The Basics of Infertility: How Fertility & Reproductive Counseling Offers Hope

Dr. Amy Balete walks the audience through the basics of infertility and outlines how fertility and reproductive counseling can offer hope through a safe counseling space. She covers a wide gamut of topics such as primary and secondary infertility, PCOS, hysterectomies, pregnancy loss, and various infertility treatments such as intrauterine insemination and in vitro fertilization. 

She is a licensed clinical psychologist and life coach specializing in women's emotional resilience. With over 15 years of experience, she expertly guides women through infertility, pregnancy loss, and overwhelming life transitions. As the owner of AR Courageous Life Solutions and founder of the Brave Hearts Community, Dr. Balete combines her extensive clinical background—from directing nonprofit mental health services to school-based counseling—with compassionate coaching. Her evidence-based approach helps women transform challenges into opportunities for growth, empowering them to create fulfilling, purpose-driven lives.

Transcript

Amy Balete  0:00  

To my understanding, when they start calling it secondary infertility is when you have now started to try to have a child or conceive a child, and it is taking longer than six months or a year, depending on your age, when we hit that magical age of 35 they say that six months of trying without success, you should probably start getting checked up and looking at you.

Speaker 2  0:24  

Welcome to perinatal and reproductive perspectives. This is a podcast where we empower birthing individuals, partners and health professionals with evidence based insights, holistic strategies and relatable stories, hosted by a healthcare expert. This podcast fosters understanding equity and growth in perinatal and reproductive health. Here's your host, Becky Morrison gleed,

Rebecca Gleed  0:56  

welcome everyone. I have another incredible guest, Dr Amy valetti, she is a psychologist and life coach, speaking to us all the way from California. Welcome Amy. Thank

Unknown Speaker  1:08  

you. Thank you for having me. We are

Rebecca Gleed  1:10  

going to be covering primarily the topic of fertility, and we're going to hopefully do some wide landscape on the topic, and we're really excited to have you on today. First, I wanted to ask if you'd be willing to share some of your personal story and what brought you into this space.

Amy Balete  1:32  

Yeah, so I, I'm a licensed psychologist. Have been practicing since 2012 and while I was in my practice, we were struggling with infertility ourselves, so I was typically seeing individuals at the time who were kind of in crisis. I did a lot of folks that were having severe trauma and grounding and doing these kind of skills as I was walking through my own fertility challenges, sometimes having symptoms of loss happening concurrently while I'm walking with others through their process. And so it really opened up a space for me of like, this is something I want to help other people through, because it was quite challenging, and so we had been diagnosed with with what was called secondary infertility. It was unexplained, um, according to the doctors, there was nothing seemingly wrong with my husband or I. We had all the tests done. We had gotten pregnant at 34 very easily. See, I mean, the first time my my first daughter came first try, we were like, wow, I thought that would take a little longer. And so we just kind of felt like everything was fine. I gave birth after 35 though, which then put you into that risk of at the time, they were calling it advanced maternal age, which I was like, I don't want to hear that again, like a May means against medical advice. I don't want that acronym used at all. So now it's geriatric, which is hardly better, but

Rebecca Gleed  3:16  

Angela's quickly what secondary infertility is?

Amy Balete  3:19  

Oh, yes. So secondary infertility is this unique group of individuals who have had a successful first pregnancy and now run into infertility issues after the first child, you actually could have multiple pregnancies. And so it really is to my understanding when they start calling it secondary infertility is when you have now started to try to have a child or conceive a child, and it is taking longer than six months or a year, depending on your age, right when we hit that magical age of 35 they say that six months of trying without success, you should probably start getting checked up and looking at if you are having infertility issues or something's in the way there under age 35 they generally say one year, to my knowledge, and so

