Counseling Services

As part of OHSU Fertility Consultants philosophy of treating the whole person, we understand how difficult it is to want a child and struggle to conceive. That is why our program recommends the services of a professional counselor to provide additional support, understanding, stress management , and therapy, if needed, to our patients. Paula Acker is a psychotherapist who sees patients for a wide range of issues including struggles regarding medical options, what to do if each partner wants to go in a different direction, depression resulting from failure to conceive, third party reproductive decisions and psychological issues, stress management tools, relaxation techniques, nurturance , grief and loss issues, adoption information and support, and help for those considering ending treatment. She is a reference for community resources for additional support as well. Ms. Acker has been a member of Resolve for over 24 years and is the clinic liaison to connecting patients to this resource. Ms. Acker has also worked in the field of adoption and provides interested patients a wealth of information about alternative family building options. 

Counseling for infertility issues can help couples and individuals improve their decision making ability, cope with loss and grief, and gain insight into the complex psychological issues of assisted reproductive technology and third party reproduction. In addition, our counselor can help with:

• Dealing with a failed cycle.
• Coping with a miscarriage.
• Give insight about psychological dimensions of third party reproduction (egg and sperm donation).
• Teach relaxation and coping techniques as well as stress reduction strategies.
• Adoption information, support and referrals including transition from infertility to adoptive parenting.
• Disclosure issues regarding egg/sperm donation.
• Coping with pregnancy and associated fears.

Paula can be reached at (503) 940-5777 or visit her new web site.   Her office hours are Tuesday through Friday and her office is conveniently located 10 minutes from OHSU, at 1962 N.W. Kearney St., Suite #104, Portland, OR 97209.

Paula sees patients for all third party reproduction, (donor egg, donor sperm) and does psychological screening for both egg and sperm donors.  She is available for phone consultation appointments for out-of-town patients as well.  She provides individual, couple, and same sex couple counseling plus group therapy for fertility related issues.

Infertility Stress

   Patients often ask if they are contributing to their own infertility by the stress they are experiencing. They worry that their stressful lifestyle, job, or working schedules may be detrimental to their success at achieving pregnancy.

   After having attempted conception without success, or having experienced miscarriage, most patients experience loss, grief, sadness, anxiety, depressive feelings and sometimes a sense that their lives are out-of-control. They worry that they may never experience pregnancy, childbirth, or parenthood. The unusual feature of infertility is that it is composed of a series of choices which bring anxiety and stress. We do know that infertility causes stress, but does the stress in your life cause infertility? 

   Research suggests that at least 85% of fertility problems are physiologically caused. But there is new evidence that the mind also plays a crucial role. A 1993 study by reproductive biologist, Samuel Wasser gives a clue about how stress may affect fertility. Wasser gave a battery of psychological tests to 38 women. Then the women and their partners had a medical workup to determine why they had not conceived. He found that women whose infertility was caused by hormonal problems showed much higher levels of stress, than those whose partners were found to be infertile or whose infertility was caused by anatomical problems, like blocked fallopian tubes. The stress of infertility from hormone problems may be because the hypothalamus, a part of the brain that controls the flow and timing of reproductive hormones, is sensitive to tension. Stress can affect the way the hypothalamus orchestrates these hormones. 

   Stress management strategies are proving to be an effective method of coping through infertility and, in addition, they may prove to play a positive role in improving conception rates. Alice Domar, Ph.D., has written an excellent book about the benefits of stress management and infertility called "Healthy Mind, Healthy Women. Using the Mind/Body Connection to Take Control of Your Life" (Delta Publishers). Some of the suggested ideas for coping through infertility include meditation, relaxation techniques, yoga, improved nutrition, cutting back on alcohol and caffeine, smoking cessation, extra sleep, cognitive restructuring, journaling, joining an infertility support group and finally, making a realistic treatment plan with your physician and partner, together. This helps with decision making and not neglecting an important component to managing stress. The mind/body connection is an important issue not to be ignored. Patients that feel they are managing their stress the best seem to manage through treatment with the greatest success. 

   For further information on stress management and coping through infertility, read Dr. Domar's book. Also recommended, "Choosing Assisted Reproduction, Social Emotional and Ethical Considerations," by Susan Lewis Cooper and Ellen Sarasohn Glazer (Perspectives Press, 1998). 

Self-Nurturance:

Self-nurturance is quite simple. It means seeking out pleasurable activities that are self-satisfying. Yet women in our society feel quite guilty when they take time out of their schedule for personal development or satisfying activities. Why is this? Perhaps many women receive the message from family, friends, spouses, coworkers and/or bosses to be highly productive.  This is often equated to personal success, which in turn affects self-esteem. To be highly productive often means working long hours, and then trying to cram into your personal time a
meaningful life with some pleasure. Personal time for many women means housekeeping, laundry, cooking, groceries, child care, and other care taking responsibilities and not much time for relaxation, reading, visiting friends or family, or hobbies.

Before having children, women often dream of the time they may have off from work to be with their child(ren). They fantasize, then they will have some control over their schedules.  However, waiting and putting off self-nurturing activities could have a profound impact on one's self-esteem, sense of peace, and physical and mental health. Women are prone to depression and anxiety when their circuits are overloaded, or their schedules are too full. Ask yourself:

• Are you and your spouse both working outside the home?
• Are you the one that plans most social engagements?
• Are you sharing in the cooking, cleaning, laundry, yard and house maintenance?
• Are you the one that remembers everyone's birthdays and holidays, including his family? Is this taking too much of your time?
• Were you brought up to be selfless, nurturing toward others before your own needs were met?
• Do you feel your life is in balance?

Positive moods are a direct result of feeling good about your life and yourself. They enhance our immune system. Positive moods are often a direct result of strong social support from family, friends and partners, as well as joy experienced through pleasurable activities, such as exercise, dancing, reading, writing, painting, classes, massage, aromatherapy, or naps. Our health and well being depend on giving yourself time for personal pleasure. It is telling yourself you can take care of yourself and deserve to do so.

Women who have experienced infertility sometimes feel they are spending so much on treatment they cannot afford "to take time for relaxation or self-pleasure". They feel a continued sense of urgency and anxiety that does not cease. Try to remember that if anyone deserves to be nurtured you do, and that giving yourself permission to indulge in your passion or interests will make treatment less stressful and give you something else to focus on besides your time schedule. Also this is true for women waiting to adopt and wondering when they will ever be mothers. Incorporating these techniques will help make you feel good about your sense of self and your self worth as you approach motherhood.