Tune into the interview here:
Listen to the follow up Q&A here:
Welcome to The Egg Whisperer Show. I am so excited to have Dr. Nicole Kangas as the guest for today’s interview and she is going to talk to us about where to find support during your fertility journey.
Dr. Nicole Kangas is a therapist with a specialty in reproductive psychology. She works with patients facing infertility, and all things related to the family building process. She also sees patients who have had pregnancy loss and the emotional and mental health issues that go along with pregnancy and the postpartum period.
She has a private practice in the San Francisco Bay Area. She works with individuals, couples, and groups via telehealth sessions. She offers psychoeducational sessions for donors and surrogates and recipient families in the context of third party reproduction.
I am delighted to have her on the show. She has helped so many of my own patients.
Dr. Aimee: Welcome, Nicole. What made you go into this work?
Dr. Nicole Kangas: I became a therapist for a combination of professional and personal reasons. Professionally, I have a longstanding interest in women’s reproductive mental health. During my PhD program, I focused specifically on infertility and women’s well being. Personally, I have my own fertility story and that really drives my passion for this work.
When I started trying to have children, it became clear pretty quickly that I wasn’t going to be able to do that without medical assistance. I went through a series of failed treatment cycles and suffered through pregnancy loss. Ultimately, I had my own very high-risk twin pregnancy on my journey to motherhood.
I understand how incredibly hard it can be. I did not have a therapist, or a coach, or anybody to help me when I went through it. I wish I had because I know it would have really made a difference. Now, through my work, I am able to help other women and other couples on their journey. And it is really, really meaningful to me. I absolutely love what I do.
It is such a privilege to get to work with other people on their family building mission.
Dr. Aimee: And you certainly have helped so many of my patients. So, thank you for your work. What do you see as the most stressful part about being a fertility patient?
Dr. Nicole Kangas: For most of my patients, the main worry or the ultimate worry is, will I be able to have a baby? Will I be able to become a parent?
With each treatment cycle, the question is, will this work?
It is not just the pregnancy test showing a positive or negative. There are so many hurdles and tests and milestones within each cycle that can create a lot of stress and anxiety. For some of my patients, it can be that very first ultrasound where they are getting a look at how many follicles there are, or it might be how they are responding to the medicine. They might be concerned about the thickness of their lining when it’s time for implantation. And during IVF, others might find high levels of stress around how many eggs are fertilized and how the embryos are developing. And, they have questions around the genetic health of those embryos.
The pregnancy test is sort of the ultimate stressor. But for women who have been dealing with infertility, or those who have had prior loss, pregnancy itself can cause a lot of anxiety. Because then the worry becomes will the pregnancy last, and will I be able to have a healthy baby? There are a lot of milestones and hurdles to go through. There is a lot of waiting and getting through each one of those hurdles can be really, really hard.
Dr. Aimee: Are there other stressors that you see that can be challenging among fertility patients?
Dr. Nicole Kangas: There are a lot of stressors that are associated with infertility, and I will walk through a few of the more common ones that I see.
I see a lot of people who are coping with financial stress and strain because treatment can be so expensive.
I also see a lot of people who are encountering stresses within their relationship. Two people within a relationship will often cope with infertility very differently. If there’s loss, they grieve loss very differently. Working on communication, and getting the couple to see each other’s perspectives, and coping styles is really important.
Sometimes friends or extended family can cause stress by saying inappropriate things, or not being supportive in the way a patient had hoped they would.
I also see a lot of people with really stressful work lives. Trying to balance the pressures of a professional career with fertility treatment can be really challenging.
And something that I have been seeing a lot more recently is people who are stressed out because they are trying to adhere to a strict fertility diet or exercise regimen. They really beat themselves up if they miss a couple of days, or they are at a party and they have a piece of cake or a glass of wine.
A lot of the work has to do with finding some balance and understanding that perfection is not attainable and certainly not necessary to have a successful fertility treatment.
Dr. Aimee: I think I need to make that a bumper sticker: “Perfection is not necessary or attainable.” I know I do get these panic emails sometimes around dinner time where a patient sends me a message and is a little panicked after she ate gluten. I reassure them that it is OK.
Tell us about your approach to helping women with infertility.
Dr. Nicole Kangas: First and foremost, I focus on the relationship between myself and my patients. Every single reproductive story is completely unique, and for me to work with a client, I need to really understand their priorities, their goals and their concerns. I also think there is a lot of value in letting people just sort of talk about where they are, what their worries are, what their hopes are.
