Interview with Diane Cote, Fertility Counselor in San Mateo, CA

6.) KP:  What are the specific tools you use when working with patients who are struggling with infertility? 

Diane: Both in my psychotherapy practice and in my own life, I’m very pro mindfulness meditation, yoga and acupuncture.  Combining interventions from the East and West.  A lot of these practical tools, like mindfulness meditation, guided imagery, and breath work, I really encourage clients to cultivate a practice with these tools.  I often get them started in my office, leading them through guided imagery and mindfulness meditation and then refer them to resources.  I’m a yoga person.  Anything that can relax the mind and the body.  I’ll refer them to different yoga teachers and studios, to get them exposed to it so they can start to practice this feeling of relaxation, calming the mind, calming the intrusive thoughts.  Of course, the more you practice, the more it becomes an autonomic response, where you can call it up in the most difficult situations.

Also, helping people connect with others who are in the same boat.  I used to run groups, but I haven’t done one in a while; I’m thinking next year I may start leading one again.  But, there are some really great support groups out there.  Some of the groups are with independent clinicians.  Some are led by RESOLVE – which is a national infertility organization that’s been around for 50 years.  They have chapters all over the country and RESOLVE support groups are run by therapists (or peer led) in particular geographic locations.  Support groups are fantastic for people with infertility diagnoses because the people in those groups really get it, like nobody else.  So, I often will recommend that patients attend support groups.

Getting their partner in the room can also be quite helpful.  Most times, the woman comes to me for help and after a while I might invite her partner to come for a session or two. This process can be very, very stressful on relationships.  There’s the emotional stress and there is often great financial stress.  These are couples that are generally pretty stable and happy, but often times the goal of getting pregnant and having a child takes over everything. I work to get them back on track, how to come together on goals and how to have fun again in the relationship.

Diane: I also want to add that I’m connected to a couple of great acupuncturists.  Acupuncture is highly recommended for infertility.  There have been some studies that show that acupuncture can improve pregnancy outcomes.  A lot of times the acupuncturist and mental health people will send each other patients, which has been great.  I work with a few acupuncturists that I refer patients to and they often refer their infertility patients who require counseling.  We’re trying to help people by referring them back and forth.

KP:  Acupuncture has applications in so many arenas, but I wasn’t aware of how it can help with infertility, that it’s been scientifically validated in that arena, so that’s good to know.

Diane: A lot of the big clinics also have an in-house acupuncturist.  Right after an embryo transfer, they’ll do an acupuncture treatment session right there at the clinic. It has proven to increase pregnancy outcomes for in-vitro fertilization.

KP:  On a side note, do you find that most people are open to the suggestion of acupuncture or does that freak people out at all :-)?

Diane:  Of course in the San Francisco Bay Area, many people have already tried it.  For some people it is scary, but honestly, by the time people are coming to counseling, they are  desperate to try anything.  So, if it means sticking needles in them, they will try it.  There are acupuncturists who specialize only in fertility – they study how acupuncture can increase fertility and they’re really good at what they do.

KP:  That makes sense.  I’m really glad you brought up the piece about support groups.  That seems like connecting people to others who are going a similar process could be incredibly helpful.

Diane:  Yes, and I should also add that the support groups are starting to bifurcate, where you have “general infertility” groups for people who are just finding out, who have recently received the diagnosis of infertility.  Then there are egg donor support groups, for people who are trying to figure out if they want to go to donor and/or people who have already made that decision.  Those who are going with egg donor can speak to their experience about that process and help others who are trying to make up their mind about whether to go in that direction.

Next: What is the greatest barrier to individuals or couples pursuing fertility counseling?

  1. This is helpful!

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