Chana News & Views VII by Unitech

NEWS & VIEWS VII

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I donâ&#x20AC;&#x2122;t know what the future holds but I know who holds the future

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Editors Letter

TABLE OF CONTENTS

Dear Friends,

PERSONAL EXPERIENCES: 62 A Daunting Detour 26 A Glimpse Into My IVF Diary 23 A Mother Without a Child 16 Adoption Second Time Around 18 Channelling My Pain 56 Face To Face With Infertility 19 How Can I Say Goodbye 68 Is He Your Youngest 54 Just Adopt 40 Light at The End of The Tunnel 31 Our Dream Come True 11 Our PGD Journey 37 Scuba Diving 30 The Challenge of Fitting In 48 The Gift of Hope 66 The Power of Hope 08 The Ripe Pomegranate 13 To My Dear Sister 38 To Our Precious Daughter 20 Where Do I Fit In MEDICAL FOCUS: 59 Coming Out of The Shell 45 Medical Advisory Panel 14 Meditation Part I 49 Meditation Part II 29 Natural IVF Cycle 47 Ode to Mr Lindsay McMillan 39 The Art of Healing – Reflexology 53 The Role of The Reproductive Hormones 69 What Are The Causes of Secondary Infertility 12 What is PGD? 22 What You Can Expect From Your GP

This magazine has been a long time in the making and we are now delighted to present you with our seventh edition of CHANA News & Views. Following our last edition - as with previous editions - we were thrilled to receive a great deal of positive and encouraging feedback. When we sat down to start work on this edition, we debated as to what should be the tone and content of the magazine. In the past it had been pointed out to us that many of our articles are in fact, very distressing for some of our readers as they identify so strongly with the writers and their moving issues. However, we feel that this in itself is the strength of CHANA News & Views. The issues and concerns we are dealing with are in fact painful and emotionally laden and we want the magazine to reflect the needs of those for whom it is designed. We believe that CHANA News & Views has an important role to play in creating awareness to the wider public as well. Therefore, we asked people from a broader spectrum to incorporate views from a wide range of perspectives. Whether it be the view of those in the midst of the journey, a couple considering the challenge of adoption, a sister or mother suffering with their loved ones, or other friends and family walking alongside someone close to them, there is something for everyone in this edition. Since our last magazine, CHANA has continued to expand and many new ventures are underway. We are pleased to inform you of the launch of the services of our Nursing Team in May 2008. CHANA will be working in association with JDOC to provide nursing assistance in North and North West London and neighbouring areas. Our team of nurses will be available to administer injections for CHANA members who find this difficult; or to support and teach people to manage this process themselves. Please look out in the local press for further details. Whilst on the subject of medical issues, we are thrilled to welcome several new members to CHANA’S Medical Advisory Panel. Since its inception in 2003, CHANA’S Medical Advisory Panel has expanded from a small to a sizeable group consisting of renowned specialists in the fields of male infertility, endocrinology, miscarriage, genetics, sonography, gynaecology and includes G.P.’s who work within the Jewish Community. The Panel meets regularly and is instrumental in helping us at CHANA to be aware of up to date medical information, as well as assisting us in developing our policies regarding medical issues as CHANA grows and develops. However, at the same time we are deeply saddened by the loss of Mr Lindsay McMillan last November. He was a valued member of our Medical Panel since its inception. He was a highly regarded gynaecological surgeon and respected by all especially for his warmth, care and support which was of tremendous benefit to CHANA and its members. He is truly missed by all of us. Another new addition to the CHANA team is a second male support worker. For anyone who wishes to contact him directly we have extended our Help Line hours to include Wednesday evenings from 7:30–10:00pm and Friday mornings from 8:30– 10:00am when he will be manning the line. It has been a busy year at CHANA. We have offered many Well Women and Specialist Infertility events, branching out to locations in Barnet, Bushey & Edgware on a range of topics. If you missed any of these events CD’s are available and you can order through the CHANA office. A highlight in the CHANA calendar this year was our recent Brunch which was held in Stamford Hill and attended by more than 200 ladies. Once again, CHANA was privileged to be addressed by Rabbi Malcolm Herman whose uplifting message helped the audience to understand the trials of those experiencing infertility. – and like a dream, time flies….. It is hard to believe that Pesach is upon us once again. Yom Tov is always a challenging time for all of us experiencing fertility problems but Pesach must be one of the more difficult ones. As we approach

LIFE PERSPECTIVES: 43 Attitude 51 Connecting Through Prayer 44 Destinations 61 Don’t Tell Me to Cheer Up 25 The Secret Formula 15 The University of Life 70 Your Inner IPod REGULAR FEATURES: 76 Book and Tape Library 79 CHANA Services 72 CHANA Specialist Events 05 Dear CHANA 03 Dear Friends 72 Fertility Helpline 80 Membership Form 78 Notice Board 58 Well Woman Helpline POETIC THOUGHTS: 67 A Life Poem 74 Miracles 17 Praying 60 Today 42 Whisper on The Wind NEW FEATURES 71 A CHANA Support Workers Working Day 75 A Day in The Life of The CHANA Office 32 An Interview With Rebbetzin Holly Pavlov

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SPRING 2008 / 5768

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Editors Letter

Pesach, we feel a mixture of unease and excitement. The long winter is finally over giving way to Spring; we experience excitement when we see the first blossoms and the sun peeping through into the longer days. But the anxiety of spending Yom Tov with all the family and its consequences can simply overtake us throwing us into total disarray. When will be zoiche to have a child of our own at the Seder table? How are we going to cope and get through yet another Yom Tov after a failed cycle? These and so many other questions gnaw at us and are at the forefront of our minds as we enter into this difficult Yom Tov. We feel it is apt at this juncture to bring you a thought from the Hagada. Infertility is a struggle. We don’t always understand why we have to struggle. Maybe by understanding the following idea it will be a little clearer to all of us. It is mentioned in the Hagada Blessed is he who keeps his promise to Israel. What promise is the Hagadah referring to? It alludes to the promise given to Avrohom Ovinu at which then follows with the words – you should know – that the children of Israel will suffer for 400 years in Egypt after which they will leave – with great possessions. This promise was made at the same time as Avrohom was told that he will at long last have a child. Rav Ordman ztl explains, why now? Just try to imagine, Avrohom Ovinu, a 75 year old man, is finally being told that he will have a son so why tell him now that his descendants will suffer badly in the hands of the cruel Egyptians, why must he hear of the future hardship and suffering of his nation at this time and why must he be told about this altogether? The gemoro states - a newborn ox is considered an ox. When an ox is born, it stands up and within 3 to 4 hours it is able to function as a fully grown ox – it can walk, run, eat and use its senses fully. But a human being takes 20 years to develop, why? Because a human has enormous potential and the higher the potential the greater the struggle to reach it. Avrohom Ovinu was greatly exposed to the nations around him yet he wanted a child who would become the chosen nation. To reach that high level of chosen nation, it could only be preceded by a struggle. That struggle was very much part of the good news that was revealed to Avrohom Ovinu at the same time that he was told he would have a child. Am yisroel faces many struggles yet as it was promised to Avrohom Ovinu, – and after that they will go out with great possessions – the struggle and hardship will lead to – great rewards. The greater the struggle, the greater the potential and achievement. Before I end, I would like to thank all of you who helped with this edition, the copy typists, proof readers, those who sourced articles and of course, my co-editor. You all know who you are and I thank you. We continue to be indebted to those who work at the CHANA Office and behind the scenes so tirelessly to enable the smooth running of the organisation. To you, our dear readers, please continue to send us your News & Views and feedback – we love to hear from you! One last thought... MASTER OF THE UNIVERSE Give me the strength to accept peacefully that which I cannot change, And give me the strength to change that which can be changed And give me the wisdom to differentiate between the two. With this wisdom may we all be blessed with a … We ask Hashem to look down from above and give everyone their personal yeshua swiftly. With best wishes, THE EDITORS

EDITOR: Shelley Groszman DEPUTY EDITOR: Efrat Schimmel COPY TYPISTS / PROOF READERS: CS Hus D Korman J Rottenberg L Werjuka M Wittenberg S Sylkin GRAPHIC DESIGN: Create Services www.createservices.co.uk CHANA is a non-profitable charitable organisation. All expenses towards the cost of this publication have been sponsored. Anyone wishing to make a donation to help benefit the work of CHANA please send to 23 Ravenshurst Avenue, NW4 4EE. Charity No.1070196. The views expressed in any articles or correspondences included in this magazine are those of the individual writers and not necessarily of CHANA or the CHANA editor. Their inclusion does not necessarily imply endorsement by CHANA. CHANA is in no way linked to any clinic/company, nor do we recommend or endorse any one clinic/company. The editors do not accept liability for any printer’s errors, although every care is taken to avoid mistakes. All material in this magazine is copyright to CHANA – no part of this publication may be reproduced or used in any form without the prior written permission from the editors. The purpose of this publication is not to give specific or individual advice in any one case. Persons who require advice for their individual situation must contact their professional advisors. CHANA welcomes your letters, articles and poems. All suggestions and comments are welcome. CHANA reserves the right to edit all articles. Please send all correspondence to: CHANA News & Views 23 Ravenshurst Avenue London NW4 4EE

IN LOVING MEMORY OF OUR DEAR FRIEND CHANA-HANSY JOSOVIC A”H

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Letters

Dear CHANA News & Views,

Dear Editors,

Dear CHANA,

You are to blame for my messy house! I came home from work today at 2pm and was so excited to see the CHANA News & Views in my post. It is now 9.30pm and my house is still flying. My husband came home from work shocked exclaiming, “What’s going on here? Are you ok? Did anything happen?” I was still in the same position on the couch reading the magazine. As soon as he saw it, he grabbed it away and said “Ok now it’s my turn to read it.” The content, presentation, graphics, layout, and design are unbelievable. The thoughtfulness with which it has been written makes it accessible to anyone who wants to read it in any situation.

I just wanted to say good Yom Tov and Kesiva Vechasima Tova. May you be repaid over and over for all your special work at CHANA. It’s really due to all of you that I am where I am this Yom Tov. Thanking you would never be enough. May you all be zoiche to shefa brochoh.

After having been married already some time without conceiving, I conceived but suffered an early miscarriage at 11.5 weeks. I felt very depressed for a time after this, and it was during those difficult first months after the miscarriage that I decided to contact CHANA and become a member.

Thank you. Kind regards L.S. .................................................................... Dear CHANA Your website is wonderful. I feel like I have just lain down on a very large and very soft cushion. Thank you R.S. .................................................................... To my dear CHANA Support worker, Just to say thank you very much for all your help, advice, listening, time, patience.... I was just wondering where the magazine was and then it came! Please pass on my thanks and appreciation to whoever else was involved. I would like to thank everyone who was involved in putting together such a wonderful publication. Could you please forward me Rabbi Rosenblatt’s email address so I can thank him personally for his inspiring and thought provoking speech from which I gained a lot. Wishing you Gmar Chasima Tova, Good Shabbos, Thank you once again, G.D.

From An appreciative CHANA member .................................................................... Dear News & Views Editors, I have been absolutely riveted by the CHANA magazine all Shabbos. Every article is written with such sensitivity, with each portraying a slightly different angle to this tremendous nisayon. Our community is so blessed to have an organisation like CHANA. Thank you An avid Reader P.S. Also loved reading the “WAITING GAME” from a grandma’s perspective. All in all magazine better than ever! .................................................................... Dear CHANA, Today I received my new copy of CHANA News & Views. I cannot sleep because I am reading the magazine - I can’t put it down. I feel so humbled, sad, happy, all in one. The stories are amazing, and the presentation excellent. It is such an insight as to what people have to cope with. It is really extraordinary. Well done! Can’t wait for the next one!! S.B. .................................................................... Dear CHANA, Thanks for a super special magazine. Both of us can’t get over it, especially the poem “Dear G-d”. It came at a perfect time for us. Thank You! R&M

It was suggested to me by CHANA that I perhaps make use of the CHANA counselling service, which I decided to do. I then had counselling sessions over the phone with a most understanding, sensitive and knowledgeable counsellor and I found these sessions to be most useful. Boruch Hashem, it was not too much longer before I conceived again. I remember, particularly in the early stages of the pregnancy, feeling anxious about whether all would proceed normally. The memory of the miscarriage was still very fresh in my mind. I carried on talking to my CHANA counsellor right through this ‘anxious’ stage and beyond, always finding the sessions a very useful opportunity to talk through whatever may have been an issue for me at the time. When Boruch Hashem, my daughter was born, I was happy to share the news with my CHANA counsellor. I would recommend to all those who feel the need to discuss issues, whether of a fertility or more of a general ‘well - woman’ nature, to make the move to talk to a CHANA counsellor. Don’t think there is no-one sensitive to these issues to whom you can talk in confidence, because there is. Thank you ‘CHANA’. From Mrs. ‘Grateful’ .................................................................... Dear CHANA I would like to share my story with a happy with you and your readers. My story shows the power of chesed and trust in Hashem. My husband and I married over three

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Letters

years ago, with the expectation I would fall pregnant straight away. We tried for a year and a half and then I was diagnosed with PCOS. I had not realised that there had been anything wrong. Although I would receive my period only once every four to five months, doctors told me this would change once I was married. I was led to believe it would be for the better. Baruch Hashem, in Israel, the doctors tracked my ovulation for months on end. When we moved back to London I started acupuncture. We could not afford this but CHANA very kindly paid for the treatment. When I found it did not work for me, I stopped the acupuncture and instead I purchased ovulation kits in bulk. My husband was very supportive. He always reminded me that I should have trust in G-d because at the end of the day it’s in His hands. Deep down, I had the emunah and bitachon. I knew it would happen one day. The question was WHEN? HOW LONG WOULD I HAVE TO WAIT? I knew I needed to improve myself somehow. I decided to work on my code of dress; the women’s struggle. I resolved not to walk out of my bedroom without a hair covering. (I was once told a story of a women who was rewarded with great children because the walls of her house never saw her hair). Moreover, we prayed at the Kever of the Shotser Rebbe in London, and the Kever of Miriam HaKovest in Israel. (She was not blessed with children but when she died it was said that people who go to pray by her will merit children). I prayed to conceive a child naturally by Hashem without medical intervention. As time went by, our friends started to look at us with pity and we became the childless couple amongst our friends. We were very happy when we heard their good news of another pregnancy but often they felt uncomfortable telling us; some even avoided telling us. This pressure was one of the hardest things for me to deal with. In the meantime, I found all sorts of ways to help people and to do Chesed.

I have opened two gemachim which are very popular as there is a great need for them. Then a few weeks later I found out I was pregnant. What a great surprise. This was with no help from any doctor. This was a gift direct from Hashem. I have learnt the power of chesed and the power of tefillah. If I would have fallen pregnant earlier; I would not have had all those opportunities to do chesed. And I will continue to do chesed for the zechus of our future family and for all those couples who are still waiting. With best wishes D.R. PS since receiving this letter Boruch Hashem this lady has given birth to a healthy baby boy!! .................................................................... To the CHANA Trustees, My husband and I would like to thank you for the extremely generous donation you made towards the cost of our treatment in Israel. Without your help we would not have been able to consider undergoing treatment at our preferred clinic. I would also like to thank the support worker for all the help she has given me over the last six months. With many thanks R.M. .................................................................... Dear Friend, Please come visit me!

on a Shabbos afternoon. So I sit and listen at my window to your happy children frolicking in the park. Because, I feel empty handed when you are pushing your strollers in the streets. Because, I am tired of people thinking that I am a newlywed, when I’ve been married longer than they have. You know that I come and visit you all of the time. I know that my home is not fun for your children, that there is no one to play with. Don’t you know that I would gladly buy toys to keep in my house if you would come with your children to visit? How I’ve worked to childproof my house just so that you would come? I know that it’s easier for me to come to your house. It is less of a hassle, less of a pain. But maybe, just once in a while, you could come the other way? I don’t think that you know how many times I have sat around waiting, just to see, “Maybe this time someone will come to my house.” How many times has my husband returned home from shul just to hear, “No one came.” You should know that most of the time I am OK. That while I await the day that my nisayon will be over, I have, to a certain extent, learnt to deal with my lot. I listen and smile while you talk about pregnancy and child rearing. I come to your house and play with your kids and honestly think that they are adorable. I join you outside on a Shabbos afternoon and try to dismiss the fact that I am the only one with no one to look after. You are really a great friend and I am happy that I am getting to enjoy spending time with you!

No, I am not new to the neighborhood. No, Boruch Hashem I am not sick. No, I have many friends. So why do I ask you to please come and visit? Because you are my friend and I know that you care. So I thought that maybe this would be a nice way to let you know that I am hurting inside, that the smile on my face is hiding a broken heart. And no, there is not much that you can do to mend it. Just one thing I ask, “Please come and visit me!”

But…sometimes I don’t come out, I don’t come visit. Do you wonder why? Well maybe now you will. Sometimes the pain inside is so great that I don’t want to have to face it. So I stay at home. And the pain is only greater. Because I know that no one will knock on my door. So please, prove me wrong.

Why? What a strange request! Because, just sometimes I can not bring myself to come outside and smile

Dear CHANA,

Please come and visit me! From your Lonely Friend. ....................................................................

I am sending you a cheque as a touched

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Letters

listener and observer. I have found your magazine very emotional and heartbreaking for those who struggle to have a family. I hope this will be of use to you and hopefully help families along their emotional struggle. Yours sincerely L.L. ....................................................................

support and encouragement you offered during my years of waiting. Boruch Hashem, I have just given birth to my second daughter after eight years. It is you, at CHANA who enabled me to get through these difficult years. May Hakodosh Boruch Hu repay you manifold and I wish you all much Hatzlocha to continue in your wonderful endeavours.

To all of you at CHANA, Our PGD journey has finally ended. It took us a year to get to this point and unfortunately for us, the treatment was not possible. We tried everything possible and did our best to research and initiate the treatment. We didn’t realize the enormity of the task until we began. Throughout the whole process, the most amazing support has come both emotionally and financially from CHANA. It is difficult to express in a letter just how much your help has meant to us. We have never experienced such kindness and generosity towards us. Not just that, the empathy too was so heartfelt. We were expecting you to say no, “You have two children already, sorry but we can’t help you”. But quite the contrary happened and you understood our “need” to have a healthy child and seemed to know what it meant to us. We will forever be grateful for your kindness. We thank you so much for the absolutely incredible work that you are doing for couples with fertility issues. We want to thank you for giving us the opportunity to “do our best” because we could not have done it without your help. If we can be of any help to other couples we are more than happy to share our experiences with them. The whole process is such a minefield and we now have a PGD reference folder which may be helpful to others.

Thanking you once again An appreciative Mother .................................................................... Dear CHANA We just have no words to thank you for all you do!! Many many thanks With Best Wishes S.V. .................................................................... Dear CHANA Please find enclosed a donation to CHANA as a token of our gratitude and deep appreciation for all the support that was given to our children over the last few years.

We would like to take this opportunity to thank all the supporters of CHANA. Thank you for your continuous generosity thus enabling us to further and develop our services to the community. Your kind contributions allows us to provide vital support to couples and their families that call on CHANA for help.

We hope that this money will enable a couple like ours to afford the treatment they need and pray that they will be successful and experience the same joy we all have had in the last few months. With grateful thanks to you all The proud Grandparents. .................................................................... To the funding committee, With deepest gratitude we would like to thank you for the tremendous zechus which you had of alleviating the financial burden from us during our difficult months of treatment.

To Moishe Morris We simply have no words

Once again we thank you. With kindest regards M & J.A. ....................................................................

Now that we are Im Yirzeh Hashem awaiting a Simcha we would like to wish you a Gut Gebensht Year and lots of Hatzlocha and koiach in continuing your wonderful work for the Klal.

Thank you!!

Dear CHANA, Please find enclosed a small donation as token of appreciation for all the

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With heartfelt Hakoras Hatov. Mr & Mrs B. ....................................................................

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Personal Experience

he news that high-tech fertility treatment was our only option came as a terrible shock. That was the verdict of the very first doctor we consulted, a year after we were married. Such drastic intervention, with powerful hormonal drugs and surgery, seemed more than distasteful: it seemed to go against the very essence of how we lived and approached life; trying to be so careful with what we ate and drank, consciously avoiding additives and known carcinogens. Dismayed, we pushed off the additional testing that the doctor recommended. When I had bursts of willingness to seek other medical opinions, we saw more doctors and underwent more invasive tests, all with the same conclusion: IVF was our only option. But surely, I reasoned, G-d, who parted the Red Sea, could perform a miracle for us? Yet, each anniversary marked another year without children. I was wary of tampering with my body, afraid of exposure to hormonal drugs and their potential side effects. How could I willingly expose myself to these chemical hormones to which no one could predict how I personally would react physically and emotionally? And a positive outcome wasn’t even guaranteed! How easily I remembered my vulnerability, seven years earlier, before undergoing the operation that had caused our problem. A team of physicians had entered my room on the 17th floor of Sloan Kettering Memorial Hospital, overlooking the East River. They had come to give me more details about the exploratory laparotomy that I would endure the next morning. “Also, we will have a gyneacological surgeon participate in the repositioning of your ovaries,” explained one nurse. “What?” I cried in alarm. “What are you talking about?” “It is an important part of the procedure. Didn’t anyone tell you?” “No, nobody told me anything about it!” I sobbed, wanting to wake up and escape from this nightmare. “In case we discover cancer cells in your abdomen, you will need radiation therapy on the lower half of your body. By moving your ovaries away from the lymph glands that would be exposed to treatment, we will be able to protect your ovaries from sterilization,” she calmly explained. I did not feel calm at all. The whole operation seemed unnecessary to me. Intuitively, I sensed that this highly treatable cancer had not spread beyond the lump in my neck, and a tiny, almost imperceptible bump under my arm. But in the world of

THE RIPE medicine, my intuitive feelings were not established facts that an oncologist could rely on to determine a course of treatment. The next morning, half an hour before the operation, when I was already drow-sy from a pre-op dose of Demerol, the gyneacologic surgeon came to meet me. “I heard that you were upset yesterday, about the transposition of your ovaries,” he began in a kind voice. I was only eighteen. Marriage and family were not uppermost in my immediate life plans. Survival was first. I answered slowly, “I’m all right, I understand.” “So you are aware that tampering with your ovaries involves a risk? There is a chance that they may not work at all, but it is a chance we have to take, lest the radiation destroy them completely.” Shocked anew, I could not speak. There was no time to protest. For some mysterious

reason, this whole experience was to be part of my life. Looking back, I am grateful that I combined holistic/alternative approaches to healing with conventional radiation and surgery. I am sure that my wonderful

But surely, I reasoned, G d, who parted the Red Sea, could perform a miracle for us? oncologist was afraid that I was going to refuse treatment altogether. He had reassured me at the time that I would not have a problem becoming pregnant. But that reassurance was given years ago, and now I was married and time was ticking by, with our hearts yearning and our arms empty.

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Personal Experience

Eventually I was persuaded by a friend to join a small fertility support group. There I met other women dealing with the same issues. In a community that was totally child focused, it was vital for me not to feel alone. One woman shared with me the practice of saying “CHANA’s Prayer” (a prayer women say when struggling with fertility) after candle lighting. “Ribbono shel Olam (Master of the Universe), everything that you have created in a woman, You have not created anything for naught. Eyes to see, ears to hear, a nose to smell, a mouth to speak, hands to do work, legs to walk, breasts for nursing. Praised are You for putting breasts on my heart! Why should I not nurse with them? Give me a son, and I will nurse with them!” (Brachot 31b) Identifying with CHANA’s yearning, as well as our Four Mothers: Sarah, Rebecca, Rachel, and Leah, gave me a connection to a historical process that many women had endured, survived, and eventually triumphed. Surely G-d would answer our prayers. We willingly investigated suggestions of Jewish customs or alternative practitioners that sounded reasonably respectable. For example, a visit to a well-known Rebbetzin gave me a stronger connection to reciting Psalms. She also emphasized to have special concentration during the blessing of “Matir Assurim” in the prayer of the Shemoneh Esrei.

POMEGRANATE A friend was foster parenting an infant whose fate was being decided in court. I became completely intrigued with the idea that we could become her parents. When my husband and I held her, we discovered how easily we could love her. We thought she was beautiful. One day my friend allowed us to help care for the baby. We changed her diapers, made her bottles, fed, held, burped and soothed her. We cuddled and talked to her. The very next day, we called the adoption agency handling her case and inquired about how to proceed in officially adopting her. They, of course, were obligated to inform us that there was already a six-year waiting list! We were heartbroken by this news, but decided to continue the adoption process, attend meetings, and await “our turn”. Meanwhile, another year went by, silently enduring monthly disappointments.

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One way of coping with the quiet in our lives was to have Shabbos guests. Living in a thriving Jewish community near a college campus, we could easily welcome over a dozen students a week who had never experienced a taste of Shabbos in their entire

Now I was married and time was ticking by, with our hearts yearning and our arms empty lives. It was a privilege to be involved in answering their questions; and it gave us something to look forward to each week. It became an opportunity to share our values in a meaningful and life-promoting way. “He who teaches Torah to his friend’s son, it is as though he gave birth to him” (Pirkei Avot).

“May G-d release you from the constraints of your situation!” What was I waiting for? I still felt too fearful of IVF to seriously consider doing it, but really, deep inside, perhaps... I wondered if I was worried about the implications of actually becoming a mother? How long should I wait? We were given only one medical option... when would I be willing to take the plunge? I wondered what was I afraid of. I prayed for clarity. A good friend who was aware of our situation invited me to accompany her to the birth of her fifth child. A month after witnessing this profoundly moving event, I told my husband that I felt emotionally ready to visit the IVF clinic, not for a consultation, but to actually begin treatment. We could apply our knowledge of holistic methods to the IVF procedure. I reread up on guided imagery, which I had used while coping News & Views VII

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Personal Experience

I saw us sitting beneath a pomegranate tree that drooped with the weight of full, ripe fruit

with the cancer that was long gone, thank G-d, but which had directly contributed to our current dilemma. We hoped that our years of prayer for G-d’s compassion, carrying newborn boys at their circumcision (an honor bestowed to couples who are trying to have children of their own) and numerous other Jewish customs we had done, as well as the collective prayers of many people on our behalf, would perhaps have added up to tip the scales in our favor. We contacted rabbis, both for the necessary guidance in Jewish law through the maze of fertility questions, and for their blessings for success. We asked specific people, particularly our parents, to pray for us. We felt surrounded by a supportive network of prayer. I recalled the trip to Israel we had made one summer. We had visited the Children’s Memorial at the Yad Vashem Holocaust Museum. In the dark, amidst the reflections of a million tiny lights, as the names of one child after another were called out in the eerie stillness, I pleaded with G-d to send us just one neshamah, just one soul. When treatment began, I prayerfully visualized each step of the procedure, imagining what was happening within my body: the follicles slowly developing into ripe eggs, and my ovaries protected from over stimulation by soothing cool waters, the eggs joyously being fertilized, and a heavenly light guiding and assisting the embryos as they deeply implanted into the welcoming tissue of my womb. I pictured everything in as much detail as possible: the tiny little capillaries connecting and supplying our babies with all the necessary, essential nutrients to help them grow

into strong, vital human beings, the lining of my uterus thickening with a fervent exuberance to shelter her new charges, and G-d’s constant Presence supervising all functions. There were four embryos at first. Even though a multiple pregnancy would be difficult, and possibly fraught with complications, how could I pray for only one baby, and not express concern for the other three potential lives? G-d, whatever You decide is good, but You should know that I am willing to host everyone!

We asked specific people, particularly our parents, to pray for us. We felt surrounded by a supportive network of prayer The days between blood tests were agonizingly slow. I tried to remain calm and optimistic, keeping my mind and body as relaxed and tension-free as possible. At last—the crucial beta-HCG blood test tentatively came back positive. Two days later, a repeat test of this vital beta-HCG confirmed that the numbers had increased. I was definitely pregnant! An ultrasound showed one embryo had implanted. Our joy was immense! But we still had months to go, with the fear of miscarriage uppermost in my mind. In an attempt to retain some autonomy, we decided to learn to do the daily progesterone shots at home for the following three months. With an entire team of doctors, nurses, technicians, surgeons, anesthesi-

ologists and assistants participating in the intimate details of our lives, I felt like a piece of public property. Now, instead of having to rush in and out of the a clinic nurse’s office, by doing the shots myself, I could rest at home in privacy, using that time in particular to relax and visualize myself and my husband in a flower filled field of the Galilee, beside a crystal clear running river. In my mind’s eye, I saw us sitting beneath a pomegranate tree that drooped with the weight of full, ripe fruit. In this Edenic setting, we prayed for healthy children. A soft beam of light surrounded us, and when it receded back to the Heavens, we were surrounded by beautiful, cherubic babes. I turned inwards, becoming very private as I focused all my energy on maintaining this precious pregnancy for the full nine months. I quit work. I rested. I ate nutritious meals and avoided anything deemed harmful or unhealthy. I drank raspberry and nettle herbal teas to strengthen my system. I worried and tried not to worry. I cried and prayed and prayed and cried. I continued my prayerful imagery, picturing the changes taking place within my body, the baby nurtured and growing well. When the forty weeks were complete, on my due date, my waters broke. With the assistance of a competent midwife, many hours later, our beautiful, healthy baby was born at home into our extremely grateful, welcoming arms. By Noa Kaufman Reprinted. Reprinted with permission of Special Delivery, - a publication of Targum Press - a collection of birthing stories, edited by Sarah Goldstein

Life can only be understood backwards but it must be lived forwards.

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Medical Focus

OUR PGD JOURNEY

By N.R.

Two years ago we found out that my husband had inherited a kidney disease called Adult Polycystic Kidney Disease (APKD). We subsequently discovered that one of our two sons had also inherited the disease (our other son has not been tested yet) and that there was a 50% chance of any child of ours inheriting the disease (the disease being autosomal dominant). Although APKD is an adult onset condition, its symptoms can be very debilitating and life threatening and the only long term cure is a kidney transplant. We decided to investigate whether there was anything we could do to prevent the disease being passed on to any future children that we may be blessed with. Our preliminary investigations resulted in us discovering that there was a treatment called “Pre-Implantation Genetic Diagnosis” or PGD. In simple terms, this involves testing fertilised embryos for a specific disease and then undergoing an IVF cycle to implant the healthy embryos only. PGD is used successfully for many conditions such as cystic fibrosis, Tay Sachs and Canavan Disease, to name a few. PGD is a relatively new technique (it has been 11 News & Views VII

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around for about 10 years) and the list of diseases being tested is expanding at a very fast rate. Our research showed that we could not currently undergo PGD for APKD in the UK and it was unlikely that such treatment in the UK would be available in the near future. We therefore carried out further research and discovered that the treatment was currently possible in Chicago and in Israel.

