February 19, 2020

Addressing the Emotional Pain of Infertility

Kady Harari (far left), Dr. Karen Friedman and Dr. Jordana Heyman, Gefen Medical adviser

“When a woman wants a child, she wants it with every fiber of her being. It’s a very primal desire.”

Those were just a sampling of the emotionally laden words used by Karen Friedman, the founding director of Gefen Fertility in Jerusalem, during a recent fundraiser for the organization in Beverly Hills.

Gefen Fertility offers a slate of mindfulness-based psychological and emotional support services for women trying to conceive. The much-needed services are a response to women who struggle and fail to get pregnant, month after month, and who may be left feeling gut-punched and depressed, immobilized by the fear that they may never conceive.

In family-centric Israel, fertility challenges can also be a major source of social isolation. Israel’s fertility rate is 3.11 children per mother, the highest of any country in the Organization for Economic Co-operation and Development, a nonprofit whose 36 member countries include the United States, France, Germany and Australia. The average fertility rate across OECD countries is 1.7 children per mother.

Unlike in the U.S., where a single round of in vitro fertilization (IVF) to help a woman conceive can cost tens of thousands of dollars, the procedure is practically free in Israel until a woman is 44. Free treatment might sound great, but it also means a woman might try IVF numerous times, all without any psychological support to emotionally sustain her through the process. “That causes a huge amount of stress for a woman, and stress itself can negatively impact fertility,” Friedman said.

Friedman, 59, who was raised in Beverly Hills and attended Beverly Hills High, moved to Israel in 1988 after receiving her doctorate from Harvard in counseling psychology. 

A mother of eight, Friedman recalls how, after she had her sixth child, her mother called from Los Angeles and demanded, “What are you doing for your community?”

“I’m raising a community!” she responded.

While that might seem like a strange demand from most mothers, Friedman’s mother is Jean Friedman, founder of the Los Angeles Zimmer Children’s Museum. Her father, Jerry, started Shalhevet High School. 

“My parents showed me that finding yourself means finding a way to make change in your community,” Friedman said. “My whole life I was programmed to start something, raised with the idea that self-actualization comes when you find what you can give to your community, [how you can perform] tikkun olam. Where can you make a change?”

That change for Friedman began when she tried to have her seventh child and had trouble conceiving. She met many other women who were also struggling. “One in eight couples suffer from infertility. They are all around us,” she said. 

Friedman said that was when she “made a deal with the one above,” that if she had another child, she’d devote herself to helping others do the same. In 2010, she had not just one child, but twins — who, incidentally, joined her in Los Angeles for the fundraising event. 

She kept her promise and, in 2013, launched the Rimon Center at Hadassah Hospital-Mount Scopus in Jerusalem to support couples undergoing IVF there. Then, in 2014, she opened the Gefen Center in Jerusalem’s German Colony. Friedman continues to run both centers, together with Kady Harari, a yoga therapist, who oversees the yoga fertility program.

The program helps with stress reduction, which has been shown in studies to improve fertility rates by as much as 30 percent. “The supposition, ‘I’m never going to get pregnant!’ raises stress,” Friedman said. “When you teach people to challenge their negative thoughts, that can lower stress and depression.”

Both locations offer a range of services, including mindfulness-based cognitive behavioral therapy, yoga, workshops on modern methods of fertility preservation, text study of women in Jewish history who coped with the desire for motherhood, and the process and psychology of using an egg donor. Some programs include an expressive writing component. Some are geared toward specific populations, such as Charedi women.

The programs are organized into 10-week sessions, giving women continuity when facing the marathon of fertility interventions. People also drop by for acupuncture, reflexology or to sit in the courtyard and have a coffee. 

“What’s great about Gefen is the synergy,” Friedman said. “Someone might go to a yoga session, and then [after feeling the benefits] say, ‘Oh, I’m going to try mind-body therapy.’”

All of the programming aims to help women stay connected to themselves as whole people, remembering the many positive, successful aspects of their lives beyond fertility challenges. It also helps with stress reduction, which has been shown in studies to improve fertility rates by as much as 30 percent. “The supposition, ‘I’m never going to get pregnant!’ raises stress,” Friedman said. “When you teach people to challenge their negative thoughts, that can lower stress and depression.”

Gefen Fertility recently began a partnership with Nishmat, a center for advanced Torah study for women in Jerusalem, to train a cadre of experienced female advisers in Jewish law to become fertility counselors. The training includes meeting with IVF doctors, rabbis and psychologists who specialize in fertility.

Friedman volunteers her time at Gefen Fertility and has a paid staff of about 15. Services for women are free or “close to free,” she said, and no one is turned away due to economic hardship. 

Many local Jewish community philanthropists helped Friedman to establish the center, including Stanley Black, Judah Hertz, Marilyn Ziering and the Gindi family. Friedman is currently seeking donations to expand Gefen’s offerings to more women. “Every time we start something new,” she said, “we have more demand.”

Wendy Paris is a writer in Los Angeles.