Rebecca Gleed  4:07  

that's my understanding too, yeah, unless that's changed, and

Amy Balete  4:11  

things can kind of integral. But so yeah, we we had secondary infertility. Since we didn't have any issues with that first child, we really ran into a wall, what felt like a wall with our second so I was not ovulating during breastfeeding, to my knowledge. So we were like, told, okay, this may happen, and you may need to decide if you want to try to get pregnant again, to stop breastfeeding. And so we did, and we got pregnant within three or four months after trying at that point, but we lost the baby pretty early, so we're talking like the five, six week mark and that kind of then I think it was another nine months before we got pregnant again. So at that point, we had gone to see a fertility specialist. I had friends around me that were having issues with getting pregnant. So I was already kind of on alert for my age and and just the statistics there to go and get things checked out. We were seemingly healthy. They had no, really no understanding of why we were having trouble. But during that, I had a hard stop at only doing IUI, which is inner uterine, oh gosh, yeah, thank you.

Rebecca Gleed  5:24  

Don't know what that is. What did that process involve? If you're comfortable sharing? No,

Amy Balete  5:29  

no problem. So IUI. There's several ways that doctors will do this. My particular doctor, some doctors will put you on a medicine called Clomid. It is. It's a medicine that helps your eggs produce more than one or your ovaries, excuse me, to produce more than one egg in a month. Most of the time we only produce one egg. Sometimes we produce more, but it ensures that you'll get a few more follicles than what you would normally get. Then some doctors will say you're just there's more eggs you can try there. My doctor decided to pair Clomid with the IUI, which then is we would do. We would take the medication for a week. They're monitoring you. It's pretty intense, because you're going in quite regularly, getting exams and screenings to see if your follicles are in the right place. When they deem you're at a you've got a healthy enough egg selection. I mean, they're not testing these eggs. So they just know the follicles look nice and ready to go. They will then you have to inject yourself with what they call a trigger shot. And then it's timed. At that point, they know when you're going to the trigger shot is going to start ovulation. They know the timing of this. And so my husband would then go and provide a semen sample, and they just, I would go in at a time, and they would make sure, they would inject that semen into my cervix, and it just makes sure everybody meets at the same time. The odds here are not wonderful for IUI, when you look at the statistics, you're really only looking at a 30% rate of success, which IVF doesn't really have that much more they can be sometimes 30 to 60, depending on what a doctor is saying. But in my case, I had a mom who had a very aggressive breast cancer in her 40s, and so one of the side effects of taking some of these medications, because they are estrogen based, is that it can cause cancer, and so you're signing these paperwork. So when you go to these doctors and agree to these treatments, it's not always likely, we didn't have any issue as a result of these treatments, but it can cause that because of my mom's early stage cancer and how aggressive it was, I did not personally want to do the IVF. My doctor agreed that that was probably not my best route, given my history, since it was my mother, and so that was all I was willing to do at the time through IUI, we ended up doing eight rounds to get to our second baby. So that was 16 months of trying to get pregnant. There's times where you're going through these rounds. You may or may not know, I certainly didn't till I was in this process that your ovaries are always producing cyst on them when we are ovulating, and so sometimes we would do a round of IUI, the cysts don't go down, which there's nothing wrong, but you can't do another round until they have dissipated. And so I would have to wait. And it was, you know, just a very trying process of going through we got pregnant, then three times on IUI that didn't work. They were early miscarriages. Some people call that chemical miscarriage. A lot of my clients have some real strong feelings around that term, and so I just kind of find that some people it doesn't bother them. For me, that was a conceived child. I mourn the loss of that child, and then we were able to finally get pregnant. After the fourth miscarriage, we were able to carry a pregnancy to term with our second child. And so it was a long process, journey. Yeah, it was a journey. And then we decided that we knew we wanted three that we went back on the journey for my third child. We started to have a conversation of whether IVF was going to have to happen or I was going to have to make a choice, because the IUI was doing nothing. I wasn't miscarrying. We just we did four rounds of it, and my doctor, the IUI, statistics wise, is like or like one in three pregnancies is a miscarriage, and so if we didn't conceive on the fourth one, my doctor, in her opinion, was saying we were outside of the statistical norm, and that we needed to look at probably egg quality wasn't good, and we needed to consider IVF

