Most people simply take it for granted that they will be able to have children. It's what we all grew up to believe. The fact is, that one in six couples trying to have a baby will experience problems in doing so. The urge to have a baby is so strong that infertility is often described as a life crisis, creating upheavals not unlike those associated with a death in the family or divorce. People are often shocked when they discover that they are infertile and commonly go through a period of disbelief. Others rush into treatment without first coming to terms with the diagnosis, therefore, preventing adequate psychological adjustment. The overall impact of infertility on individuals differs greatly, and is influenced by factors such as cultural background, family pressure and the importance a person places on having children in their life.
Different women have different responses to infertility but there are several feelings that are common. Women may feel a sense of anger at not being able to have children and resentment towards other pregnant women. They may also have feelings of guilt, regarding their infertility as punishment for using contraception, for having a number of sexual partners or for a previous termination.
Some women may feel uncomfortable around children and consequently start to isolate themselves from family and friends who have children. Increasing isolation leaves the women without any support networks to help them overcome the feelings of depression and frustration commonly associated with infertility at a time when these systems are needed most. Holidays and other important dates may become painful reminders of their infertility instead of a cause for celebration.
A woman may develop feelings of hatred or disgust towards her body, perceiving it as inadequate, dysfunctional and diseased. Similarly, a woman's sense of femaleness is often closely associated with pregnancy and motherhood. Infertility, therefore, may have a serious impact on a woman's sexual identity, leaving her feeling less sexually attractive or asexual.
Infertility and attempts to overcome it can lead to a loss in perspective. Women may put everything else in their lives on hold, putting all their energy and time into getting pregnant. They may delay making changes in everything from their careers to their current housing situation, deciding to wait until after they have "had the baby".
Infertility and, in particular, medical treatments can place women on an emotional rollercoaster of hope and then despair. Women may often go through a cycle of hopefulness leading to disappointment at the arrival of their period.
The impact that infertility has on men is often very different to the impact it has on women. Because many of the medical treatments for infertility focus on the woman's body, men often feel helpless and left out of the process. If the couple's infertility is due to a male factor such as sperm dysfunction, the man may feel that he is impotent or lacking in masculinity. The strong societal link between fertility and virility causes many men to keep their infertility a secret, in turn increasing their feeling of isolation. While women may find some support from female friends, it is not uncommon for men's male friends to show little understanding.
Infertility can also place a great strain on a relationship, particularly in cases in which the problem lies with one partner. The infertile partner may constantly fear being left for another (fertile) person, while the fertile partner may blame or feel anger towards their partner. Frequently there are differences in a couples'; expectations concerning children, with women more likely to express a greater need for a child. Differing levels of enthusiasm are often apparent in couples where one partner has children from a previous relationship. Coming to an agreement on what fertility tests to perform, what treatment options to pursue and when to stop treatment can all cause conflict in the relationship. If one partner does not want to begin or continue with treatment, the other partner may feel as though they are being denied the chance to have a child and become resentful.
Treatment for infertility also frequently interferes with a couple's normal sex life. The initial discussions to identify possible fertility problems involve disclosing many personal details regarding one's sex life. Similarly, the loss of privacy associated with tests such as sperm counts and the post-coital test can destroy feelings of intimacy. Sex often becomes timed around temperatures and ovulation times. This regulation can make sex feel more like a chore than something pleasurable. The lack of spontaneous sex and sex for enjoyment rather than procreative purposes can lead to sexual dysfunction such as erectile problems in men and vaginal dryness in women.
Although infertility is potentially the source of much strain on a relationship, many couples also report that going through the experience has made their relationship stronger. Couples that have shared the physical and emotional stresses of infertility may feel that it has brought them closer together and has cemented their relationship. Successfully coping with infertility can result in couples feeling confident that they can tackle any future problems.
Infertility can also place a strain on relationships with family and friends. Families, in particular prospective grandparents, may place added pressure on people by publicizing their expectations for grandchildren. Enquiries from in-laws can be especially stressful and the daughter or son-in-law may feel that the comments are intrusive. Friends who are unaware of the full implications of infertility may appear unsympathetic and offer unhelpful suggestions such as "go on vacation to somewhere intimate" or comment on the fun involved with "trying". Friends with children may assume that people with infertility do not wish to be reminded about children and so will avoid announcing their own pregnancies and issuing invites to social events like children's birthday parties and baby showers. Arranging for time off work to undergo diagnostic tests and treatment can be difficult. Employers may not be supportive and the employee may not feel comfortable revealing why s/he requires the time.
