This is the second installment of Barren Advice. You can ask questions that are fertility or non-fertility related.
Barren Advice is posted each Tuesday. If you have your own question for Barren Advice, click here to learn how to submit. Please weigh in with your own thoughts in the comment section and indicate which question you're addressing if there are multiple questions in the post.
I want to keep TTC, but I need some dental work. The dental work may not be complete before my next cycle, and I definitely need it done. Should I not keep TTC?
--Queenie from Baby, Borneo or Bust
You didn't specify what type of dental work--if it would be a one-shot deal or a multi-part surgery such as a root canal, but regardless, the answer remains the same: focus on one medical crisis at a time and take care of any problems with teeth and gums before trying-to-conceive.
If something (and teeth fall into this category) affects pregnancy or trying and you can address it and remove it from your plate, I would simply take care of it and move on. Once you become pregnant, teeth can also play a possible role in some types of loss. I say this with a slight cringe because so many times with loss, you are seeking an answer and there isn't a clear one. Emotionally, that can be very difficult to accept and leads to many fears in future pregnancies (or can stop someone from trying again). Studies have been done that show a correlation between gum disease and preterm labour (according to the AAP, women with periodontal disease are 7 times more likely to have a preemie). Beyond that, the hormones in pregnancy--higher levels of estrogen and progesterone--can change the way your body processes bacteria and create gingivitis even if you never had dental problems prior to getting pregnant.
You can drive yourself crazy with the what ifs that arise out of each study that states or disputes a correlation between loss and another aspect of your health. I seriously wonder--even as someone who believes everyone should be a key player in the medical decision-making process--if Google Medschooling and reading all of the studies as they come out is emotionally healthy or if it simply leads to more fodder to beat yourself up with when things aren't going as planned. Regardless, the bottom line is take a break from trying and address the dental problem simply to be done with it so you can return your focus (and give over the enormous time commitment inherent in treatments) to trying-to-conceive. And I give this advice even in the face of time and sensitivities with age and conception. When things go right, we don't have to deal with the what ifs. But I always lean with the insurance of addressing the what ifs just in case things do go wrong.
In real life, I am very open about my infertility with family and friends. As a result, I have a lot of conversations with people about infertility. A situation has arisen recently that I'm not sure how best to approach. I'd like your input: what can I do when someone tells me something about their infertility that sounds medically incorrect? I'm not talking about something like minor variations in IVF protocols, but something that makes clear that this person isn't understanding or isn't being communicated with appropriately. How might I get involved, ideally without making a total ass of myself? How can I help encourage someone to take control of their infertility in real life?
Here's the one silver lining in being infertile in this particular situation. You can take your own experience with infertility and ask yourself what you would want to hear, keeping in mind the unique needs and desires of the other person. If the other person is extremely private and you are open about your infertility, what you would want to hear may not match what she would want to hear or vice versa. But it can be a useful barometer.
It can be painful to read or hear someone you care about stumbling around on a path when there are clear steps they could take to help themselves. Sometimes, those steps are very personal to how we view the world--we can look at someone struggling with a piece of information and think to ourselves "their life would be so much easier if they just came out with the truth rather than keeping it hidden." Other times, the steps are a different shade of grey--a person may be making choices you would never make such as not visiting an RE after recurrent losses because they don't wish to enter treatments. And still other times, those steps are clearly black-and-white: their RE is telling them that recurrent loss is okay and not running any tests or encouraging them to transfer 15 embryos at a time.
In the first example, I would always caution a person not to place their own opinions or what works for them on another person. We need to keep in mind that even with the people closest to us in life, we only have a small portion of information--whatever they wish to reveal to us. We can never be inside the head of another person or know how their previous life experiences are affecting this current decision. Therefore, do nothing. If you can't stand the decisions they are making, remove yourself from those conversations.
In the middle example, the greyer situations bring about greyer answers. I always take a step back and ask myself if they are doing something physically, financially, or emotionally harmful to themselves. If the answer is no, I move these situations into the first category. If the answer for any of the three is a yes, I sit with it longer before moving it into that third category.
The third category does require attention--if not to help them than to relieve your own guilt over watching someone you love doing something harmful to themselves. How would you feel down the line if the worst case scenario happened and you could have stepped in and helped? That said, much like beauty, help is in the eye of the beholder. Meaning, you may see yourself as helpful and the other person may view your actions or words as meddlesome. There is always the chance that stepping in will create a wedge between you and the other person. That said, sometimes I would take the wedge over standing by and watching someone get hurt.
A case in point, I had a student who was cutting herself and asked me not to tell her parents. Of course, it would be irresponsible of me to know that she was hurting herself and not pass along that information to people who could help her and needed to know. The student never spoke to me again, but I'd rather take the wedge and know that I have her eternal frustration than know that I could have helped and did nothing in case the worst case scenario came about.
Often times, people share information with us because it doesn't quite sit right with them either. Perhaps this person is sharing details with you because they want your opinion. Or they may be sharing details out of a sense of obligation or because they simply need to vent. Regardless, weigh out which category they fall into on the spectrum and act accordingly.
A handy chart to summarize...
No really, the beauty of a blog advice column is that you get to weigh in with your two cents too. Let the questioner know if you support the advice, add to the response, or dispute it completely.
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