes:

  • 96% rated the workshop as excellent
  • 4% rated the workshop as good
  • 100% felt they understood more about their fertility
  • 100% felt they understood more about what affect i.e. illegal substances, binge drinking, anorexia, bulimia, STI’s age etc. could have on their future fertility.

Some comments received:

“This is extremely useful knowledge for the future.”

“Interactive games are great for getting the message across.”

“Knew nothing about BMI.”

“This will make me think more about choices I make.”

F N Scotland will continue to work with other 3rd sector/voluntary organisation in 2019/20.  We are currently in progress of linking again with the charity BEAT who are now trying to increase their presence in Scotland and work with young people in relation to Eating Disorders.   F N Scotland are also in talks to deliver a workshop to younger people for the MS  Society.

Nursing and Midwifery

Presentations have been given to student Nurses and Midwives Napier University and Stirling University. This involved a presentation from F N Scotland combined with a presentation from a past patient giving an overview of their journey.

Following the presentations evaluation forms were given to the students with the results below:

Nurses and Midwives – 197 participants

  • 94% rated the information provided as excellent
  • 6% rated the information provided as good
  • 100% felt better informed about the patient experience
  • 100% felt better informed about the impact of infertility on mental health
  • 100% felt better informed about infertility treatments.

We received positive comments some of these are below:

  • thank you so much for taking the time to come and meet with the student nurses. I think they found your talk extremely interesting and that it will be very useful for them to have that knowledge in their future interactions with patients”
  • “Great source on information”
  • “This will help me in my role in the future”
  • “So informative”
  • “This information should be more widely available in schools”
  • “Lower chances of success with IVF than I thought”
  • “How fertility can affect your mental health is eye opening”

Health/Education events

Throughout the year we have continued to attend clinic patient evenings/days/ Health weeks/smoking cessation events  including The Gathering in Glasgow, Aberdeen, Fife, Edinburgh, Dundee, Perth, Ayr, Crosshouse Hospital, Dumfries, Cumnock, Glasgow, Girvan Hospitals etc.

General Practitioners

Presentations to 32 GP Practices/Community Link Practitioners (CLP’s)

  • 98% rated the information provided as excellent
  • 2% rated the information provided as good
  • 100% felt better informed about infertility pathways
  • 100% felt better informed about the impact of infertility on mental health
  • 100% felt better informed of the current and updated criteria
  • 100% felt better informed of the services offered by Fertility Network Scotland

F N Scotland presented a workshop to 18 CLP’s who work directly with GP’s in Glasgow.  F N Scotland will continue working with GP practices and CLP’s to deliver presentations/literature to GP’s, Nurses and Health Visitors and work with the Clinics to attend GP educational events.

Sexual and Reproductive Health Clinics

F N Scotland have continued to carry out visits to some of the Sexual and Reproductive Health clinics who have continued to welcome the literature and the aim of the project, F N Scotland will continue to liaise with the clinics.  There are some clinics which F N Scotland staff are unable to attend due to location, but discussions continue with these clinics via telephone and email, and literature is provided as requested.

F N Scotland have attended and exhibited at 12 College/University sexual and reproductive health update days and also a young people’s sexual health and wellbeing symposium.

Employers

F N Scotland continues to offer a service to employers by way of a presentation/workshops to staff and HR departments on the benefits of their staff’s health and wellbeing by understanding infertility. All 32 local authorities had implemented a fertility policy and we are currently working with Unison to review and improve this where needed.

Fertility Network  Scotland staff delivered a workshop HSBC in Edinburgh at their Scottish Health and Wellbeing Staff day.  This was livestreamed across the HSBC network.  A further workshop was delivered to RBS in Edinburgh which was recorded and placed on the organisations Intranet for staff to access.

We will continue to work with the relevant bodies concerned to take this forward with employers and continue to research and develop contacts with companies and provide this and other appropriate services to aid their awareness and education on infertility issues in the workplace.

