If you\u2019re reading Fertility Road magazine, and this article specifically, there\u2019s a good chance that you already have some experience with IVF treatment. Even if you\u2019re not yet in treatment, the idea of personal boundaries will likely be familiar to you. Just as fences between properties can provide protection, security and privacy, personal boundaries protect your personal or mental space. <\/p>\n\n\n\n
They involve the physical and emotional limits of appropriate behaviours between people and help define where one person ends and the other begins. <\/p>\n\n\n\n
That\u2019s the dictionary definition stuff over, so let\u2019s get right down to what it means for people in, or seeking, fertility treatment. As an aside, in doing some research for this article, I was shocked by how little I could find addressing this important issue. I\u2019ve included a useful link to one interesting piece<\/a> offered by a clinic in the US.<\/p>\n\n\n\n Given the emotional, physical and financial implications of IVF treatment, it can be an especially challenging time for people on their fertility journey, and the need for boundaries can become acute. Such boundaries are by their nature personal or individualised because things affect different people in different ways. With my coaching clients, seeking or going through treatment, I am always struck by how much they need to learn about IVF and how overwhelming this can be. Faced with the huge amount of, often conflicting, information they receive, it\u2019s clear that they don\u2019t always have the opportunity to ask specific questions or identify and set their own boundaries before actually starting treatment \u2013 the main focus of this article. Boundaries needn\u2019t be set in stone but it\u2019s a good idea to start your treatment journey with some.<\/p>\n\n\n\n This article will discuss different types of boundaries and why they might be important for you. I\u2019ll also share some proven strategies for establishing and maintaining boundaries during treatment. There are many different boundaries to consider, and they often overlap so they shouldn\u2019t necessarily be seen in isolation.<\/p>\n\n\n\n This is about understanding your emotional limits and developing strategies for coping with potential disappointments or stress. The combination of stressors including (but certainly not limited to) infertility, treatment itself, time away from work, possible relationship conflicts, money issues and not least the effect of medications on your body and mental health need to be recognised. These stressors can take a toll on your emotional state. Once you accept this, you can take steps to counteract these challenging emotions. It may be a good idea to set up regular appointments with a mental health professional or counsellor to ensure you are not internalizing too much stress from the process and have a safe space to express your feelings.<\/p>\n\n\n\n Deciding the type and extent of treatments you’re comfortable with, the medications you are willing to take, limiting the number of cycles you’re willing to undergo, or setting rules about when to take breaks between cycles for rest and recovery are all examples of physical boundaries relating to IVF treatment. You may feel like you are constantly being bombarded with the \u2018ticking clock\u2019 of infertility and wanting to try again after a failed cycle is only natural. However, it\u2019s worth understanding that it will probably take more than one IVF cycle to achieve a live birth and the number of cycles needed only increases with the woman\u2019s age. Ask your clinic about how many cycles they estimate you might need to have a child. Otherwise, you might run the risk of burn-out and financial hardship.<\/p>\n\n\n\n Now that IVF treatment has become quite mainstream, it\u2019s easy to forget that people of different faiths may have different ethical or specific religious boundaries. For example, some people limit the number of eggs fertilized to reduce or eliminate the chance that extra embryos will be discarded without having the chance to make a child. You don\u2019t have to subscribe to a particular faith to have a strong feeling about what\u2019s right or wrong for you. Indeed, many clinics today will try to accommodate your specific needs if they\u2019re not breaking any local laws or regulations. Obviously, the earlier you communicate this to the clinic the better. One of my coaching clients, Blanche, is seeking egg donation. Her first choice for treatment would be Spain. \u2018It\u2019s incredibly attractive to me as it\u2019s less costly, with more choice and excellent success rates\u2019 she told me. However, Spanish clinics don\u2019t allow the patient to select the egg donor and all donors are anonymous. \u2018Unfortunately, Spain is not an option for me as I feel very strongly that the child should have the opportunity to have contact with his or her donor. It\u2019s very frustrating the discrepancies between countries offering treatments. They all seem to have different ethical systems.