For some couples and individuals, becoming informed, consulting a counselor or therapist and joining a support group can help in coming to terms with infertility and coping with the stresses of treatment programs. Different coping strategies will suit different people and will also be appropriate for particular stages of the infertility experience.
Obtaining information about infertility and the various treatment options available helps people to feel that they are more in control of the situation. Reading as much material on the topic as possible also allows people to make informed choices about tests and treatments and to confidently ask any questions they may have. Obtaining information about infertility and the various treatment options available helps people to feel that they are more in control of the situation. Reading as much material on the topic as possible also allows people to make informed choices about tests and treatments and to confidently ask any questions they may have.
Many people confronted by infertility find that consulting or participating in a support group can be very helpful. A support group can provide information on infertility and infertility treatments as well as contact with other people with similar problems. Being able to talk to people who have been through the same ordeal reduces feelings of isolation. Support groups offer strategies for coping with particular problems associated with infertility and can also offer a sense of hope through sharing other people's success stories. Groups such as Resolve and the American Fertility Association have helped thousands of couples through very trying times.
Visiting a counselor who is experienced in infertility issues will enable people to openly discuss their feelings about being infertile. They can also voice their fears and concerns about approaches to treatment, as well as the possibility of remaining childless. Counseling may be particularly beneficial to couples whose relationship has suffered as a result of infertility. For couples experiencing disruptions to their normal sex life, advice from a sex therapist may be useful. Visiting a counselor who is experienced in infertility issues will enable people to openly discuss their feelings about being infertile. They can also voice their fears and concerns about approaches to treatment, as well as the possibility of remaining childless. Counseling may be particularly beneficial to couples whose relationship has suffered as a result of infertility. For couples experiencing disruptions to their normal sex life, advice from a sex therapist may be useful.
For some, consulting with their religeous advisors can be very helpful.
1. How can infertility affect my psychological well being?
Infertility often creates one of the most stressful life crises that a couple has ever experienced together. The long term inability to conceive a child can result in significant feelings of loss and even inadequacy. Coping with the many medical decisions and the uncertainties that infertility brings can create great emotional upheaval for most couples. If you find yourself feeling anxious, depressed, out of control, or isolated, it is very important to know that you are not alone.
2. How do I know if I could benefit from counseling?
Everyone has feelings and emotional highs and lows as they pursue infertility treatment. Feeling overwhelmed at times is a perfectly normal response. However, if you experience any of the following symptoms over a prolonged period of time, you may benefit a great deal from working with a mental health professional:
In addition, there are certain points during infertility treatment when discussion with a mental health professional of various options and exploration of your feelings about these options can help facilitate clarification of your thinking and help with your decision making. For example, consultation with a mental health professional may be helpful to you and your partner if you are:
3. How can counseling help me/us cope with infertility?
Mental health professionals with experience in infertility treatment can help a great deal. Their primary goal is to help individuals and couples learn how to cope with the physical and emotional changes associated with infertility, as well as with the medical treatments that can be painful and intrusive. For some, the focus may be on how to deal with a partner's response. For others, it may be on how to choose the right medical treatment or how to begin exploring other family building options. For still others, it may be on how to control stress, anxiety, or depression. By teaching patients problem- solving strategies in a supportive environment, mental health professionals help people work through their grief, fear, and other emotions so that they can find resolution of their infertility. A good therapist can help you sort out feelings, strengthen already present coping skills and develop new ones, and communicate with others more clearly. For many, the life crisis of infertility eventually proves to be an opportunity for life-enhancing personal growth.
4. How can I find a mental health professional experienced in working with infertility?
Make sure you choose a mental health professional who is familiar with the emotional experience of infertility. It is recommended that they have:
Interview more than one person. Ask them for their credentials as well as their experience with infertility issues and treatments. Ask if they are currently seeing other people with infertility.
For referral to a competent mental health professional recognized by ASRM, Click Here.
When a couple receives treatment for infertility, it may become necessary at some point to decide to discontinue treatment if a pregnancy is not achieved. The constant advancement of new medical techniques in treating infertility has made setting these limits extremely difficult.
While some couples may not consider treatment,
simply accepting their situation, other couples may spend years
trying every possible technique available to realize their dream
of having a child. Undergoing infertility treatment is not only
emotionally demanding but can also be financially costly. It is,
therefore, important for couples to come to an agreement, preferably
before treatment is started, on the types of treatments, number
of attempts and overall length of time they will spend trying to
have a child. A couple should also consider their financial position
and agree on what they can afford to spend on treatment. Deciding
to stop treatment allows some people to learn to accept their infertility
and pursue other options such as adoption or living a child-free
life.