Continuing Work

 

OUTCOME

 

INDICATOR LEVEL TIMESCALE
Improved awareness among student of the factors affecting fertility and how to protect fertility Number of students reached and engaged with Distribution of 5500 future fertility leaflets

 

Attending Fresher’s and other events within at least 25 universities and colleges

 

 

Use at least two interactive tools to engage students at events and which highlight how lifestyle factors affect fertility

in project year 2019/20
Hold a minimum of 6 positive thinking CBT workshops Number of people attending Minimum of 5 couples In project year

2019/20

Closer working relationships with long-term unemployed, young offenders and care leavers, supporting the hardest to reach young people Number of young people reached and engaged with and number of workers engaged with within the organisations targeted Giving presentation to at least 6 organisations

 

Distribution of 1000 future fertility leaflets

 

 

 

in project year 2019/20
Closer working relationships and improved awareness of the emotional impact of fertility problems among student Nurses and Midwives Number of student midwives and nurses engaged with Presentations given to minimum 160 student Nurses and Midwives

 

97% positive feedback from completed evaluation forms from attendees

 

 

in project year 2019/20
Improved access to information and support for those affected by fertility problems or potentially fertility limiting conditions Number of people with fertility issues engaged with and helped through information events Work in Partnership with The Great Steward of Dumfries House Charity to continue to deliver a fit for fertility programme.

 

Organisation of an event giving people access to talks and exhibition

 

Increase attendees at main information event by 25%

 

Attend and maintain 90% Local events including support groups throughout Scotland

in project year 2019/20
Closer working relationships and improved awareness of the emotional impact of fertility problems among GPs Number of GPs engaged with At least 15 Presentations given to GPs

 

95% positive feedback from completed evaluation forms from attendees

 

Increase number of GPs engaged with by 5% on 2018/19

in project year 2019/20
Closer working relationships and improved awareness of the emotional impact of fertility problems among health professionals within Sexual and Reproductive Health clinics Number of health professionals engaged with Attend and exhibit at sexual and reproductive Health update days.

Increase number of sexual health clinics engaged with by 5% on 2018/19

in project year 2019/20
Engage with HR departments of companies Number of companies engaged with Give at least 2 presentations to companies on the benefits of their staff’s health and wellbeing by better understanding fertility issues faced by employees

 

Maintain engagement with Trade Unions and Employers to ensure that companies adopt a policy on fertility issues within their workforce

in project year 2019/20

 

Heartbreak, hormones and hope – Fertility in the workplace

Earlier this year, I joined forces with Fertility Network UK for their Fertility in the Workplace initiative; a campaign aiming to support both employees and employers whilst individuals are working and undergoing fertility treatments. During Fertility Awareness Week, FNUK are once again highlighting the utter importance of creating fair and compassionate employment practices for anyone undergoing fertility treatments. Using my voice, alongside quotes from those currently juggling work and IVF, here’s why a fertility in the workplace policy is imperative.

“It was the most stressful period of my life and without the support of my employer, it would have made everything more difficult. This would have impacted massively on my already deteriorated mental health.”

IVF is a full-time job. The appointments are endless and if it’s not the appointments, it’s the reams of paperwork. If it’s not the paperwork, it’s the procedures. Then there’s the medicating, the scans, the blood tests, the research, the injecting. And if it’s none of the above, it’s the emotional trauma, which is always present. There is no respite. There is no escape. It’s an all-consuming, around the clock feat.

It’s also incredibly expensive.

With the NHS, drastically, reducing funding for infertile couples many are left to privately finance the overwhelming cost of treatments. This means that despite the full-time nature IVF occupies, taking unpaid time out or stopping work isn’t an option for the majority. For those of us who are unable to conceive naturally, financial affluence is wrongly becoming a pre-requisite for procreation.

Although there is no statutory right to time off, many employers are now creating policies to protect staff and provide additional assistance during the gruelling process. Infertility is real. It is a disease and with 3.5 million people affected by it in the UK, there is no excuse for an absence of support or lack of sensitivity within the workplace.

“From someone who has worked with a workplace policy it makes all the difference as it takes away a huge amount of stress.”