It was a relief to be able to discuss the issues that we were facing with somebody who understood It was at this stage that we discovered, through a friend, the amazing work that v does in supporting families with fertility issues. We contacted CHANA to see if they could help us. The information that we had gathered was very complex and it took many hours of talking to our support worker, at CHANA, to try and fathom out the process. It was a relief to be able to discuss the issues that we were facing with somebody who understood.

During a subsequent trip to Israel, we visited the Shaare Zedek Medical Centre in Jerusalem and discussed the treatment options with one of their embryologists. She said that the treatment may be possible but that we would have to find out the exact disease causing mutation before she could be certain that the disease causing embryos could be identified. She explained that at present there were two definitely known disease causing mutations (type 1 and type 2) but it was hypothesised that there may be at least one more unidentified one (type 3). When we returned to the UK, we followed up the embryologist’s advice and had my husband’s blood taken and tested to try and identify the exact mutation which was the cause of his APKD. Once again, these tests could not be undertaken in the UK as technology here was not advanced enough. We therefore sent blood samples to a centre called Athena Diagnostics in Massachusetts, USA. We waited hopefully for the results and were advised that these could take up to three months to be processed. In fact, the results were ready in about a month but News & Views VII 11

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Personal Experience

unfortunately they were not what we had been hoping for. There were too many variants in the results to be able to identify the exact mutation i.e. whether it was type 1 or 2 or even another type. We subsequently sent the test results to Israel. The embryologist was still optimistic and said she could do some further tests to try and identify the affected genes through a technique called “linkage analysis”. We sent off further blood samples from both affected and non-affected members of my husband’s family to the Shaarei Zedek Medical Centre. The results were no better this time. The embryologist had hoped that through a complex process of elimination, they would be able to find the exact disease causing mutation. In our case, this was not possible. If we had more family members to test (both healthy and affected) it would increase our chances of identifying the faulty gene but we had already tested a significant number.

Throughout all this process, we were in still in regular contact with our support worker who kept us grounded and realistic about what was happening. The embryologist in Israel threw us one more life line. She said that we could perform PGD for both genes (type 1 and 2). This would mean losing some embryos unnecessarily but also running the risk of implanting an embryo with the third gene

We waited hopefully for the results and were advised that these could take up to three months to be processed which could also be disease causing. When we weighed up the odds statistically and discussed it with our geneticist in the UK, we were advised against this as it would be very unlikely that we would end up with any healthy embryos at all and, even

if we did, the embryos could still have the third disease causing gene. Unfortunately for us, our journey ended here. It was a very difficult decision to stop here. It had taken us a year to get to this stage and treatment for us was not meant to be. We hope that by the time our children have their own children, advances in the treatment will make it much easier to identify the gene. For many conditions, this is already the case, but for us, we were a little too early in the advances of modern medicine to benefit. Despite not being successful in our treatment, we had the opportunity to try our best to conceive a healthy child. We could not have done this without both the emotional and financial support from CHANA. We have never known such kindness and we thank the charity from our hearts for this. If anyone wants to contact us to ask us any specific questions about our research, we are more than happy to be contacted through the CHANA office.

WHAT IS PGD? PREIMPLANTATION GENETIC DIAGNOSIS Preimplantation genetic diagnosis (PGD) involves genetically testing an embryo in a laboratory. In order to achieve this, couples have in vitro fertilisation (IVF) treatment followed by an additional genetic testing stage. The embryo is grown in the laboratory for a couple of days until the cells have divided and the embryo consists of eight cells. At this time a specially trained embryologist will remove one or two of the cells. The cells can then be tested to see if the embryo from which they were removed contains the faulty gene that causes the condition in the family. One or two of the embryos without a copy of the faulty gene can be placed into the woman in the hope that they will develop. Any remaining unaffected embryos can be stored for later use as required. Those embryos that had a copy of the faulty gene are allowed to perish. It is really important that any couple considering PGD is seen by their local NHS Genetics service before they are referred to PGD clinics all over the place. Partly this is to confirm that the genetic diagnosis is correct, but also because it will give the couple the opportunity to fully discuss all their reproductive options. The obvious questions that any patient or clinician should ask a PGD clinic are: • SUCCESSFUL PREGNANCY RATE AFTER EMBRYO TRANSFER • RATE OF LIVE BIRTHS • MISDIAGNOSIS RISK For a list of genetic disorders relevant to this please call our support workers who will help you further.

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Personal Experience

To my dear sister

Mazel Tov! It’s a boy! Mazel Tov!

What mixed emotions I have today. My youngest sister just gave birth to a beautiful Prince to add to our wonderful growing family. Yes, Sara, I can’t stop thinking of you today. Tears just spring to my eyes wishing this wonderful news had come from you, my most special second youngest sister. You simply have an amazing koiach. I don’t know where you find it. How you have instantly hopped off to the hospital with balloons and a teddy, and with a huge smile on your face, when you are praying to be in her position, no doubt aching inside, is simply beyond anyone’s nature. Yes, Sara, you are a lesson to us all. I see you at so many special occasions with such a happy look on your face, truly joining in other people’s simchos. Like when you choose the best present for Yanky’s Upsherin; and when you come to choose the bridesmaid dresses your nieces wore for Sara’s wedding; and when you laid up the kiddush on Shabbos for Chaya’s baby Debbie. Your positive and enthusiastic involvement simply amazes me. You honestly convince me you are SO happy for everyone else. Your middos are just unbelievable. Yet, how I wish I could hug you, cry with you and be able to tell you “YES, in less than one year this is where you too will be, because I can only imagine how you are feeling inside today. I think of you and daven for you all the time. We all do, as I am sure you know. I wish I could tell you this more often, but I don’t want to bring the subject up because I know how it much hurts, I feel your pain – it hurts me too. Sara, I just want to tell you, I feel this wait could only be happening to you because you are so very special. Special like the Imahos; special like CHANA and special like all the many more tzidkonius who waited and were so close to Hashem. And Hashem answered all their tefillos too. So Sara, we will all keep on davening and doing good things in the merit that very soon yours and our tefillos will be answered and we will all be able to deliver masses of balloons and teddies with as big a smile and enthusiasm as you did today. We love you and think of you always, Yours loving sister xx

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Medical Focus

Part I

HAVEYOU EVERTRIED

MEDITATION? I am writing to you, my dear friend, even though we have yet to meet. I feel that I know you simply because we have several things in common. We are female, Jewish and it is one of our dearest wishes in life to have a child.

These areas contribute to the ability and ways of beneficial practise of meditation. Some ideas are set out below which may help us all.

I am one of those women; the latest in a long line who never thought that having a child would be a problem. In my heart I know Hashem put me on this earth to ‘procreate’; no doubt a feeling echoed by myriads of us through the ages. In my own journey of existence, the experience continues despite having three miscarriages in a relatively short space of time. I met my husband and soul mate later in life. As you will be aware, this makes having a baby a more difficult matter. Still, I always rise to a challenge.

Since the last visit to my doctor, the words ‘be positive’ echo in my head ad infinitum. This is the most important thing. To think of the cup as not only half full but totally full; a golden cup filled with sweet wine. To live life in certainty and clarity is better than perhaps and maybes.

As an alternative practitioner, Reiki Master and a fallible human being, I know what must be done to prepare myself for another attempt; the essence of my preparation is to be happy and content in myself. Being happy and content is important for all of us; including those who are not trying to have a baby.

1. Positivism

Practical tip Look in the mirror each morning, smile at yourself and remember the incredible woman that you are. Know that all will be well and today something wonderful will happen. There is always something special in every day we just have to recognise it. 2. Breathing

There are four areas upon which I will focus;

If we cannot breathe we do not have life. So each breath is precious and each breath should be deep and relaxed; through the mouth down to and coming from the solar plexus area. Sit down relax and be conscious of your breathing.

1. Being positive 2. Breathing correctly 3. Making affirmations 4. Visualising

Practical tip Sit in a comfortable armchair with your hands resting loosely on your knees and your feet firmly on the ground. Relax your

shoulders and feel comfortable. If there is any tension in any part of your body, let it go slowly. Close your eyes and open your mouth ready to breathe in the following way: 1. Inhale through your mouth slowly and steadily for your own count of four count - one, two, three, four 2. Hold your breath for your own count of two – do not let this be an effort count - one, two, three, four 3. Exhale through your mouth slowly and steadily for your own count of four count - one, two, three, four Do this breathing exercise twice and then 4. Repeat the exercise by inhaling and holding breath as before. (As 1 & 2) then as you exhale (as 3) breathe out anything which is holding you back from concentrating upon this exercise still counting to four 5. Now relax and breathe normally sitting still for a minute or so 3. Affirmation The idea of affirmation is linked to the notion of positivism; taking things one step further. An affirmation can be written and placed where you can often see it, such as stuck on a mirror or placed on a notice board.

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Life Perspectives

Often it is good to repeat them by speaking an affirmation back to oneself several times with a tone of conviction. Eventually you will become convinced even if you do not believe so at the beginning. Practical tip Choose your affirmation with care, and ensure they are within your own ability to achieve them. Some examples are set out here: Today I will be well Today I will be happy Today I will acknowledge my grief and create a brighter future Today I choose to live each moment 4. Visualisation

The Rainbow • Sit comfortably in your armchair and relax • Close your eyes • See the rainbow high in the sky • Take each colour of the rainbow in turn visualise or sense the colour coming through your body from the top of your head to the tips of your toes • Give yourself a minute or two with each of the colours flowing through you • Begin in the order - red orange yellow green blue indigo and violet • Sit comfortably with your feet firmly on the ground after completing the exercise for a few moments The Golden Flame

We all have a gift to visualize; which is the ability to make visible especially to the mind (Oxford English Dictionary) whether by seeing in the mind’s eye or sensing. It is a wonderful form of exercise and I would invite you to try one or more of the exercises set out below: Practical tip The Golden Ball • Sit comfortably in your armchair and relax • Hold your hands out parallel in front of you (with about a two inch gap between them) and palms facing each other about elbow height • As you relax into this position you may feel a slight heat or tingling between your hands • Stay in this position for a minute or two until you feel settled • Gently imagine a golden ball forming between your hands • Nurture it, feel it and move your hands wider apart as it grows bigger • When you imagine the golden ball is big enough send it up to the ceiling where it may float for some time • Repeat this exercise once or twice

• Light a candle and sit so you can see the flame • Sit comfortably in your armchair and relax • Watch the flame • See it’s colour, it’s movement, it’s size • Keep looking at the flame and see the different colours within the flame • Keep looking at the flame and see the way the flame moves • Keep looking at the flame and see the changes in size of the flame • When you are ready close your eyes and visualise or sense the flame of the candle as you saw it with your eyes open • Continue to see the golden flame for a few minutes • As the flame fades sit comfortably in your chair for a moment with your feet firmly on the ground Practise and these exercises will soon become natural and easy to do. Then progress to Part II where we shall practise a longer meditation through visualisation With Love Esther Bond

FOR THE UNIVERSITY OF LIFE One of the greatest lessons you will ever learn is that if you are or were loved, cherished, valued and accepted as you are, you are one of the richest people in the world. If you can accept that your parents or carers did the very best that they could, in the circumstances that they were in, and with the knowledge that they had at the time, you will be one of the wisest people in the world. When you can forgive those who you believe hurt you by their words or deeds, and you can forgive yourself for anything you may have said or done that hurt somebody else, you are one of the most advanced human beings on the planet. If you can reach your full potential without compromising your integrity, without doing what everyone else does, you have passed with honours. When you reach a ripe old age and know you have done all that you could, and have been caring in your dealings with the knowledge that you had at that time, you can pat yourself on the back. You have a Degree in the University of Life. You are amazing.

You can never cross the ocean unless you have the courage to lose sight of the shore. 15 News & Views VII

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Personal Experience

ADOPTION, SECOND TIME AROUND I wrote an article which was featured in CHANA magazine a few years ago (in 2004 – how the last few years have flown by) about our first adoption experience following failed fertility treatments. Well, following another successful adoption, I am once again putting pen to paper to briefly describe the process and our experience second time around... Both of them were very different, but Boruch Hashem led to a happy outcome, which I wanted to share with you. Our son was about eighteen months old when we contacted the social worker in Norwood, who had worked with us the first time, to let her know we were keen to start on the second adoption. The process had taken just under two years the first time, so we began when he was still relatively young, as we knew it was likely to take quite a while – and we were right, it took over two years... Once again, we had to meet several times as part of the home study, where the social worker asks about childhood, your relationship with your spouse, fertility problems and treatments, parenting styles, finances, support network...it was certainly easier as we had already discussed so much of this with her three years previously. Also, this time we didn’t have to do the preparation training course, which we were pleased about. Following the home study, our case went to panel. This time, as the rules had been changed, we were actually able to attend the meeting, which was not as bad as we anticipated though we were still fairly nervous! The panel looked through the home study report, asked some questions, and then they made their decision to recommend us as prospective adoptive parents. Our paperwork then had to be cleared by the DfES (Department for Education and Skills) as we were again planning to adopt from overseas and they have to issue a certificate of eligibility. This took several months as their inter country adoption department is busy, with few staff members. Finally we could start working with our American adoption agency to find a birthmother. We wrote a profile and began the matching process. Just over a year later, we received the all important phone call informing us that we were matched with a birthmother living in Florida who was at the time 24 weeks into her pregnancy (let’s call her C). It meant we had three

long months to worry, unlike with our son when we were matched very late in the birthmother’s pregnancy. Several weeks later, we spoke to C on the phone for over an hour which was quite nerve wracking, but gave us the chance to start getting to know each other. We found out that the baby was a boy so had names planned... We travelled to the US at the beginning of the week C was due and as we got off the plane in NY, we got a phone call – You have to come to Florida tonight, C’s waters have broken. Although we had flights booked for the next day, after talking to the airline I changed my flight and went straight there, only to find out that she had been discharged home... The rest of my family joined me the next day as we had originally planned. The day after that, we went to the hospital as we were told that C had been admitted due to having high blood pressure and she was being induced. We met her, her partner (who was not the birthfather, and very supportive of her adoption plan) and her parents. They gave us presents and a whole collection of family photos. This was in total contrast to our first experience, when we had no contact with the birthmother at all and received nothing from her or her family. C was in active labour on the Friday and fortunately we had found a small Chabad community not too far from the hospital and arranged somewhere to stay over Shabbat. My husband went to shul while I was at the hospital waiting for the new arrival. Although we spent time together during the labour, I couldn’t be at the actual delivery so was waiting in the corridor. After what seemed like an eternity, but was in fact only about 40 minutes, we were told that she had delivered a boy, and a few minutes later I was able to go in to see them. It was the most amazing, incredible experience. C straight away gave him to me to hold and her family were already calling the baby by the name we were planning to use. Of course he was absolutely gorgeous!! Everyone was so emotional. I was only upset that I couldn’t take photos and that my husband wasn’t there yet. He put our (older) son to bed and then had a long walk, but he eventually arrived. He got to spend some time with the baby and we then had an hour walk back to where we were staying. I did the walk again the next morning, and after Shabbat we took our

Written by a proud Mother

son to the hospital to meet his new brother. He was very excited and gave the baby lots of kisses and cuddles and we took some very cute photos. On the Sunday evening, when baby was forty eight hours old, C signed the paperwork relinquishing him and he was discharged from the hospital into our care. Following a few days in Disneyworld (we couldn’t leave without taking our older son to meet Mickey!) and Shabbat near Miami, we started the long drive to NY. Before we had left the UK we had arranged that the Beis Din in Lakewood would oversee the baby’s geirus and we were delighted that he could have his bris when he was two weeks old and go to Mikvah two weeks later. They were extremely helpful and supportive and we only wished we had thought about trying this route with our older son! We arrived at our cousins in NJ and were pleasantly surprised to find that the baby’s birth certificate was already there. We applied for a US passport for him which arrived a few days later and then had to apply for a settlement visa so we could enter the UK with him. We discovered that the British consulate in Manhattan now only accepts on-line applications and takes several days to process them, but it was done in time for us to catch our flights home. We had spent almost six weeks away and were delighted to be back. Now we have to meet with the social worker several times over the next three months as she has to write post-placement reports. Parental rights have already been terminated and the adoption will iy”h be finalised, over the phone, when baby is around six months old. In addition, we will be sending letters and photos regularly to the birthmother over the next eighteen years. I hope this short article gives hope and encouragement to those who are considering adoption to build their family. I am so pleased we made the decision to adopt, it was without doubt the best decision we ever made. Yes, it is a lengthy, stressful, intrusive process and there is always a chance that the birthmother may change her mind before relinquishing the child. On the other hand, it has worked for us and we are now the proud parents of two beautiful boys who are bringing us lots of joy. The community we live in has been so supportive and overall it has been an extremely positive experience.

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Poem

PRAYING

Don’t despair don’t give up Just pray and pray By day by night With all your heart And all your pain And floods of tears That flow upwards And burst open The Heavenly gates of mercy Pray and pray With all your soul

To the One and Only Pure infinite source Of all good Turn to Him wholly Put yourself in His hands Trust in Him totally Know That He Will never Never Leave you

Even though you may feel Deserted Lost in the wilderness Know That He Is always Always Beside you And keep praying And praying and praying

SHIRA YEHUDIT DJLILMAND 17 News & Views VII

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Personal Experience

CHANNELING MY PAIN

This story started a few weeks after my engagement, with a phone call from a friend. “I forgot to tell you,” she said, “that I davened for you right through my labour,” (her second child was born the day before I met my husband the first time). “…and when it was all over, I knew it was all going to be ok for you.” Davening for others during labour? Sure! She told me. “You’ve got to do something with all that pain. I had a whole list of people to daven for, but I only got to you.” Blessedly, it wasn’t too long before I was sitting in antenatal classes myself. The teacher outlined the stages of labour and the pros and cons of various pain relief options, as well as some segulos to ease and speed up delivery. She also told us: “and when it gets really, really bad so that you can’t bear it anymore, think of somebody else who is waiting for this, month after month… and daven for her.” Her words, together with the phone call the previous year, echoed in my mind during the weeks prior to my baby’s arrival. I knew who I would daven for, two friends, both of whom had been married significant chunks of time before me. Labour began. We went to hospital. ‘Do something with all that pain’ had she said? There was nothing to ‘do’ with it. I could hardly think; I wasn’t in control. Then the midwife and my husband reminded me: ‘Now’s the time to daven for someone else’. Right. The tefillah took only a few seconds. If I could have articulated it, it would have gone something like: “Ribbono Shel Olam, help them. They want this. Give this to them. But this minute I need You more. Help me!” I could barely articulate the words in my mind. I thought of my two friends, and that was as much as I could do. My daughter was born, besha’ah tovah, and the following year my two friends both gave birth. Can I claim the credit for their babies? Definitely not – I do not. They had been davening for far longer and far harder than I could have. My shidduch had also been well on the road before my friend had her baby. But I am convinced that those desperate tefillos were heard and accepted by Hashem, and that they contributed something. So to everyone who is Baruch Hashem in a happy matzav – hatzlacha for your births, they should be healthy and safe – and remember… when the pain gets so strong that you can’t bear it anymore, think of somebody else who waits for this, month after month… and daven for her. And may it be that very soon all our tefillos will be answered, and none of us will be able to think of anybody other than the newest newly-weds! From a friend who is thinking of you

CHILDBIRTH SUPPORT NORTH WEST Offering emotional and physical support in childbirth. Confidentiality assured. Please contact Ruth Wolinsnky on 0208 455 7663 or 07974098502 V 18 News & Views VII

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Personal Experience

HOW CAN I SAY GOODBYE WHEN I NEVER HAD THE CHANCE TO SAY HELLO? By Leah Aronson – Aish

find it so hard to say goodbye. I think I’ll never see the person again. On the other hand, I can always call or send an e-mail, so saying goodbye shouldn’t be so hard. But what happens when the person is no longer there? When they’ve lived out their 120 years and they are gone? Then I say goodbye and it’s permanent. They’re no longer there to share things with, to support me, or vice versa, or commiserate with. I can’t communicate with them directly. I can pray for their soul, but that’s not satisfactory; it feels one-sided. It’s very sad for me to say goodbye to someone this way. What about a situation where the person never actually existed? They existed only in my visions of what I wanted for myself, but not in flesh and blood. How can I say goodbye when I never even had the chance to really say hello? We never spoke or touched in life. But in my dreams we did. In my dreams, it was all so real. I held them and cuddled them. They were so cute! Some had curly hair, some had straight; some were blonde headed (like their mom) and some had light brown hair (like their dad). They smiled and cooed. We celebrated the bris or the kiddush... and I even allowed myself to dream about their wedding. They learned to walk. These children of my dreams brought home gorgeous artwork from school that I 19 News & Views VII

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hung on the fridge. In some dreams, there were twins - of course a boy and a girl! So we celebrated a bris, a kiddush... and in the wildest dreams even a pidyon haben (redemption of a first born boy). Wow - the people that came! These were global celebrations; if you couldn’t come to the event in our town, you celebrated in your town. And in places like Jerusalem, there were celebrations in several neighborhoods. In my dream, there was incredible unity because of our simchah (joyful celebration). These children existed - they seemed so real. Until I woke up and realized it was a dream. It was a dream that recurred for twenty five years, in one form or another. The particulars may have changed, but the basic story line remained the same: I became pregnant, went through a birth, was granted a healthy child, and participated in the ensuing celebrations. But this never happened. I never really said hello. And now it’s time to say goodbye. Goodbye to the potential children, goodbye to that part of my life that allows this to happen, and goodbye to the dreams. I don’t want to let the dreams go. I don’t want to part with the potential that I can create life. I’m forced into that space, like stuffing too many things into a suitcase and pressing them down. I feel the pressure of having to say goodbye before I’m ready.

The last time I felt this pressure that was when my grandfather, a”h passed away. I was only seventeen - he left too soon. I didn’t have a choice; I had to say goodbye on that early fall day. I never saw him alive again. I wasn’t ready – G-d took him anyway. It was G-d’s time, not mine. It’s the same with these goodbyes. I’m on G-d’s time line. In His infinite wisdom, He’s decided that it’s time to say goodbye to the children I will never have. He has a plan for me, and being able to biologically create life is not part of this plan. I’m having a hard time accepting this plan. I question it. I struggle with it. It’s painful to live out this idea. I’m sad. I’m saying goodbye in the hardest situation possible... I won’t be able to have regular contact. I won’t even be able to pray for their souls because they never existed. But maybe, just maybe, they did exist... in a previous lifetime. Maybe, at some future date when G-d reveals His Master Plan, I will meet all of these souls and will realize that indeed I was somehow able to create life. Or maybe the Master Plan was that I helped others create life and I will meet those souls who will recognize me as part of their heritage. In hope, there is life. By living in hope, I can learn to say goodbye.

Printed with kind permission of AISH.com

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14/4/08 11:08:51

Personal Experience

E R E WH I DO IN? FIT

ou’d never guess when you look around my house and see half finished bottles of milk, a buggy casually placed near the front door and a variety of dolls strewn across the room. No, you’d never guess that we had even thought of going back into ‘it’. You’d never guess that we had just failed a cycle – again. Infertility is hard. There is no getting away from the bare facts. We’re part of a lucky group. Boruch Hashem we were once successful and we have wonderful proof of our success. Boruch Hashem. So now what? Now we have the chutzpah to ask for more? How can that be? Are we not being grateful with what we already have? An only child is a chinuch challenge. In fact, any child is a chinuch challenge but there seems to be a lot of guidance for normal challenges. When we had no children, we were squarely placed in the category of ‘unusual’; once again, with one child we find ourselves in this category – especially in today’s frum world. To fail a cycle when you have no children is incomparably different to failing a cycle when Boruch Hashem you have children.

The fear of the never-ending night is Boruch Hashem not there. The fear of the future is not as intense. The grief, anger, disappointment, it’s all there still but the child that you do have takes away the intensity. There really is no comparison.

Time was counted in months, in anniversaries and birthdays, and in failed cycles Yet, it is still hard. It’s hard that everyone else who had babies at the same time as me have already had another and some are even expecting their third. Before I had a child, I didn’t compare myself in this way. Rather, time was counted in months, in anniversaries and birthdays, and in failed cycles. Why now does it bother me that I’m ‘behind’? Secondary infertility places you squarely in the fertile world. (I’m not too sure if this definition applies – is it called secondary when you really have primary but you were successful? If it is, what is the differentiation

between someone who had children without problems and then stops having children – and someone like me?). You go to the park with everyone else; you shop for children’s clothes and nappies. Bath time and bedtime are integral parts of your day. And yet, you are different. You may be older than everyone else who has only toddlers – all of my friends are almost making bar mitzvahs and I haven’t even started kindergarten yet! The differences are subtle, but still very much there. Treatment cycles are so different. The pressures of missing work are compounded with the difficulties of ‘early morning sonographers routine’ and funnily enough, finding babysitters at strange hours. Beforehand, when I missed work for ‘appointments’ my boss understood exactly what these appointments were for and didn’t ask questions. But now, well I have

I wanted a big family and I wanted to have children easily - naturally

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Personal Experience

These are questions that you could never ask anyone, which makes secondary infertility so isolating

a child so why can’t I arrange my appointments at a more convenient time? There are so many success stories that we hear that start something like, “They didn’t have children for X number of years and now Boruch Hashem, they have a whole family”. Without meaning to ask too many personal questions what do they mean by ‘a whole family’? Did they have to do treatment for every child? Or did something just ‘click’? These are questions that you could never ask anyone, which makes secondary infertility so isolating.

I had to understand, to internalise, that this, my life as it is, is good for me There is a part of me that is singing with joy at the brochos that I have and another part of me that is mourning a lost dream. Again and again this dream keeps rearing its ugly head. It calls to me to hide under my blankets, to avoid people and to walk through the back streets. All this, whilst cleaning cracker crumbs and folding sweetsmelling dresses. I tell myself, rightly so, that so many people would love to be in my position. I tell myself to be grateful, to be happy and to enjoy this stage. But every time I see the people who had babies the same time as my little girl was born, and they are pregnant

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or pushing new babies along with their toddlers, I feel a pang. A pang of what? Never before had I been jealous. I always prided myself on that. Yet, this time, I find that jealousy seems unavoidable. At first I was surprised at myself. What was I jealous of? Did I want their children? Did I want their lives? Slowly, and it was a slow process, I worked on myself and came to the conclusion that I was jealous because it seemed to come so easily to them. They had what I wanted. I wanted a big family and I wanted to have children easily - naturally. They – whoever they were, seemed to have my heart’s desire. Then, came the next step of working on myself. I knew that if I could get this right, then the jealousy would go. I had to understand, to internalise, that this, my life as it is, is good for me. I had to know that even if what others have looks good TO me, it wouldn’t be good FOR me. It’s like looking at a delicious food that one is allergic to. Even though it may look tasty, it would be very harmful for me. I knew that this parable should be taken a step further. Even if the food looks tasty and I want to eat it, for me it would be full of poison. The allergy should be that strong. What is not good for us, what is not the will of Hakodosh Baruch Hu, is poison for us. Do we desire poison? Of course not! And in the same way, there is no reason to desire poison dressed up as what we want, even if it comes in the form of adorable toddlers and sweet-smelling babies.

I find that the more I put Hashem into my life, the more I realise His presence

It’s a long process. Sometimes, it looks like I’m actually getting there only to be dashed by someone’s thoughtless comment – “Why is she still in a buggy? When mine were that age, they walked next to the pram (which holds the newborn)”. I don’t need a pram as I would have no one to put in it – but I don’t say that to the clumsy lady who, I keep reminding myself – is just that – thoughtless, clumsy, but not nasty. She doesn’t mean to hurt me. I try to take this further. If she doesn’t mean to hurt me then not only should I not hold it against her, but I should try to realise who the Sender of these comments is. I find that the more I put Hashem into my life, the more I realise His presence and the more I know that everything that He sends me is for the good, even if I don’t see it at first glance.

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14/4/08 11:08:56

Medical Focus

WHAT YOU CAN EXPECT FROM YOUR GP Woman

The following guide should give you a good understanding of what you can expect from your GP when faced with fertility problems.

Man

Your history and an examination

You should be asked for a history of likely problems, such as surgery to the cervix or tubes, history of infections, and for details of menstrual irregularity.

First, you should be asked for any history of damage such as previous surgery, (even a vasectomy can be forgotten!) or infection such as mumps and Chlamydia. You will also be asked if you have any children.

You will also be asked if you already have any children. You should be examined generally for any signs of ill health. An abdominal examination will show the scars of any surgery you may have forgotten about, and an internal examination will show ovarian cysts or fibroids, and give an opportunity to take a swab for infection tests. Hairiness and acne may indicate multiple ovarian cysts, or milk production, and irregular periods may indicate over-production of a hormone called prolactin. You may be asked to give a blood sample on day 21 of your cycle or ideally seven days before your next period, to confirm that you are ovulating. You should expect to be asked whether you are immunised against rubella (German measles), and to supply a urine sample to check for signs of diabetes or kidney problems. You may also be advised about your weight. You may be advised to take folic acid supplements, to minimise the risk of neural defects. Your GP is likely to refer you to a specialist sooner if: • You are over 35 years of age • Have absent, irregular or painful periods • Have had previous abdominal or pelvic surgery • A pelvic examination reveals abnormalities • The blood samples show you are not ovulating • Previous pelvic inflammatory disease or any sexually transmitted diseases

Both of you You may expect to be asked general questions such as your occupation, whether you are suffering a lot of stress, and details of any medication you are currently taking. You should be advised about the risks of drinking and smoking. All the results, and provision of any treatment or care that may be required, should be discussed in detail. You should discuss the financial aspect of any treatment required, and whether such treatment is available on the NHS. If any of the test results are abnormal, or if everything appears OK but you have been trying to conceive for longer than 18 months, you should be referred to a specialist. If the sperm, eggs and hormones are all OK, and there is nothing in your past medical history or the examination to show abnormalities, then you may expect to be advised to continue ‘trying’ for a little longer.