Rebecca Gleed  9:57  

decision with knowing. The risks with your mother's history, but also this eagerness for another pregnancy that sounds really difficult. Yeah,

Amy Balete  10:10  

I you know, it was scary. I think that's just really the truth about it. I really wasn't sure what I wanted to do. We definitely wanted to have another baby. That second baby was a girl, which I was just happy to have a perfect, healthy rainbow baby, but I also we wanted to try for that boy. And really, just in our mind, three children was the ideal of our family, and so I was fortunate to never have to take that conversation to the next step, because we did get pregnant on that fourth it was kind of funny. My doctor was like, I told her, I don't want to do IVF. And she's like, I know you better get pregnant, okay? And I did your finger. I was like, Yay, okay. And I mean, that is fortunate. I know that not everybody's journey has been that smooth, and if you would call that journey smooth, it wasn't, certainly wasn't smooth. While we were going through it, there was a lot of fears involved. There was a lot of my husband and I got into couples therapy, because it's very taxing on the relationship to go through this. And we were fighting about lots of things that were silly, because we were kind of dealing with our grief and and we need support, right? And so we got into therapy, we were doing these things, and we just kind of knew that I was very settled that I would put this to rest if the IUI was not going to work, because the IVF was just something a I'm not a the biggest fan of needles. For those who aren't, yes,

Rebecca Gleed  11:45  

that comes up a lot, yep, the that is that

Amy Balete  11:49  

was really overwhelming to me. I had to give my trigger shot once to myself because my husband was at work. I was fortunate that he could help me with the others. But this one time, it was like, go home and immediately take it. You should have brought it with you. And it it's such a mind game to be able to do those things to yourself if you're not really comfortable. And I don't know, some some folks are more comfortable with it than others, and that's great, something

Rebecca Gleed  12:14  

you don't think about, though, the little you know minutia of fertility treatment involves, you know this is, this isn't just going to a few doctor's appointments. This is so involved affects your relationships, your day to day, you're often at the behest of someone else's schedule. Can you point to a few or explain to the audience maybe a few points of conflict in your marriage, or maybe something that you see often in terms of the couple's work that you do, because primarily for fertility counseling, I don't know how you practice, but oftentimes it's In a partnership. You're seeing both both people and conflict comes up in so many different forms.

Amy Balete  13:05  

Yeah, I think the biggest struggle that I know is not necessarily unique to us, was this just sex wasn't fun anymore. It became this very kind of laborious and forced thing that's not forced in, like, an inappropriate way, but it's like, we gotta go now, and we can't miss this ovulation round. So we need to be doing it, and we need to do it several times so that we pressured. It was very pressured, and it was kind of just affecting the relationship. I think there was times where my husband was just like, no, like, there's nothing romantic about this. I don't want to do this with you under this idea where it's like we're robots and there's no intimacy involved. And I think it was bringing up different issues for both of us. We were newly weds at this point, like we had only been married a year and a half. Yeah, we walk through this. So when I look back at it now, 10, you know, we're, we're 10 years in, boy, we were, we were dealing with a lot our first year of marriage. There was, there was life happening outside of just the fertility challenge that we were having. And so it was just bringing up issues for us that I think in some ways it was confidence in being successful in a marriage, when you're kind of feeling like, man, something's wrong with me. I'm not even though that wasn't the truth. We had medical data to back that up. You're like, why isn't my body working? Yeah, me,

Rebecca Gleed  14:33  

is it her? And the unexplained component is, yes, I think, particularly challenging. And just a point for our audience to understand. 1/3 is typically the female. 1/3 is male explained. And then there's another third, which I think is really hard, is we don't know why. We don't know why this is happening. We've done all medical tests, we've run every lab, and we.

