Why does infertility cause so much emotional pain?
Many women are raised with the assumption that they'll become mothers someday. From baby dolls to baby showers, girls and women are surrounded by images and expectations from parents, peers, religion, advertising, and the media.
For some women, motherhood is an important part of their self-image. For others, it's their highest ambition. Even women who don't necessarily want to become mothers are affected by society's expectations.
The pressure to find a partner and raise a family can be enormous, and women who are unable or choose not to can be made to feel as though something must be deeply wrong with them or is sorely lacking in their lives.
Infertility can be a different experience for men because they are generally not pressured in the same way to become fathers. Though a man's image of himself can start to suffer if the fertility problem is clearly his, such as poor sperm quality.
Many men are brought up to repress their feelings, or at least keep them to themselves. They may be so used to holding in their emotions that they don't know what they feel or when to ask for help.
A man may be feeling similar frustration and disappointment as he and his partner go through yet another round of treatment – and yet another month without conceiving. But many see their role as being strong for their partner. The same is true for a female partner who is not the one with the fertility issue – she may downplay the importance of her own feelings because she's not receiving treatment.
It's true that ongoing fertility treatment can take a huge toll, both physically and emotionally. Studies suggest that, as a group, women with fertility problems are as anxious and depressed as women with cancer, heart disease, or HIV. One reason may be that the physical demands of fertility treatments, including blood tests, pills, daily hormone injections, ultrasounds, egg retrievals, and surgery, can be a source of stress and emotional upheaval.
Also, society often fails to recognize the grief caused by infertility, so people struggling to conceive tend to hide their sorrow, which only increases feelings of shame and isolation.
Here's how to avoid the most common pitfalls for couples facing fertility problems. And see a list of resources that can help you and your partner cope.
I'm undergoing treatment. How do I cope with the roller coaster of emotions?
While undergoing fertility treatment, many people tend to live in month-to-month cycles of hope and disappointment that revolve around ovulation calendars and menstruation.
As they navigate a tight schedule of tests and treatments, they place their lives on hold – postponing vacations, putting off education, and disrupting their careers. Others find that the sorrow, anger, and frustration from dealing with prolonged fertility problems invade every area of life, eroding self-confidence and straining friendships.
Realize and accept that you will have some ups and (most likely) many downs as you deal with your fertility problem. Reflect on your commitment to becoming a parent, and read our top coping strategies to help you get through this trying time. Consider joining a support group if you decide to go ahead with treatment, and connect online with others in the our site Community.
Our love life seems so mechanical now. Does this happen to other couples?
Yes. Many couples say that once they start worrying about having a baby, sex becomes more of a chore than a pleasure. Most fertility treatments require you to have sex at very specific times – hardly an ideal way to set the mood for romance or enjoy sexual spontaneity.
If you find your sex life deteriorating, and you're unable to remember the meaning of romance, take a break from your treatment regimen for a month or two and try to rekindle the love and sense of fun that brought you together in the first place.
Also keep in mind that this crisis is temporary – it will be resolved sooner or later, and once it is, you'll want to continue a healthy, fulfilling sexual relationship with your partner. For now, if difficulties persist, consider couples therapy with a counselor who has experience with fertility issues. Look for a referral through Resolve: The National Infertility Association or the American Society for Reproductive Medicine.
People keep asking me when I'm going to have children. What can I say without being rude?
These people may seem uncaring or thoughtless, but friends and family mean well when they ask about your plans for parenthood. They may not know you're having fertility problems or, if they do, want to know how things are going.
Nevertheless, having to respond to these questions can be painful, especially at get-togethers and holiday gatherings when family – and children – are often focal points. You might answer simply, "I'm working on it," or "I'll let you know when I have news."
However, if you're comfortable talking about your fertility problems and think you have a sympathetic listener, by all means be open about it. Talking about what you're going through can be a huge relief.
If certain situations are too painful for you – if all your siblings had babies in the last two years, or you keep getting invited to baby showers – give yourself permission to skip these get-togethers and other social events or at least to have a good cry afterward. Protect yourself and your sense of well-being as you undergo treatment.
We're fighting about money because the treatments are so expensive. What can we do?
Even in the best of times, financial concerns exert enormous pressure on relationships. Factor in a couple's intense, frustrated desire to have a child plus the high cost of fertility treatments, and the tension over money can be unbearable. For example, in vitro fertilization (IVF) averages $12,400 a cycle, and women often need to go through multiple cycles before becoming pregnant.
Force yourself to face facts about finances, hard as that may be. Only 15 states – Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia – require insurers to offer coverage for fertility treatments. And even if you have adequate coverage, your finances will likely suffer for a time.
To avoid arguments about money, sit down together and develop a financial plan. Start with your insurance: Find out exactly what your plan does and doesn't cover. If it covers some or all of your treatments, decide which one of you will monitor the paperwork and negotiate with the insurance company. Then review your assets and determine how much you can spend and on which treatments. Ask yourselves:
- Are we willing to deplete our savings to become pregnant?
- Are the odds of an IVF pregnancy too slim to risk our savings?
- Are we comfortable borrowing money? Will we be able to repay the debt once we have a child?
- Will we have enough money left to pursue adoption if the fertility treatments fail?
Allowing yourself to be carried away by the desire to have a child is easy, but finances require rational thinking. Set a limit on what you can spend.
I've been seeing a fertility specialist for more than two years. How do I know when to stop?
Letting go of a dream is difficult, and the variety of medical technologies available today leads many people to keep trying month after month, year after year. But about a third of women treated for fertility problems won't bring a baby to term and often must make peace with that before they can move on with their lives.
Pursuing treatment, adopting a child, or accepting a life without children are highly individual decisions, and the timing differs for everyone.
The bottom line? Consider the whole picture: your financial resources, your support network, and the impact of continued treatment on your emotional and physical health. Soul-searching from this broader context and talking with your doctor and a trusted confidante or mental health professional can help you figure out how far you're willing to go to become a parent.
If you're in a relationship, be sure to listen to your partner and communicate honestly with each other. With some time and discussion, you'll know when it's right for you and your partner to accept the situation and stop treatment.