You should then be examined for abnormalities of the testes, and may have a cotton wool swab for infection tests. Arrangements should be made for two semen samples to be sent for analysis. They should be sent to the same laboratory that is used by the clinic you are likely to be referred to. You should also be asked to supply an early morning urine sample to check for Chlamydia. Your GP is likely to refer you to a specialist if you have: • Had previous genital abnormalities • Had previous urogenital surgery • Varicocele (a varicose condition of the veins of the spermatic cord) • Any significant illness which affects your whole system • Abnormalities shown by the genital examination

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Personal Experience

A MOTHER WITHOUT A CHILD As told to Sara Esther Crispe

had it really easy growing up. I come from a loving family, with wonderful parents and great friends. I graduated with honors and attended an Ivy League university and landed a prestigious job as soon as I finished. Basically, I had it all and life seemed pretty easy. Things got even better a few years later when I met the love of my life and we decided to marry. My wedding was straight out of a book, with my perfect bridesmaids and beautiful gown and sunny afternoon for an outdoor ceremony overlooking the beach. For the first few years of our marriage, I continued to work full time, and my husband, who had a great position, was then promoted to vice president of the company alongside an impressive raise. With his new salary, it seemed like the ideal time for us to try having a baby. We looked at the calendar, just like we did before setting our wedding date, and found what we thought would be the perfect time. We figured if we wanted to go to Hawaii in May, we would probably want to wait until June to get pregnant, then I would give birth sometime in March, spring time, ideal. Little did I know that my perfect life and perfect plans and perfect pregnancy were only in my dreams. We went to Hawaii and had an amazing trip, and then we started to try to conceive. 23 News & Views VII

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I figured that getting pregnant would be as easy for me as everything else had been in my life. After all, when I really wanted something and worked hard for it, it always seemed to fall into place. So we tried, and a few months passed by, and nothing happened. I was a bit surprised, but not in the least bit concerned. If anything, my greatest fear was that if I didn’t conceive soon, I would not be giving birth until the summer, and I really didn’t want to be pregnant in the heat.

Little did I know that my perfect life and perfect plans and perfect pregnancy were only in my dreams. More months passed. Then one year. Then two years, three, four, five. During this time we went to every possible doctor. Nothing was wrong, or at least nothing they could find. The doctors weren’t anxious, as after all I was still relatively young. I didn’t care if I was young, I didn’t care if I still had time. I wanted a baby, and I had wanted a baby for years. The stress, both emotional and physical from doctor’s appointments and treatments, was overwhelming. My husband was loving and

supportive, and it was definitely hard for him, but I don’t think he could ever understand what it meant every month when I got my period. He knew it meant that we didn’t conceive, but he could never know what it felt like when my stomach ached and I felt it begin, and then I would have to stare at the cruel and bold blood, reminding me and screaming that I wasn’t pregnant. After six years of trying, I finally fell pregnant. We were thrilled. I couldn’t believe that I was actually carrying a baby. I immediately stopped working, since I wanted to make sure that I could sleep when I wanted, eat what I needed and not have any unnecessary stress in my life. Fortunately, my husband was doing extremely well financially, so I did not need to work for monetary reasons. As the weeks passed, I watched as my body began to change. First everything seemed so tender then, slowly I noticed a small bulge in my tummy. In time, it was hard to have anything around my waist. I was in love with my baby and with my pregnancy. Every morning I woke up with a smile on my face, so grateful for being able to carry this child. We had already picked out names, I had been eyeing a stroller I really wanted, and knew exactly where I would be headed for adorable baby clothes. News & Views VII 23

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Personal Experience

Everyone was thrilled. By my fourth month, it was obvious that I was expecting and no matter where I went, people would speak about it. I had always been very private about how hard it was for us to conceive. I didn’t realize that while we were struggling for a baby, others just assumed that we chose to wait. Now that I was showing, I started to hear comments, “Wow, so you’ve finally decided to have a baby!” I didn’t know how to respond. I just couldn’t believe that others thought that any of this had been my choice. But then again, before I knew how hard it would be, I also thought that it was all in my hands. I did everything perfectly right. I ate all the right foods, did the recommended amount of exercise, slept well and took my daily vitamins. I went to my doctor’s appointments like clockwork, and left each one relieved and thrilled to discover that everything was exactly how it was supposed to be. When we first heard our baby’s heartbeat in the doctor’s office, we both broke down crying. We had been waiting for so long for this.

I didn’t realize that while we were struggling for a baby, others just assumed that we chose to wait As my due date approached, I read every book on labor and delivery that was available. I knew every medical term and felt confident that I had a wonderful doctor. My mother had flown in to be with us and to help after the baby. My in-laws were also around to make sure that my every whim and need was being taken care of. I knew that most first-time mothers don’t deliver on their due dates, so I was shocked when the very morning of my due date, my water broke. My husband joked that our daughter seemed to already be following in my footsteps--always on time and very organized. We waited until my contractions were five minutes apart, and then headed for the hospital. Everything was routine. Everything was fine. I was progressing nicely and by the intensity of the labor I figured it wouldn’t be much longer. The nurses were supportive and helpful and tried to get the monitor strapped on properly to check for the baby’s heartbeat. I was already at eight centimeters and they kept telling me how great I was doing. But for some reason they couldn’t get the monitor

to read properly. They tried a few different ways before a look of concern crept across their faces. Before I knew what was happening, my calm and supportive environment became frantic and panicky. I just started crying and praying, not knowing what was happening. I was wheeled into the surgical ward for an emergency c-section. There wasn’t time to explain but it was clear that they had to get my baby out immediately.

They couldn’t get the monitor to read properly. They tried a few different ways before a look of concern crept across their faces I didn’t feel any pain, though it didn’t make sense since there wasn’t even enough time to give me much in the way of anesthesia. Even if it had hurt, I wouldn’t have cared, since all I wanted was my little baby girl to be alive and well. My husband stood in the corner crying, knowing that he needed to be strong but fearing that he couldn’t. They opened me up and the doctors screamed to one another about the cord. I watched in a daze as they tried to unwrap the cord from around my baby. I could see her, but I hadn’t yet heard her. She never screamed. I kept waiting for them to remove the cord since I figured that it was preventing her from crying. It was preventing her. Unknown to anyone until that point, my cord had been so tightly wrapped around her little neck that it had strangled her. They removed the cord. But my baby girl was no longer. No one needed to tell me what had happened. The tears streaming down their faces were enough. The doctors cried as they started to explain that as she descended in the birth canal, the cord tightened and tightened. There was nothing they could have done. There was nothing I could have done. I was asked if I wanted to see and hold my baby. I did. We did. The nurses washed her off and wrapped her perfectly, so caring and loving. Then they handed me my daughter, peaceful and beautiful, as if she was sleeping. We stayed with our baby for a while, holding her and crying. She was perfect, absolutely perfect. Everything was developed, ten little fingers and ten little toes. She was exactly how I had envisioned her. Only she wasn’t alive. We decided to name her Bracha, mean-

ing blessing, since we felt that despite all of our pain, she was truly a blessing, and we prayed that our journey with her would also be the beginning of future blessings. When we felt we had said our goodbye, I kissed my Bracha and handed her to the nurse. I can’t explain it, but I wasn’t distraught. I wasn’t hysterical. I was broken but not in a destructive way. Bizarrely, I felt that my time with Bracha had been complete. Deep down, I somehow knew that she had lived for the exact amount of time that she had needed to. And even though it was the most excruciating experience I had ever gone through, I felt I had been blessed to have been able to carry her around and love her and give to her for nine months. We had been blessed to see her and hold her and tell her we love her. The strangest part was that this strength wasn’t coming from within. Both my husband and I knew that Bracha was helping us through this and was responsible for this attitude. While I may have been prone to spend the next year in bed crying and feeling sorry for myself, Bracha instilled me with a sense of purpose and responsibility that until then I didn’t have. A few days later I left that hospital, a mother without a child. But being a mother, I was filled with love and caring and passion that needed to be shared. And I knew I needed to find a child or children to share it with.

I was filled with love and caring and passion that needed to be shared. And I knew I needed to find a child or children to share it with Following our loss, we tried again to have children. But for whatever the ultimate reason is, I never became pregnant again. Yet, Bracha always was our reminder that we needed to have hope and we needed to give hope. I felt that if I had suffered such an experience, there had to be a reason and a meaning. I knew how much I loved Bracha, and I knew how I would have taken care of her had she lived. And yet, as I mourned my loss, I read in horror of stories of women who had abandoned their babies, left them for dead, or abused them terribly. Those babies were more fortunate than Bracha since they were able to live, but something had to be done to ensure that they live a life of joy and not suffering.

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Life Perspectives

Furthermore, our whole experience had also brought my husband and I much closer to our Judaism, since during our pregnancy we felt the need and desire for a community and spiritual meaning in our lives. Our increase in Torah study and practical observance gave our lives a structure and security in an otherwise very difficult and traumatic period. And from our learning, we began to understand and believe that our ordeal had a higher purpose even though it was hard for us to see. We discussed with our rabbi our decision to dedicate my time and energy to helping children. He suggested I contact a Jewish organization that took care of orphaned children whose parents had either died or couldn’t care for them. Within a week, I had a position working with the babies. My new full time job was caring for these precious souls, feeding them, bathing them, playing with them and loving them. I will never forget the first time one of these children hugged me and called me “mommy.” I wanted to correct him and tell him I wasn’t his mommy, when I realized that I really was. To them, I was their mother. And to me, they were my children. No, I hadn’t given birth to them, but I had given them the security, love and care that I would have given to my own Bracha. And Bracha had given me the ability to do so. I’ve been working with this organization now for over 20 years. Next month is what would have been Bracha’s 21st birthday. Over the years, I have helped raise hundreds of precious and beautiful babies, and watched them develop into productive and successful children and young adults. Twenty-one years ago Bracha made me a mother. But it was the children who I dedicated the rest of my life to who made me a mommy. And thanks to the hope and ability that my Bracha instilled me with, I now can also proudly call myself a bubby (“grandma”), since one of the girls I cared for just gave birth to her first daughter. And you can imagine how much I cried when I held her little girl as they named her at the Torah.

THE SECRET FORMULA Count your blessings instead of your crosses; Count your gains instead of your losses. Count your joys instead of your woes; Count your friends instead of your foes. Count your smiles instead of your tears; Count your courage instead of your fears. Count your full years instead of your lean; Count your kind deeds instead of your mean. Count your health instead of your wealth; Count on God instead of yourself.

~~Author Unknown~~

You see, they named their beautiful baby Bracha.

Reprinted with kind permission from www.TheJewishWoman.org a site dedicated to providing jewish women of all backgrounds intellectually challenging, emotionally uplifting and inspirationally stimulating articles.

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14/4/08 11:08:59

Personal Experience

A GLIMPSE INTO MY IVF DIARY

By S.B.

or several years we have been married and on this rollercoaster of doctors and investigations. After much searching and just trusting our instincts, we seemed to have found the right consultant to help us. I was finally diagnosed with endometriosis as well as discovering some small fibroids. Having recovered from a Myomectomy¹ I was told to wait six months to see if I would become pregnant naturally. Still experiencing much pain, I was getting concerned as to whether the myomectomy had actually proven successful. The six months were coming to an end, and we were getting impatient, so we felt the time had come to start researching IVF clinics. My previous consultant had retired, so we were once again on the rollercoaster to find the appropriate doctor. A friend had recommended a clinic which in the league tables was the third top in the country. Even though statistics are not

always reliable, at this point we had no other clinic in mind so thought we would go for an initial consultation. We were also advised that due to the nature of our problem, it was not worth travelling out of town, therefore we really felt this was our best option for the moment. We went along for our first appointment, but were not very impressed with the doctor. He seemed a bit removed and did not take any of our questions seriously, but nevertheless our instincts were to go ahead. He seemed very confident and we hoped that as long as he would get us the result we hoped for, we would keep our reservations to ourselves! The consultant suggested that we start immediately, but thankfully again we were wisely advised to wait until after Yomtov, as it would probably have added a lot of pressure, going through treatment during that time. Yomtov came and went and our situation had not changed, so

apprehensively we made an appointment to start the treatment. We had to do a month dummy2 cycle first, which involved doing tests to see how my body would react, and to determine the level of drugs that would be needed for the actual treatment. Excerpts from my diary: Day 18 of ‘dummy’ trial cycle: I tried to phone the nurse as I still was not clear what to do. I had taken prescribed Primolut tablets together with the nasal spray on Day 14. I was not supposed to have started the nasal spray until day 21. The consultant said it was ok and that I should continue. Even though the consultant had reassured me, I could not help regretting my mistake I still did not know if the cycle would now be ruined. During the trial I had to take a nasal spray but got a little confused and actually took it on the

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Personal Experience

wrong day, I thought at this point that I had messed everything up, and frantically called the consultant who reassured me that it wouldn’t matter. I think that the pressure was getting to me…and this was only the trial. We were worried: if this is how I coped in trial then how would wNow the trial was behind us, it was time to face the real thing! Below are snippets I jotted down in my diary… Sunday – Day 1 – of cycle Monday – Day 2 Phone for scan appointment. Tuesday – Day 3 – 12.30pm Scan appointment: Cyst found on right ovary, need blood test to check if cyst producing hormones. If so, this IVF cycle could be cancelled for another month or two. If not, I could have ‘cyst aspiration’ on Wednesday morning. Tuesday – 6pm Called clinic, the blood test was ok, I can go ahead with cyst removal. Wednesday – Day 4 – am Cyst aspiration, did not realise it involved me going into theatre! I had no slippers, was given a hospital gown. The consultant warned me of all the worst case scenarios. I was petrified, I wanted my husband to be with me but he was travelling out of town that day. If I had known what I was in for, I would have felt more prepared, but it all happened so quickly. I was just taking it in my stride, trying to act bravely, when suddenly the enormity of it hit me and I did not feel all that courageous any longer. I was lying on the operating table, one nurse was standing at the door, another one at my side, and the consultant was facing me. I felt very unprotected, I had never before felt so exposed. Scared and uncomfortable, I silently began to cry. The nurse was surprised to see me so upset and tried to comfort me. She said she would explain the whole procedure to me. From then onwards, the nurse talked me through each step while the consultant was inserting a speculum. Ouch that hurt! The scan showed my bladder was full. As I emptied my bladder with the help of a catheter I felt some pain. They continued to clean me and prepare me for the insertion of the needle. That was painful! The procedure was quick. When over, I covered up and got up from the operating 27 News & Views VII

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table slowly, feeling quite dizzy. I was escorted to a bed curtained off to enable me to rest for about an hour. Luckily I had brought some music and reading material along so I could keep myself busy. I felt constant period-like cramps. The consultant came to check on me. The nurse explained to me that it was very important to empty my bladder when feeling the urge. She also warned me that I might experience needle-like pains. I was prescribed antibiotics to avoid infection. The nurse then demonstrated how I should inject myself with the hormoneinducing drugs to start my IVF treatment. The thought of it made me come out in a cold sweat. There was so much I needed to remember. It was a good thing I was given some written instructions. I was testing my injecting skills and was happy to have managed (even if this time it was with the nurse’s help).

I was just taking it in my stride, trying to act bravely when, suddenly the enormity of it hit me and I did not feel all that courageous any longer I was then told that I would need a blood test on Shabbos, and I panicked. I then phoned my Rov who gave me a heter to get in a cab on Shabbos, and explained to me how I should go about it. I really did not feel comfortable and was nervous about the whole prospect of going to the hospital on Shabbos. Thursday – Day 5 Only an injection to worry about. Boruch Hashem I did not have to inject myself totally on my own. I went to Nurse Goldberg, the CHANA nurse, who supervised me while I did it. .(Nurse Goldberg did all of them as once a couple of years back I made a mistake in an IUI cycle, I did not want that to happen again. I thought if Nurse Goldberg was available and happy to do them, I had enough to worry about, at least one aspect can be taken care of. It was a great relief. ) Friday – Day 6 I phoned the clinic with all my questions about Shabbos issues. They obviously realised I wasn’t comfortable about the whole thing. They then phoned me back a few minutes later and said that it actually

did not matter if I had the injection today. They asked if I could come in that afternoon, three hours before Shabbos. This was bashert as I was off work on Friday afternoon anyway. I considered myself lucky as we were warned that we may have to stay near the clinic over Shabbos if need be. However one thing I had not envisaged was that I may need to just go to the hospital for a blood test so near to Shabbos. The blood test was fine and I managed to get home with time to spare for Shabbos. Once Shabbos came in, my husband walked with me to nurse Goldberg, for the daily injection later that evening. Shabbos – Day 7 I was so relieved not to have to think about inconspicuously getting into a cab on Shabbos morning as I had the blood test Erev Shabbos. Motzei Shabbos another injection Sunday – Day 8 Injection Monday – Day 9 I had a scan in the morning, things were progressing as expected. Tuesday – Day 10 Injection and my usual routine (lucky I had warned my boss that I would probably have to attend many medical appointments that would sometimes interfere with work. Although I knew this came first for me, I still tried to make appointments out of work time or miss as little work as possible. Boruch Hashem for understanding bosses!) Wednesday – Day 11 Scan am Thursday – Day 12 Scan and blood test am Sunday – Day 15 Scan am Monday – Day 16 Blood test am Tuesday – Day 17 blood test in the morning and HCG injection at night Thursday – Day 18 Major day! Egg collection. My husband did not always come along but for this part News & Views VII 27

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Personal Experience

of the treatment he was needed too! We had stayed in a hotel nearby overnight as we had to be at the clinic early in the morning. The egg collection happened under a General Anaesthetic. I was glad I would be asleep for the procedure, yet I was still very scared. It all happened so quickly I did not have much time to think about things. When I woke up I felt ok and happy to see that my husband was there near me. After getting back home we called the Embryologist to find out whether fertilisation had occurred. We were told that nine out of fourteen eggs had fertilised. We were in touch with the clinic on a daily basis and they reported to us on how the embryos were developing.

It was surprising that the most important stage of IVF was actually painless Gradually some embryos stopped developing but those who continued were doing really well. They recommended that we wait for five days before doing the Blacocyst3 transfer. The transfer was scheduled for Tuesday, which traditionally was considered an auspicious day. I was told to drink one and a half litres of water before arrival. When I was scanned it was pointed out to me that I should drink some more and suggested I drink tea as it might be more effective. I felt totally bloated and truly sick from all the liquid. By then, they decided to go ahead with the transfer. In theatre, the consultant inserted a tube round the bend of my uterus; he managed to navigate it successfully. This time I felt no pain. It was surprising that the most important stage of IVF was actually painless. Before the procedure they showed us on the screen the two embryos that were to be inserted. They were miniscule but it felt unbelievable to look at potential life. On our return home I was extremely sick from all the drinking but feeling very positive and hopeful. The next two weeks dragged on forever. The emotions and physical feelings were driving me mad. I tried to take it easy, to lie down whenever possible and not to overdo it at work. My husband was a real support. The day for the pregnancy test had arrived. We woke up really early as we couldn’t wait to find out the result. I prepared myself for the worst and psyched myself up on how I was going to cope with a disappointment. I got out of bed, went to the bathroom and braved it. I did the

test. Not being able to look at that stick, I handed it over to my husband to read it. After a few minutes he shrieked and showed it to me. I simply could not believe what I saw. The positive line in the right window was there! It was so exciting to see a positive for the first time in our lives after all we had been through. After the initial elation we tried to calm down as we wanted it confirmed by a blood test before we got totally carried away. Once the blood test confirmed it was true we started to believe it and get excited. But, we still were wary until we would see the first scan. The first 12 weeks were scary and we still couldn’t believe it was real. But once we saw our baby on the 12 week scan we began to relax and started to believe our dream was coming true. We still felt somewhat cautious until the day when we would hold our baby in our arms. Now on reflection of all that we went through, we are so overwhelmed with gratitude to Hakodosh Boruch Hu. We feel we have changed as people forever, through our experiences. We are eternally grateful to Him for the wonderful gift He has given us – our child, who made us into parents and who brings us so much joy.

We still felt somewhat cautious until the day when we would hold our baby in our arms At this time of joy we remember all the people who helped us get to where we are today. We can not possibly list them all: our parents who knew when to be there for us and when not; a frum Embryologist with whom we were in constant contact with; my CHANA support worker who was always at the other end of the phone when I needed her; Nurse Goldberg who was always so friendly and helpful at any ridiculous hour; our esteemed Rabbonim whom we could approach anytime with sheilos; our new friend who had experienced infertility himself, who was a true rock for my husband; our friends who were there for us non-judgementally. So even though it was an extremely difficult time and we could not talk to anyone else, we had these supportive people to turn to. We could not have got through it successfully without all of you – our true messengers from the ONE ABOVE. 1. Myomectomy is a procedure in which uterine fibroids are surgically removed from the uterus. Uterine fibroids (also

known as myomas) affect 30% of women. While many fibroids do not need treatment, others can cause abnormal uterine bleeding, pressure, pain, or other symptoms 2. A ‘Dummy’ cycle is a trial run (normally carried out between day 6-10 of the menstrual cycle) for the process of embryo transfer. It is necessary to do this to establish whether the transfer is likely to be easy or difficult, and allows them to take measurements and note any deviations of the uterus. When the time comes for the actual embryo transfer, this information allows them to proceed with the least amount of trauma to the fragile embryos. 3. Blacocyst - Human embryos require a very specific environment for optimal growth that varies throughout differing stages of development. Standard culture media cannot meet these specific demands. Consequently human embryos, obtained through IVF treatment, are routinely transferred to the uterine cavity on either day two or day three after egg collection when they are at the 4-Cell or 8-Cell stage respectively. With the introduction of sequential cultures for embryos at different stages of development, it is now possible to successfully culture embryos up to the blastocyst stage (Day five after egg collection). One of the causes of failure of IVF treatment is believed to be the growth arrest of embryos after transfer to the uterine cavity. The blastocyst embryo transfer does not differ from normal IVF treatment with regard to the preparation of the couple. The only difference is that the embryos are cultured for a longer period of time and transferred five days after egg collection. On Day five the embryos have already survived a number of obstacles and consequently the chances of achieving a pregnancy are much higher compared to embryos transferred on days two and three. However, not all patients are suitable for blastocyst transfer. Some patients may benefit from an early transfer rather than continued growth to the blastocyst stage. Blastocyst transfer can be an option for patients with repeated IVF failure and for older patients with multiple, seemingly good, or poor quality embryos. In these cases waiting for more days will enable us to select and replace the best embryos at a further stage of development. Blastocyst transfer may also help to reduce the risk of high order multiple pregnancy.

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Medical Focus

A NATURAL IVF CYCLE

By Dr Geeta Nagrund At present the conventional approach to IVF treatment is aimed at maximising the number of eggs for fertilisation. This is done using high dosage drugs to stimulate the ovaries into producing extra eggs to generate a choice of several embryos for selection and transfer. What is Natural Cycle IVF? Put simply, it is IVF without the use of stimulating drugs. In conventional IVF/ICSI cycles, the patient takes drugs to stimulate her ovaries to produce multiple eggs. With natural cycle IVF, the treatment cycle relies on the spontaneous development of one follicle only and therefore the aspiration of only one egg from the follicle. Occasionally a cycle can produce more than one or no eggs. There is nothing new about natural cycle IVF, in fact, Louise Brown, the world’s first “test tube” baby, was conceived using this method 25 years ago. Does this mean no stimulating drugs are taken with Natural Cycle IVF? Yes. But drugs may be given to prevent spontaneous ovulation. This is called a Controlled Natural Cycle. In addition, the patient will need to take hCG (as with other, less invasive treatments such as Ovulation Monitoring and IntraUterine insemination) to time egg collection as well as progesterone pessaries to supplement the body’s progesterone levels. Progesterone aids implantation and supports pregnancy in its early states. What are the concerns of ovarian stimulation? Daily injections of stimulation drugs can cause menopausal symptoms and side-effects such as bloating, nausea and mood changes and/or a combination of all of them. There is also a risk of Ovarian Hyperstimulation Syndrome (OHSS) which may in severe cases (0.5 – 3%)

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require urgent hospitalisation. Some scientific evidence suggesting adverse conditions in the endometrium (lining of womb) for implantation of the embryo and an increase in chromosome abnormalities in eggs and embryos following high dosages of ovarian stimulation used in IVF cycles. What are the benefits of Natural Cycle IVF? Due to the effect of ovarian stimulation drugs on the body, patients undergoing stimulation cannot pursue consecutive cycles of treatment and need to take 2-3 months break between treatment cycles. In contrast, natural cycle patients can repeat their treatment in consecutive cycles. Also, as only one embryo is transferred in a natural cycle, there is virtually no risk of a multiple pregnancy. Furthermore, ovarian stimulation drugs are expensive and this means that the cost of natural cycles is significantly less compared to the cost of stimulated cycles. What are the disadvantages of Natural Cycle IVF? The success rate per cycle is low compared to stimulated IVF. There is also a small risk of spontaneous ovulation before egg collection. Who can have Natural Cycle IVF? Women under the age of 45 who ovulate regularly can be considered for natural cycle IVF. Natural cycle ICSI is also offered, although patients should be informed that natural cycle ICSI success rates are lower than natural cycle IVF.

Who can’t have Natural Cycle IVF? Natural cycle IVF is not suitable for those who do not ovulate spontaneously. Instead, they will need a low stimulation option. What is Mild IVF? It is aimed at producing 2-7 eggs. It does not involve shutting down hormones for 2 weeks. It is conducted in woman’s natural menstrual cycle. Smaller dosages of stimulating drugs are given for a shorter period to help ripen 2-7 eggs. Spontaneous ovulation is blocked with injections so that eggs could be collected. This approach is also called Soft IVF. It is safer, less expensive and avoids side-effects associated with suppression of hormones in a conventional IVF cycle. It also reduces the risk of Ovarian Hyperstimulation Syndrome (OHSS). Dr Nargund says: It is my view that tailored protocols (natural, modified natural, mild) should become standard during IVF treatment cycles in order to make treatments safer, lower-risk, more patient-friendly and cost effective. Women should receive information about all options during consultation. The HFEA must provide information and outcome of natural/mild IVF in the Patients’ Guide. The savings made by increasing the availability of Natural/Mild IVF would also help to get more IVF cycles funded on the NHS. What’s more, the scientific evidence supports this.

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Personal Experience

THE CHALLENGE OF FITTING IN Referring to last year’s article: “The Challenge of Fitting in”, I thought, it was such a terrific article, as my husband and I have been through all those long and painful years, both mentally and physically, but unfortunately to no avail. We have now reached our MIDDLE YEARS and although we display no evidence of our disappointment and sadness as we go about our daily lives, we are feeling the hidden loss and silent pain that childlessness brings. Many women like me feel too vulnerable to share our feelings with others and of course not every aspect of our lives must be shared with others. Too often though, by remaining silent, we cut ourselves off from the comfort and support others can give. No two experiences will be the same. Our reactions, our feelings of loss, will be unique in many ways, but in many other ways, our experiences will be like those of others, who, like us, have not been blessed with children. After reading this article I realised that I was not alone and that gave me the strength to call CHANA and ask them to set up a new group for people like us. A group that could validate our feelings and experiences. A place where we will find the strength to face our fears and heal our hearts. Are you also looking to share your concerns, questions, and happy occasions, or just spend some time with like-minded people? We are a group of couples who, like ourselves, have not been blessed with children and through CHANA have started an International Network where we can link up with other individuals or couples in the same boat. If you would like to receive our first Network Letter, make any suggestions or just want to contact CHANA (in the strictest confidence), please call the helpline on 020 8201 5774. You can also write or email us to chanact@chana.org.uk

CHANA has started an international network with the specific purpose of providing support to couples who face a certain future without their own biological child. We are aware that many individuals and couples who find themselves in this situation may feel isolated and on their own. CHANA is establishing a framework wherein people can offer and receive mutual support. For more information, please ring 020 8201 5774 in confidence.

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Personal Experience

OUR DREAM COME TRUE

or those of you that have read previous issues of this magazine, you may recall the story of our journey of infertility. I recounted the rollercoaster of emotions from our various consultations and treatments for which we had to travel the world, detailing descriptions of our search for “rescue” from our plight of male infertility. I wrote about the testicular biopsies and the vaseoepididimostomy that my husband received and the hormone treatment that I had to undergo. I also wrote about my feelings of anguish and the battle of envy versus joy when learning of news of a family member or friend becoming pregnant. For seemingly such a long time I agonised and wondered when, if ever, will it be my turn? After two ICSI treatments, the first of which was successful but sadly ended in miscarriage and the second of which simply failed, my husband and I decided to embark on our third cycle of ICSI. I was determined that this time it had to work, so I did everything I could to ensure its success, such as reflexology, eating healthily, resting and most importantly praying. We travelled abroad once again, took all the medication and had all the relevant procedures that ICSI requires and waited those excruciating two weeks to find out if the treatment had been successful. The pregnancy blood test was scheduled around the time of my birthday. Well, it was the 31 News & Views VII

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best present I could have wished for, the test was positive. A few weeks later the scan revealed I was carrying twins!! It felt like a long and hard pregnancy, I was so nervous throughout especially because twin pregnancies are considered higher risk. I constantly prayed that all should go well. At 37 weeks a baby boy and girl were born. I can hardly describe the feelings of joy and happiness that we experienced!

For seemingly such a long time I agonised and wondered when, if ever, will it be my turn? We think back to our doctors’ appointments earlier on in our fight with infertility, and remember their remarks about how it was unlikely we would ever conceive one baby let alone two. We remember the heartache, not to mention the debilitating surgeries required to go through treatment. We look now at our twins and feel so unbelievably blessed to have received such wonderful gifts. We also feel a tremendous sense of relief. So much of our life was a secret. We couldn’t or rather didn’t want to let everyone know about our treatments as we were going through them. We found that it was

as though we were living a double life, having to constantly dream up excuses for why we couldn’t attend things, or why we were not feeling well. People often asked if I was working. Even though I had a profession, my main occupation was trying to get pregnant. With all the research, phone calls and appointments, there simply wasn’t enough time to do much else! So much joy has been showered upon us, but this joy is tinged with sadness as I have now found myself on the other side of the fence. I thought that after going through what we had, I would be able to offer some words of support and encouragement to those who were in a similar position to us. I hoped that there would be some magical healing words that I could bestow on friends suffering through this plight. I feel so guilty that I can’t make things better and help other peoples` pain disappear. I am ever conscious of every word I utter to those of my friends who are suffering. I’m scared to mention my children as it may hurt them, but I also fear that, avoiding the subject will offend them even more, as it may make them feel inadequate. I only pray that seeing our twins will instil a ray of hope in those waiting for children. Let it be an example of the mercy and kindness of Hashem and let it give us all the strength to have the faith that our tefillos will be answered soon. News & Views VII 31

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FROM THE DESK OF REBBETZIN HOLLY PAVLOV Glimpses of a Woman’s travails as she becomes closer to G-d Letter 1 “I shall lift my eyes onto the mountains, from where shall come my aid?”