Amy Balete  15:00  

Unexplained, unexplained. Every, every sample that was provided, we had good motility, good mobility, like, so for him, it was like, you know, my doctor was always kind of pumping us up, like, oh yeah, tell your husband, great job, you know. And, and for me, there wasn't anything wrong, seemingly outside of age and potentially maybe egg quality. I mean, that's what they just kind of were deducing it down to. We never tested those eggs. And so I think Hindsight is 2020 and as you as I've worked with patients and and clients and coaching and in therapy, I'm like, I think there's a little more that possibly could be involved there to help people feel that they are at their best for having a child and checking all these things. And in the end, you know, I've ran summits where I've talked to other professionals, where they're receiving clients that, I mean, they've done everything anyone in this place generally has the desire to do all and everything they need to do. Yes, and are willing, if you want me to change my diet, absolutely what diet driven by? Hope, yes, I will do whatever you ask, because I really want this to work, yeah. And even then, things get missed. And so it is quite a mind game for a couple to walk through. And I think therapy for us was helping me, particularly my type a driven attitude was like, We can do this. All you gotta do is do the things we have to do. You know,

Rebecca Gleed  16:35  

yes, but the burden comes in so many different forms. I'm thinking financially the time. You know you're trying to adjust to marriage. You know you've you've got, we

Amy Balete  16:47  

had a child. You had a child. You're needed, yeah? Life stresses

Rebecca Gleed  16:51  

that already exist compound that with. You know, additional stress marriage is hard enough, yeah? But then to add something else to the mix you talked about just to define rainbow baby. What is that? So our audience knows what that is. So

Amy Balete  17:08  

rainbow babies and the in the miscarriage and loss world, anybody who has suffered miscarriage or loss at any whether that's the early conception to a baby, a full, healthy pregnancy, baby to term after miscarriage or loss, is considered a rainbow baby. And it's just kind of that idea of the promise of the rainbow, if you are spiritual minded, or if Christian faith, it's I it kind of hones to that God's promise of the rainbow in the day of Noah, but it it's just kind of a nice way to receive a baby after loss, because, you know, going through the infertility process is one part of this getting pregnant is a whole nother mind game. Absolutely

Rebecca Gleed  17:53  

and tell our audience what that looks like clinically for someone being pregnant following loss. Well,

Amy Balete  18:01  

I, you know, what I find with the ladies I worked with is just a real hard time with wanting to trust that the pregnancy is going to stay, almost feeling like they, you know, there's, there's more that anxiety, almost like a post traumatic stress response, in a way, absolutely, you know, some people don't want to necessarily have that type of diagnosis, or they're like, Wait, that seems a little intense. However, there is this constant checking, Am I bleeding? If you've suffered a miscarriage, however that happened for you, constantly checking to make sure that didn't happen. Constantly checking, do I have symptoms? Yeah, well, I'm not nauseous today. Did something happen? Is this baby still there, and then going into every follow up appointment, just terrified for the news of heartbeat has stopped, or or whatever that may look like. I think at some point that it's just, you're just like, is the heartbeat there? Is it strong? Is everything good? My experience and experience I've with the ladies I've worked with fertility clinics usually carry you through that first trimester. And so you're you graduate every two weeks, you get to graduate to your normal OB, where a normal OB, GYN generally won't see a woman before nine weeks because of the likelihood of these early loss in pregnancy. And so nine weeks is a long time to wait if you have had multiple miscarriages. And so the beauty of that fertility specialist is that you did get a little more that hand holding I was always in every two weeks at some point within the first usually fix eight weeks, they'll stop taking blood work every week just to make sure hormone levels are increasing. And we see that they're all the indicators of baby growing is happening and so but even past that, when you get graduated onto the OH. B, G, y, n, there is always a bit of that lingering fear of, when can I trust that this pregnancy is real? And for some women, we're working through that up until Labor and Delivery. That

Rebecca Gleed  20:16  

can come in the form of, yes, it just transfers to the baby.

Amy Balete  20:20  

It's unfortunately this, this little gift that can keep giving until we kind of can work through some of that and break that cycle. Yeah, absolutely.