\u2019<\/p>\n\n\n\n You may wish to decide on a specific budget for your IVF treatment and you can communicate this to your healthcare provider to make decisions about the most cost-effective course of action. At the very least you should understand the potential costs involved, setting limits on what you’re willing to spend. IVF treatment can be very expensive and typically only a minority of patients receive state funding depending on the country. It may also be worth seeking financial advice prior to starting treatment \u2013 after all this is one of the most important \u2018investments\u2019 you will make in your life. This is why transparent pricing is very important and why unexpected costs are one of the most common complaints made by patients. For this reason, the UK\u2019s fertility regulator (HFEA) requires clinics to provide all patients with a costed treatment plan (best estimate) before starting treatment.<\/p>\n\n\n\n Decide with whom and when you want to share information about your IVF journey, which can help avoid unsolicited advice or intrusive questions even from well-meaning friends and family. Blanche shared with me two examples of unsolicited advice she received recently regarding her decision to continue with treatment to try for a second child. \u2018You mustn\u2019t do this\u2019 one family member said and another friend offered the following: \u2018your child is wonderful, you won\u2019t have another child so wonderful\u2019. It\u2019s also common for members of the LGBTQ+ community to receive a disproportionate amount of unsolicited advice or questions because of their particular need to access treatment. Understand that IVF can be a time-consuming process. Set boundaries on how much time per week you dedicate to IVF-related activities, including appointments, research, and discussions, to avoid having the process take over your life.<\/p>\n\n\n\n Establish boundaries at work, like whether or not you disclose your treatment to your colleagues or manager. Request time off or a flexible schedule as needed for treatments and rest. This is a hot topic in many countries right now with many organisations (such as Peppy<\/a> och Carrot<\/a>) emerging to support fertility rights and promote employee benefits in the workplace.<\/p>\n\n\n\n Make it clear to your healthcare provider that you want to understand all your options, risks, and benefits before any procedure. This includes the right to second opinions and sufficient time to make decisions. Some IVF clinics and doctors can be quick to get you into what I call the \u2018IVF funnel\u2019 (you know – the type that\u2019s hard to climb out of once you are in it). In most cases, this is done with good intentions, but it can come across as not respecting your boundaries. The solution to the \u2018problem\u2019 of you not getting pregnant may be obvious to them (after all they do this process multiple times every day) but you may still be \u2018processing\u2019 your options.<\/p>\n\n\n\n Identify the people whose opinions you value in your decision-making process. Limit the influence of others who may not understand or respect your choices. Everyone has an opinion, and they are entitled to it. However, you may get more benefit hearing from people with some detachment from the process and no specific emotional connection such as an independent fertility counsellor or a fertility coach. In any case, you are better off finding the decision that\u2019s right for you with support rather than being offered a \u2018ready-made\u2019 decision.<\/p>\n\n\n\n If you use social media, decide early what you’re comfortable with sharing online and stick to it; whether that’s nothing at all, every single step of your journey, or somewhere in between. Undoubtedly social media has been beneficial in bringing people together to share experiences and learn from each other. The negative aspects are well documented, but its clear that responses to whatever you post are not under your control. Given that the entire IVF process is often seen as a lack of control you might want to limit the opportunity to lose yet more control.<\/p>\n\n\n\n Figure out what activities help you relieve stress and how often you need them. Whether it’s a weekend getaway, a yoga class, or reading a book, make time for these activities and treat them as non-negotiable.<\/p>\n\n\n\n Yes, I know \u2013 that\u2019s a lot of different boundaries to think about! Now that we\u2019ve covered most of the important boundaries, let\u2019s take a moment to think about how to establish which boundaries might be important for you.<\/p>\n\n\n\n To establish your boundaries, you have a couple of options. First, you could address every category above and put in place a personal boundary for each. Second, you could work through the list prioritizing which, if any, is important to you right now. <\/p>\n\n\n\n Some people find it helpful to do a self-assessment:<\/strong> <\/p>\n\n\n\n For each category, rate yourself on scale of 1 to 10:<\/p>\n\n\n\nWhy it\u2019s important to set personal boundaries for IVF treatment<\/h2>\n\n\n\n
Emotional Boundaries <\/h3>\n\n\n\n
Physical Boundaries<\/h3>\n\n\n\n
Ethical boundaries and your values<\/h3>\n\n\n\n
Financial Boundaries<\/h3>\n\n\n\n
Communication Boundaries <\/h3>\n\n\n\n
Attending events: It\u2019s okay to decline an invitation to a baby shower, party, or any event that you worry will be too hard. You are not being antisocial or inconsiderate, you are taking care of yourself by setting a boundary.<\/p>\n\n\n\nTime Boundaries <\/h3>\n\n\n\n
Work-Life Balance<\/h3>\n\n\n\n
Healthcare Provider Relationship<\/h3>\n\n\n\n
Decision-Making Boundaries<\/h3>\n\n\n\n
Social Media Boundaries<\/h3>\n\n\n\n
Coping Mechanism Boundaries<\/h2>\n\n\n\n