Tehillim 121-1 Dear Rebbetzin, I know this will be a question, which no one could really give a satisfying answer to. We finally met with a reproductive specialist who has a wonderful reputation. We agreed that I would begin an IUI (Intra uterine insemination) procedure this cycle. After the meeting, two weeks ago, (when I still hoped I might be pregnant naturally. However, I recently realized, once again, that this was not so) we actually left feeling very positive and confident that things would happen soon. We were thankful to have resources and a plan. Spiritually, though, I am in conflict - I just don’t get this. On Shabbos during davening, I felt an inability to daven, at all. I just felt really angry at Hashem. I am not generally from the hard core davenners- admitted. Not that I don’t talk to Hashem, I do. However, I don’t like the “prescribed prayers”. I therefore find it hard to engage with the tefillot in a disciplined way. That said, I go to Mikvah, light Shabbos candles, do Challah separation, and talk to Hashem in my own words. I am now beginning to feel a new sense of wanting to turn closer to Hashem and try to figure out what he wants from us. On the other hand, I also feel hurt and want to turn away. I do have perspective - I look at my husband and he is truly all the proof I need, that Hashem is there and loving me daily. I feel thankful, too, for the amazing technology we are given to 1. Intra uterine insemination - The process by which a woman is medically impregnated using semen from her husband. Artificial insemination is employed in cases of infertility or impotence, the procedure, which has been used since the 1940s, involves injecting collected semen into the woman’s uterus and is performed under a physician’s supervision.

overcome fertility struggles. I am also pleasantly surprised, by the comfort I take in having other friends to talk to about the same struggles - I don’t know what I would do without their support, which has been a gem throughout. I know too that I will be a better therapist for this experience, and that the most precious things in my life, are those I had to struggle for. And yet, why am I filled, at times, with this very intense hopelessness and anger? I know as a psychologist, the importance of being able to hold many feelings at once for others in our relationships. - Love is about integrating strengths and limitations and reaching intimacy and trust.

This connection is part of the purpose of our suffering - to know that all comes from Hashem, that we human beings are helpless and dependent on Hashem, that nothing is impossible for Hashem and that He can help us. Yet, here, I feel this to be harder. Perhaps, because it’s so faith based, maybe since I don’t rationally understand Hashem’s “Plan”, so to speak, what with so many unwanted babies in the world, while M and I, though far from perfect, have spent so much time coming back to a Torah life, again not 100% ideally, but intentionally, committed to Shabbos, a kosher home and Mikvah. Is it strange to believe somewhere, that Hashem might make things easier for us? Or is thinking so simplistically, completely childlike? Anyway, this email is a huge flow of associations and feelings. I really do need some guidance about praying-what to say, how to connect meaningfully and not by rote. How do I feel that Hashem is on our team, so to speak, and will bless us with beautiful

healthy Jewish children? What am I not doing that I need to be doing? How can I at least keep from turning away from prayer? I would love any thoughts and would certainly appreciate any davenning/brachot you can have us in mind for. Thank you so much, Love, Y. Response 1 “Israel, Trust in Hashem, He is their salvation and their shield” Tehillim 115-9 Dear Y, I was so glad to see you at the Day of Learning. I am also happy to hear from you in this letter. Incredibly, you answered all your questions in the same letter that you asked them in. You clearly understand that suffering has a purpose, although, you are feeling angry and sad. There is one thing you did not say, yet I know you know. This is that Hashem is incomprehensible. Although there are so many adjectives that we use to describe Him, and although all of these adjectives are mechanisms through which we connect and relate to Hashem, they are not sufficient to describe His totality. He is merciful, loving, giving, and forgiving. We know these things, yet we do not know even a tiny bit of the endless capacity of Hashem in those things. We know he sends suffering for a reason - and we struggle to comprehend the reasons. As you say, YOU have turned to Him more often and more deeply. You feel more connected - even if sometimes that connection is expressed through anger and hurt. This connection is part of the purpose of our suffering - to know that all comes from Hashem, that we human beings are helpless and dependent on Hashem, that nothing is impossible for Hashem and that He can help us. Anger and hurt are part of how you feel, because you know that Hashem could do this for you yet, He has not yet done so for you.

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You know too that this suffering is bringing you other spiritual gains: a deeper empathy and understanding of you clients (and all people), a clearer grasp of the limitation of human beings in the scope of the universe, an appreciation of all the good things that Hashem has given you - like your husband, and a growing realization that we are completely dependant on Hashem for everything in our lives. And of course, when you will have your child, you will look at him with wonder and tremendous gratitude, especially, because of the difficulties you have experienced. ON TRUST Trusting Hashem, Bitachon, is a life long goal for us. Trust is one of the most profound human experiences. And if we have reliable parents, we learn how to trust from them and, as we grow, we apply that trust to Hashem, as well. As much as we learn trust through our parents, it does not fully evolve in our relationship with Hashem until we face life’s difficulties. When we realize that we are not in control, we begin to rely on Hashem in a bigger way. When we experience real pain, fear or terror, we can develop an even more intense trust of Hashem because we find that over the really big and important things in our lives, we have no control. We have no control over our health, our fertility, our singleness, and our finances (although we fool ourselves to think we do, until we find out we don’t!). So, the irony is that we can only learn true trust of Hashem through suffering. We can not learn it when things go well in our life, when we think that WE are in charge. We can only learn, through our own vulnerability and helplessness. When we do learn this, it is profound, and humbling, and gives us a little more sense of the incomprehensibility of Hashem, an appreciation for every small miracle in our lives, and of life itself. You have experience with Hashem. There have been other times when things did not go the way you wanted. You alluded to your husband. Yet, that very experience developed in you, a sense of trust that Hashem takes care of you. Now you have been given another test, another opportunity to build Bitachon, trust. I am not saying this is easy. I am saying this is good. In the end, you can make this into one of the biggest growth experiences of your life.

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ON PRAYER What is the role of prayer? Truthfully, Hashem does not need our prayer. The mitzvah of prayer is not there to keep Hashem happy. The obligation to pray is there so that we can create a connection with Hashem. Human beings forge relationships with other people by talking. They create deeper relationships by speaking about deep things. They create the deepest relationships through speaking about the most vulnerable thing in their lives, their pain. The same is true of our relationship with Hashem. When we speak to Him, we create a relationship, and the more we speak to Him, the more emotionally open we are with Him about our pain, the deeper the relationship becomes.

And if we have reliable parents, we learn how to trust from them and, as we grow, we apply that trust to Hashem, as well The more we share of our frustration, pain, and vulnerability, hurt and even anger the closer we become to Hashem. That is why our Rabbis teach that Hashem sends suffering to the righteous - because He desires their prayers. Suffering is Hashem calling out to us, to say:” I want a relationship with you, talk to Me.” (Hashem does not send this same suffering to the wicked, because He is not asking for a relationship with them). When you daven from humility and sadness, vulnerability and powerlessness, you create a bond between you and Hashem. Parents will often do whatever they can to relieve the child’s pain, but part of their job is also to discipline their children. Sometimes, they may even appear to hurt their children, as they take them to the dentist to have a tooth filled, or take away a bag of sweets. It may not feel good to the child, but the parent knows that this “pain” or “deprivation” is healthy and will help the child develop more. The child cries, but the parent’s actions are motivated by pure love. Hashem is our parent, and He always does what is best for us, even if what is best means causing us pain. The world often proposes that our goal in this life is happiness, but that is not a Jewish perspective. For us, the purpose of life is to connect with Hashem, to learn to trust Him, to want to serve Him, and to

grow in our righteousness. The price we pay for these tremendous spiritual gains is struggle and suffering. Through this suffering, we learn that everything comes from Hashem; we learn to trust, to accept that whatever the plan is, no matter how incomprehensible to us, Hashem is doing this for our ultimate good. Through our difficulties, we grow and change. We become “different” people, and hopefully evolve to the point where Hashem says, that is good, you have come closer. That is when Hashem often fulfills our prayers. He answers us, so we will learn the next point - That He truly listens to us. I know that the siddur prayers are often hard to connect to. So firstly, I encourage you to daven in your own words, with your own thoughts. Any speaking to Hashem creates a relationship, and when we daven in our pain, Hashem is very close. Dovid Hamelech tells us in Tehillim that Hashem says: “I am with you in your troubles” - that means that when we tell Hashem our fear and pain, He is right there. He is with us, in the thick of things. He feels what we feel. He is deeply empathetic. When you know that and you tell Hashem your feelings, you have connected to Him. However, the siddur prayers have a power of their own, as well. When you daven, you connect your prayers with the prayers of our great forefathers who wrote them. So it is not just you davening. You and Avraham are davening together, you and Dovid Hamelach saying Tehillim together. That is powerful, deep and strong as dynamite.

While you are going for treatments, remember that nothing is impossible for Hashem. He can do this for you So I urge you to learn a little about the prayers you say and their meaning. Once you know what they mean you will be able to attach yourself to the meaning of our forefathers’ prayers. Don’t overwhelm yourself. Start by learning the early morning brochos. Each one is beautiful and you will see yourself in many of them as you learn about their deeper meaning. I know a year has passed. But, that year has taught you so much. The spiritual learning of that year has been tremendous. If you were holding a baby at this moment, you would probably say; the News & Views VII 33

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suffering was worth it, because I learned so much about life, Hashem, empathy. But, if one year stretches into two, there must be more to learn, to grow, to deepen, to connect to and accept. In the end, when you achieve that, you will say “it was worth the wait.” One more thing: Nothing is impossible for Hashem. While you are going for treatments, remember that nothing is impossible for Hashem. He can do this for you. Please G-d, He will do this for you. You want to raise your baby with Torah. This suffering is giving you the tools to raise him in a better way, with more depth and a greater understanding of the incomprehensibility of Hashem and the miracle of life. Love, Rebbetzin Pavlov

The question for you is: “Will Hashem answer MY prayers?” And no one, but you, can truly feel the fear that goes along with that question Letter 2 “I turn to you in my sorrow” Tehillim 86-7 Hi Rebbetzin, Unfortunately, we were unsuccessful this time. I found out on Tuesday. Obviously feeling very sad, angry and disappointed and frankly a little more scared of the chance this may not happen. The doctor feels very confident it will happen, the cycle was good, and everything looked very promising. I just feel so discouraged at this moment. We are going ahead with a frozen embryo cycle (the chances are not as high as with a fresh one, so I am looking at this as a “gravy” try, not with as high hopes as I had for the fresh, but this does work for some people with a 40% success rate). I have taken a break from my prayers for the last 2 days. I feel like I opened my heart so wide in my praying the last month, especially with the chagim. I don’t know what more I can say to Hashem and keep getting this answer. I don’t know how people do it! How do you keep praying for something without 34 News & Views VII

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an answer?! I am not asking to move a mountain! I am asking for what seems so easy for every woman I pass on the street. Anyway, I am obviously not in such a great place this morning, I think the hormones crashing are probably not a big help. I just wanted to give you an update. Y. Response 2 “see, for you have had faith”

Rashi on Yirmiyahu 2;2 You ask how to keep praying without getting an answer. So, I guess the answer is, until we either are answered in the way we want, or we accept an answer we do not want. Prayer is a relationship, not merely a formula to make demands/ requests and have them answered. Again, this reminds us that we are not in control, not of our bodies, and not of Hashem. Prayer requires submission to the reality that things we truly desire - health, livelihood, fertility, wisdom, success, are not in our hands. Feeling powerless is humbling. Acknowledging that we truly are powerless is more humbling. Yet prayer reminds us that we have an address, someone to cry to; someone who will listen and truly understand. This does not mean that the answer is yes, or that the answer is no. This means that you are speaking from the heart to the One who is in charge, to the One who knows what is truly best for us - including the “ifs”, the “when’s”, the “where’s” and the “how’s”. Understanding why or why not is not in our hands either. Who can comprehend Hashem’s ways? Who understands the infinite? Who fathoms why this seems simple for so many, yet it is not simple for you? Who can know why this is your travail, and not someone else’s? Faith is not about the understanding the incomprehensible. Rather, about accepting it. Y, I know you feel a huge sadness. But this is not the time for despair. This is not over. This is definitely not over. Not medically, and certainly not in the world of personal miracles. I do believe this will happen for you. Warmly, Rebbetzin Pavlov 35 News & Views VII

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Letter 3 “For my mother and father have abandoned me and G-d has embraced me” Tehillim 27-10 Dear Rebbetzin, Thanks for your note and your words. I do understand what you are saying to me, and I know that my reactivity does not come from my highest spiritual self either. My relationship with Hashem cannot be based on getting my way or understanding His way. Sometimes, when it hurts so much that is where I go. I really needed the week to feel bad, to accept and prepare for moving forward. I know I have to keep working on this, I know that “it’s not over”- not by any stretch of the imagination. I just find it hard to keep feeling disappointed, with each increasing intervention step we take. Anyway, I’m sure you know, I will continue to be in touch, I will continue to re-read your words to feel inspired in reaching out to Hashem, even, when I am feeling unhappy about some things. Thanks so much again for your support and concern and your belief that this miracle will happen for us. Y.

There is just me and Hashem, and of the two of us, only He can help me Response 3 “And God heard their groans”

Shemos 2-24 Dearest Y, When a person is in pain, they feel that pain. Surely, you should not be angry with yourself for your emotions. True, we try to elevate ourselves past our first reaction. But, that takes time - and tremendous effort. You can allow yourself the “mourning”, as you deal with your feelings of disappointment and sadness. And then, when you have allowed yourself to feel, you can move forward. Please do not think that I was upset by your “reactivity”. Please read my words as a way to offer comfort. I can only

imagine the fear and pain involved in this process. Yes, I do deeply empathize with your struggle. Yet, this is not my struggle and I cannot truly “know” your pain. Sometimes, I offer words of chizuk, and they are the right words. Other times, the words might feel like a “lecture” from someone who can’t possibly understand. What I have learned is that when a person is in pain, no words can be right. One woman described this to me in the following way: “Whatever you do, will be wrong, because my pain is like a raw wound. If you notice it, that will hurt me. If you don’t notice it, that too will hurt me. If you try to sooth it, the wound hurts. If you don’t sooth the wound it will hurt more. Since the pain is so deep, no reaction can be right. Your reaction is not what hurts me; rather my pain, which

When a person is in pain, no words can be right becomes so much more noticeable, no matter what you do.” In the end, the reality of that aloneness can be crushing. Ultimately, you are an individual who stands alone in her fear. The question for you is: “Will Hashem answer MY prayers?” And no one, but you, can truly feel the fear that goes along with that question. You are clear that Hashem is in charge. That is a tremendous gift, because you are reminded that Hashem is in charge of everything, big and little. Yes, it also hurts when the answer is no. I urge you to consider two things: 1. The answer is no-until now. But the answer is not: “No”. He has not finished answering. The anticipation and fear is great, but the answer is not “No”. 2. We can only build true Bitachon, trust of Hashem, when we find ourselves in times of difficulty. Until then, we can learn about it, intellectualize it, and accept it on a rational level. But real trust comes only when we are afraid and learn to rely on Hashem’s decisions. In the end, the lesson of reliance on Hashem; trusting Him through the pain and knowing that this difficult test is good for you even if you don’t understand it, will be the biggest gift of all. As great as the baby that you will one day hold in your arms. Warmly, Rebbetzin Pavlov

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New Feature

Letter 4 “As a person who is lost in a garden maze.”

. Meslias Yesharim – The path of the just-chapter3 Thank you Rebbetzin, I appreciate this letter so much. I wanted to spend some time taking it in before writing back. The woman’s words you shared with me resonate

This whole thing is very scary. There are so many pieces to this that feel scary, I am sure you have heard them all deeply- it didn’t always hurt that much throughout the process, but recently, I certainly feel more that way. I do hope that Hashem understands my inconsistent dialogue with Him. I find things so hard, when I am this disappointed. I definitely know the answer is not ‘No’. As you say - I know this in my heart I’ve gone into this defensive stance, where I feel like this is just going to take a long time for us, and that I have to learn how to live with this pain for longer. I don’t know if there is any accuracy to this. The failed first cycle really shook my confidence. I don’t know if any of the women you have spoken with, have shared feelings of the fear of being all alone with this as more and more of their friends get pregnant. But, I am certainly feeling that right now. This whole thing is very scary. There are so many pieces to this that feel scary, I am sure you have heard them all. Thank G-d, we have so many positive things from the last cycle that we are grateful for- everything went so well. Maybe this is just a matter of time and I need to surrender a bit to the process. I am certainly feeling less attached this cycle; the frozen transfer will take place next month. Please G-d, all will go well, but like I said, I just find it hard to get excited like last time, especially, knowing the stats are lower. Then

again... it’s worked for others, and you never know. Thank you, for your correspondence with me- it feels as if you are holding my hand and you cannot imagine what a difference it makes, you have no idea. Love, Y. Response 4 “I shall put Hashem before my eyes, always.”

accept the situation. They are together in their pain, but really, still alone. The process you are describing isn’t easy, but rather a huge effort, and yet, you are capable of this. Although you might not see this within yourself, you have the power to accept and live with the pain and fear. Perhaps you don’t see that yet, but it will come. Perhaps at this point, this ability lives within you, only in potential, but with effort, you will find strength you didn’t know you had. I bless you with the words of Dovid Ha’melech:

Tehillim16-8 Dear Y., Yes, in answer, each person in their sorrow feels alone and afraid. What you have said - that you fear being the last one, the only one who doesn’t conceive, is the most normal feeling. Like single women who watch their friends get engaged and married, and wonder: “will I be the only one who never marries?” The reality is - that we are alone, in this world. Most of the time, we forget that. We have social circles, spouses, family and friends who love us and share life with us. Once a year, we stand before Hashem in awe - on Yom Kippur - and remember that with all our support systems and all our friends, we stand alone before Hashem. When He judges us, we cannot defend ourselves by saying, “but everyone says or everyone does”. We are reminded of our solitude in standing before Hashem. When we are in pain, we take comfort in those around us, when we can. But when things boil down, we realize that we are alone in our fear. We realize and accept that there are just me and Hashem. No one can help me. No one can comfort me. No one can convince me that everything will be all right. There is just me and Hashem, and of the two of us, only He can help me. Even husband and wife, who are going

I really needed the week to feel bad, to accept and prepare for moving forward through the same pain, experience it differently. One of the women I am speaking to at present has accepted that she will not conceive, (she has totally different circumstances than you, including, a recent fight with breast cancer, that precludes the use of hormones) yet her husband refuses to

“Hashem will answer you on your day of oppression; the name of the Lord of Ya’akov shall shelter you, forever. He will send you help from the holies, and from Zion He will shelter you... Hashem will protect your comings and goings from now until the end of the earth.” May my words be received, with the empathy that I feel! Fondly, Rebbetzin Pavlov Rebbetzin Holly Pavlov, Director Shearim College of Jewish Studies for Women, Jerusalem, Israel.

Do not dwell in the past, do not dream of the future, concentrate the mind on the present moment

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Personal Experience

SCUBA DIVING THROUGH CHALLENGES By Risa Waters Creating a diversion from the constant thoughts of my infertility, I wanted to find an alternative focus. My goal was to channel my energy in a positive direction and do something with my husband that would bring us closer together in the process. While we were on holiday, we both decided to try scuba diving for the first time. We found this to be an incredible experience which we were able to do together, that we could not have shared if I was pregnant. Our first experience, felt like we had discovered a new world and I was seeing a part of the universe most people do not explore. Swimming metres below sea level and being so close to countless beautiful fish enabled me to see the beauty of the world Hashem created and I suddenly began to appreciate my life in an entirely different way. After our first experience of scuba diving, we were hooked. We came back from our holiday determined to become qualified Recreational Scuba Divers. We studied the books, watched the DVDâ&#x20AC;&#x2122;s and quizzed each other on the numerous test questions we would be asked by the instructors. This gave us a focus and allowed me to put my pain of not succeeding in having children aside. Scuba diving was now our main focus. We passed the written tests and then moved onto the challenging practical applications which needed to be mastered.

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Experiencing the process of putting on the intricate equipment while learning to breathe consciously through my mouth, not my nose, taught me to be 100% committed to this and give it my all in order to succeed as a qualified scuba diver. Concentrating on the many safety regulations does not allow your mind to wander. My pain of childlessness that I tormented myself with daily, vanished when I began this venture and it was a relief to have something more constructive to focus on. Sharing our experiences with friends and family brought interest and stimulating conversations wherever we went. My husband and I revelled in our closeness over our new hobby. Completing the scuba diving qualification successfully and incorporating the many techniques we learned was the climax of our experience. Swimming in the clear, blue, sparkling water surrounded by multi coloured fish was exhilarating! I learned to overcome my fears and appreciate every breath I take. Scuba diving taught me that the hand of Hashem is in everything.

When Hashem wants things to happen, they will. I realised while watching various fish following one another that having a partner in life to share joy and pain with was something I needed to learn to appreciate more. Then hopefully, Hashem would allow my husband and I to have a child. To be a safe scuba diver, you must always dive with a buddy. My husband and I were always paired up together as buddies. I found we spent a lot of the time diving making sure the person was ok and comfortable. This has allowed a new aspect of closeness in our relationship to grow. We shared a transforming experience together, exploring the underwater world which opened our eyes to the incredible creations Hashem made possible. While we were diving, we came out of our pain and suffering to appreciate life and cherish what we have. G-d willing, through our appreciation of one another G-d will grace us with the birth of children in the near future.

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Personal Experience

To our precious daughter, Esther Writing these words to you my face is stained with tears and my heart feels as heavy as lead. For so long there has been so much we wanted to say to you, but have held back. “Why now?” you may ask yourself. “Why have we kept silent for so long?” Now that your youngest sibling has given birth to a healthy baby girl we feel we can no longer keep up the charade and not tell you how we really feel. Daddy and I feel closest to you, after your husband of course. For a very long fifteen years we have stood by and watched your pain and anguish, admired your courage and strength and are in awe of you both. We have always tried to place ourselves in your shoes, to try to experience a little of what you must feel. For all these years we have remained silent, no questions asked, no explanations given, just a heavy loving silence that has fallen between us. That dark, heavy silence called infertility... How can we begin? Thirty six years ago we were blessed, after our three sons, with you, our beautiful Princess. What joy and excitement you brought into our lives and home. You were the perfect baby and grew up into a fine elegant young lady. We were so proud of you when at your Chupah you stood with your special Chosson (it took us a long time to find the one worthy of all your fine qualities). Our hearts were filled with love and excitement, praying fervently for you both, to have a wonderful future. Esther, our prayers for your happiness and joy have never ceased since. Not one day goes by that you aren’t on our minds and in our tefillos. I know it’s hard for you to understand your family’s perspective as long as you’re embroiled in your own anguish, but we ask you to try. Our hearts are so full of the unspoken words and unshed tears... all the things we wanted to tell you, but couldn’t. So many times your father and I discussed ways and approaches of how to discuss this issue with you but never wanted to interfere. We never knew the right thing to do. We were so torn, we did not want you to feel we don’t care and are just enjoying all the grandchildren and have accepted your plight. Please don’t EVER think that since we, your parents, don’t talk about it, we’ve accepted and have moved on with our lives. We never will fully relax and enjoy all the nachas we have while we have such a hole in our hearts aching for you. You see your siblings come and go, another baby, another niece or nephew, their expanding families... but you don’t know of their inner torment. You can’t imagine how many hours in the day they daven for you, keep Shemiras Haloshon hours and think of you. No, you can’t know. We haven’t told you. Perhaps it was a mistake. Perhaps we should be more verbal about the whole situation. And yet, we felt we should take the cue from you. You never spoke up and we felt that perhaps this was your way of telling us that the topic was one you didn’t feel comfortable discussing. We only tried to respect your feelings and need for privacy. But yet, we still want you to know... As Purim is now approaching, we want you to understand how much we feel your pain. It must be one of the most difficult days in the year for both of you. In fact every Yom Tov must be so overwhelming – we honestly marvel how you constantly pull through. Don’t think for one moment we think it is easy for you. Just the opposite. Esther, you are always the one who comes up with the most creative Mishloach Manos and surprises for each niece and nephew. You are the one to help them all with their Purim costumes. You are the one to help me cook the food for the seudah, to get it all just right. But I, your mother, see your pain when all the children are singing and dancing together the whole night long, only to fall asleep in their parents’ arms. When all the while you are alone – isolated, yet totally immersed in the atmosphere, not letting anyone feel your pain of yet another Purim passed with no child of your own to dress up and enjoy. Do you know how much my heart is bleeding for you every step of the way?? But there is no way we can compare our tzaar to yours. We realize that we may never fully understand you and may never totally comprehend what you’re enduring. Yet the pain we, your family, feel is very real, too. All we ask is for you to understand that though it may seem otherwise, and though we may not always show it, we can honestly, truly say, Emo Anochi Beztarah – we are ALWAYS with you. Maybe now we have finally tried to break down the wall of silence between us, you will feel that you can too. If you ever feel you want to or need to talk, you know we are here for you. May all the tefillos of your parents and grandparents, sisters, brothers, nieces and nephews, combined with your own, help that Please G-d next year we will enjoy a true and celebrate the day with the true Simchah of another proud Mummy and Daddy at the Purim Seudah. All our love, Daddy & Mummy

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Medical Focus

THE HEALING ART OF REFLEXOLOGY One in six couples seeks specialist help to conceive at some stage in their lives. The true incidence however may be grossly underestimated, as data regarding statistical evidence is gathered during conventional/medical care, and does not take into account those who seek the guidance and advice of complementary and alternative therapists. The inability to conceive will prompt responses unique to each individual and will be influenced by cultural, religious and personal values. Common to all, however, is the knowledge that infertility is traditionally shrouded in stigma. Many couples suffer greatly, struggling with their beliefs whilst punishing and blaming themselves for their predicament. The potential social and psychological consequences of this must never be underestimated. The term Infertility dictates an absolute inability to conceive, and as this is rarely the case for most couples, most Clinicians have opted to use the term Sub fertility. This indicates a reduction in the ability to conceive naturally and reflects the potential for change in fertility status. The term sub fertility is also less stigmatising. Reflexology is a Complementary Therapy that works on the feet or hands enabling the body to heal itself. Following illness, stress, injury or disease, the body is in a state of “imbalance”, and vital energy pathways are blocked, preventing it from functioning effectively. Reflexology can be 39 News & Views VII

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used to restore and maintain the body’s natural equilibrium and encourage healing. A Reflexologist uses hands only to apply pressure to the feet. For each person the application and the effect of the therapy are unique. Sensitive, trained hands can detect tiny deposits and imbalances in the feet and by working on these points the Reflexologist can release blockages and restore the free flow of energy to the whole body. Tensions are eased, and circulation is improved. This gentle therapy encourages the body to heal itself, often counteracting a lifetime of misuse.

Reflexology is a Complementary Therapy that works on the feet or hands enabling the body to heal itself While many people use reflexology as a way of relaxing the mind and body and counteracting stress, at the same time many doctors, consultants and other health care professionals recognise reflexology as a well established, respected and effective therapy. Reflexology in particular plays a very valuable role in the management of sub fertility. It is non-invasive, natural and pleasurable. It has benefits for couples often on both a physical and emotional level.

Many clients who present with sub fertility are extremely desperate, stressed and sometimes depressed. The reflexologist as a complementary practitioner is well placed to offer support and guidance through this traumatic period. As Reflexology is a holistic therapy, it has a unique ability to balance and treat areas of the body where abnormalities/deficiencies have occurred that are not obvious on routine questioning and medical examination. ‘Unexplained’ is one of the leading reasons for sub fertility and is proof that not all fertility issues need conventional reproductive technologies. For couples experiencing the pain of unexplained infertility, there are no easy answers or quick fixes. Hopefully in the future a combination of medical science together with a more holistic approach will offer the best possible chance of conception to couples who are putting mind, body and spirit into their search for a child. “Often it seems that complementary medicine can bring a different perspective and fulfill a real human need for a more personal touch... The goal we must work towards is an integrated healthcare system in which all the knowledge, experience and wisdom... is effectively deployed to prevent or alleviate human suffering”. Prince Charles, The Kings Fund Report. Oct 22 1997. Lesley Woolfe MAR (Member of the Association of Reflexologists)

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Personal Experience

LIGHT AT THE END OF THE TUNNEL I

got married relatively late at the grand old age of twenty seven, having had a rough time in my early twenties with shidduchim. I certainly gave my parents (and myself) enough grey hairs to last a lifetime! Following some lonely and painful years I was looking forward to some inner peace and fulfilment as I entered married life. I remember thinking under my Chupah that surely iy”H, my difficult nisoyon is over. I am now a member of “the club”, I don’t have to feel like the weirdo anymore, and deal with pitied stares and people wondering what’s wrong with me that I am not married. I could sit and discuss sheitels and cleaning ladies at weddings and catch up with my younger siblings who were married long before me. And indeed, the first few months after my wedding were blissful, and Boruch Hashem lived up to my expectations. I thank Hakodosh Boruch Hu every day for sending me my wonderful husband. But a few months down the line, that inner gnawing feeling, that feeling of dissatisfaction, discontentment and that something is incomplete and lacking started surfacing

again. Friends who got married after me were heavily pregnant; again I was being left behind. I knew, deep down, we had a problem, and it seemed as though Hakodosh Boruch Hu did not want my path to attaining life’s brochos to be an easy one.