Before being infertile became my reality, I had a hugely different opinion of what exactly IVF and fertility treatments were. I’d seen films, I’d read books, and it all seemed a rather amusing foray into a world full of hilarious dining out anecdotes. And whilst infertility does indeed hold its own humour, nothing prepared me for the burdens I’d carry and the brutality I’d experience.

Ask anyone and they’ll probably know a little about in vitro fertilisation, how a baby is, miraculously, created in a petri dish and how a man gets intimate with a cup. What most individuals won’t realise is that to get to the petri-dish point there has been endless heartbreak, hormones and hope. There’s been guilt and grief, physical invasions and an all-encompassing sadness. Five out of six couples are lucky enough to never need assisted reproduction yet, for the one left over, medical science provides our only option.

And so we embark upon the whirlwind which is IVF, whilst trying to continue as normal in a life which is anything but the “norm”.

The hormones make us feel strange and bloated and downright ill. It wasn’t uncommon for me to pass out on my commute to work, when I was injecting. They’re sore too; I had bruises and welts on my tummy and my bottom, and constant migraines. Treatment also comes with a punishing timetable involving scans and blood tests every other day, timed injections and a big dose of the unpredictable. Scheduled Egg Collections happen early or late, embryos may be transferred on day three to day five, and when waiting for endometrial linings to thicken, the body doesn’t play fair. I discovered that IVF is an untameable force. It can’t be controlled or organised and there are so many unexpected situations which arise, per cycle, that maintaining a job becomes increasingly difficult, intensely stressful and ultimately unrealistic.

“Ignorance about treatment can lead to stress. These feelings are increased if HR teams aren’t aware of how impactful infertility is on the health of employees.”

“Then treatment might fail and, again, we’re expected to simply carry on as we were. In reality, we’re left wondering how we’ll find the strength to be ourselves once more. We’re mourning and attempting to make sense of a grievous life changing event.

Coping in a workplace full of the fertile masses becomes challenging too. The regular baby showers, pregnancy announcements or new-born visits can feel like a personal attack, a public recognition of failure, and leave us sitting at our desks harbouring that toxic cocktail of shame, grief and desire. Whilst babies are indeed a celebration, commemorating them is never going to be easy for those who live with infertility.

The importance of understanding in the workplace is crucial. I was fortunate that not only was I able to work flexibly, I was also offered a wonderfully high level of emotional support and compassion, which I couldn’t have continued without. Despite doubting my own confidence and commitment, I was always left feeling valued and, during a time when self-worth is at an all-time low; proud. However, not everyone going through IVF will have even told family or friends, let alone colleagues, managers and HR. It can feel embarrassing, overly personal and ostracising, especially where no policy is in place.

“It would help to have a policy in place because it would make me feel they recognise infertility as a medical problem, and they recognise the physical and emotional challenges it brings. It would also help to make conversations about infertility possible.”

No one ever imagines the need for needles and hormones and a whole host of additional people, in order to do something which is meant to be private and romantic and full of the joys of spring. I still remember the beautiful moment my husband and I decided to start our family, in the life before infertility it was a wondrous secret the two of us carried, full of excitement and hope. Which is how it should be, yet the reality is that dreams can turn to dust and secrets can turn sour.

I’d ask you to spare a thought for those co-workers facing infertility, pumping themselves full of hormones, undergoing undignified and unpleasant procedures. Those nursing heartache and anguish because they may never be able to have a desperately longed for child or create a much-wanted sibling. All under the façade that everything is okay.

When it’s not.

“My manager always said to me “tell us what you need.” They always worked around my appointments for me. Following my miscarriage, I received in-house counselling. They have also now referred me to an in-house complementary therapist for treatments and relaxation advice leading up to this round of IVF.”

Voicing infertility out loud is frightening and isolating. It’s not an easy subject to raise or discuss and asking for time off can feel completely impossible. It’s imperative that the proper level of support is in place, and that’s why a fertility in the workplace policy is invaluable. A formal arrangement can help infertility feel less of a taboo, IVF less fearsome to accept and reduce the additional worries produced by a treatment, which is already exhausting, strenuous and merciless. It educates, manages expectations and recognises the whole person; a person who is desperate to remain professional but is living under circumstances which are hard for even them to find the courage to comprehend.