Rebecca Gleed  20:32  

What does that look like? More granular if you're working, if you're someone psychologist or life coach, what type of treatment will you be offering them to work through? Whether it's the post traumatic stress symptoms or the checking with anxiety can be called obsessive compulsive. Tell folks what they might expect, especially if you're they're seeking you out as their provider. Yeah. What might that look like?

Amy Balete  20:58  

Well, it's tricky, right? Because it's a little different for everybody. And so part of that is, when we're working with the women that are trying to get pregnant, right? We're, we're in that process still of trying to conceive and and work through infertility. A lot of that at that stage is, you know, my expertise are more with mental health. I'm not necessarily I have knowledge of the medical aspect of things, but I tend to stay in my lane here, and so most of that is helping people with their mindsets and dealing with the anxieties, the sadness or challenges that might be coming up in marriage. So when then we are looking at a lot of grounding techniques, I feel are very helpful for folks in general. All of us can benefit from practicing from them at one point or another, whether you have, you know, I think of, I think of our ranges of our symptoms, like an odometer on a car, right? If a lot of anxiety and sadness is normal, right when we start getting into that yellow, orange hour that looks on a car we're in that that upper third of it practicing these grounding skills and meditations, deep breathing, really getting granular of like what self care actually works for me. A lot of people will turn to a glass of wine. Well, that starts to maybe become a problem, or they don't want to do it because it's really not recommended by a provider. So then what are we going to do that actually brings us genuine care and helps us with those Rise and Falls of the emotions that we're having throughout the day. So is it journaling a couple times a day, I find having that kind of gratitude morning practice checking in with ourselves a deep breathing there's several grounding practices that I like to do with people that I find I'm like, this is something you can do at your desk, that people aren't like, Oh, what is she doing over there? Like, we can really be grounding, and nobody knows what we're doing. And so it is working through something like that. I find that our afternoon, you know, research shows that in the afternoon our creativity can spike. In that two to four hour for us is a great place to be, journaling and brain dumping.

Rebecca Gleed  23:09  

I didn't know that that's that sounds like a great tip. Yes, it's something that

Amy Balete  23:14  

I've come across with Joe Dispenza. I think I'm saying his last name, right? Great. But yeah, so that is a great place to it's kind of that afternoon fatigue too, where we can really stretch ourselves in worry, because we're kind of working through that afternoon lull there. And so it's a great time to really journal, practice another grounding, even if it's just for 10 minutes, really centering ourselves back in hope, having a evening ritual that is nice, soothing and calming for the nervous system, so that we can calm down at night. Again, a great place I find to do some brain dumping and really some gratitude for the end of the day, because we can reach the end of the day and feel like it has been a terrible day.

Rebecca Gleed  24:01  

Yes, I love what you did. Yes, I think what I heard you say was recenter yourself back in hope. I just that sounds like a beautiful mantra, if you don't already have one. Amy has given you a beautiful gem. You as an affirmation or mantra for grounding, and grounding is, is what you gave some great examples, right?