Friends who got married after me were heavily pregnant; again I was being left behind Infertility is defined as the inability to conceive. After a year, but we dragged ourselves to doctors on a trip home for my brother’s wedding, after we had been married for just seven months. If there was a problem, I wanted to know about it so we could deal with and correct it. I didn’t want to wait and become more anxious as the months went on. We received a provisional diagnosis. I remember my world caving underneath me. Not again, why me? Why couldn’t anything in my life be straight forward and simple? All the bitterness and

anger stored up from my single days started resurfacing and threatening to overwhelm me. My brother’s wedding was that night. I spent most of it outside, emotions storming through me. I couldn’t face the world that was continuing around me when I felt my world had just been shattered. I simply couldn’t participate in the joy inside when my heart was aching. And so, my journey into the uncharted waters of infertility had begun. We got back to England. I spent hours and hours on the internet devouring information re our diagnosis and prognosis. I became a walking encyclopaedia on infertility. I made an appointment with my GP; a frum man, and told him I wanted a referral to a specialist fertility unit yesterday. “Chas Vesholom” he said, “take some clomid.” Three months later, when I still had no referral, I told my GP I would not leave his office until I had the referral. The English system is enough to make anyone pull out their hair from sheer frustration - you cannot see a consultant, both in the private sector or the NHS without a referral from a GP - and I was desperate to move on. Then you have

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Personal Experience

to deal with long waiting lists, both within the private and public sector. I managed, with a huge struggle, to get a referral to three different units. I saw four different doctors, but if I saw each of them for five minutes during the initial assessment it was a lot. I didn’t have confidence in any of them. One would weigh me every time I came to see her, and even when I came with positive pregnancy tests, she still weighed me, and wouldn’t see me if my weight was over a particular amount.

Infertility changed my life completely. It turned me into a person I didn’t know I changed GP practices. Fifteen months after our initial diagnosis, fifteen months of battling the system, we met our shaliach, Mr Aird, a wonderful and compassionate man. The initial assessment took fifty minutes. He was thorough. He examined me. He was aware of the halochos pertaining to frum Jews. He had an excellent plan of action. I felt like a different person. Infertility changed my life completely. It turned me into a person I didn’t know and to be honest one that I didn’t like much. The cold stab of envy every time I heard about another younger family member or friend pregnant ate away at my heart. There was a very fine line between being happy for them, but sad for me. Would my turn ever arrive? I became a more intolerant person. Everything else in the world seemed trivial compared to my all encompassing pain of not having a child of my own to hold. I lost friends on my journey. The loss of a good friend is very painful and compounds the general pain and loss, of infertility. People don’t mean to deliberately hurt you; but hurtful comments and actions erode friendships. I felt I had nothing in common with my friends, who were busy with young families. I was alone. I felt my life was empty. I couldn’t tolerate my friends complaining about their children, and comments such as “You are so lucky you can sleep” left me sobbing for hours. Sleep? I lay awake for hours at night worrying, with the fear that I would never become a mother chas veshalom, choking me. It worked two ways. Friends avoided me. Friends who invited us for shabbosim stopped inviting us when they were pregnant. Pregnant friends avoided me in the street, moved tables at weddings, stopped calling. I am forever indebted to those good 41 News & Views VII

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friends who made the effort, called me, sent me flowers when times were really rough. The expression “A friend in need is a friend indeed” took on a new meaning. Relationships with family members changed as well. Parents love you, and are concerned about their children, but prying and comments also took their toll, I started avoiding calling. Younger siblings were building families, I was left behind. One Sukkos, both a sister and sister-in-law had babies before Yomtov. I did not go home that year. We went to Eretz Yisroel. Even the warmth of the Israeli sun and the Simchah soaking the streets with simchas hachag could do little to warm my heart. I remember sitting by the Kosel, the excitement and crowds swirling around me. I was cold, bitter, and angry. As on many previous occasions, I could not bring myself to daven. I find it often impossible to pour my heart out to Hashem when life becomes overwhelming. One of the hardest aspects of infertility for me was dealing with hurtful and ignorant comments. There were many Neviim on my journey who gave reasons why I wasn’t pregnant and what I should do to become pregnant. You don’t daven hard enough. You don’t try enough segulos. You haven’t been to the right doctors. You are too fat. You are too thin. You are too tense, just relax and you will get pregnant. My cousin’s nephew’s best friend’s grandmother’s cousin’s niece’s sister did such and such and had a baby nine months later. You are not nice enough to your sister-in-law. You don’t cover your hair well enough. You were not nice to a guy you dated ten years ago. Just adopt, then you will have triplets. I received every one of the above comments,

Pregnant friends avoided me in the street, moved tables at weddings, stopped calling And as for segulos we tried many, some of them more weird and wonderful than others. I davened we weren’t oiver on . We did Kol Haneorim, Shiluach Hakan, drank Arovos leaves. I wore Kemayas. We ran to Mekubolim. We went to an old Yerushalmi woman to remove Ayin Hora by pouring lead. I also tried acupuncture and reflexology. I did it all. People going through infertility find different times in the Jewish year difficult and heartbreaking for various reasons. Some

people find Simchas Torah extremely difficult, watching fathers dance joyfully with their children. Others find Purim difficult, with children running around excitedly in their costumes delivering Shalach Manos. For others, it was the absence of expectant young faces around the Menorah on a freezing winter’s night. I found the Yomim Noroim extremely difficult. It was all being decided now. Would the coming year be a year of pain and suffering like the last year, or would I have my yeshuah? I sat in shul at times being overcome with emotion, at times feeling a cold detachment. I felt I was judged badly last year which was why I had a terrible year, what have I done this year to change my matsav?

I think I became a more sensitive person, more aware of other people’s pain Infertility is extremely emotionally challenging. There are many strong emotions associated with infertility, such as despair, anger, bitterness, anticipation., frustration, grief, fear, isolation and loneliness. You feel that no one in the world can fathom your pain. I could go on for hours. It’s extremely emotionally draining trying to work and continue with day to day life when you are having treatment or fail treatment. The anguish and hopelessness when failing a cycle and trying to find the strength to start from the beginning each time, are indescribable. There are many physiological difficulties as well, such as the side effects from the hormones and being bloated and moody. There are daily painful injections you have to give yourself, invasive, painful and repetitive examinations and treatments. The financial implications are also huge, the treatment is extremely expensive. I lost a few pregnancies along my journey. I felt a piece of my soul being buried with each one of them. The stress of a pregnancy following years of infertility, and even more so following pregnancy loss, is beyond words. Waiting two long weeks to find out if the treatment has worked is torture. Then once we found out it had, having to go through blood tests every two days to see if the hormone levels were rising appropriately was even more agony. In one of my pregnancies we had heard a heartbeat quite early on. I was beginning to let hope seep into my emotions, starting to think about maternity clothes, names etc. With News & Views VII 41

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Poem

WHISPER ON THE WIND Each day I wait For a little sign Each day I wait As the Light grows dimmer My soul shrinks From the world of Malkhut I hold my breath For a whisper on the wind I crave the moment For a gentle tap on my shoulder Of the coming of a little soul And still I wait As time rolls forward And still I wait For a whisper on the wind… But now the pining fades As I turn to share in the joy of others Who hear a whisper on the wind Who wait for the moment Of the coming of a little soul Each day I smile When I see the little bundles Each day I smile As the Light grows brighter My soul soars In the world of Malkhut I no longer hold my breath For a whisper on the wind

Esther Bond

nervous anticipation we went for the next scan. The doctor took a long time scanning me, my heart was racing, the panic rising, threatening to choke me. Finally he said, “I’m sorry, there is no heartbeat”. I will never ever forget the shock of that moment. I felt my world had collapsed. The phone call arranging for the burial of the foetus was the hardest I ever had to make. The months following that and the subsequent D&C were the worst in my life. I sobbed so much; I couldn’t believe a person had the capacity for so many tears. I used to pull over on the side of the road when driving as I couldn’t see through my tears and sob. We once went somewhere for Shabbos, I cried so much, I got makeup all over the linen and ruined it so I bought them another set. The day of my due date I didn’t go to work. Every time I failed treatment cycles after that, I was inconsolable for days. I understood the possuk I felt my eyes would never be the same again. There were a few positive aspects to my journey, which I had to work very hard to focus on through all the darkness and pain. I had my wonderful husband. I had and met a few supportive friends going through a similar plight. We tried to take advantage and go away as much as possible. Holidays and changes of environment saved what was left of my sanity. I think I became a more sensitive person, more aware of other people’s pain and of hurting other people, even unintentionally. And most importantly, I truly felt yad Hashem. Admittedly, I often felt anger towards Him, why is this happening to me? Why couldn’t I become a mother when so many people who aren’t worthy of being a parent are? But underneath it all, I knew my Yeshua could only come from Him, and as long as He decided I couldn’t have children, no matter how many doctors and treatments I did, I wouldn’t have children. The only thing I had left to do in those heartbreaking moments was to put my faith in Hashem, as only He has the key to giving me a child. And we had our CHANA worker. She knew everything about us. I felt I could tell her everything. I could phone her at any time of the night and day. She would take time out of her heavy schedule to make time for us. She was my rock and comfort throughout my journey, I truly felt she did a chesed shel emess and I can never thank her enough, I could never have gone through infertility without her. She was the only person in the whole world to whom I could fully pour out

my heart to and express all my pain, and she would listen objectively and do all she could to help me. At the beginning of December 2006, I finally had a positive cycle. I was pregnant again. As I had been pregnant before, being pregnant for me was an extremely scary experience. Getting through every day was so difficult. I couldn’t function. I couldn’t sleep. My boss gently suggested that I was too stressed to work and I should take time off. I ran to the hospital to be checked and have scans very very regularly. The days and weeks dragged by very slowly. As advised by an Odom Godol, we didn’t tell ANYONE about the pregnancy. This wasn’t difficult for me as I was too scared to talk about it, too scared to acknowledge it. Even when I started showing, I couldn’t talk about it at all. I was a nervous nonfunctional wreck until the very end. Boruch Hashem, , our baby was born in August 2007. I have no words or advice for others experiencing the all-encompassing pain of infertility. My heart just breaks for you all. It is an experience that has changed my life, the way I view the world and the way I

We had our CHANA worker. She knew everything about us. I felt I could tell her everything relate to others forever. I once read that when Moshe Rabeinu asked Hakodosh Baruch Hu to reveal His face to him, he was asking Him to please explain the concept of “Tsaddik Vera Lo”, why bad things happen to good people. Hakodosh Boruch Hu told him no. It is not within human understanding to understand why there is suffering and pain in this world. Even Moishe Rabeinu, the greatest man who ever lived, a man who was so close to G-d was told he cannot understand this. We cannot see the full picture. We all know the parable that to us the world is like the back of a tapestry, a complicated mess, full of suffering and pain whereas the other side is clear and beautiful, as G-d sees the full picture, the beginning and the end. We don’t know what purpose our souls have in this world and what each soul has to do to fulfil its tafkid. Only when the tafkid of all our souls is complete, can Moshiach come. Let as daven that Moshiach comes soon and end all our suffering.

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Life Perspectives

ATTITUDE

’ve seen so much suffering, and it seems to me that the key is “attitude.” How people deal with it depends on what attitude they have. I have seen people, whose attitude were, of anger or hurt to such an extent that they never got beyond a particular event - which then became the defining moment of their lives. In a certain sense, life stopped at that particular moment. On the other hand, I have seen people who have gone through the most horrendous things, but their attitude was a positive one of believing that there is an ultimate good, of asking how I can learn and grow from this. It was incredible to see their sense of dignity, and the inspiration they gave to others. How they moved on with their lives. The contrast is so unbelievable between these two attitudes. Living with the concept of a good God is so much more uplifting and gives a person the ability to remain joyful and hopeful and have the strength to go on and fight. I want to share a story that I heard from a friend who experienced the following incident. If you’ve ever ridden a bus in Israel, you know how people enter the bus from the front door and pay the driver, and people exiting the bus do so from the back door. Sometimes the crowd is so great, that people will also enter from the back door, passing their money up front to pay the driver. Well, this one time the driver decided he wasn’t going to allow that. So he announced that whoever had entered through the back door, must now get off the bus and walk around to the front. Everybody complied grumpily, except for one very old man who could barely walk in the first place. Well, the driver stuck to his guns and announced that the bus would not move until this old man came on through the front door. So slowly, slowly, one small 43 News & Views VII

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step at a time, the old man got off the bus and walked around. And all the while, the people on the bus were shouting at the driver for not only his insensitivity to the old man, but for wasting everyone else’s time! Finally, the old man managed to make it up through the front door and pay the driver. And then he turned toward the bus full of angry people and told them: “Please, don’t be upset. We should be grateful that my legs still work and I still have the strength to walk. Thank God!!” I want to conclude with the following poem I once read:

I asked for strength and God gave me difficulties to make me strong. I asked for wisdom and God gave me problems to solve. I asked for prosperity and God gave me brawn and brain to work. I asked for courage and God gave me dangers to overcome. I asked for love and God gave me troubled people to help... My prayers were answered. News & Views VII 43

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Life Perspectives

DESTINATIONS By a Friend of CHANA

tanding innocently, it awaits its passengers. The journey that this train will run is, as yet, unknown. None of the passengers have any idea of the ride that they are about to take. The platform is full. The conductor guides the people onto the carriages. With whom shall we sit? It seems random, yet the conductor carefully calculates which route we will be taking. The journey begins and we hear music playing softly in the background. As the train continues along its way, my carriage suddenly veers off onto a different track. I watch with horror as the rest of the train travels along its peaceful journey around the lake. Where is my carriage going? I begin to realise that I am on a different journey as my carriage races towards an unknown tunnel. I pick up speed as I hurry into the darkness. All around me is a thick blackness. The only sounds are the shrieks of pain that seem to bounce off the walls. “Am I screaming too?” I begin to wonder to myself. Cobwebs dangle in front of me and brush against my face. “Where am I?” I wonder, “What has happened to my journey?” I have come to a new place, traversing a path that is not often crossed. The end is as yet unknown, for if it were to be a continuum of the present, this would be too fearful to contemplate. The ride slows down. Now and again, I glimpse a view of the journey that I

thought I would take. The picturesque route, filled with laughter and song. Don’t think that there is no laughter on my journey. We often hear hysterical cackling through the darkness. We hear the cynical sniggers that are often the response to reassuring glances. And the stares, these are an intrinsic part of the ride. The eyes, they seem to be everywhere. Some are sympathetic but most are simply curious. The scrutinising eyes that think they understand. The disdainful eyes, the sad eyes, all these, and many more, are part of this journey. They pierce our very flesh, and instead of blood, evoke tears. Tears are a prerequisite for this carriage. They are shed often until slowly but surely, there are no more. This happens when the heart has endured too much pain and has turned into a stone-like substance; it is a common reaction to the ride. Sometimes, snippets of conversation drift over to us from the lake. We listen in carefully, trying to take a part in the life that we dream of. We are shocked – they are complaining!... Their lives are so hard... the sun is too bright... the soft wind tickles their faces... they have so much to do... We cannot believe our ears. As we gaze into the darkness, we wonder how they can complain of the light. For sure we can appreciate that sometimes the brightness makes them squint. We understand that their job can at times

be overwhelming. But, can’t they see the solid reality that they are creating in the world? The satisfaction of viewing the continuum of life – where is this? Have they forgotten the indescribable privilege that they claim as their own? Even without us darkness-dwellers to compare themselves to, their lives are, should be, could be, filled with happiness – if only they’d let it in. But, our hands are tied. Just as they, do not, cannot, understand us, we do not understand them. We cannot change their attitudes, nor can we make them smile at the clear blue sky. The glorious sunsets and the warmth of the midday sun – all these go by them unnoticed…. But we cannot help them unless they themselves want to be helped. There are times when we hear a sadness coming from just outside our tunnels. We peek out to see what it is, and are oddly satisfied. It is one or more of the outsiders, who feel our pain and are crying with us, for us. It is glimpses like this, however minimal, that give us hope. We are cared for – and one day this journey will end. For now, we must continue our journey, with its dangerous twists and turns, until one day when iy’h, all these tunnels will close, and we too will emerge into the world of warm sun and clear, blue skies.

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Medical Focus

CHANA MEDICAL ADVISORY PANEL Since its inception in 2003 CHANA’s Medical Advisory Panel has grown from a small group and expanding to consist of renowned specialists in the field of male infertility, endocrinology, miscarriage, genetics, ultrasound scanning, gynaecology and infertility. The panel also includes GP’s who are particularly sensitive to the needs of the Orthodox Jewish community in North West London and Stamford Hill as well as a paediatrician and medical liaison who are able to offer specialised input. The aims of the panel include, being a source of advice and support to CHANA regarding medical information for members and support workers, being available as a source of referrals; to help CHANA establish links with a range of medical specialists, and to raise the profile of CHANA, so that individuals and couples can utilise CHANA’s services. Members of the public can access specialised information through the CHANA helpline who have direct contact to the Medical Panel with up to date medical breakthroughs. The Medical Advisory Panel meets four times a year and they are instrumental in helping us at CHANA to develop our policies regarding medical issues as CHANA grows and develops. This enables CHANA to offer an outstanding and high calibre service to the community. Many of our panel members kindly support us by speaking at our Well Woman and CHANA specialist infertility events.

Dr. Miranda Abraham (Glick) General Practitioner in practice for 13 years with a special interest in gynaecology. Practices under the NHS in West Hampstead and privately in Golders Green and has experience working with the Stamford Hill Jewish Community. Dr. Yossi Adler General Practitioner who practises in N.W. London with a large percentage of Orthodox patients. Involved with helping patients with a range of infertility treatments. 45 News & Views VII

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Dr. Veronique Berman Currently the senior scientist in the Molecular Diagnostics Laboratory in Haematology at the Hammersmith Hospital, providing the full range of molecular diagnostics and molecular monitoring for malignancies, chimerism for transplants as well as diagnosis of clotting disorders and Thalassemias both for the Hammersmith Hospital and the West London region. Doctorate in molecular endocrinology with a particular interest in hypogonadism and infertility. Dr. Anthony Cohn Consultant paediatrician at the Watford and Hemel Hampstead Hospital. Had his children through treatments. Is aware of issues resulting from treatments as they relate to premature and multiple births. Dr. Gerard Conway Dr Conway is lead clinician in endocrinology at UCLH and maintains a clinical research interest in pituitary, ovary and adrenal disorders as well as developmental conditions. Much of this work comes under the heading of reproductive endocrinology which is a specialist interest in the department. Dr Conway has pioneered the development of multidisciplinary clinics for Turner syndrome and Congenital adrenal hyperplasia which have become a model for care of these conditions applied throughout the world. In the area of reproduction Dr Conway undertook research into the Polycystic Ovary Syndrome under Professor Howard Jacobs and has developed this interest over the last 20 years. He runs a clinic specialising in PCOS in the Reproductive Medicine Unit at UCH where he is the physician overseeing hormone aspects of infertility. Dr. Simon Fishel (associate member) Dr Simon Fishel is Managing Director of the CARE Fertility Group. He is recognised for his pioneering work in IVF, especially in the fields of microinjection for male infertility and preservation of fertility in children with cancer. He has been active in the field for over 30 years, researching at Cambridge with Professor Robert Edwards before the birth of the first IVF baby. He has written over 200 scientific articles

and edited 3 books on the subject. He was awarded a personal Professorial Chair in Human Reproduction in recognition of his work and is also an Inspector for the Human Fertilisation and Embryology Authority (HFEA). CARE Fertility have been associated with the introduction of many of the advanced and specialised technologies in IVF, and their patient Bulletin Board has been described as “one of the best patient-patient resources in the field” www.carefertility.com Dr. David Goldmeier Consultant physician in Sexual Medicine at Imperial College NHS Trust at St. Mary’s Hospital. Clinical lead for the Jane Wadsworth Sexual Function Clinic. Involved in clinical research. Sits on editorial boards for a number of academic journals and on the board of directors/councils of a number of national and international sexual function organizations. . Dr. Lyann Gross Lyann Gross is a junior doctor training to be a GP who has special interest in gynaecology, fertility and family planning. She also works as a Family Planning doctor for Barnet Primary Care Trust and has lectured to other doctors and health professionals on gynaecological issues in Orthodox Judaism. Mr. Anthony Hirsh MB, DRCOG, FRCS Andrological Surgeon Anthony Hirsh is a surgeon specialising in male subfertility and male sexual dysfunction. His principle interests involve the management of infertile men by conservative, medical and surgical methods, including surgical sperm recovery techniques and assisted reproduction. A graduate of Westminster Medical School, he is Consultant in Andrology to Whipps Cross Hospital London, Bourn Hall Clinic Cambridge, Guy’s Hospital Assisted Conception Unit, where he is Honorary Senior Lecturer, and The Fertility Unit, Homerton Hospital, London. He served on the Development Group for The NICE Fertility Guidelines (2002-2004). He has regularly lectured on the British Fertility Society special skills courses, King’s, Guy’s and St Thomas’s Medical School, The Bourn Hall academic News & Views VII 45

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Medical Focus

programme, and various clinical meetings. He has also contributed several papers and chapters on the investigation and management of infertile men in the assisted conception unit, and introduced reproductive medicine specialists in several units in the UK and abroad to the skills needed to manage infertile men including surgical sperm recovery. Mr. Arjun Jeyarajah Mr Arjun Jeyarajah was appointed Consultant Gynaecologist and Gynaecological Oncologist at St Bartholomew’s Hospital in 1999. He has sessions at Queen’s Hospital Romford in his role as Gynaecological Oncologist in the North East London Gynaecological Oncology Network. Mr Jeyarajah qualified from Cambridge University and Kings College Hospital London. He trained in Obstetrics and Gynaecology at Beth Israel Medical Centre in New York City, USA. On his return to the UK he completed his membership of the Royal College of Obstetrician and Gynaecologists and carried out a further sub-specialisation in Gynaecological Oncology between St Bartholomew’s Hospital and The Royal Marsden Hospital. He was awarded the Fellowship of the Royal College of Obstetrics and Gynaecologist in 2007. His research interests include screening for ovarian cancer and laparoscopic pelvic surgery. In addition he is Chairman of the North East London Gynae Oncology Tumour Advisory Group and his specific areas of expertise include laparoscopic surgery and coloscopy. He has extensive experience in radical pelvic surgery. In the private sector he consults in Wimpole Street, London and has operating sessions at the Princess Grace and The BUPA Roding Hospital. Mr. Eli Kernkraut Mr. Eli Kernkraut has for many years familiarised himself with information about clinics, specialists and treatment procedures. In a voluntary capacity, Mr. Kernkraut helps prospective patients in the Jewish community, to find out particular information specific to their own interest as well as help them liaise with appropriate specialists in the field. Ms Sara Levene Sara is a Genetic Counsellor based in the Clinical Genetics department at Guy’s Hospital. Aside from a broad

genetics caseload of general and cancer genetics, Sara has previously managed the long-term follow-up of families with chromosomal re-arrangements, and has more recently taken on the management of long-term follow-up of Fragile X families. Sara is also works in a team running a local multi-disciplinary clinic for women with disorders of sexual development. Sara’s special interest is in genetic conditions which are more common in the Jewish population, and as well as running the Tay Sachs screening clinic at Guy’s she has more recently completed a Dept of Health funded ‘Visiting Fellowship’ to visit Jewish Genetic screening programmes in the USA, Canada, Australia and Israel. The UK National Screening Committee has now funded further work to review the current Tay Sachs screening service around the UK. In addition, the Guy’s Genetics department where Sara is based, in conjunction with the local Assisted Conception Unit, run one of the most active Pre-implantation Genetic Diagnosis (PGD) services in the NHS. Mrs. Geeta Nargund Geeta Nargund is the Consultant and Head of Reproductive Medicine services at St George’s Hospital, London. She is also the Medical Director of Create Health Clinic, London. She was awarded a “Visiting Professorship and Gold Medal for her contribution in infertility by the University of St Marco, Lima, Peru (oldest university in Latin America) in September 2007. She has been a Senior Governor of primary and secondary schools in south London. She has published extensively on the use of Advanced Ultrasound Technology in Reproductive Medicine. She pioneered the use of follicular Doppler for assessment of egg quality in infertile women and “One-Stop Fertility Diagnosis” using advanced ultrasound technology. She has also published the first scientific paper of cumulative live birth rates with Natural Cycle IVF (IVF without ovarian stimulation). She is the President of the International Society for Mild Approaches in Assisted Reproduction (ISMAAR) She is passionate about prevention of infertility & making Assisted Conception Treatments (ART) more natural, safer and affordable globally. She is the Chief Executive of the UK national women’s health charity, Health Education Research TRUST (www. hertrust.org). Through this charity she is

committed to raising public awareness about women’s health and funds for scientific research. Dr. Jeremy Nathan Dr. Jeremy Nathan is primarily a General Practitioner working in North-West London. His particular interests include Medical Acupuncture and Medical Education. He is a fully accredited member of the British Medical Acupuncture Society, holding their Diploma in Medical Acupuncture and is the official Acupuncturist for CHAI Cancer Care. He is also a Clinical Teaching Fellow in the Academic Centre for Medical Education at the Royal Free and University College Medical School, UCL. He lectures undergraduates in Health Promotion, tutors 1st and 3rd year medical students, and is a finals year examiner. His website can be found at www. privateacupuncturegp.co.uk. Mr. Nick Panay BSc MBBS MRCOG MFFP Nick Panay is a Consultant Gynaecologist with a Special Interest in Reproductive Medicine and Surgery, Menopause and Menstrual Disorders. As director of the West London Menopause & PMS Centre at Queen Charlotte’s & Chelsea and Chelsea & Westminster Hospitals, he heads a busy clinical and research team which publishes widely, presents at scientific meetings and trains health professionals at all levels. Much of his team’s research has focused on improving the understanding and management of premature menopause, PMS, new HRT preparations and complementary therapies. Nick is currently the Editor-in-chief of Climacteric (The Journal of the International Menopause Society) and is on the editorial boards of the Journal of Obstetrics and Gynaecology and Journal of Family Planning and Reproductive Healthcare. He has a particular interest in minimal access surgery, both laparoscopic and hysteroscopic. He heads the operative outpatient hysteroscopy centre at Queen Charlotte’s Hospital which facilitates the one stop investigation and treatment of women with bleeding disorders. As council member of The British Menopause Society and The British Society for Gynaecological Endoscopy, Vice President of The Royal Society of Medicine, Chairman of The National

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Medical Focus

Association for Premenstrual Syndrome and Patron of Daisy Network, he campaigns actively for women’s health issues both nationally and internationally. Professor Lesley Regan MD FRCOG Professor Lesley Regan is Head of Obstetrics and Gynaecology, Imperial College, St. Mary’s, London. Her specialist interests are in recurrent pregnancy loss, sub-fertility, non-invasive therapies for the management of uterine fibroids and general gynaecology and obstetrics. Recently received a Woman of Achievement Award for services to Reproductive Medicine. Mr. Bill Smith Technical Director of Clinical Diagnostic Services. Ultrasound practitioner with extensive expertise in women’s healthcare issues including obstetrics, gynaecology and reproductive medicine. Recognised internationally for his pioneering work in developing ultrasound technology in many aspects of gynaecological scanning. Has been involved in setting up several fertility/IVF units within the UK over the past two decades. Dr. Davina White FRACP MB/ChB, Diploma in Gynaecology Davina White is a Specialist in Reproductive Medicine based at Imperial College NHS Trust, St Mary’s Hospital, Paddington. Mrs. Carolyn Cohen Principal Social worker of CHANA, responsible for help line and counselling services and member of management committee. Experience in marital and family social work. Mrs. Rae Adler Community Development officer, responsible for helping CHANA widening its links in the community and help potential members access CHANA’s services more easily. tMember of the senior social work team. Mrs. Devorah Gelley Support worker for the CHANA helpline. Broad experience in the community, having worked with adolescents in school setting and been involved for many years as Rebbetzen and Kalloh teacher. Also works for other Jewish charity as support group facilitator. Fluent English, French, German, Yiddish, Ivrit.

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ODE TO MR LINDSAY McMILLAN It is with great sorrow we report the passing away of Mr Lindsay McMillan who died peacefully at home during November 2007. Lindsay was a highly regarded consultant gynaecologist and especially recognised for his pioneering skills as a surgeon. Greatly respected by his colleagues and much admired and loved by his friends and family, he leaves a tremendous emptiness in so many lives. An emptiness that is impossible to fill but one which reflects the impact he had on so many people, particularly his patients. He qualified in medicine in his native South Africa and came to England during the 1970’s. He rapidly established himself in the field of gynaecology, eventually achieving consultant status at Whipps Cross Hospital, London. It was really here that he earned his reputation not only as an outstanding clinical consultant but also perfecting his skills in endoscopic, or “key-hole surgery”, techniques. Over the years he not only continued to develop his surgical expertise, but was responsible for teaching large numbers of his colleagues the modern surgical techniques now available in most hospitals. Lindsay was held in the highest esteem both within the UK as well as internationally for his clinical work, particularly that involving treatment of more complex diseases such as endometriosis and gynaecological cancers. As a doctor, he continually strived to provide the highest standards of clinical care and remained totally committed to his patients. As a human being he had a tremendous presence which touched so many people. Despite his professional success he retained a warmth and humility towards others and it was largely these attributes which created such a bond between himself and his patients. He always had time for others and was so pleased to be invited by CHANA to join their medical advisory board. He felt very strongly about the need to provide patients with accessible advisory and counselling services and realised many years ago the need for emotional support, particularly in areas of women’s health care issues. Lindsay greatly respected the role of CHANA in the community and felt it a privilege to be involved in his capacity as a clinical consultant. His input in this respect, although only for a few years, was nevertheless of tremendous benefit and his loss is so greatly felt by all currently working as part of CHANA. A day does not pass when Lindsay’s name is not mentioned. His energies remain and fuel our awareness of the need to support others. Nowhere else is this more apparent than within CHANA where we remember Lindsay McMillan with great fondness for what he gave to us all. We send our sincere condolences to Lindsay’s family who cared for him with so much love and dignity throughout his final days.

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Personal Experience

THE GIFT OF HOPE By Rosalyn Lesser

am 31 weeks pregnant now. I know I am not holding my baby in my arms just yet, but I never thought I would get here; I wanted to write this article for the CHANA magazine to give other couples going through the pain of infertility….. hope. CHANA helped me during my difficult time to not feel so alone, by giving me the opportunity to meet other women in the same situation as me, and it really helped to speak to the CHANA councillor as she really understood what I was going through. After three years of marriage, three miscarriages, a failed IVF and endless months of not conceiving, I could not see the day when we would be out of the ‘Black hole’ and able to move forward and become parents. All around me, my friends were announcing their pregnancies, first and second time around, and still we had no news of our own. We had been married longer than most, and even though we had decided not to try for a baby until our second year anniversary, so we could concentrate on our careers, enjoy married life and our time together, I never saw this coming.