Sometimes that includes, working through really difficult decisions that they might have to make on their journey. Sometimes it includes processing grief. The specifics of what that looks like vary quite a bit. But, engaging in talk therapy (and being able to talk through things) is one important element of what I do.
Equally important is that I teach my clients strategies and tools that they can use to help manage their stress and to help them feel well. I wholeheartedly believe that you can get through this process and feel well. Tools that help to calm the mind and the body are important, along with self-care.
A lot of my patients are busy, so these are not painstaking long things. They are short and simple strategies that can be done anywhere. Many of them take a few minutes, but in combination they can really make a difference.
Dr. Aimee: So, what I understand is that you not only see patients on a one on one basis, but you also run group sessions. Tell us about your work with groups.
Dr. Nicole Kangas: I have been running groups for almost 15 years and it is one of my favorite things to do. I think part of the reason why I enjoy it so much is because the women get so much out of it. There is an added benefit of the social support.
And you and I both know that infertility can be a very isolating and lonely experience. Many women feel like they do not have anyone to share their stories with. A group setting gives them an opportunity to be around other people who are in a similar situation and to talk about what is going on for them and get to hear other perspectives as well.
Dr. Aimee: What are the specific types of groups that you run?
Dr. Nicole Kangas: I run several kinds of groups: infertility support groups, groups for pregnancy loss, and groups for women who are trying to conceive using donors or surrogates, also a group for single women who are trying to build their families.
I have been running the group since 2005, and until now I have always done them in person, in my office. Now, I offer them online, which is a new experience for me, and I am really, really excited.
Dr. Aimee: And are the topics going to be the same?
Dr. Nicole Kangas: Yes. I will be starting groups with the same types of topics. The first one I am running will be the general infertility group. That is always a great place to start for anyone because they can come and get support no matter where they are in their journey.
Dr. Aimee: How can women enroll in your group?
Dr. Nicole Kangas: You can enroll by reaching out directly to me by leaving me a voicemail (925) 732–6878, or by emailing me at email@example.com. Once I hear from people, I will send out a poll and we will determine a time that is convenient for everybody.
Dr. Aimee: And then what about the cost? How much does it cost to join the group?
Dr. Nicole Kangas: It is $50 per session, and I asked for people to pay for the sessions in advance. There is a total of six sessions, and we meet once per week for six weeks.
Dr. Aimee: Is there anything else patients should know about your groups?
Dr. Nicole Kangas: Yes. I want women to know that everyone is welcome in the groups. Single mothers, people in same sex relationships…it is diversity of perspective and experience that really makes the group a rewarding experience. I know sometimes people are a little bit nervous about participating in a group. They worry that they might be triggered by other people’s stories, or they are not sure if they want to share their experiences. If that is the case, I want to encourage people to contact me. I am happy to do a phone consultation and we can determine if it seems like the right fit or not.
Dr. Aimee: And you also might meet some lifelong friends by being in the group too, by having that shared experience.
Dr. Nicole Kangas: Absolutely. So many of the women I work with go on to build lifelong friendships. And I love hearing the stories about the Facebook meetups and the live meetups for lunch. And later, when people have families and they’re getting together with their children, it is amazing.
Dr. Aimee: Yeah. That is great.
Well, tell us again, where can patients find you?
Dr. Nicole Kangas: The best place to start is at my website: https://drnicolekangas.com/
All my contact information is there, along with links to social media. There is a lot of resources for the fertility journey, along with more information about my practice and my approach. If you have questions from there, please reach out and do not hesitate to call or email me, and we can set up a phone consultation.
Dr. Aimee: Thank you again for being on the show and talking about this especially important topic. I want everyone to build a fertility team around them. The T of TEAM stands for Therapy, and it does not mean that there is something wrong with you. We all need help in our life.
Just like Nicole says, you do not have to suffer with emotional issues as a fertility patient. When my patients see Nicole, they feel so much better about their experience as a fertility patient. I want everyone to have that same experience. It does not mean it is easy. Dealing with the emotional trauma is the hardest thing that I see my patients go through. So, I am just so incredibly lucky to have Dr. Nicole Kangas here in the Bay Area to help my patients. I hope you guys will reach out to her too.
Thank you, Nicole. I so appreciate you. Thank you again for everything that you do, and we’ll see you soon.
Dr. Nicole Kangas: Thank you so much.
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