Amy Balete  24:23  

Yes, it truly is what it sounds like. We are grounding ourselves into lowering our that parasympathetic nervous system, right? If we're activated in high stress and cortisol that our nervous system is, we're reeling like even if we're not necessarily one to be prone towards anxiety. Our brain is active. We are the cortisol levels are spiking. We need to kind of bring ourselves down, and so when we can ground it truly is the best visual, I think, for people when they're confused or not understanding, is the cat rooting with the claws where they're kind of just sitting there rooting on their mama or. You know, they're human that they love. Um, it truly is getting in touch with our physical body in the present moment. And as we bring ourselves into our present moment with our body, we're feeling, you know, our butt bones, right, bones and thighs on a chair. Um, it can be even like I have a zipper on today so, and it has a little toggle, so a chain on a necklace, something that kind of puts us in a present moment, because our brain, we are really activated, and we're kind of getting into that anxiety and ruminating on a negative thought. We're kind of off in no man's land. We're often in the future. You know, future forecasting all the negative things that could happen. And so it is truly bringing us back to this present moment and focusing on what is good in this moment or what is just happening. It doesn't even have to be labeled good. But oftentimes people will tell me, Well, I'm just so inconsistent. And I'm like, well, let's step back a bit. Did you brush your teeth today? You know, did you take a bath? Did you put on clothes? Did you put, you know, your bed together in a way? Did you nourish your body? These are things that are little wins of consistency, that are examples that we can hold on to. We did do something consistent today. And sometimes, when we begin to focus on those little wins, they outweigh the things that aren't working or aren't happening for us. And it's not to ever deny or act like it isn't happening that waves are the I really am into mindfulness of from what we learned from DBT, which is Dialectical Behavioral Therapy, if anybody has heard that, they have a module in there, in their group programs, where it's really about mindfulness. And so I think of that all or nothing, thinking when we are we're switching from one to the other, becoming very rigid in our thoughts, either we're very emotional and kind of really in the emotional land, or we are becoming so concrete rational, we're kind of operating like a robot, not allowing any of those emotions to come in. We have to kind of find our place in the gray. We can do that with getting in the present. It's kind of your place in the gray, the waves of the ocean, whichever visual works for you. I think people then can find like, Okay, this getting back to center may just look like I'm standing at an Ocean's edge and the wave isn't taking me out, or my pendulum isn't swinging black or white. It's really in those shades of gray.

Rebecca Gleed  27:30  

I love that, and I think that will be so helpful, especially for individuals, for example, going through pregnancy after loss, of when they launch head to Oh my gosh. What is it going to be like at my appointment next week? Well, how can you be present in this what's happening right now and using those mindfulness grounding techniques to be as in your body as you can that's not to dismiss or invalidate those scary thoughts of loss, but to just help you cope a little bit better. Yeah,

Amy Balete  28:03  

I find that when we kind of disengage that and we are able to ground and root ourselves, we the fear isn't as present. We haven't given it as much life. Yes, right? Our thoughts tend to go in that direction of negativity, of like, what if it happens again? And, I mean, what ifs the what ifs I mean, I It's so funny, because sometimes I work with interns and I'm like, we gotta practice what we do. Guys, these skills were not just skills. I was working with my patients at the time. I was doing it myself. I had a full on practice of everything that I was we have to,

Rebecca Gleed  28:38  

we have to sing with people, yes, to help others.

Amy Balete  28:42  

Yes, it truly, it truly helps and and I think it came from a place there that, wow, I really engaged in my own practice, and it looks a little different for everybody. It's whatever feels the most natural for you, but these skill sets really can help us through those moments when it just feels like it's tough. Yeah, and it's really, you know, life happens outside of the bubble of just infertility, which is the hardest part, I think, of this diagnosis or walking through it, is that you have a job that has its own stressors, you have a marriage, you have family life happening on happening. You know, on a daily basis, life is people are are being born and dying in your life as you are going through your own process of that, and it can be very difficult to see people in their joy and in their grief when we feel like a very live wire of our own.

Rebecca Gleed  29:36  

Yes, you talked about diagnoses, and what are some of the diagnoses you might see as part of the infertility for for individuals listening who may not know some of the basics,