I had never had any gynaecological problems and had always been healthy; my mother had no problems at all conceiving me or my sister and my friends were all falling pregnant immediately, so I could not understand why it would be any different for me, and it was a huge shock when it didn’t all go to plan. My consultant told me I had been unlucky in miscarrying and there was nothing wrong with my husband or myself. Eventually a fertility specialist discovered that my womb lining was not thickening during the cycle so I was not conceiving. This was probably the reason why the miscarriages had happened. Over time, with trial and error, the specialist searched for medication to thicken the lining including Clomid, Viagra and HRT; without success. In the end, acupuncture and herbs worked for me. The experience of infertility has taught me that life does not always go to plan. Life had always gone more or less smoothly for me. You do your ‘A’ levels, go to University, have a career, get married and have a baby?!! So the plan goes. But my plans were delayed for a while. This was my first experience of not ‘fitting in’ socially. We stopped seeing certain people and going to parties and large gatherings. I found it to be too painful listening to other people talk about their children and seeing pregnant bumps. I remember making a wish to live on a desert island somewhere; away from it all. I felt abnormal and dreaded the questions; ‘How long have you been married?’ and ‘Have you got children?’ and when I said we did not have children, this often prompted the most difficult question; ‘Do you want children?’ During that time, my husband and I spent a lot of time alone together and we have a very strong marriage now.

I wish that I could have enjoyed those wonderful treats we arranged for ourselves much more that I did. We went to the theatre and had romantic dinners. We also went on wonderful holidays. I joke now that I have cried all over the world. If only I had possessed the gift of…hope. I am enjoying my pregnancy and not taking a second of it for granted. We can plan things and not feel like we are stuck in a world of uncertainty. I feel that G-d has given me my life back and finally answered my prayers. I listen to other women moaning about being pregnant and getting fat. For me pregnancy is special and very precious. The pain of infertility, the anger and frustration, the ‘why me?’ has certainly lessened, but as yet, I cannot forget. Some people say when I hold my new baby (P.G), it will all disappear. We will see. I had planned to have two children by now. Since my plans did not work out, I have to make the most of what I do have; such a supportive family, a lovely home, wonderful husband and what great things we have accomplished together in this time. I am trying to focus on the positive and I certainly feel that it has changed me. I am a deeper and stronger person, and I know how very lucky I am to have such a special relationship with my husband. Now I hope that our ‘bundle of joy’ arrives safe and sound. I really feel that if it could happen for me, then it could happen for any of you. Don’t lose the gift of hope!

Since writing this article, with thanks to Hashem, I have given birth to a healthy baby boy, Samuel Harry, my beautiful little miracle!

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Medical Focus

Part II

HAVEYOU EVERTRIED

MEDITATION?

My dear friend, as I write to you and my wish is that you are feeling happy and contented today. I hope you have found benefit in following the exercises for being positive, breathing correctly, making affirmations and visualising in Part I. Now we are ready to progress to a longer meditation through visualisation

A Fertility Meditation • Sit in a comfortable armchair and relax • The flower smells idyllic, it is beautiful with your feet placed firmly upon the ground • You continue on the pathway feeling energy and life of nature and the • Close your eyes wonder of Hashem now • Do the breathing exercise as in Part I • Ensure that every part of your body is relaxed • All tension is released and you are in the present • As the room fades visualise or sense that you are walking down a pathway

• You see two deer, one male and one female nestling each other from behind one of the trees. The female deer flutters her eye lashes and the male deer responds by nuzzling her • You smile as you feel their love for one another • As you progress you come to a white picket fence with a gate in front of you

• The path is smooth and clear • Above the sun is a golden orb, shining brightly • There is hardly a cloud in sight except for the one fluffy white cloud that appears to be resting in the sky as if placed by Hashem’s hand • The sky is a beautiful azure blue colour • Lining the pathway are tall majestic pine trees giving off a wonderful scent • The birds are chirping arias in the trees • White butterflies flutter past in pairs • You stop a moment to look down and see flowers growing beneath the pine trees • You bend down to admire their beauty and find one growing which is your favourite flower

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• Reach into your pocket you find a golden key

• The stream is quite deep • The stepping stone pathway leads up to a hill and as you continue to walk on the stepping stones you find yourself at the top of the hill • Across the horizon you see a salt water lake • You follow the stepping stones which lead straight to the lake side • You sit by the bank and contemplate in this quiet place • You have all the time in the world to think here. Is there anything holding you back from having a child? Whether the reason seems large or small or insignificant, it does not matter

• This golden key fits the lock to the gate; open it going inside and lock the • You see old branches of an old bare door behind you so and wizened tree scattered on the ground around you • Inside the white picket fence is the most magnificent garden • Bend down and collect these old branches of tree scattered around you. • There are exotic flowers birds and Some are small branches, some are a trees here. Ones that you have never little bigger but all the branches are seen before but you are captivated by lightweight and easy for you to carry. their beauty and love flows all around As it happens, there are exactly the the garden same number of branches as reasons that you had decided are holding you • There is a quaint pathway with back from having a child stepping stones in front of you • Take a different branch for each and • Take the pathway to see where it every one of those reasons, break will lead it and throw the pieces into the lake. These broken branches dissolve • You pass by a clear running stream before your very eyes and they are with incredible coloured fish that jump extinguished forever high out of the water and dive back swiftly into the water without fear News & Views VII 49

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Medical Focus

• As you throw the broken branch into the lake you know that this reason that has held you back no longer exists in your world • Once you have completed your task, sit a while at the bank of the lake and relax • As you look around you see a wicker basket near by • Go to the basket and inside you will find some items which have been precious to you in the past • These are items symbolise old ways and thoughts and are no longer of use

• You leave the water and find yourself dry, comfortable and ready for the next part of the journey

• After chatting with you visitors it is time for them to leave • You bid your farewells

• You see a very large oak tree and a seat with a plush velvet cushion beneath its comforting branches

• It is time for you to leave the garden

• Sit for a while and relax

• Take one more look around this beautiful place knowing you can come back at any time

• You hear the beautiful music of nature; the birds humming, bees buzzing and the sun still shines

• Take the golden key from your pocket and let yourself out the gate and lock it behind you

• You feel happy and secure in this place

• Take the key with you and keep it safely in your pocket

• To your left side you notice a huge flower growing. It has the same shape as the reproductive organs of a woman

• It is time to let them go • For the first time you notice strings attached to the wicker basket. It is a hot air balloon and ready to fly away • Put these old items in the basket, secure the lid and release the balloon

• The flower is strong vibrant and curved with a wonderful fragrance • It is a perfect flower just as your physical body is perfect • You know that your body is working perfectly now to conceive a baby

• Watch the balloon sail upwards into the blue sky and float away. Stay for a moment. You feel much lighter and brighter now you have rid yourself of those old and useless ways of being

• As you sit under the oak tree you see the acorns growing from the branches

• It is time to return to the garden using the stepping stones

• As you sit you find visitors come to see you one by one

• After making your way back over the hill to the garden you see the sparkling water of the clear running stream

• They may be people you know but all are so happy to see you and send their love to you

• Go to the stream, see the beautiful coloured fish jumping joyfully around you and you decide to dive in

• In this beautiful place you know your baby awaits it’s time and place

• You find yourself back on the pathway from whence you came with the abundance of gifts given by your visitors • Smell the pine trees, see the sun shining and the birds chirping • Come back to the present taking all these wonderful things with you. Feel your feet press firmly into the ground and take as long as you to relax before moving after this journey

Practical tip Perhaps record this meditation yourself and play it back or ask your husband or a friend to read it for you whilst you visualise

With love Esther Bond

• They bring gifts for you, which you accept graciously and with love. Each gift has a different and precious meaning to you

• The water is deep enough for you and warm and cleansing • You know this water will cleanse you physically and emotionally and will make every thing ready to conceive your baby. The beautiful coloured fish swim playfully around you. You laugh and respond to these wonderful creatures

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Life Perspectives

CONNECTING THROUGH PRAYER By Rabbi Shaul Rosenblatt

Tehillim tells us, (Tehillim 91:15). I (Hashem) am with a person who is in pain.

ashem is closer to us at times of pain than He is at other times. As an aside from my main point, it’s interesting to note that this is more than a small side benefit to challenge. Feeling close to Hashem is what this world is about and if a time of pain can help us do that, then pain can’t be all bad. But I’m straying from my topic. What I want to talk about is the concept of tefillah because if Hashem is closer to us when we are in pain, then it’s obviously a very meaningful time to daven. I’ve heard people say that it’s harder to daven at a time of need. But the Shloh Hakodesh lists need as one of ten elements that increase kavannah in tefillah. Anger and bitterness will not help kavannah, that is true, but sincere need will help a person to daven their socks off. When my wife was ill with cancer, I prayed like I have never prayed before or since. As a result, I felt closer to Hashem than at any other time of my life. It was an incredibly painful time for me and it did not end in the way that I would have chosen, but that doesn’t

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mean that I didn’t feel a deep closeness to Hashem almost throughout. Yes, anger, frustration, sorrow, despair and a thousand other feelings were also manifest at various times along the way. But I realise that only Hashem is perfect, and in general, tefillah kept me hopeful and kept me feeling close to Hashem even during my darkest hours.

Feeling close to Hashem is what this world is about and if a time of pain can help us do that, then pain can’t be all bad Not only is a time of challenge a great opportunity to daven, sometimes it is the purpose of the challenge itself. We are told that Hashem wants the tefillos of Tzadikim (Yevamos 64a). In particular we are told that Avraham and Soroh, and Yitzchok and Rivka were given fertility challenges in order to increase their davening and help them to develop a deeper closeness with Hakodosh Boruch Hu. In fact, in the Tenach, fertility challenges seem to be reserved only for Hashem’s loved ones. CHANA is,

of course, another example. And tefillah always seems to be the main response of those Tzadikim. Tefillah is probably more associated with CHANA than with any other character in the entire Tenach. Yet we seem to live in a generation that is particularly challenged by prayer. People struggle to connect to Hashem and feel kavannah in prayer. So much so, that a young secular Jew who is searching for spirituality is more likely to go to an Eastern religion than he is to a Shul. Judaism seems to have become less spiritual, and prayer is one of the casualties. I’d like to give a few thoughts that I hope will be helpful for people looking to pray meaningfully during a challenging time. Firstly, we say in Ashrei three times a day, . Hashem is close to those who call Him in truth. There is very little that is more precious before Hashem than a sincere tefillah. Even when other gates are closed, the gemarah tells us, the gates of tears are never closed (Brochos 32:2). The Rambam poskins that if a person davens without kavannah, he should daven again (Sefer Ahavah 4:15). In all other mitzvahs, as long as a person has kavannah that he is doing a mitzvah, he is yotze, even News & Views VII 51

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Life Perspectives

if he is thinking of being on a beach in the Bahamas while he is doing the mitzvah. There is no question that the more kavannah, the more meaningful the mitzvah, but no kavannah does not invalidate the action. This applies to all mitzvahs except for tefillah. If you stand and read the Shemoneh Esrei while your mind is somewhere else, you have not davened. You have read some very meaningful words; you will get some reward for the effort, but prayed you have not. I guess this is pretty obvious, but I feel it should be said nevertheless. It’s true that the halacha is different nowadays. The Shulchan Aruch paskened (Orach Chaim 101:1) that one should not daven again if one does not have kavannah the first time. Not because one has already davened, but simply because who says you will have Kavannah the second time either! The halachah has changed but the principle remains the same. Tefillah without kavannah is not tefillah. As the Abarbanel says, prayer without Kavannah is like a body without a soul (Avos 2:13). So how do you have Kavannah – how do you concentrate? There are many ideas that are helpful and I will try to say a few that I find most useful myself. Firstly, language. The Shloh states that a person should daven in a language that

If you feel without hope, ask Him to give it back to you they understand. I’m not necessarily suggesting that one daven Shemoneh Esrei in a language other than Hebrew – though I am by no means saying that one should not either. The Shemoneh Esrei is a difficult prayer to understand. It is tefillah at its highest potential level and while I could talk about how to pray it in its most effective way, that would take more than the length of this article. So I want to put the Shemoneh Esrei to one side for a moment and talk about personal prayer instead. Saying your own prayer in your own words in your own language. Chazal tell us that – God wants our hearts (Sanhedrin 106:2) and probably nowhere more so than in tefillah. Prayers that will awaken our hearts are going to be the best ones and usually that happens when those prayers are personalized. The Shaloh again lists in his elements that assist kavannah – chiddush (newness). One must ask for new things or

ask for the old things in new ways. If we are going to say the same set words time and time again, they are bound to lose their meaning to us. There is a way to do this in the context of Shemoneh Esrei, but as I say, that is for another time. For simplicity’s sake, there is another very valuable way of doing this and that is to say one’s own prayers in addition to the formal prayers. Why not go to a quiet room and simply talk to Hashem one on one? It’s a very special thing to do. Sit and explain to Him in detail, why what you want, means so much to you. Why do you want it, why is it important, what are you doing about it yourself to show Him you are serious etc. Just sit and have a chat with your loving and caring Father. It’s so refreshing. Cry if you like, but don’t feel it’s necessary. If you feel pain, ask Him to comfort that pain. If you feel lost, ask Him to help you find yourself. If you feel without hope, ask Him to give it back to you. Maybe ask Him to show you why he is doing this to you. Ask Him for understanding. Ask Him that you are able to change. Ask Him to help you feel closer to him. Maybe don’t even talk at all. Just sit with Him and feel comforted by His presence and His love. The more personal you can make it, the more you can feel the need and express that to Him, the closer you will feel to Him and the more likely He is to respond. In my mind, the key to tefillah is the question of why. Why do you want what you want? The deeper the needs that you can tap into, the more clearly you can clarify the source of the yearning, the more you will feel and the more powerfully you will pray. We all have the ability to send very powerful prayers straight to Hashem. But those prayers must be sourced deeply in our hearts. And when they are, Hashem is close to us, Hashem comforts us and, ultimately, Hashem will answer us also. There is no greater source of comfort in this world; in fact there is really no other source of comfort at all, other than Hashem. So sit down, talk to Him and allow Him to comfort you.

Smile. It is the key that fits the lock of everybody’s heart.

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Medical Focus

THE ROLE OF THE REPRODUCTIVE HORMONES IN BOTH MEN AND WOMEN

IN MEN

• Hormones are chemical messengers secreted by glands • In both men and women, the process of reproduction starts with the Hypothalamus. • The Hypothalamus is a region of the brain which secretes Gonadotrophin Releasing Hormones (GnRH). • GnRH stimulates the Pituitary Gland into secreting Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH).

• FSH and LH are constantly being secreted into the bloodstream. They are transported to the Testes where FSH stimulates growth of the seminiferous tubules and early development of the germ cells which is where sperm are produced. • LH stimulates the secretion of a group of hormones called Androgens. One of these is Testosterone, and is produced by the Leydig cells, which lie between the tubules. • Testosterone is involved in the appearance and maintenance of male sexual characteristics, e.g. a deep voice, muscular body. It also stimulates sperm production.

IN WOMEN During days three to 11 of a 28-day cycle (approximately). • FSH travels in the bloodstream to the ovaries where it makes a number of egg-containing follicles start to grow, and the eggs contained within develop. • As the eggs mature so they release their own hormone, Oestrogen, secreted by the follicle’s granulosa cells. • This rise in Oestrogen signals to the Hypothalamus and Pituitary, that the secretion of FSH should be reduced. • The decrease in this stimulant means that only one follicle, the biggest and most mature, will survive and continue to respond to its effects; all the others shrivel up. • As the follicle grows, so its granulosa cells increase in number, and there is a rise in the level of Oestrogen being secreted into the blood stream. • Oestrogen is responsible for the appearance and maintenance of female sexual characteristics e.g. breasts. It also makes the womb lining (endometrium) grow during the first half of a menstrual cycle. • Oestrogen also has an effect on the cervical mucus, making it amenable to the entry of sperm, allowing the latter a presence at the time of ovulation. • The Hypothalamus and Pituitary judge the time of ovulation by the levels of this Oestrogen. The higher the levels, the larger and more mature the egg. During days 12 to 16 of a 28-day cycle (approximately). • The Hypothalamus will secrete GnRH to stimulate the Pituitary into sending out a surge of LH. • The LH enters the bloodstream and is carried to the ovaries. Here it completes the maturation of the egg, and then instigates the rupturing of its follicle. 53 News & Views VII

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• The egg is released into the Fallopian tube where fertilisation will hopefully take place. • The ruptured follicle turns into Corpus Luteum, which begins secreting the hormones Oestrogen and Progesterone. • Progesterone maintains the womb lining and prepares it for the implantation of a developing embryo. • The immediate increase in Progesterone levels, signal to the Hypothalamus and Pituitary that the output of LH should be reduced. During days 17 to 28 of a 28-day cycle (approximately). If the egg HAS NOT been fertilised: • As the LH levels fall the Corpus Luteum deteriorates, and the progesterone and Oestrogen secretions diminish. And during days one to five of the next 28-day cycle. • This results in the breakdown of the womb lining i.e. a period starts. • The whole process then begins again. During days 17 to 28 of a 28-day cycle (approximately). If the egg HAS been fertilised: • The Embryo’s placenta will secrete the hormone Human Chorionic Gonadotrophin (HCG). • HCG will prevent the Corpus Luteum from deteriorating. • The Corpeus Luteum will continue to produce Oestrogen and Progesterone, and the womb lining will be maintained. • The Embryo implants in the womb lining.

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14/4/08 11:09:33

Personal Experience

“JUST”ADOPT

By M.S.

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Personal Experience

y husband and I are forty eight and forty years old respectively and have been married for fifteen and a half years. We are yet to start a family, having tried the conventional fertility treatments (double figures’ worth) and non conventional routes of treatment, travelled for brochos, segulas, visited kevorim and more. We started our adoption journey some years ago, a year after stopping treatment, as required by the authorities, necessary to demonstrate our full commitment to adoption. Along our journey, people, some friends, some virtual strangers (what right have they?) have bestowed upon us all sorts of comments, recommendations and advice. Anyone who has adopted knows that it is far from being a simple process but depends on the country you adopt from, the social worker on your ‘case’, the waiting time at the government offices, the medical profile of the child or birth mother etc. Each person/couple’s journey will vary. Many years ago, whilst in the middle of grieving over yet another failed treatment we were told rather helpfully/unhelpfully by a very frum man to ‘Just Adopt!’ (as if there is a ‘just’ about it!). This article is for those trying to get some semblance of understanding of what may go on behind the predominantly fake (though thankfully sometimes genuine) smiles and closed doors of the childless couple, as well as for those contemplating adoption themselves. It is not meant in any way to scare or put you off, but simply for you to be prepared, in case you need to be. We chose to adopt from the USA because we wanted to adopt a newborn baby even though we knew that it came with the risk of the birth mother changing her mind up to 48 hours after the birth. This story is unique to the adoption of a newborn baby from the USA. Having been approved in the UK and fully accepted by the USA agency, and after nearly two years of waiting, we were finally matched with a birth mother whose baby was due at the end of last year. We received the call from the agency telling us we had been matched on the day we completed on the sale of our house. The sale of the house we loved and the home that had become a haven for us did not come easily and we were moving to a new town, so this seemed to be a clear sign from Above that we were doing the right thing. Wow! In five months’ time we would at last become a family. Over the following months we emailed and spoke a number of times to the birth parents (unusually, the birth

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father was very much involved) building up a relationship of trust. We, more so than they, had to demonstrate how we could be trusted. Even more unusually, in our case, we met the birth parents and continued to strengthen our relationship after spending a week together. The whole way through they were adamant about not changing their minds and kept reassuring us that this was something they were very clear about. A number of things took place along the way that confirmed to us that this was all ‘meant to be’. We felt like a new lease of life had taken over and whilst at times were nervous, we actually found ourselves getting excited. As we drew ever closer, a c-section was deemed necessary and so we now knew the date by which we had to be in the USA, unless the baby came naturally beforehand. In the final few weeks we bought a few baby things, much against the advice of others who have adopted, and borrowed many essential things from close friends. Finally, I could browse and shop in the baby stores with a wry smile and not just because I was buying another present for someone else. Despite having no bump, I was due in a few weeks! We prepared ourselves, though did not ‘make’ a nursery as this would be a step too far and too dangerous.

I can only communicate by e-mail and text as I just can’t talk without crying We prepared our minds and cleared our diaries of Shabbos and social arrangements as we were about to be very busy ‘enjoying’ sleepless nights…….. We checked out flights and apart-hotels to rent, though did not make any firm bookings yet. I went stroller shopping with a friend but of course did not buy. I said I would never do any of this until the birth mother had ‘signed’ and the baby was legally in my/our arms, but somehow I let go and let the excitement at becoming a parent take over, a little. It was a Tuesday afternoon, a week before the baby was due, I was making sure our bedroom was ‘ready’ when my husband popped home at an odd hour. He wasn’t due home for another two hours. I was so happy to see him and wondered what he wanted or had left at home. He came upstairs and delivered the news that the birth parents had changed their minds

and decided to parent the child themselves. He held me tight and we both sobbed. We were sick to the very core. We were devastated. A month on and we are still devastated! If there were so many signs that this was ‘meant to be,’ then how could Hashem do this to us and after all this time? What trickery! How can this be happening? Although my husband doesn’t see it this way I feel that we have been played for fools by Hashem! We have to tell our friends. I can only communicate by e-mail and text as I just can’t talk without crying. This has gone on for some weeks! We are ‘empty’, shattered, and the new lows that I in particular have found seem to surpass those reached after each failed treatment, and yet I know at some point I/we will recover. We go off on another holiday. We close down on the world. We put on brave faces, when we can. We deal with our grief. Our GP and close friends have been amazing. I have never felt so distant from Hashem and don’t know how my husband makes it to davening. I can’t face people most of the time but entertain and accept invitations on Shabbos to try and keep myself functioning and to return to ‘normal’. I know I will get over this, but it’s so hard right now. I have to hang in there despite one friend telling me that since we’ve had so many setbacks, perhaps we should have read the signs years ago and not pursued our journey any further, accepting our fate not to be parents! I guess she’s entitled to her view, though I don’t think she needed to verbalise it. I still have a bit more fight in me and HOPE, I leave the praying to my husband at the moment, as I cannot, that we will soon have that happy ending we have pursued for so long! So you see, there really is NO ‘JUST ADOPT’ about it. Six weeks after that phone call from the agency telling us it was all off we are still struggling. We have paid the agency (a very reputable and well established one-don’t worry) the full amount now, over a year and a half period, and it’s not so straight forward therefore to just switch to another country or agency, if that’s what you are thinking. Enough people have suggested it as they think it’s just so straightforward, like taking a dress back to a retailer to get your money back. After all, when you are approved, you are approved to adopt a child of a certain age span, from a certain country, using a certain agency. We continue to wait……… News & Views VII 55

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Personal Experience

hardly knew her. Miriam was a thirtysomething professional - we sat in the same office, and had worked side-byside for about a year. She was always very nice, intelligent and charming, but we were never close since she lived in another community and we didn’t travel in the same circles. I guess we were just so busy with our own lives, and since our lives were so different, they never coincided. While we really enjoyed working together; talking about this and that, we just never had all that much in common: After all, her whole world seemed to revolve around her work, whereas my career was my family; with the office but a small part of my life. I’d always thought she was happy: everything in her life was going just as she’d planned - she loved her job and was advancing up the corporate ladder, she had a caring and successful husband, and they had just bought a beautiful home. Everything was going right. Everything was perfect. Or so I thought. And then, one day, out of the clear blue, as we stood around the coffee machine, she suddenly burst into tears. Startled, I tried to calm her, and when she felt a bit better she poured her heart out to me. Everything was going right in her life... except for one thing. She was not getting pregnant. Miriam told me she and her husband had been trying to conceive, never expecting any problems, but after trying for over two years - nothing had happened. At first they’d laughed it off as ‘work-induced stress’, but after a while they realised it was a more serious problem. And so, while everything else was going so well, this one thing was certainly not. And this one thing was what they desired more than anything else. “I thought of nothing else,” she recalled to me. “I would be sitting in a meeting with a client and would be thinking about having babies. I remember once, one of our coworkers made an innocent remark about going away for the weekend with her husband and leaving the kids with her mother. She was nervous about the kids missing her, and about her mothers’ ability to cope with three little ones. She smiled at me and said, ‘You are so lucky you don’t have these problems.’ I gritted my teeth, smiled at her, and then went to the bathroom and cried for two hours.” I felt so terrible that someone said that to her, and then realized how easily I could have been the one to have. What had I said in the past? How had I been insensitive? It never even occurred to me that this was a

FACE TO FACE WITH INFERTILITY By Leah Weitz-Cohen

painful topic. Never having had any inkling that she struggled with fertility problems (in truth, never having realised that anyone struggled with fertility problems) I was not aware of what a painful issue it was in so many lives. I was taken aback - here I had worked next to this young woman for a year, we’d chatted casually about all kinds of things, and I had had the feeling that her life was proceeding just as she’d planned. Yet all along she’d been feeling deep-down miserable, and just hiding it well. And then, one day, over coffee, she could keep it in no longer - out it poured...and to someone she barely knew! At first I didn’t know how to react. Ironically, I had always been a bit intimidated by her. Miriam was a real powerhouse. Next to her, such a successful career woman, I felt like an ordinary housewife. Little did I know that it was what I had that she valued most. But Miriam seemed to need someone to confide in, someone objective and somewhat removed from her personal life; and I had a responsibility to listen. While I did not know why she picked me, I figured that if she had, I owed it to her to try and help in whatever way I could. She told me she had started seeing a medical professional, a fertility specialist, who kept sending her for more and more tests - with no results.

“I was overwhelmed; I would go to the doctor’s office to do an ultrasound test to see when I was ovulating, and then rush to work. Many times I came late, and though the boss was very understanding I felt bad having to explain to him and to all my co-workers why I was always late and often grumpy. And then when I started on medication I felt worse physically, as well. And after all that, I would get my period - I was a total nervous wreck.”

What had I said in the past? How had I been insensitive? But just getting to a doctor, she explained, is not enough. Apparently each doctor has a specific speciality, and a doctor who helps one couple may not be able to help another. Miriam said she’s met many couples who spent endless hours pursuing unsuitable doctors and inappropriate, timeconsuming, anxiety-provoking treatments. Sometimes they would wait for months just to get to see a particular doctor only to be told that they should stop trying, that they were too old to conceive. “You just don’t know what to do, who to talk to”, she said. “And I couldn’t speak about it with anyone around me - my immediate family felt bad for us, didn’t want to bring up the subject at all; my younger

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Personal Experience

sister was wrapped up in her own kids; and it was obviously too personal a matter to discuss with professional colleagues. All my friends either had their own children to keep them busy, or weren’t even interested in becoming pregnant... and they certainly didn’t want to hear about my troubles. I felt all alone, as though I was the only person in the world with such problems - I had no one to turn to.” Well... I was certainly flattered that she’d decided to confide in me, a virtual stranger - it must have been an act of sheer desperation on her part. But I was also flabbergasted: here was a problem I personally - thankfully - had known little about, an issue which, for many, is all-consuming and even life-determining. In retrospect, of course, I should have realised how overwhelmingly difficult it must be to have trouble conceiving, especially in our community. After all, Judaism places incredible value on family life and raising children. And it is impossible not to have your life revolve around your children once you have them. From the moment of conception on, your lives are forever changed. I’m ashamed to admit I’d not really given the whole subject of infertility much thought. I guess I had just taken it for granted that people had babies when they chose to. Once Miriam and I started speaking, I began to wonder who else I knew who might have 57 News & Views VII

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been affected. It had never occurred to me, that maybe some people that I thought just must not have wanted, might have very badly wanted children and couldn’t have them. I never thought to be sensitive when meeting someone and immediately asking, “So, how many children do you have?” I started wondering how many people might have extremely painful stories to relate about my thoughtlessness.

One in six of all couples may have problems with fertility at some point during their married life The first thing I did after Miriam and I spoke was to search the computer to learn more about infertility. Sadly, Miriam and her husband are far from the only ones - they are just one of the thousands of couples who experience problems conceiving. In fact, about one in six of all couples may have problems with fertility at some point during their married life. And it appears that the numbers only increase as the couple gets older. This means that around 15% of couples may not become pregnant after trying for twelve months. Some will subsequently conceive without any intervention, but most will require some

medical assistance. It is unfortunately a rather widespread problem affecting many...and I was basically unaware. A few months after the ‘coffee-machine incident’, Miriam arrived in the office one day looking much more at peace than I’d seen her in a long time. She had finally found a medical professional whom she trusted, one who was a source of tremendous emotional support and comfort for her and her husband and was guiding them through the entire process of fertility treatments. He was helping them put things into perspective and regain control of their lives. With the positive feedback she was now receiving, she was continuing treatment with greater confidence and a renewed sense of hope. Miriam continues to thank me for ‘’being there’ when she needed me; the truth is, I have learned a lot from her and have a lot to thank her for. I have learned to be more aware, to open my ears and my heart to others. And if someone should choose to confide in me and to express her feelings, or if someone just appears to be overwhelmed and in need of some support, I will try my best to listen, to let her speak freely of her frustrations and disappointments. Because of Miriam I have started volunteering at a centre for couples with fertility problems, sharing with these people their hopes and concerns. There are hundreds of couples like Miriam and her husband, most suffering in pain and in silence. They may well be our neighbours, our friends, people we go to synagogue with; and we may often be oblivious, or insensitive, or too absorbed in our own lives to share their worries. Through this incident, I have become determined to help, in any way I can. And not just by providing information about infertility to those who suffer from it, but to those who fortunately don’t, so that they will hopefully become a source of support and strength to those who do, rather than a source of pain and sorrow. Most importantly, I have learned to count my blessings and never to take anything for granted. I hope and pray that one day I will be able to join in the happiness of Miriam and her husband, as well as the other families trying to conceive, so that I can be there when they do become pregnant, and give birth to a healthy baby, and gratefully welcome a little one into their homes. Reprinted with kind permission from www.TheJewishWoman.org a project of www.Chabad.org. The Jewish Woman is a site dedicated to providing Jewish women of all backgrounds intellectually challenging, emotionally uplifting and inspirationally stimulating articles.

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Regular Features

WELL WOMAN HELPLINE Do you have a question about your reproductive health and wellbeing? The Well Woman Helpline offers you the opportunity to telephone in confidence, and obtain answers to these questions, clarify your concerns, discuss a medical procedure, or find out when to ask for a second medical opinion. A sensitive and discrete professional counsellor will answer your query and offer support on a range of issues including irregular cycles, miscarriage, hormone imbalance, early menopause, PMS, fibroids and general gynaecological well-being. Through the Well Woman helpline you can access specialist medical information via the consultants and medical professionals of CHANA’s Medical Advisory Panel.