Fertility Network UK’s Fertility Awareness Week runs from October 28th – November 3rd and is aiming to spread awareness of fertility issues to a wider audience. It’s time to put a spotlight on infertility. It is a real issue and one that matters.

Bio
Caro Townsend is a writer, survivor and advocate of all things infertility. After discovering medical science was required to have a family, Caro became fully ensconced in the world of fertility treatments. Multiple ICSI cycles, a miscarriage and an ectopic pregnancy later, she finally became a parent. Caro is the creator of one of 2018 and 2019’s top ten UK fertility blogs and her award nominated, The Cuckoo Mama, is an honest, open and compassionate account of her journey to parenthood and beyond. In between writing, she spends her time walking the dog, winging motherhood and working to break the silence which surrounds infertility and miscarriage. You can read Caro’s blog at www.thecuckoomama.co.uk

The experiences and psychological distress of fertility treatment and employment

The use of fertility treatment is increasing, yet despite the fact that the majority of men and women of child-bearing age are employed, there are no statutory entitlements to absence or flexible working during the long, physically and psychologically demanding process of treatment. Policy focuses on supporting expectant and existing parents, and although some organizations have workplace policy relating to fertility treatment, this is not normative and policies vary greatly.

Research published in the Journal of Psychosomatic Obstetrics & Gynecology by Dr Nicola Payne and Professor Olga van den Akker (Middlesex University) in collaboration with Fertility Network UK (Susan Seenan) reported the results of an online survey of 563 employees in the UK. The survey examined their experiences of combining fertility treatment and work and some key findings are reported below. The article may be accessed at http://eprints.mdx.ac.uk/24066/

Absence from work: The average number of days of absence during a treatment cycle was nine, but 50% of participants took more days than this, with some taking more than a month. More days of absence were associated with reports of greater levels of distress related to treatment. The most frequently reported methods to manage absence from work were the use of annual leave and sick leave. Only 23% reported their workplace had specific policy relating to treatment and those with no policy experienced greater levels of distress related to treatment. Where policies were available they varied greatly. In some cases policies stated that fertility treatment is elective so no absence from work was allowed. In other cases the policies were vague or left decisions to the discretion of the line manager. Some policies allowed a specific number of (paid or unpaid) days of absence (generally between 2 and 10 days) but often restricted the number of treatment cycles that would be supported (generally between 1 and 3).

Disclosure: 74% of participants disclosed to at least some colleagues. Of those who disclosed to colleagues, 35% received a great deal of support, 47% received a bit of support and 18% received no support. 72% disclosed to their employer. Of those who disclosed to their employer, 42% received a great deal of support, 48% received a bit of support and 10% received no support. Those with no support from their employer reported greater levels of distress related to treatment. The most frequently reported reasons for non-disclosure to their employer were that it is a private matter, fear their employer would not understand and fear of career consequences, stigma and gossip. The most frequently reported reasons for disclosure to their employer were needing to ask for leave, wanting to be honest and having a good relationship with their employer. However, 60% reported their employer would benefit from education/support to help them better understand the needs of employees having treatment.

Combining work and treatment

58% of participants reported work affected their treatment (e.g. it was difficult to make clinic appointments), 87% reported treatment affected their work (e.g. it was difficult to concentrate) and 51% were concerned it would affect their career prospects. These concerns increased with more cycles of treatment and those who reported these concerns experienced greater levels of distress related to treatment.

Conclusions

Overall the findings suggest that workplace policy is needed. This may have implications for psychological and physical health and some research evidence suggests that psychological distress may affect fertility treatment outcomes. The provision of workplace policy may also benefit the employer through increased employee commitment and retention. Workplace policy should incorporate flexibility, so that, for example, time can be made up later. Guidance for supervisors/line managers, who may have limited understanding of the needs of someone having treatment should also be incorporated to ensure that policy is effectively translated into practice. Ideally this would be combined with clinical practice changes in flexibility of clinic appointments to allow at least some of these to take place outside of working hours. Additionally, psychological intervention to support those having fertility treatment is needed and should incorporate discussion of work-related difficulties and dilemmas.