Amy Balete  29:47  

yeah, well, so I'm not always the expert on the medical side of that. I always give my little caveat there, or my my little spiel, but I. A lot of what we see with a high percentage of what the medical world will see as PCOS. Those who have PCOS, they know they have that generally, but it can be very tricky to get to that diagnosis. Yes, I think we're getting better at landing on PCOS, but it's very common, and it's just really a again, not my area of expertise, but there are higher levels of androgen, which is more in the male test. Male Yes, hormone happening in our body, and our ovulation isn't typically happening on a 2628 day, you know, 30 day cycle. Some women are really regular in that way with PCOS, we can see people ovulating at various different times, and so it's more of a process of monitoring when ovulation is actually happening to be able to conceive. I've spoken with many naturopathic doctors who have very, I mean, they have very planned protocols for those with PCOS. So I think naturopathic doctors, OBGYNs, I mean, these are great doctors to go with. If this is a issue that you know you are handling, most women will see that in their youth with very painful menstrual cycles, because there are those cysts that will then develop, but they actually they will burst, and that can send some people into ers because they've exactly like my appendix is something has happened, you know, right? Super painful. That is one route. Endometriosis is another really common route that people can have, and this is, and it's basics, the lining of your uterus is growing on other either outside of the uterus, it can attach to other various aspects of the organs, and so treating that is pretty important, because it affects implantation. And to my understanding, occasionally I'll see folks that have like, maybe one tube, so they've had an issue already, that they have lost a tube, or they have found in their process that there's blockages or cysts happening in the tubes or fibroids in the uterus itself. A woman that I worked with that had a fibroid that was the size of a grapefruit inside her uterus that was blocking. There was no way for the ovum to be able to attach the lining of the uterus because of this fibroid taking up space. And so there are probably some other diagnoses that I am missing. I and we talked about this off camera, I definitely have seen more in my practice women with an explained infertility. And so unfortunately, there wasn't anything really driving the doctors to say, This is why you're having difficulty conceiving. And you know, they were generally past the age of 35 and they're kind of attributing it to potential egg quality, sperm quality, they can test for egg quality for women, but we really don't have anything solid that tells us whether or not sperm quality is good or bad, to my knowledge, and so that has been pretty consistent amongst the interviews of the professionals that I've done,

Rebecca Gleed  33:08  

yeah, and I just want to highlight for everyone listening, there's a space there are providers who specialize in infertility. Oftentimes we're like, Well, I hope they have some background and but one of the benefits is that, and I'll ask that you speak to what it means to be, you know, someone who specializes in in fertility, but folks can know going in that you at least have that medical, at least some medical knowledge. So they don't have to say, Well, I have PCOS, and spend seven sessions explaining to you what that all involves. Yeah,

Amy Balete  33:44  

well, so there are, there's no training, to my knowledge. There's different trainings that therapists can go through to specialize in this area. I think oftentimes the therapists that I've met that are specializing in this they have lived experience, or they have just kind of gone down that path and have come across reproductive health challenges. This is something that they're interested in. So they are educating themselves with, Deus, sorry, continuing education coursework, going to, you know, conferences and such, to make themselves as knowledgeable as possible for infertility. And so there's also resolve, which is a website. They are the national institute infertility, excuse me, Association. And so resolve has a website that people can find professionals that are infertility specialists. I think for mostly we you'd want to see a provider who feels like they are. This is somebody that they have worked with. They're advertising in that way. Therapists have ethics that they can't necessarily say that they're an expert in something that they're not. And so I'll

Rebecca Gleed  34:51  

add that to the show notes for everyone who wants that link to resolve. And then just to add the American Society for Reproductive Medicine is another. It's. It's more medically heavy, but there are a lot of us fertility counselors who I think we actually carry most of the membership, believe it or not, but it does tend to be a little bit more medically heavy. But those are two resources all I'll add to the notes.

Amy Balete  35:15  

Yeah. And you know, as you probably have experienced as a therapist, I think sometimes we think, Well, we found this specialist that should be the one. And a conversation I have with every person who comes on with me is that, you know, we bring our expertise and our knowledge to this situation, and a big portion of this is, can you sit across from this person and talk to them and tell them the intimate experiences of your life? And if that is a challenge. It is okay. There are tons of therapists, generally speaking. I know when we get to rural areas that can be a challenge, but with pandemic, it sounds like insurances are still allowing people to use and I just don't think they can take that away from us. Now that that was too much, I agree. Open. So that does give you, even if you're in a location where there's not so many immediately, and you're surrounding, to go on, zoom in, zoom therapy, if that's something you've never tried, can be just as beautiful and impactful as in person. But I couldn't agree. We give up sometimes because we're like, oh, I went to this person. I really didn't like them, and it's like, don't give up. Sometimes it takes two or three introductions to a new therapist to really feel like, okay, this is someone I can talk to. I can I can sit across the screen or across the room from this person. Yeah, and really get open and vulnerable about what's happening in my life. Well, I

Rebecca Gleed  36:35  

don't know about you, Amy, but just because you have someone coming in with the same medical diagnosis doesn't mean much, because it's I've never heard the same story twice, and people experience it in different ways, and the condition presents itself in different forms and fashions, and the emotional and relational needs are going to look different from one person to The next. So thank you for bringing that up. Do you have any you know wisdom, or what would you impart to individuals, maybe just starting, you know, the diagnostic process, or maybe they're in the midst of it. What words of wisdom or comfort would you offer?