The Helpline is manned at the following hours: MONDAY 11:00 – 13:00 TUESDAY 09:30 – 12:30 WEDNESDAY 13:00 – 18:00 THURSDAY 10:00 – 12:00 At others times you may leave a message and a counsellor will get back to you. The CHANA Well Woman Helpline number is 020 8201 7101.

WELL WOMEN EVENTS IS IT MY HORMONES OR IS IT ME? Oct. 2006 – NW London. July 2007 – Edgware. Mr Nick Panay, Consultant Gynaecologist, Queens Charlotte’s & Chelsea Hospital, Director of the West London Menopause & PMS Centre.

THE LOW GI DIET – CAN IT REALLY HELP ME? Jan. 2007 – NW London. 10 March 2008 - Stamford Hill Professor N Farid - Consultant Endocrinologist & General Physician. Leanne Green - Dietician.

Two opportunities to hear Mr. Panay speak about understanding how your hormones affect you at various stages including pregnancy, post pregnancy, pre-menopause, early menopause, as well as living with PMS.

The presenters spoke about the Low GI Diet and how it can be helpful for a number of conditions including Diabetes, PCOS, Pre-Menopause & Hormonal Irregularity, offering recent research and practical information.

IS STRESS WEARING YOU DOWN? Nov. 2006 – Barnet. Sharing thoughts on preventing and coping with stress were a panel consisting of: Donna Abraham - Cranial Therapist Carolyn Cohen - Counsellor David Uri - Hypnotherapist Nadine Fox - Therapeutic Massage Valerie Landenberg - Homeopath Each professional looked at a different angle of how stress can affect individuals both physically and emotionally.

Obesity / Anorexia HOW DO I FIND THE RIGHT NUTRITIONAL BALANCE FOR ME & MY FAMILY? Nov. 2007 – Edgware. 5 February 2008 - Bushey Dr Marilyn Glenville, FRSM, PhD. Author of numerous books and publications. Dr Glenville spoke about nutrition and diet and its impact on various aspects of health, including reproductive health.

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Medical Focus

COMING OUT OF THE SHELL ASSISTED HATCHING

The actual number of embryos transferred will depend on a variety of factors such as age, the reason for infertility and the number of previous, failed treatment cycles

In some cases IVF failure may be due to a hardening of the shell of the egg preventing the embryo breaking free and attaching itself to the womb. Many people undergo repeated cycles of IVF treatment with no success. Added to the frustration of failure is the inability of ‘the experts’ to determine the reason for failure, particularly when up to two ‘good quality’ embryos have been transferred into the womb and, in some cases, additional embryos have been frozen and stored. During the course of IVF treatment a number of embryos are generated in the laboratory to transfer back into the womb. Two embryos are usually transferred as this optimises the chance of the treatment resulting in a pregnancy. The actual number of embryos transferred will depend on a variety of factors such as age, the reason for infertility and the number of previous, failed treatment cycles. The shell of the egg or the ‘zona pellucida’ has a protective role. It has a rigid structure which protects the main body of the egg, and the genetic material within, from damage. It also prevents more than one spermatozoon from penetrating the egg, in order to ensure that the resulting embryo has the correct amount of genetic material. However, once fertilisation has occurred and the embryo is five or six days old, the shell becomes superfluous and its presence interferes with the continued development of the embryo.

IMPLANTATION For pregnancy to occur, the embryos must continue to develop inside the womb. Thus, three or four days after the embryo transfer they must ‘hatch’ free of the shell and stick to the lining of the womb; this process is referred to as implantation. Some studies have suggested that a possible reason for the failure of embryos to implant following IVF treatment may be the inability of embryos to undergo this ‘hatching’ process, possibly due to a hardening of the shell of the egg. A laboratory-based procedure called ‘Assisted Hatching’ helps improve the chance of embryos sticking to the lining of the womb. This is achieved by thinning or making a small hole in the shell of the embryo. There are several ways in which this can be achieved and the technique used (chemical solution of laser) will depend on your clinic. Assisted hatching is carried out in many centres around the world. The Cochrane review concludes some evidence of improved chances of pregnancy in women who have been repeatedly unsuccessful but more research is needed. There is insufficient evidence to determine any effect on live birth rates. Assisted Hatching improves the success rate of implantation of viable embryos as quoted by the – Cochrane Library review (last amended August 2005) The HFEA says that so far safety and outcome data is fairly limited. However results to date indicate that babies born following IVF with Assisted Hatching are no more likely to be born with abnormality than those using IVF without assisted Hatching, However, there is an increase risk of monozygotic twinning following this technique and hence more multiple births.

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Poem

TODAY If I don’t smile when you meet me today, Don’t judge me wrongly and walk away. Sometimes I am good at concealing my grief, I’ll dress in my smile and mask what’s beneath. Sometimes I know how to put on an act, But today I can’t fake it; my smile has cracked. My world is caving in; I am falling apart, I can’t face your world with this hole in my heart. No one can fathom the anguish I feel, No one can tell me this suffering will heal. No one can know what it means to be me, No one can share in what I have to be. But please, do not give up while I need to hide, Only wait a bit longer; this pain will subside, And when I feel stronger I will answer the phone, It is just I need space now to be on my own. In these fragile times when I am low for a while, Please don’t judge my emotions which wipe out my smile.

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Life Perspectives

DON’T TELL ME TO CHEER UP O

ften as a rabbi I am surprised how things I say are remembered with appreciation by the hearer long after I have forgotten having said those words. I have come to realize that one just doesn’t truly know the effects of one’s utterances. Sometimes it takes years, even decades, before one learns how touched someone was by a few thoughtful remarks. I have met people all over the world who repeat to me something significant that I had said to them, which I had thought nothing of at the time. A recent example of that was the response I received to an article I supplied upon request to a major Jewish website called Chabad.org.. My message to you – and to myself – is to keep sharing warm, positive and inspiring words, because the effects are amazing, even if you don’t always know of them. Here goes: You are walking down the street when you pass an old friend whose head is down, a deep frown etched on her face. You instinctively say to her “cheer up,” hoping to lift her spirits. Well, it won’t. It will, however, make her angry, frustrated and more depressed. You are being an insensitive boor and you don’t even know it. If that’s all you’ve got to say, keep quiet and offer a friendly smile, not a trite comment. If I am going through a hard time I don’t want someone to tell me to be cheerful - I want someone to understand why I am miserable. “Cheer up” implies that I have no reason for feeling bad. Let’s face it: chances are that I’m not sad for the sheer fun of it. Something is obviously troubling me, causing me to be melancholy. Telling me to cheer up is effectively denying me the right to feel upset about it. Imagine the burden I now carry: I not only have a worrying problem, I’m not even allowed to feel bad about it! It is also an insult to imply that becoming cheerful is simple and easy. It is like saying, “What’s wrong with you? Pull yourself together.” When someone is depressed - over finances, a troubled marriage, or whatever - the last thing they want is to be made to feel inadequate for feeling low. If it were that easy for them they would have cheered up without your sage advice. Take a leaf out of the book of the biblical Joseph. He was languishing in an Egyptian jail with two of Pharaoh’s ministers when one morning he notices they are in a foul mood. What does Joseph tell them? Does he tell them “chin up”? Actually, he doesn’t tell them anything - instead he asks them a question: “Why are you sad today?” which is their cue to unburden themselves to Joseph. Joseph did something very profound: he didn’t tell them how to feel; instead he gave them an opportunity to talk about their problems. Joseph realized that in 99% of cases 61 News & Views VII

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people are upset for a reason. The way to help them is to encourage them to talk about the problem and to help them work towards a solution. So on the next occasion that you are tempted to tell another to “cheer up” consider that perhaps you are merely furthering his or her misery with your insensitive remark. Here is a simple rule: when something is the matter with another person, it is almost always better for them to do the talking, not you. Whatever your huge brain conjures up will almost certainly be irrelevant, and potentially offensive. When you ask someone, “How are you?” are you really prepared to wait for the answer? That is the real reason we say “cheer up” – it is quick and easy. We convince ourselves that with our nugget of wisdom we have done our part for humanity, while in reality the recipient of your brilliant aphorism is bursting inside, “I hate you for saying that!” Remember, once the words have gone out, they cannot be put back in. Maimonides wisely advised not to say anything without reviewing it in one’s own mind three or four times. On these occasions five or six would not be amiss, and assiduously observe the rule: if in doubt say naught. If you care about someone going through a rough patch, find some time to listen. If you are not good at listening, offer a hug or–very Jewishly–a cake...

By Rabbi Yossi Ives taken from his forthcoming book There Must be a Better Way: Life Coaching Strategies for Successful Living.

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Personal Experience

A DAUNTING DETOUR (AN INSIGHT INTO THE PGD WORLD)

s we boarded the train I reflected on my journey so far. After nearly three years of marriage, we were finally on our way for an induction appointment for our long awaited IVF cycle. Of course I was nervous, yet I told myself that nothing too terrible was going to happen that day. At most they would just draw some blood. Other members of the infertility world would have considered us lucky. We knew what the problem was. We knew we needed PGD. The doctors had hopes that the cycle had more of a chance of being successful. Our combined test results were quite good. We were a determined couple and we had set about the process of starting treat-

ment with high hopes. There were many tests to be taken before we started, all part of the PGD protocol. After the last test result, we were “promised” a cycle within a year. That wasn’t so bad. We had been married for just over two years married. However because of some silly technicalities our referral was delayed by several months. Finally after persistent phone calls the clinic managed to offer us a cancellation. If we were unable to attend, the next availability would be seven weeks later! Of course we jumped at the opportunity. The clinic assured us that they could offer us a cycle two months later (Pesach time, HELP!). Wow! Things were finally moving along… what could be better? PGD is complicated and specialised. Although the clinic near to us is a highly

rated clinic, our problems were too specialised for them to deal with adequately. We were referred to a major clinic quite a distant from our home. And so we travelled the long distance to the hospital. I remember taking in all the scenes. This hospital was to be our home away from home (well, sort of). We arrived early for our appointment. Incidentally we were called in ten minutes later. We entered the room, a smiling couple – yet emerged some two hours later disappointed and confused. To be honest, I was shocked!! What transpired in those two hours had shattered our very dreams and hopes. Where we thought we had answers, there was enigma. Where we thought we could be helped, there was uncertainty. A cycle in two months’ time was out of the ques-

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Personal Experience

induction for PGD. In this case an entirely different set of rules came into play. It began quite smoothly. We were asked if we knew what IVF entailed. I answered in the affirmative. This was followed by a brief explanation of PGD. (I must admit that it was rather fascinating). Afterwards, we were asked for a detailed family history, which was recorded. This was when the trouble began. (Well, that’s how it seemed to us). We felt as if we were undergoing an FBI investigation. They wanted to know everything! Any family history (including extended family) was recorded along with any accompanying illness, condition or assumption of a condition. The focus of the interrogation shifted from family history to individual history – namely myself. They were very concerned about a group of isolated symptoms which I possessed. Furthermore they were unhappy with the slight asymmetry of my body. In addition there was a strong possibility of a congenital abnormality, which I would have never known about had I not gone to an evaluation less than a year ago. This last fact caused the alarm bells to really ring! They duly informed us that they could not proceed as planned. They had a responsibility because they were carrying out PGD. (I later mustered up the courage to ask them, “Isn’t there a Creator in all this?”) They understood that we needed PGD for

However because of some silly technicalities our referral was delayed by several months tion. It would be another four to six months at least. Even then, this new waiting period could only determine whether we could even actually do the treatment. What had happened that changed our prognosis? The truth is I am not so sure. I can tell you part of what happened. I do not want to go into full detail as I wish to remain anonymous. We had come to our appointment with the notion that it was an “induction” to treatment. We were wrong. I can vaguely recall how a woman related to me about her induction meeting, where many couples contemplating treatment attend a large group lecture. We assumed that our appointment would be something similar. What we were not prepared for was that this was an 63 News & Views VII

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a certain condition, but given the family background they could not proceed without a further round of gruelling investigations. Firstly, they were concerned about a condition in my family. They were afraid that IVF treatment could significantly raise the risk of me developing this disorder. I argued with them that I was more at risk having never yet been pregnant. My arguments fell on deaf ears. No matter what I said they were still concerned. Secondly, they began drawing conclusions from isolated symptoms and my mild facial imbalance. I could have a very serious chromosomal disorder. This could have serious ramifications for me as well as for our future children – a 50% chance of bearing a child who could be so severely ill it would not live long.

I argued all I could. I told them point blank that they were drawing conclusions which had no findings. There was a valid medical explanation for all my symptoms including the lopsidedness. I also had scans and medical reports to prove this. Again, try as I might, they were dissatisfied with any explanation. They told us all my symptoms I was experiencing were legitimate. However, they still had reason to believe that I possessed this terrifying disorder but they would not give me a diagnosis. The rest of the discussion was more of a daze for me. They gave a further explanation on the process of isolating genetic markers. They also explained once more about the PGD cycle and procedures. At the conclusion of the two-hour appointment they reiterated their concerns. I still continued to argue my case. In the end they acceded to discussing the kit and caboodle of our story with another professional before requesting us to undergo the genetic screening. It would be another 4-6 months before any treatment could begin and “to top it off with a cherry” there was no guarantee that we would even be offered a cycle. Surprisingly, we left in pretty good spirits. I think it was because it just didn’t sink in. We spent some quality time together and then headed back on our long journey home. Life continued pretty normally for six more days. Less than a week following our appointment we received a very crushing letter from the hospital. I had actually been looking forward to this day. There was a lovely performance scheduled for that evening. I was also busy with meal preparations for a few families that needed help – I was feeling accomplished. I noticed the letter at dinner time but I had no time then to read it, so I left it on the table and rushed back to work. I returned home in the afternoon when I saw the letter unread. The letter stated things more bleakly and more concisely than the professionals had done on our appointment day. It restated that we might not be able to be helped. There was a very strong possibility that we could have children with severe abnormalities. Furthermore treatment could have a very adverse effect on my health. It had finally hit home. It hit really hard. My whole being trembled and shook. My sobs wracked the very core of my soul. I cried out in anguish to Hakadosh Baruch Hu, “YOU CAN’T TELL ME NO BABY! YOU CAN’T TELL ME NO BABY! It can’t be hopeless. It just can’t. I’M SCARED! News & Views VII 63

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Personal Experience

I’m afraid to find these things out.” I just cried and cried. Somehow I mustered up the strength to dial our Rav, our Daas Torah. Through choked sobs I explained the prognosis detailed by the hospital. I also asked how far one must go with this genetic business. Where do we draw the line? I told the Rav I was afraid to know the results of the testing. “Tell me”, he said in his grandfatherly way, “Will the hospital refuse to offer you the treatment if you do not go ahead with the genetic testing?” I answered in the affirmative. “Then I’m afraid that you must agree to go ahead with the testing.” “Okay”, I sobbed, “I will tell them that we agree to go ahead with the genetic testing, but I don’t want to be told that I can’t have a baby because of a rare chromosomal disorder.” “Don’t worry. I’m telling you that there are ways around these things.” Our Rav reassured me that Klal Yisroel are above statistics and that nothing is hopeless. The NHS likes to cover themselves so they paint a very bleak picture. “I don’t think things are as bad as they are putting it” he added. I asked the Rav if it was necessary for me to find out if I was at risk for a particular condition. He reiterated that should the hospital refuse treatment, I would need to comply even though it would be emotionally difficult for me. He gave me a Bracha that I should be able to handle this knowledge well. He told me not to worry and that I should have Bitachon that things will work out Be’ezras Hashem. He gave us some heartfelt Brochos and urged me to inform him of the results. I was strengthened by his words but I was still crying. I noticed the cake batter on the parve surface through my tears. I still had my duties. I completed the cake with an ad-

ditional round of sobbing. I then tried really hard to pull myself together. The ladies would be picking me up shortly to see the performance and I couldn’t be in a state. The performance was just the thing I needed. I was able to forget the possible bleakness of our situation and allowed myself to be transported to a lovely fantasy world. I thanked Hashem for coordinating the arrival of the letter with the day of the performance. The show was much-needed therapy.

We felt as if we were undergoing an FBI investigation The first week or so after I received the letter was very trying for me. Try as I might to emulate the Rav’s words; “Don’t worry”, I couldn’t. I cried and cried. The pain was so real. I realised why this time was all the more difficult. We had been through other tests in the past. The worst-case scenario was painted for us each time. Why didn’t it hurt so much then? Because with all of the other tests, statistics and percentages were the concern. We could always rely on the fact that we were quite likely a part of the better percentage. However, this time they were talking about our outcomes as a couple. We had no comparisons. They were deeming our situation as possibly hopeless, with no help to offer. It was terrifying. IT HURT! I thought I would never pull through the next four months. There were times when I thought I would collapse. I recall a time when everywhere I looked there were babies in pushchairs. I cried out: Why is it that some mothers are given so many children and yet I am denied even one? I then became angry at myself for harbouring these thoughts. After some reflection I realised that I had to forgive myself for thinking

this way. I was in a moment of severe pain. I then began to appreciate that there is another dimension to “Tzaddik ve’ra lo”. We can’t understand the ways of Hashem – why some people are given many children when other potential parents are denied. Hakadosh Baruch Hu sent a fair share of activities my way to keep me occupied. I punched out my frustration many times whilst kneading Challah dough, which was shared out amongst needy families for Shabbos. I cooked meals and helped others in difficult situations. It was good therapy for me. I realised over time that I was indeed pulling through. Did I break down in tears? Yes, many times. There were so many times when I felt that I just could never believe in the impossible. Yet somehow I recognised strength within me which I never knew I possessed. I also learned how to take things day by day. Finally the appointment letter to see the geneticist arrived. Although I was dreading this, I was also relieved that things were moving forward again – it wasn’t checkmate. I begged my husband to come along with me. I desperately needed his support. I also was not looking forward to being looked upon as a set of symptoms and anomalies instead of as a human being. Surprisingly, the geneticist was a kind lady with a pleasant manner. She put me at ease straight away. She raised the same concerns as the hospital did – but she was optimistic. She also respected me as a person, not some strange creature from Planet Mars. However, it wasn’t easy being scrutinised from head to toe in order to pinpoint all possible abnormalities and deformities. I coped with it because I realised that this doctor respected the Tzelem Elokim in a person even though that person could be a genetic mutant. She also respected what I had to say for myself. She reassured me that all these

There was a valid medical explanation for all my symptoms including the lopsidedness symptoms and abnormalities were due to my already-diagnosed conditions (which are all not genetic). However, there were two indications that strongly suggested a rare chromosomal disorder. I suggested a name for the disorder. Her eyes lit up. “Yes, that’s the one, how did you know?” 64 News & Views VII

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Personal Experience

I told her that I had come across information for this disorder during a search for medical information to help someone in need. (My knowledge of the disorder helped me cope too. I realised that some of the hospital’s conclusions were unfounded. This kept me going. How strange it is to help yourself by helping someone else!) We then discussed the familial risk factor. Yes, unfortunately it was quite likely to be genetic. However, there was no proven study that IVF had an adverse effect if one had it. Also, it wasn’t necessary to know if I was indeed at risk during the childbearing years. We had to wait five and a half weeks for the test results, instead of three. It was not easy! It was very beneficial that we went away for some of that time. However, during our stay, I learned the hard news that the condition in the family was indeed genetic. When we returned home, I phoned the geneticist’s secretary. I dictated my message to the specialist. When I began saying over the name of the faulty gene, the secretary interrupted me. “Just one minute, let me transfer you to the doctor.” I was stunned. This never happened to me before. Once again the geneticist gave me her time; this time on the phone. We arranged another appointment. I felt like everything was happening too fast. I was afraid to know the outcome of these next test results. Subsequently, a letter arrived stating that all my chromosomes were normal. We were overjoyed! Chasdei Hashem! However, the hospital was still worried about a possibility of a genetic predisposition and its effects on IVF. “You can’t win!”, I muttered. I went to my second genetic screening appointment. The geneticist had had a long talk with the health professional at the hospital in order to verify exactly what they were concerned about – how generous! She began the session by explaining to me that given the new information that I had gleaned about a definitive genetic predisposition in my family, this was sufficient. I did not need to undergo further screening. She enumerated the concerns of the hospital. They wanted to ensure that I was fully aware of the ramifications of this possible predisposition. They also wanted to ensure that I had a strong support system should Chas V’Shalom it become needed. They also wanted us to see a fertility guidance counsellor to discuss all of these issues. I left the surgery with mixed feelings. On the one hand, I was so grateful that I had 65 News & Views VII

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normal chromosomes. I was also glad that I was spared some very difficult knowledge. However, I was equally flustered because I felt we were really being taken for a ride. Even after this awful testing, the end just did not seem in sight. No matter what we did, the hospital was still not happy with us. I discussed my frustration with my CHANA support worker. She also voiced her annoyance. Somehow in the midst of our conversation she remembered that there was a Frum specialist who worked at our hospital. She asked me permission to speak to this specialist about us. I finally felt that I could see the light at the end of this dark tunnel.

Through choked sobs I explained the prognosis detailed by the hospital Two days later, it seemed as if we had been hit by a domino effect. First, there was a message from our coordinator at the hospital saying that we may finally get an appointment. I had just finished listening to the message when the telephone rang. It was the IVF coordinator from the hospital on the line. She told me that somebody had approached them about our case and they had agreed to grant us an appointment. She then confirmed that we needed two appointments, one week apart. I then was in a frenzy making train bookings and arranging accommodation. The appointment letter arrived for us to meet the guidance counsellor, which would be followed by preliminary blood work that is necessary before starting a cycle. That meant they were finally willing to treat me! Chasdei Hashem! We were brimming with happiness and sighing with great relief. I would like to sign off now. I must mention here that I was quite reluctant to share “Our Daunting Detour” with others. However, our unique experience taught us that there must be others out there in a similar situation. They too need Chizuk. To all people out there, I would like to say, “Don’t let the NHS (or any other medical establishment) let you down!” They may give the worst possible prognosis merely to cover themselves and save their own skin. We must remember, “Ein Mazal L’Yisrael” – we Jews are not bound by the laws of fate. There is always hope! Another reason which drove me to write this article is that part of our ordeal is the fact that PGD is still relatively new and

therefore we were not pre warned of the standard procedures of a PGD cycle. It is very different from an IVF cycle. The experience can be harrowing. It would have been a tremendous help to have known beforehand that a PGD clinic can take a very thorough family history and that if they do, they can harp on about every detail. This experience can be rather frightening – as it was for us. I do not wish our experience on anyone. However, if you do need to go down the route of PGD, I hope our story helps you to feel a bit more prepared than we did. Hang onto your rope! Hold on real tight! Get a good circle of support - you really do need it! Also, although the reason for needing PGD can be quite unique and personal, try to share your experiences with a few people you can trust. It will help you pull through. (I obviously don’t mean all the nitty gritty details but enough that you can feel emotionally satisfied.) Don’t be afraid to ask any question whatsoever and do your own research. Hopefully you will be able to sail through more smoothly than we did. It has been a year since that terrifying appointment. It looks like I may start a cycle soon. I’m scared of the prospect of being a pin cushion. Yet I realise that it is far worse to be deemed hopeless by one of the top hospitals in the country and never be given a chance. So we ask ourselves “was it really necessary for us to go through all this trauma when in fact I do not have the condition that the doctors were concerned about”? For some reason this “daunting detour” was necessary. We will never fully understand why. Yet I learned a lot from it. I learned how much a medically intervened treatment is truly in the hands of Hakadosh Baruch Hu. I realised that there is a lot which we do not know. We thought we had everything going for us, yet we were deemed as possibly hopeless. Also, I realised that I had strengths I never knew I had. I learned to stop anticipating treatment and get worked up for nothing. I learned to appreciate that everything has its time. I learned to live each moment and to appreciate the gifts that I do have. I also think that our experience has drawn us closer together and has helped us to become better people. I will conclude that this is a happy story. I know it didn’t end yet with a baby or a successful cycle. However, it shows that with the power of Emunas Chachamim and a good dose of Bitachon, we can pull through the darkest tunnel and emerge triumphant. News & Views VII 65

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Personal Experience

THE POWER OF HOPE By S.Q.

ertility is something every woman is assumed to possess. There are usually no symptoms of infertility before one needs one’s body to perform. Besides, for all of life’s health issues that come along once in a while to the healthy adult (flu, the yearly cold, or a common virus going around), there is normally an easy solution. Taking a course of antibiotics if needed usually does the trick and in a week or so all is fine once again. Infertility? “No that would never happen to me” the young kallah thinks. Indeed for most newly weds it doesn’t even cross their minds. Infertility - that’s something that happens to other people. Then after a while the months turn into years, new kallahs come along and are soon blessed with precious little ones and reality finally hits. It’s been two years now... maybe just maybe its time to ask a sheiloh to see a doctor and get tested to see if all is as it should be. Maybe it’s something small that can be fixed. How common is infertility anyway? The answer is very. Statistics tell us its one in six! That means for every six kallahs on average one will have trouble conceiving. More importantly, the figures also tell us that we are not alone.

“No that would never happen to me” the young kallah thinks Many other women have to struggle with this “shameful” secret of their inability to become a fully fledged woman - a mother, thus, finally completing their childhood dreams (after being a kallah of course). As we nursed our dolls and played house and dressing up we thought one day we could do it all for real. Today however, as reality strikes, it seems not all our dreams are not going to be as easy as we envisioned. Weren’t we supposed to find our bashert, marry, have our own homes and raise wonderful families just like that? Wait just a minute, I don’t recall any medication being involved, no pricking myself with needles for six weeks, side effects and still having to hope for the best. That wasn’t in my domestic blissful fantasy and I’m sure it wasn’t in yours. However as the saying goes “when life hands you lemons, make lemonade,” and what exactly does that mean anyway? It means when things don’t work out as planned (in this case our bodies not working as they should), let us grow from 66 News & Views VII

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Poem

that experience. Let us make something positive come out of this “bump in the road”. The road of life is not always smooth. Life’s nisyonos help us to find our inner strength by being strong in order to overcome them with the help of our emunah. Hashem is always there for us (as we know) whether we understand why this challenge has been thrown our way or not. As Rabbi Akiva states in Pirkei Avos (3:19) “All is foreseen, but freedom of choice is given…” Whatever is meant to happen will happen. It is only our reaction to it that we can choose.

A LIFE POEM Life can seem ungrateful and not always kind. Life can pull at your heartstrings and play with your mind...

Whatever is meant to happen will happen. It is only our reaction to it that we can choose

Life can be blissful and happy and free...

The way may be hard and seem impossible but we are required to try. Even though we’ve tried and hoped so many times before as long as there is physically a (safe) chance, however minute we perceive it to be, we are not permitted to desist form the struggle. Often success comes when we least expect it. There is of course the well known story of Sarah Imeinu who was long past her childbearing years when she had her son Yitzchok. Even today, there are many modern day nissim of older women having children and those considered by the medical world unable to have children, having them. When we are tired and exhausted, we must never give up hope. Hope is the key that has given the strength to thousands to override many a doctors’ prediction and leave them in awe and speechless. For as we know all that happens in this world is under the control of the Ribbono shel Olam only and no other. There are many tales of hope in times of strife that have even saved lives. In Devarim in Moshe Rabeinu’s song Haazinu (32:7) we are told: “Remember the days of old; reflect upon the years of [other] generations. Ask your father, and he will tell you your elders, and they will inform you,” meaning we can learn from past events for the future. With this in mind I’d like to repeat the following true story I read recently that illustrates the power of hope. This event happened in the 1940’s at the end of the war. One young man, whilst a part of the so called “death marches,” was hit by a bullet in the shoulder. He was already half- starved, tired, cold and weak and was now ready to give up and fall down, where upon he would have been trampled to death. His fellow marcher to his left (a stranger to him,) tied a tourniquet of sorts to stop the bleeding and told him “soon we’ll be safe..” and held him up, so he didn’t fall. The fellow Jew said “see that steeple over there? When we get there we will be free. Just hold on!” When they passed that steeple and still they continued, he said “just one more. keep going…” There were many steeples in this part of Europe and there were many miles for them yet to go. The hope that “just one more” and they would be free gave this marcher the strength to carry on... and live. Both survived the war and became great Rabbonim. Today, Boruch Hashem we are not generally faced with such Nisyonos. However, in our struggles to bring new life into this world, for the first time or after many years of trying, we must try not to give up hope. We cannot afford to lose sight of our goal. It might just be “one more steeple” we need to pass to be free, free of infertility and basking in the joys of motherhood. May Hashem bless us all with the ability to conceive easily and have healthy babies.

Life can overwhelm you and make your head spin...

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Life can put beauty in the things that you see... Life can place challenges right at your feet... Life can make good of the hardships we meet... Life can reward those determined to win... Life can be hurtful and not always fair... Life can surround you with people who care... Life clearly does offer its Up and its Downs... Life’s days can bring you both smiles and frowns... Life teaches us to take the good with the bad... Life is a mixture of happy and sad... So... Take the Life that you have and give it your best... Think positive, be happy let God do the rest... Take the challenges that life has laid at your feet... Take pride and be thankful for each one you meet... To yourself give forgiveness if you stumble and fall... Take each day that is dealt you and give it your all... Take the love that you’re given and return it with care... Have faith that when needed it will always be there... Take time to find the beauty in the things that you see... Take life’s simple pleasures let them set your heart free... The idea here is simply to even the score... As you are met and faced with Life’s Tug of War

Never be afraid to try. Remember the Ark was built by amateurs, the titanic by professionals. News & Views VII 67

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Personal Experience

IS HE YOUR YOUNGEST? By R.S.

Having given birth to two children with relative ease, my husband and I thought that even though we had been trying for another child for nearly two years, there was one problem we surely didn’t have, namely INFERTILITY. I had mentioned something to my GP after a year, but he just dismissed it and told me to just try harder. Although I felt a little angry and out of control, I decided for lack of better knowledge to follow his advice. We were caught completely off guard, as we had always believed that having conceived in the past, we would not encounter any problems trying to have any more children. Although my husband was very upset with our current situation, he believed that if we were to put our trust in G-d and daven harder, the situation would resolve itself. I unfortunately wasn’t able to cope this way and needed urgently to talk to someone and do something about it. I decided to see my GP again, who formally diagnosed me with Secondary Infertility, something I had never really heard about. At first I felt better knowing that I was suffering from a recognised condition and not something that just didn’t make sense. The GP explained to us that the causes of Secondary infertility can

be very similar to those of primary infertility, and that we would need to go through all the relevant tests and then decide how we wanted to move on. However, as the first appointment to the fertility clinic landed in my mail box, I was overcome with all kinds of distressing feelings.

