Counseling

Dr. Kris Bevilacqua is a clinical psychologist at Montefiore's Institute for Reproductive Medicine and Health, where she has also conducted nine years of research with patients. She has helped countless individuals and couples through all stages of infertility, which is one of life's most difficult challenges.

"Most of the time I see couples once and set the stage for their next step and how to go about executing it," she says. "But I'm here when and if unexpected issues arise. Patients have a lot of flexibility with my counseling, and the door is always open so I can help them function better in their particular situation. Sometimes, it's just reframing it in a different way, such as taking the self-doubt out of it or overcoming adversity. Our patients are great problem-solvers, as they have pooled their resources together to get this far, so they shouldn't feel that they've failed. Sometimes, they just need a little humor."

Who Typically Seeks Counseling

An individual or couple may have a certain issue today, and a different one in a few weeks. For example, a couple may undergo a specific treatment, but then may have to progress to a donor egg. These are very different stages, all of which are associated with an array of emotions. Dr. Bevilacqua's services are available to all patients, especially those experiencing one or more of the following circumstances:

• Couples who have married late
• Those using donor eggs or sperm
• Women with ovarian failure
• Those with genetic anomalies undergoing Preimplantation Genetic Diagnosis (PGD)
• Anyone on psychiatric medication for conditions such as bipolar disease or depression
• Women with a history of sexual abuse or needle phobia (several medications are administered through needles)
• Those who have been turned down at other facilities

"All of these situations are associated with what-ifs that keep patients up at night," Dr. Bevilacqua notes. "I give them a folder of information with my email address and say, 'If you think of something at 2 o'clock in the morning, email me! I will get back to you.' Sometimes everything can be discussed during one appointment; other times, questions are answered later, and for others, it may take multiple visits to ease their concerns.

"A little anxiety is expected, and it keeps patients motivated. Those are the people who are goal-oriented and persevere through the process. I always say, 'Kids don't come with instructions, but you'll get through it!'"

At Montefiore's Institute for Reproductive Medicine and Health, patients are able to receive counseling at any stage of treatment, and they may return post-treatment. In fact, they may begin counseling prior to treatment if they wish to discuss their concerns before ever getting involved to make sure fertility treatment is right for them. Likewise, they might be pregnant or have already delivered. It's part of our continuum of care.

Her Story

A mother of twins born from a donor egg, Dr. Bevilacqua can empathize with patients. "We did it right here, so I'm able to provide patients with a firsthand understanding that they may feel down at the moment, but that they need to and will feel entitled to be a parent. It comes in time, when you realize you're the only person that can make it better. It's not about genetics, rather how to cope with the situation.

"I don't mind telling my situation to patients; it was hard, especially after having a number of losses and feeling a giant hole. I didn't know what my kids would look like, and they don't look at all like me or their father, but they are better looking than either one of us," she says with a chuckle.

"All families evolve. We dream about what they will be like, and then we adapt to the reality. I want patients to be comfortable with their decisions they are making about how to have a family, and be on an evolutionary path of peace as to who their family members will be.

"My donor profile showed that she liked to cross-stitch, as I do. I imagined having a little girl would do all these crafts with me. As it turns out, I had twins - a son and a daughter, but it's my son that is a fabulous knitter! So you never know how Mother Nature is going to mix it up!"