Amy Balete  37:17  

Well, I think walking down the road of infertility is so challenging, and it takes most of us by surprise, because we just don't expect that to be something that we're going to deal with, whether you're in your 20s or your 30s or in your 40s. And so finding a good team of providers, I think, is really the only way to get through this successfully, and feel like, on the end, on the other side, come let me whether we're able to conceive that healthy baby or child or we don't. This is having that support team around you is imperative. It's so crucial, yes, and that may look like an OB GYN that you're trusting if you're going the fertility. Because I know some of the folks that I work with getting the diagnosis is like, I don't want to have that diagnosis. Yeah, I want to exhaust other things. But getting a functional medical doctor that you is an expert in this area. There's so many to choose from. There are so many special sources, yeah, so many specialists. There's ways to work with people, even internationally. Yeah, and there are good routes. There's no one bad route. I think finding that route that feels great for you, that feels like a natural fit for what you want to do, is half the battle and then committing to that and giving it your all and keeping your hope there. Of we want to hope for this child to happen, sometimes that can be very scary. And if we don't have hope in this process, it can be very just devastating and hard emotionally to go through, and so allowing yourself those times and not being stuck in the fear that we feel, that we're unable to really access those people around us to use the different techniques and things out there that can be helpful to us, or to say, Man, I need to take A break. This is yes, and that's our marriage, and it's okay to pause. I think we get scared and feel like, oh, but it's the next cycle that could be the cycle that could be the one sometimes we need to take a couple months off and come back to it. Because if we're in that place of fear that we are being driven in that way, and we're kind of ignoring our emotional health. All of that chemistry happening in your body is being present there for when you do actually conceive if that happens for you. And so giving yourself that that best opportunity to be as relaxed as we can it's hard to be relaxed. It just is nothing about it. So. Actually, if you're working with infertility doctors, it doesn't feel very relaxing, but there's ways that we can manage that so that we are bringing our healthiest, best self to the to this plan and working it to the best of our ability.

Rebecca Gleed  40:14  

I hear, take the break, validate the challenges, and if you can draw upon hope, draw upon hope. What a beautiful message. Thank you so much for coming on and for all of your wisdom and expertise. I really think this is going to benefit not just individuals, but couples and providers and anyone else who's listening. Where can, where can everyone find you?

Amy Balete  40:37  

Where can everyone find me? You can find me at my website. I'm Dr Amy ballet.com, but also my brave hearts with fertile hopes community, that is a place I can share with you, a opt in there, that people can come in. And I've ran a couple summits. I will probably do some more this year. And there's a lot of resources that in interviews that I have there, that people can access and just get some good, solid information. I'll

Rebecca Gleed  41:07  

be sure to add that to the show notes. And anyone looking for your services and they can access you through coaching to internationally and throughout the United States, okay,

Amy Balete  41:19  

coaching is open nationwide or internationally, absolutely. Yeah,

Rebecca Gleed  41:24  

if you need support, reach out to Dr Belletti and thank you again for coming on and I'll be in touch soon.

Unknown Speaker  41:30  

Thank you. Thank you so much for having me.

Speaker 2  41:37  

If you would like to learn more about how we can help, visit our website at perinatal reproductive wellness.com, and while you are there, check out the latest edition of our book, employed motherhood. We also invite you to follow us on social media at employed motherhood. Finally, if you enjoyed listening to the show, please subscribe and rate it. Thank you.

Unknown Speaker  42:03  

Applause.