Anger – at not understanding why this was happening to me, when I am perfectly fertile? Guilt – how could I sit at a fertility clinic with women who were still waiting to have a child after five or maybe ten years of trying? Self blame – not being grateful enough for having my two children and questioning myself; why am I so desperate to have more, is it that I just don’t love them enough to be satisfied?

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Life Perspectives

“Nevertheless after much hesitation I decided to phone the CHANA Helpline again not sure of what to expect” I needed to talk to someone, but just didn’t know who to turn to, and was feeling increasingly isolated. I didn’t want to overwhelm my husband with my emotions, as his strength and emunah were a source of comfort that I couldn’t afford to lose. Amongst my friends, I was afraid to say anything as I had children, and on the rare occasion when I mentioned my worries, I was always reminded about others who didn’t have any children yet. It was also difficult for me to socialise. By now my youngest was starting school for most of the day and I couldn’t join my friends in the park or indoor play area. At simchos I felt very left out, when inevitably, the discussion would be about sleepless nights, or the latest mischief the baby had been up to. I also had to cope with comments like “what do you do with yourself all day?!!” or Lady of leisure! I felt caught between two worlds, the primary infertile, and parents of larger families. Nevertheless after much hesitation I decided to phone the CHANA Helpline again not sure of what to expect, as I already had children. When I put the phone down after one hour, I felt that for the first time someone was not judging me or telling me how I should be feeling, but listening to me and validating what I was going through.

I kept in touch with the CHANA Support worker for over a year receiving practical medical advice from her as well as emotional support. Finally, after 6 years and a miscarriage, our beautiful baby girl was born. Thank you CHANA for your time and patience and for acknowledging that the emotional pain of secondary infertility is REAL AND INTENSE.

WHAT ARE THE CAUSES OF SECONDARY INFERTILITY? Secondary infertility can happen at any time and the causes are almost identical to those of primary infertility. Both male and female factors may be involved, and in about one-quarter of the cases the cause is multi-factorial. In just 19% of cases the cause of secondary infertility is not identified, but most of these couples will conceive within three years. It could be possible that there was an underlying health issue such as those listed below, that did not affect conception on the first occasion: • Ovulation disorder caused by polycystic ovaries or PCOs • Damage to the uterus or fallopian tubes caused by endometriosis • Obstruction to fertilisation or implantation caused by fibroids • Damage to the fallopian tubes from a previous ectopic pregnancy • Uterine adhesions, possibly caused by a previous caesarean section • Male reproductive problems • Age could be another important factor in secondary infertility A change in diet and lifestyle can impact on fertility in both men and women. Women who put on excessive weight during pregnancy can develop ovulatory disorders. Excessive exercise, smoking and alcohol are factors that can affect male fertility. The treatments for secondary infertility are the same as for primary infertility, and steps can be taken to improve fertility through diet and lifestyle changes.

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Life Perspectives

YOUR INNER IPOD By CHANA Weisberg

I sit ensconced in my seat, miniature speakers carefully inserted in my lobes. With the touch of a button, I’m transported wherever I wish to go. One second, my heart strings are being tugged by a stirring melody. A moment later, my feet are tapping and my blood is racing to quick energetic beats. A flick of a finger, and I feel a trickle run down my cheek at a particularly poignant line of a sad song. Another flick, and my brain is stimulated by a recorded lecture, awed and inspired by a new insight. With a touch of a button, I navigate a story, a class, an upbeat song or a wistful melody, select the mood of my choice, and I’m transported to a different place, time and zone. (To be honest, it’s only recently that I’ve mastered this magical device. Initially, my non-technical brain reacted with bafflement to the flat little box with the unfamiliar controls. But after a few hands-on coaching sessions with my eight-year-old son, I got the hang of it, and soon enough, was i-poding like a pro.) What a powerful device this is! No wonder these little gadgets are selling to the tune of tens of thousands a day. Imagine if we each had a built-in dial in our own inner makeup. Imagine that with the mere touch of a button, we would have such control of our psyche and personality… Actually, we do. Chassidic teachings assure us that, by our very nature, we possess the quality of moach shalit al halev--”the mind rules the heart.” Unlike animals, whose behavior is dictated by instinctive responses,

the human is, in essence, a rational being, capable of achieving full control over his thoughts and moods. Using this “device” is not automatic--it requires a process of study and practice. But once we learn to use the high-tech gadget that is the human mind, we can get to a point where we are in control of our emotions, feelings and responses. Happiness is a choice, not a condition. So is integrity, kindness, humility, graciousness and compassion, and, on the opposite extreme, useless feelings of envy, anger and depression. Imagine being able to touch a button to turn off an angry outburst, or a lethargic, depressing mood. Imagine pressing a button to be surrounded by empowering happiness and constructive energy. Imagine having such a power of concentration, focus and control. Now imagine what a difference that would make in our personal growth and in our relationships. We do have the device. We do have those buttons, and we even have the manual on how to use them–our Torah. All we have to do is learn it. Now, maybe that’s something for Apple to consider marketing.

The content in this page is produced by Chabad.org, and is copyrighted by the author and/or Chabad.org. If you enjoyed this article, we encourage you to distribute it further, provided that you do not revise any part of it, and you include this note, credit the author, and link to www.chabad.org If you wish to republish this article in a periodical, book, or website, please email permissions@chabad.org

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New Feature

A CHANA SUPPORT WORKER’S WORKING DAY

settle into my office, located in a quiet alleyway in Hendon and get ready for my first meeting of the day. The couple I am seeing have, after much investigating, been given a diagnosis of unexplained infertility. Having been through four unsuccessful I.U.I treatments, they have been advised to go for their first I.V.F. I have been meeting them for over a year now, supporting them and working through their ups and downs. At times we talk about their emotions whilst at other times we brainstorm with more practical, medical issues. After they leave, I answer a call. M. has a very poor egg supply, produced after having been given the highest possible dose of medication to stimulate her ovaries. She sounds really down and tells me that she is worried about her negative feelings affecting the treatment outcome. M. also wants to discuss some segulos she heard about, have I heard of them and do I know what their value is. I put the phone down and have a quick coffee as I hear the bell ring. My next clients have arrived- they have been married for three years now. The wife has been through many tests and investigations and now, the husband has been told that it is his turn to go for tests. I sense that the husband is nervous and uncomfortable and we talk about his worries. I feel the anguish of this couple as they are moving on to the next stretch of their journey. We talk about the implications of giving a semen sample and cover the issues which he should discuss with his Rov. As the end of this session draws near, they seem more relaxed in the knowledge of having a clearer picture of what is about to happen next. I see them off and deal with some missed calls. 71 News & Views VII

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Great news! One of my clients announces that she is pregnant; we chat about how excited she feels and move on to discuss some practical issues. She wants to find out what resources are available to her. It always is a difficult step to move from the pampered, supportive care of a fertility clinic to a N.H.S antenatal unit. Her pregnancy is so precious to her and her husband as it has taken so long to achieve so she is anxious too. She worries about whether she should be concerned about every twinge and ache. I direct her to different comprehensive services available. A quick glance at my watch, I do have to get going, as I am meeting with another CHANA support worker at one of the fertility clinics in London. Medical procedures are changing so fast in the fertility field and we have to constantly keep our finger on the pulse in order to be able to help our clients as best as possible. The consultant whom we are meeting is extremely helpful and informative. I am particularly interested in clarifying the clinic’s treatment procedures. I enquire how often a client’s cycle gets monitored when on Clomiphene. I ask the consultant for his opinion on using clomiphene together with Metformin; I also enquire whether any of their treatments are funded by the N.H.S. Of course, I do not miss the opportunity to ask this leading expert if he would be willing to talk at a future CHANA evening which he willingly agrees to. Back at the office, I forward some research papers to a client who wants to find out more on I.V.I.G. This client called in a few days earlier to find out what our comments were of this procedure. I also send

her a summary of an I.V.I.G presentation which was held at CHANA in September 2006. I am sure that all this is going to give her a much clearer picture on the ins and outs of I.V.I.G. Listening to the answer phone messages, I find out who was in touch during my trip to the clinic. Before leaving, I have to complete my outstanding tasks of the day. I remember to call one of the CHANA Rabbonim who deals with our halachic questions. A client wants to know if she is considered a niddah after having gone through a specific treatment. I then email the Medical Panel about a client who has just had to abandon an IUI cycle. The clinic believes she is over stimulated and is being over cautious; the client is devastated. I ask the Panel for feedback and answers for this couple. Lastly, I consult with Mr. Kernkraut about a particular clinic. A client has to have a procedure on Shabbos and none of the support workers have had couples in that hospital for Shabbos. Mr. Kernkraut was familiar with the clinic and could advise me information to forward to the couple about accommodation, a shul for the husband, electric doors. The above is just a glimpse at what happens at CHANA on one given day. CHANA’s support workers get calls concerning a very wide spectrum of issues.

Whatever the problem may be, there is no need to hesitate, we are just a phone call away... News & Views VII 71

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Regular Feature

THE CHANA FERTILITY HELPLINE

One of CHANA’s most personalised services offers assistance in and of itself and is also the gateway to many of CHANA’s other services. CHANA’s Helpline is staffed by experienced and sensitive counsellors who are able to offer information and support on a wide range of issues. Men and women can telephone and speak in confidence from the UK and abroad, asking medical questions, raising concerns and talking about how they feel about their situation. In addition to English, Yiddish, Hebrew, French and German are also spoken. The Helpline is designed to help callers deal with the stress of infertility, including a range of possible emotions, e.g. anger, fear of what treatments entail sadness and despair. Through the Helpline, callers can receive information about lectures, specialist clinics, books and financial assistance for treatment in order to feel better equipped to handle their situation. The Helpline is also open to family and friends who may wish to understand aspects of fertility treatments and discuss ways to support a couple. Topics that callers enquire about include PCOS, endometriosis, nutrition, new treatments available privately or through the NHS. The CHANA Helpline is backed by members of our Medical Advisory Panel, who offer their specialised medical expertise. You may telephone the Helpline on a one-off basis or arrange an appointment to speak to a counsellor on the telephone or in person. If you prefer to speak anonymously, our counsellors will be happy to advise you as well. The Helpline is manned at the following hours: MONDAY 11:00 – 13:00 TUESDAY 09:30 – 12:30 WEDNESDAY 13:00 – 18.00 / 19:30 – 22:00 (Male Support Worker) THURSDAY 10:00 – 12:00 FRIDAY 08:30 – 10:00 (Male Support Worker) At others times you may leave a message, and a counsellor will get back to you.

The CHANA Fertility Helpline number is 020 8201 5774.

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Regular Features

CHANA SPECIALIST EVENTS 1. FERTILITY TREATMENT OPTIONS SEPT. 2006 Are you trying to find your way through the maze of different treatment options? Do you wish you were better equipped to ask the right questions? CHANA offered both men and women dealing with fertility issues an opportunity to hear from medical specialists, including doctors and nurses, about recent research to help them evaluate vital information. By making sense of published data, and finding out unbiased information, people gained tools to ask the relevant questions to their own doctor and explore the approaches which may be most appropriate for them. Treatments included: • IVIG • INFECTION SCREENING • MALE INFERTILITY • ICSI • BLASTOCYST TRANSFER • ACUPUNCTURE • HYPNOTHERAPY The presenting panel included: Dr Jeremy Nathan, GP & Acupuncturist Dr Judith Tobin, GP Mrs Guida Kurzer, Nurse Mr Anthony Hirsh, Consultant in Andrology Mrs Linda Goldberg, Nurse And research by Dr Wendy Freedman, GP 2. NATURAL CYCLE / MINIMAL STIMULATION IVF, AN ALTERNATIVE MAY, 2007 Mrs Geeta Nargund, Consultant & Head of Reproductive Medicine at St George’s Hospital, medical Director of the Centre of Reproduction & Advanced Technology. A presentation by one of the UK’s specialists in this area giving detailed information and research on why utilising this method of treatment presents a real alternative for many couples. 3. CHANA WAS PLEASED TO WELCOME RABBI GIDEON WEITZMAN OF MACHON PUAH IN JERUSALEM JULY, 2007 Rabbi Weitzman has specialist knowledge of Fertility Clinics & Treatments in Israel. He had appointments to speak to individuals and couples in confidence to discuss options available, in Stamford Hill, Golders Green and Manchester as well as having meetings with CHANA’s committees and support workers. 4. YOUR FERTILITY QUESTIONS ANSWERED……. FEB, 2008 MR A GADIR, CONSULTANT GYNAECOLOGIST & FERTILITY SPECIALIST AT THE HIGHGATE CLINIC. When to change to a more complex fertility treatment. Monitoring a cycle. Which drug to use for ovulation induction. Hyperstimulation - when to cancel treatment. CD’s are available on CHANA specialist events. To order a CD, £5.00 including postage & packing. Please telephone the CHANA Office on 020 8203 8455.

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Poem

MIRACLES We know, we really do What it takes How many tiny details Must combine, unite go right For a miracle To occur. But we don’t know We really don’t That other details Some tiny, some not Some terribly painful Some shatter us, break us; They also combine For a miracle To occur. Would the Yidden of Persia Have ever known That a chain of terrifying events A decree By the Angel of Death Would lead to their Greatest moment To a miracle That established one of our Greatest days? And would the Yidden of Egypt Have ever known That their suffering Their backbreaking, heart-wrenching labour Their dreaded days, their children snatched Would lead to

A wondrous redemption A Geula of miracles The birth of a Great Nation? The gentle words of a Gadol Comfort me Give me strength A purpose “All of you suffering your Yesurim, Your pain, Your tears Are precious. You will see They add up And will pave the way for The tremendous Simcha You will soon have.” We know we really do How much it takes For a miracle to form. Hashem, take it all! Our tears, our pain Our hopeful dreams Our broken hearts Our pleading Tefillos I know it’s your Derech To take it all into My very own

MIRACLE!!

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Regular Features

A DAY IN THE LIFE OF THE CHANA OFFICE

first saw the CHANA building on a bright summer’s day: tucked away among lush green foliage it nestles discreetly at the junction of several pathways. As I paused to study the structure, I was reminded very much of a building where I used to live which was used by the local Girl Guides. And do you know something? While not wishing at all to sound condescending, now that I have been working in the Admin office a little while, and have come to know more of the nature of, and necessity for, the work of CHANA, the more apposite I feel the analogy of ‘guidance’ has become. A typical day in the office starts early: Sandra (Admin Manager) and Nurit (Admin Secretary) are usually in place before 8.30 am. In summertime the first task is to open the slanted windows down to the security bars, to allow in the fresh air: in wintertime the first task is the same! The central heating boiler is in the Admin office and having been timed to come on early morning to warm the whole building and generate hot water, the Admin office is ‘cosy’ to the point where coats and cardigans are very speedily discarded! In the office, the Admin phone lines have to be checked for overnight messages. (The Well Woman helpline goes direct to the Counsellors’ room.) Can we action the message/s or do we need help/guidance? The same is true as computers are turned on and emails checked. Overnight, who has requested, and who has forwarded, information? When these overnight queries are resolved, we move on to the general day to day matters. The work is varied and always interesting. There may be ‘copy’ for newspaper advertising to be prepared, and invoices for previous advertisements to be checked. Perhaps we need guidance with the details for a forthcoming event, researching venue, speaker, date, etc. 75 News & Views VII

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Then, again with guidance, a poster can be composed, discussed, amended and subsequently photocopied and distributed. On the day of an event, we go through a ‘checklist’: for instance, do we need to take a laptop, a pointer, any back up information on paper, any money (!) etc. etc.? How is the speaker travelling to the venue and have any necessary parking arrangements been organised? How precise is the timetable, e.g., how long are we allocating for questions? What refreshments are we serving? The subject of refreshments will invariably generate a discussion on who wants what for lunch and which bakery (Mr Baker or Hendon Bagel Bakery) should we patronise today? And who is ‘volunteering’ to go get it all?! There will be post which usually arrives during the morning: it may bring donations in the form of charity vouchers or cheques to be acknowledged (always remembering to use a 2nd class stamp). It may bring invoices for checking and passing for payment. Or it may be a letter from a kind would-be volunteer offering to help from time to time. In between the phone will be ringing. Perhaps it’s a counsellor to advise that she is on her way in but is going directly into the counselling side of the building (through its separate entrance) to meet a client – and offer guidance. Perhaps it’s a generous benefactor, seeking guidance on how to go about making a special donation. Perhaps it’s a newspaper, checking the advertisement schedule. Perhaps it’s a trustee checking on the date of a meeting and wanting an agenda prepared, or offering guidance as to how the draft Minutes of the previous meeting can be amended and the final version then circulated. The day wears on: on the other side of the building, the counsellors will come in and go into their own rooms where they will catch up on their paperwork, make/

respond to phone calls, check their emails etc., possibly in between seeing clients to offer CHANA’s unique guidance. And maybe from time to time they will pop into the Admin office where we will be asked for help in checking out a supplier, or ascertaining a specialist’s new address, or recording (and banking) an ‘anonymous’ cash donation which a client has given to the counsellor. Volunteers may also come into the office, perhaps to help with photocopying the Newsletter, or re-organising the books in the library, or – in the “Volunteers’ Room” -checking the number and quality of DVD’s from events. There’s also this Magazine that needs guidance and ‘nurturing’ into completion, be it requesting articles, acknowledging contributions (including comparing deciphering of handwriting!), soliciting advertisements etc. Then pages need to be set up and proofed, and articles need to be juggled around till a logical and smoothly flowing format is achieved. As the 5pm closing time approaches we start to wind down and perform the ‘end of day’ tasks. Check all computer programmes are closed so that the back-up can be done efficiently. Check that all the windows are now shut. Check that all appliances and lights have been turned off. Check that all paperwork has been put away and that all cupboards, cabinets and internal doors have been locked. Check the answering machine is active. Then allow yourself the luxury of a moment’s reflection. What did we achieve today? For the benefit of others as well as ourselves, did we implement the guidance we were given? And thinking all this over, we turn off the main light, activate the alarm and close and lock the outer door. The building is shut, and quiet, its secrets safely under lock and key... and the ‘Girl Guides’ can go home. News & Views VII 75

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Books

TITLE

AUTHOR

YEAR

Beyond Infertility. The new paths to parenthood.

Cooper, S.L. & Glazer, E.S.

1994

Coping with Childlessness

Houghton, D. & P.

1987

Counselling in Male Infertility

Lee, S.

1996

Feeling Good. The new mood therapy

Burns, D.D.

1980

Getting Pregnant Faster

Glenville, M. PHD

2008

Getting Pregnant. When You Thought You Couldn’t

Rosenberg & Epstein

2001

Getting Pregnant. What you need to know right now

Lauersen, N.H. & Bouchez, C.

1991

Inconceivable Conceptions – Psychological aspects of infertility and reproductive technology

Haynes, J. & Miller, J.

2003

Inconceivable. A woman’s triumph over despair and statistics

Indichova, J.

2001

Is Your Body Baby-Friendly? “Unexplained” infertility, mascarriage & IVF failure explained

Beer, A.E. MD

2006

Miscarriage. What every woman needs to know. A positive new approach

Regan, Prof. L

2004

Miscarriage. Women’s Experiences and Needs

Moulder, C.

2001

Natural Solutions to Infertility. How to increase your chances of conceiving and preventing miscarriage

Glenville, M. PHD

2000

Never To Be A Mother

Anton, Linda Hunt

1992

Nutritional Health Handbook for Women

Glenville, M. PHD

2001

Overcoming Infertility - A guide for Jewish couples.

Grazi, R.V. MD

2005

Roni Akara. A guide for the childless.

Hillel, Rabbi Yaakov

2005

The Infertility Cure. The ancient Chinese wellness program for getting pregnant and having healthy babies

Lewis, R. PHD

2004

The Low Gi. Guide to managing PCOS

Brand-Miller, Dr J. & Farid, Prof N.R. & Marsh, K.

2005

The Third Key. The Jewish couple’s guide to Fertility

Finkelstein, Rabbi B. & Finkelstein, M

2005

When a Baby Dies. The experiences of late miscarriage, stillbirth and neonatal death

Kohner, N. & Henley, A.

2002

Your Essential Infertility Companion. A user’s guide to tests, technology and therapies

Furse, A.

2001

Your Pregnancy Week by Week

Regan, Prof. L

2005

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Tapes

Below is the list of tapes etc. available from CHANA. Tapes and CDs are £4. SHOWCASE 4 2005 is £10, SHOWCASE 5 2006 is £15 and SHOWCASE 6 2007 is £18 THE FOLLOWING TAPES ARE CURRENTLY AVAILABLE TO ORDER:

TAPE

DATE

SPEAKER

Chizuk for CHANA members

01-Jan-02

Rabbi Paysach Krohn

Dayan Abraham - CHIZUK 2005

05-Apr-05

Dayan Y. Abraham

Fertility Clinics - Shawaf and Herreboudt

21-Mar-05

Shawaf and Herreboudt

How to be sensitive to others

01-Nov-03

Rebbetzen Twerski

How to live a Stress-Free Life

10-Jan-05

Rabbi Silver, Jeremy Nathan, Bill Smith, Sam Lyons & Leslie Woolfe

How to survive Inferility on a daily basis

01-Dec-03

Mrs. Loli Berisch

Infertility - How does it affect our marriage?

15-Mar-04

Dayan Abraham

IVF and other Treatments for Infertility

24-Jan-05

Mr. Paul Serhal

Mothers of Teenage Daughters JAN 05

09-Jan-05

Dr. Miranda Glick & Mrs. Esther Pearlman

New Aspects of Infertility

01-Mar-03

Mr. A. Hirsh

Parents & Siblings - do we want them

27-Jan-04

Mrs. Adela Katz

Pelvic Pain

16-May-05

Mr. Lindsay MacMillan

Thyroid Disorders

10-Feb-05

Professor Nadir Farid

You Are What You Eat

01-Oct-02

Dr. Glenville

CDS

DATE

SPEAKER

Challenge in Face of Adversity

09-Jan-06

Rabbi Shaul Rosenblatt

Challenge in Face of Adversity

27-Mar-06

Mr. Aba Dunner

Concerned about... Pelvic Pain

03-May-06

Mr. Lindsay McMillan

Fertility Treatment Options

13-Sep-06

Various

How Do You Feel Inside & Out?

Feb-08

Dr Marilyn Glenville

Is it my Hormones or is it Me?

30-Oct-06

Mr. Nick Panay

Is it my Hormones or is it Me?

Jul-07

Mr Nick Panay

Natural/Minimal Stimulation IVF

14-May-07

Mrs. Geeta Nargund

Recent Research into Miscarriage

28-Jun-06

Professor Lesley Regan

Shiur for Men

01-May-07

Dayan M. Gelley

Stress Relief

29-Nov-06

Various

The Low G I Diet

Feb 07

Professor Farid & Leanne Green

Thyroid & Hormonal issues

08-May-06

Professor Nadir Farid

You & Your Daughter (Hormones)

Dec-07

Ms Amma Kyei-Mensah

Your Fertility Questions Answered

Feb-08

Mr A Gadir

DVDs

DATE

SPEAKER

SHOWCASE 4 DVD

June-05

SHOWCASE 5 DVD

June-06

SHOWCASE 6 2007

01-July-07

to be involved

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Notice Board

Would you like someone to accompany you to a medical appointment? If you would like support or assistance with translation, please ring the Helpline, 020 8201 5774.

Support others Have you been through the experience of primary or secondary infertility? If you feel that you would like to support others as a ”buddy”, we’d like to hear from you on the Helpline, 020 8201 5774.

Do you need help in understanding medical results of tests/investigations?

Have you missed a Well Woman or CHANA infertility evening but wanted to hear the presentation?

CHANA has volunteer nurses who can help you make sense of it all. Please ring the Helpline, 020 8201 5774, for more information.

Please telephone the office 020 8203 8455 to purchase a CD of the event.

No experience necessary! Are you available to help send out mailings for CHANA? Please phone the office on 020 8203 8455 so that we can call upon you to help get important information out to Shuls, mikvehs and GP’s surgeries.

Are you energetic and motivated? Please help CHANA’S Fundraising Committee to raise much needed funds. To find out how you can help, please ring the office on 020 8203 8455.

Do you need help/support in administering injections for your treatment? CHANA has nurses available to assist you. Please ring the Helpline for more information on 02028 201 5774.

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Regular Features

CHANA SERVICES CHANA FERTILITY T: 020 8201 5774

CHANA WELL WOMAN T: 020 8201 7101

CHANA Fertility HelpLine & Professional Support

CHANA Well Woman Helpline

A team of qualified counsellors offers the opportunity to talk about the issues and concerns that you as a couple are experiencing. Support is available on a one-off basis or via on-going counselling by telephone or in person in NW London and Stamford Hill, in a confidential setting.

CHANA Well Woman Medical Information Evenings

Especially for men CHANA recognizes that men in the community may feel particularly isolated. CHANA provides male support workers for individual consultation which can be accessed through our HelpLine. Specialist Information Sessions CHANA invites infertility specialists to address men & women with fertility issues on current research and treatment options. Financial Assistance

Through the HelpLine you can access information on a range of gynaecological and reproductive well-being issues. The HelpLine is available for discussing a variety of medical treatments and concerns and is supported by CHANA’s Medical Advisory Panel as well as CHANA’s Nursing team.

A series of lectures by renowned medical specialists held across Greater London offers members of the community information on a wide range of topics related to gynaecology and reproductive health. Shiurim CHANA organises a series of shiurim entitled “When Challenge Comes Knocking”. Each shiur offers insight on tackling life challenges as well as chizuk for difficult circumstances.

Grants are available to assist in meeting the cost of investigations, fertility treatments and counselling.

MEDICAL ADVISORY PANEL CHANA is supported by a team of specialists and GP’s who are sensitive to the impact of Jewish Law on all aspects of gynaecology, infertility and reproductive health.

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EXPERIENCED NURSING TEAM Volunteer nurses are available for support and information and to discuss your medical concerns or treatment (via the HelpLines)

BOOKS AND AUDIO LIBRARY A wide range of materials are available to borrow or buy.

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Adverts

DIET TIPS • IF NO ONE sees you eat it, it has no calories. • If you drink a diet soda with candy, they cancel each other out. • Foods eaten for medicinal purposes, such as chocolate for energy, have no calories. • Cookie pieces contain no calories because the breaking process causes caloric leakage. • If you eat standing up, the calories go to your feet and get walked off. • “Stressed” is “desserts” spelled backward.

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Adverts

IF YOU HAVE ANY: SUGGESTIONS QUESTIONS IDEAS NEWS VIEWS THOUGHTS COMMENTS STORIES POEMS SEND THEM OUR WAY TO CHANA NEWS & VIEWS 23 Ravenshurst Avenue, London NW4 4EE Fax: 020 8202 8635

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Adverts

Clinical Diagnostic Ultrasound Services “A more personalised approach to women’s healthcare issues and ultrasound scanning” Clinical Diagnostic Services is a very well-known ultrasound practice based in St John’s Wood, North West London. It is recognised for its expertise and pioneering work carried out particularly in areas of fertility and women’s healthcare issues. Patients benefit from the state of the art ultrasound facilities that CDS is able to provide. CDS offers a gentle approach to patient care and scanning techniques and is committed to the emotional and clinical needs of every patient referred to its clinic. We co-operate very closely with all referring clinicians to ensure a safe and clinically effective environment for the patient. Our experienced team of ultrasound practitioners are recognised internationally for aspects of their work, not only in infertility but also in general obstetrics, pregnancy screening and assessment of gynaecological problems. CDS works very closely with gynaecologists and complimentary therapists as part of an integrated approach to women’s healthcare.

We also have extensive experience in general medical assessments and male screening. A comprehensive range of clinical applications include:

• Fertility assessment and ovulation monitoring • General gynaecological assessments and ovarian screening • Breast screening • General medical • Male screening – prostate etc • Pregnancy screening – detailed fetal assessments • Early pregnancy problems • Recurrent miscarriage • Paediatrics • Musculo-skeletal problems

For more information please contact Mrs Ruth Carr, Practice Manager on 020 7483 3611/1717 Clinical Diagnostic Services, 27a Queens Terrace, St John’s Wood, London NW8 6EA Also at 37 Manchester Street, London W1U 7LJ

DAY LEWIS PHARMACY

229 GOLDERS GREEN ROAD, LONDON NW11 9ES VERY SPECIAL PRICES ON

PRIVATE PRESCRIPTIONS FOR “CHANA” MEMBERS.

TEL : 0208 455 1517 H C HEARD PHARMACY For your information a male fertility pack (for testing purposes) is now available at H C Heard Pharmacy, 43 Brent Street, NW4 2EA The cost is £5 each (through some hospitals, cost is £20!). Please ask the pharmacist, mentioning that you come from CHANA. 82 News & Views VII

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Adverts

Patrons: Dr J. Adler Dr J. Spitzer Dr M. Glick Dayan C. Ehrentreu Rabbi Ch. Halpern

23 Ravenshurst Ave London, NW4 4EE Support line: 0208 201 5774 Office: 0208 203 8455 Fax: 0208 202 8635 Email: CHANAct@aol.com

MEMBERSHIP FORM 2008 PLEASE FILL IN THE FOLLOWING DETAILS:

SURNAME: TITLE:

FIRST NAME: ADDRESS: TELEPHONE:

POSTCODE:

FAX:

MOBILE: EMAIL ADDRESS: I enclose a membership donation of £15 for 2008

TO HELP US SEND YOU THE MOST RELEVANT INFORMATION, PLEASE TELL US IF YOU ARE: A Medical professional A Counsellor / Social worker / Therapist Experiencing / have experienced infertility issues Wanting more information on Well Woman issues Interested in becoming a volunteer Other:

ALL INFORMATION IS TREATED AS STRICTLY CONFIDENTIAL

SIGNATURE:

DATE:

Please complete and return this to: by using the enclosed reply envelope or send it to: CHANA, 23 Ravenshurst Ave. London NW4 4EE Please enclose your cheque or voucher for £15 made payable to CHANA THANK YOU FOR YOUR TIME AND SUPPORT ENROLLING AS A MEMBER YOU WILL BE ENTITLED TO: • Receive invitations to specialist medical information evenings, Shuirim and social evenings arranged exclusively for CHANA members. • Receive CHANA News & Views magazine. • Receive regular CHANA mailings with details regarding public events featuring prominent speakers. • Access to CHANA’s library. 83 News & Views VII

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