Read Alex’s Blog

Alex’s story – September 2019

I have always known that conceiving would be difficult. I have two hidden disabilities: a complex endocrine condition, which affects sex hormones (growth hormones as a child), cortisol (stress hormone), and salt retention; and Crohns disease, which is inflammation of the bowel. I take six medications every day including two steroids, and have had quite a bit of surgery over the years to manage both conditions.

My fertility journey started at the end of 2009 when my partner and I started trying to conceive. In 2012 I was put on the ovulation drug Clomid for 12 months, and when that didn’t work, we were referred to hospital for a series of tests at a reproductive clinic. The hospital checked his sperm and my fallopian tubes, and everything came back clear – a good result. Following several months of eager anticipation we were put on the waiting list for Intrauterine Insemination (IUI).

For me, IUI started with taking seven days of tablets and then inducing a medical menopause with a nasal spray (given to men with testicular cancer), taken five times a day. This was used to down regulate my hormones, so the ovulation drugs could be managed more effectively. Once the hospital was happy the nasal spray had done its job (after about two weeks), I started to inject myself in the upper thigh with gonadotropin (used to stimulate follicle growth) every evening, whilst continuing with the nasal spray. This was a lot to manage on top of all my normal medications and meant I ended up having eight alarms set on my phone as reminders to take everything I needed to!

The injections went on for over two weeks with early morning hospital appointments every other day. A nurse took blood and another did an internal examination of my follicles and endometrium (womb lining). The tests were okay, but waiting in a room full of pregnant women and their happy partners was not. After 19 days of injecting myself and sitting in various waiting rooms I was booked in for my first IUI procedure.

We were optimistic first time round – how could it not work? We’re putting both things in the same place; what could possibly go wrong? We were incredibly upbeat and excited about the whole thing; after all we had been waiting for treatment for over six months, and trying to conceive for nearly 4 years.

As I lay in a special chair in an undignified position, the nurse prepared to induce me with my partner’s sperm. It was over quickly and was relatively painless. We left feeling positive and convinced it had worked. Unfortunately we found out three weeks later that it hadn’t. We’ll never know whether it was a very early miscarriage because I didn’t have the heart to do a test. All I knew was that I was in a lot of pain, my bowel was upset, and my heart had been broken. It hurt like nothing else. My chance of being a mummy had been taken from me.

Not wanting to delay I called the hospital and started the whole process again, after a mandatory 21 day break. The second time was awful from the beginning; I was a wreck from the first cycle of treatment and hadn’t given myself the space to recover mentally or physically. But, being strong and having already dealt with a lot of medical problems in the past I wanted to persist, confident that my efforts would pay off and we’d have the family we deserve.

The process was the same, but I knew that it wasn’t going to work. We were rushed into the procedure because there was a bank holiday which messed up our timings. It was very painful and we sobbed as I was induced. We knew this wasn’t to be and we were right. The effect on my wellbeing was enormous; I hurt badly and was giving up on everything. What is the point I

kept asking myself? What did I do to deserve this on top of everything I’d already been through? I was unwell for about a year and problems relating to my existing health conditions were apparent. I was forced to take some time out to get better.

After a 12 month break I referred myself to see a top consultant endocrinologist who specialises in fertility. He put me on a high dose of different steroids in place of my usual steroids to try and induce ovulation. Unfortunately it made me very ill again and after 9 months of treatment I was struggling with depression, anxiety, and significant weight gain. I was a mess and on antidepressants to counteract what was happening to me. I was having breakdowns and crying all the time for no reason. The final straw was breaking down in floods of tears at the hospital pharmacy where I proceeded to collapse onto the floor. I knew in my heart that I had to stop.

