Welcome to the December issue of Connections. In this issue you will find:

• A Holiday Greeting from the AFA Executive Director, Pamela Madsen
• Golf "Fore" Kids: A Special Thanks to our Sponsors and to Our Host, Dara Torres
• This month's featured article
  

Dear Friends,

It is hard to believe another year has passed. As the holidays quickly approach, and I take stock of what we've accomplished, I am awestruck by the achievements of the staff, volunteers and board members of The AFA.

By the word ‘achievement’ I mean activities that actually help people; activities that actually make a difference in someone's life. I believe The AFA has touched so many people, in so many ways. Whether you are a new AFA member, or one that has been with us for a while, we hope that we have touched your life, and helped you to successfully negotiate the difficult journey in your quest to build your family.

When we started the year, we had lofty goals and the energy to achieve them. Fueled by the needs of our members, we set out to reach more people, to provide more services, and to continue to evolve our organization to meet the expanding needs of the reproductive health community. With over 20,000 members, and with more joining every day, we are achieving our goals.

One of our most significant and visible achievements was the successful change of our name from The American Fertility Association to The American Fertility Association (AFA). Your positive feedback and support of this initiative has been overwhelming. In moving from infertility to fertility, we more accurately capture that which truly defines our organization. We are about embracing the possibilities for family building, and conveying a sense of hope for all our members whether they are struggling with reproductive disease, looking for ways to preserve their procreative abilities, or build their family through adoption.

Our name change embraces the goals and desires of our members and communicates our belief that you can achieve your goals of having a family you can call your own.

I invite you to visit our new and improved Web site - www.TheAFA.org – to learn about all the services and activities we've provided in 2004 and stay tuned for 2005 program announcements coming soon!

Happy Holidays,

Pam

Golf "Fore" Kids
A Special Thanks to our Sponsors and to Our Host, Dara Torres

	The winning foursome, from left to right: Dr. David Hoffman, Dara Torres, Ron Delgaudio, and friend.
	Golf "Fore" Kids host Dara Torres and Pamela Madsen.
	Joe Tawil and former NFL-player Siupeli Malamala (center) and friends.

Resolution Time

New Year's Eve is just around the corner. It is a time of all-out celebration as well as a time of introspection and reflection. Many of us will actively ponder the year that has passed and how it changed our lives. We will think about how we have lived and what we would have, or should have, or could have, done differently. We will dream and make specific resolutions about how we will approach the year to come. It is a time symbolic of hope, a chance to start over, a chance to do better.

For many people who are experiencing fertility problems, however, the New Year brings with it different symbolic meanings. Rather than a chance to start anew, many of my patients tell me that the New Year represents more of the same. They are still on the treadmill of infertility treatment. They have lost yet another year, one in which they have not yet been able to fulfill their dream of a child. "Our lives are on hold," they tell me, as they express frustration about being stuck in the limbo of the infertility experience.

New Year's Day is different from any other day because of the symbolic meaning that we attach to it. It is a holiday because of a cultural consensus that we will celebrate at a particular time and in a particular way. This idea of a designated meaning applies to a number of symbolic dates, including birthdays and anniversaries of specific events including, miscarriages, D&Cs, and the beginning of formal infertility treatment. They allow us to mark time.

The concept of time is abstract and highly symbolic. Why is an hour an hour or a month a month? It is because we have given meaning to a particular span of experience. For instance, when we are not trying to conceive, a month is a month with a name, like December. But when we are attempting pregnancy, a month becomes a “cycle.” Ovulation becomes “that time of the month,” rather than the release of an egg from its follicle. For many of the couples I work with, “it's time!” is a demand for sex, rather than a statement about what one reads on the wall clock.

The passage of time is highly symbolic. As a birthday approaches, women often talk about lost time and feeling out of time. The internal biological clock seems to tick more loudly with every passing day, bringing with it urgency and, often, fear. Men and women speak about their friends having children and, with the passage of time, second and third children. “It's time for us to have a child” because those in the social circle are doing it. Time equals pressure and competition.

What symbolic meanings are you bringing to the challenge of infertility? Having no control? Inescapable torment? A punishment from God? Do you think of yourself as defective? A loser? Or is infertility something that has brought you closer to your partner, as you have worked through a difficult challenge together? Have you congratulated yourselves for doing what you can to build your relationship? Are you surprised by your ability to learn so many new things that you never knew that you would have to know? Are you persistent? A survivor?

In her book Women's Bodies, Women's Wisdom, OB/GYN Christiane Northrup writes that how we think actually changes our physiology. I absolutely agree. I cannot count the number of times that I have spoken with patients who are seeking to do inseminations or IVF but do not believe that they will become pregnant with the procedures. They feel that they must grind through the motions in order to get things over with. I counsel people who are at this stage of anger, resignation or clinical depression to think about how their body is processing that point of view. My clinical experiences and a growing number of studies suggest that this approach is highly problematic. While I am not able to predict whether a cycle will be successful or not under these circumstances, I will tell you that the process itself will be miserable. The meaning—“just one more thing that I have to do to be finished”—brings with it bitterness, despair, self-blame and anger between partners.

I hope that you do not think that I am being Pollyanna. I, too, bristle when I hear simplistic platitudes like “Relax and it will happen” or “Just think positive.” What I am saying goes deeper than that. I am talking about altering the way that we approach infertility by considering new meanings. Meaning is what allows us to live and to understand.

My martial arts training has reinforced the meaning and beauty of living in the moment. We weave words like balance, authority, humility, power, focus, self-control, and stamina into our physical exercises to expand and better live the experience. The black belts I train with say that attaining a black belt is a new beginning, not the pinnacle of their training. The achievement brings with it new responsibility to be mindful and open to something as yet unknown.

So I put to you a challenge. In the days ahead, and with each birthday to come, will you make time to consider new meanings? How can you integrate the concepts of balance, authority, humility, power, focus, self-control, and stamina into the infertility experience and, more important, into your everyday experience? When was the last time you honored yourself and your partner for living through all of the things you have endured up to this point? Time’s a-passing. There is no time like the present.

Dr. Deborah Simmons is the Director of Counseling Services at Reproductive Medicine and Infertility Associates in Woodbury, Minnesota (651-222-6050 or dr.simmons@rmia.com).