It’s now 2019 and although we’ve been tempted to try again, life has conspired against us with my partner being seriously ill for several years; in and out of hospital. Sadly I have had to try and accept that I won’t be a biological parent. It’s not a decision that anyone wants to make, but I know I have to listen to my body, and try and find other things in life to give it meaning and purpose. It’s not easy, but I know I’m not alone.

page2image21532416 page2image21532608

Read Tori’s Blog

Trying to conceive can be a lonely and isolating place

As is the way for many, my fertility struggles crept up on me. I slid into being 1 in 8 when I wasn’t looking. I’d never had any reason to think there’d be a problem, my periods had always been regular and I was fit and healthy. I have curvy hips which once prompted a friend to say ‘You look like you’d get pregnant easily’. This made me smile at the time, as we’d only just embarked on our trying to conceive journey and I believed it’d be true. Each month we’d eagerly await the time we could reliably test, analyzing every possible early pregnancy symptom, which cruelly are very similar to symptoms of your period arriving. Each month we felt just a little crushed at the sight of that one line. Were we doing it right? Why wasn’t it working?

As the months passed by, hopefulness and excitement slowly morphed into frustration, fear, and eventually, obsession. I would dream of seeing two lines on a white stick and of having a lovely round belly, full of a baby. Then I’d wake and feel grief wash over me. Then guilt. I hadn’t lost anything; I didn’t have any right to feel grief. I needed to get a grip. I could do better than that. And anyway, it was probably just a matter of time. Sadly, I’m sure this cycle of thinking will be familiar to many. It’s not helpful that we beat ourselves up for feeling sad about something that is sad.

I spent two and a half years struggling to manage my obsession with getting pregnant. It affected my whole life in ways I would never have anticipated. Trying to conceive, for good or bad, became my sole purpose. When I was standing in the queue in a coffee shop, my mind would be going over dates and calculations, working out the optimum time to have sex. When I was in a meeting at work, I would be arguing with myself about whether to take a pregnancy test a day earlier than I’d decided to allow myself to. On the train home, I was wondering whether I should have done that shoulder stand for an extra two minutes, as that could have been the one thing that made the difference between my dreams coming true and trudging on in this state of semi-existence.

The trying / struggling to conceive journey can be a lonely and isolating place. It’s not easy to talk about; people don’t know what to say. If you’re a stressed-out parent with a toddler who’s causing havoc in a supermarket, you can exchange wry smiles with other parents, the older generation who’ve been there, or basically anybody else who happens to be around.

Being a parent is hard work but feeling frustrated because your child won’t put down the bag of sweets and move on to the shampoo aisle or being exasperated because your child has thrown their food all over the floor (again), are actually Good Problems to Have. I say this because they’re relatable. You can use them to bond with others, they make good anecdotes and you know that however annoying these things are at the time, you’re blessed to be experiencing them.

Infertility is a Bad Problem to Have. When you’re self-consciously brushing tears from your cheeks, overcome with emotion in the nappy aisle, there’s nobody there rolling their eyes with you or offering an understanding smile. When you have to leave the room because someone has announced their pregnancy and they’ve only been trying a couple of months, you’re pulling yourself together alone in the toilets. This doesn’t make an amusing anecdote over dinner with friends, later. It makes people uncomfortable. I want to change that. I want it to be okay to say ‘hey, I’m struggling to get pregnant and it’s tough’ and for people to know what to say back.

In the end it was a matter of time for us. And also a matter of medical intervention. God bless IVF for giving us our beautiful daughter. We’re blessed to have our happy ending, but the struggle to get there changed me and I found I had an overwhelming urge to write it all down, to share my story with the many, many others for whom the struggle is still real.

In April this year, I published my book Warrior. My warts and all account of my journey to conceive. My hope is that it may make some fellow sufferers feel a bit less alone, a bit less like they’re going insane and maybe raise a few smiles and laughs along the way. My little contribution to the struggling to conceive community.

Love Tori x

Purchase a copy of Warrior here
Check out Tori’s blog
Instagram – ToriDayWarrior
Twitter – @ToriDayWrites