Infertility

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Physically, infertility treatment is often not as difficult as people expect it to be. However, the emotional aspects of infertility can be very difficult, especially if fertility treatment doesn't succeed or takes much longer than anticipated. Having a family is something that many couples consider to be their first priority, and there are few conditions that have such a strong impact on one's present and future. The sense of family, connection with friends, financial security, spiritual grounding, and self-esteem can all be affected.

To reduce the stress associated with infertility, women are increasingly becoming aware of things that they can do to improve their emotional health and perhaps even increase their chances of becoming pregnant. For example, support groups are becoming increasingly popular. Others turn to meditation, yoga, acupuncture, and massage. Taking good care of yourself can give you a feeling of control over a process that often feels so elusive and without end.

In some situations it may even be advisable to reach out for professional help from a counselor or therapist who is specifically trained in the field. Being able to challenge inflexible thinking patterns and learn to become more emotionally resilient can offer optimism and a sense of confidence.

For some people, infertility treatment may never lead to pregnancy. Many may find that, while adoption did not originally seem like the best option, it may be a beautiful solution. Research shows that no matter how couples resolve their infertility, they love their children, regardless of genetic origins.

This section has more information on:

  • Family and friends
  • Effects on relationship
  • Effects on sexuality
  • Support groups
  • Feelings of guilt
  • Depression
  • When to stop or take a break
  • Telling children about their genetic origin
  • Adoption
  • Family and friends

    Many people feel they want support from friends and family, but the people around them may not know how to give it. The best strategy is often to ask for the kind of support you want, for example by saying, "I don't want suggestions, I want your support." Many people with infertility have had the experience of a friend saying, "Why don't you just adopt?" This is a sensitive issue for many people with infertility, and explaining that may help your friend understand. When people do make insensitive remarks, it may help to remember that their comments are usually well-intentioned; they aren't trying to hurt you.

    It's a good idea to think ahead of time about what to tell different friends and families. For example, if you have a friend who says hurtful things without thinking, you might not want to tell him too many details about your infertility. Someone who is usually more supportive might be better able to handle this milestone in your life, too. Or you may choose not to tell anyone about the treatment and to find another way to deflect questions about why you don't have children.

    Parents can sometimes be unsupportive without realizing it, by unconsciously putting stress on the couple. Just questions about when to expect grandchildren can make couples feel stressed or even angry. It may help to promise you'll let them know if there is any good news.

    One useful tip: Try to avoid being specific about dates of treatment. For example, if you tell everyone you're going to find out if you're pregnant on December 2 and the procedure fails, you may not want to spend the evening on the phone telling everyone that.

    It isn't unusual for couples who use donor eggs or sperm to end up wishing they had told fewer people, so it may be wise to be cautious with this information. You can always give vague answers to questions about how you got pregnant, or refuse to answer the question—"My husband and I have decided that now that we're pregnant, we're not looking back." "We had great doctors and that's where we're leaving it." Overall, if you feel comfortable with the treatment you had, and you present yourself that way, people will probably follow your lead.

    At work, you are legally protected from having to share your diagnosis with your employer. You may want to tell your boss and coworkers that you're having some medical treatments done, but make sure it's clear that you don't have cancer or terminal illness. Infertility treatment requires so many appointments that your coworkers may think you are seriously ill.

    Effects on relationship

    People with infertility often feel a sense of loneliness, regret and isolation. Although they may be in stable and supportive relationships, it is unusual to see couples cope the same way at the same time. In general, men are a bit more optimistic. Often they don't realize how badly their partner wants children or have difficult empathizing with their partner. Many women feel infertility, particularly female-factor infertility, as a personal failing.

    When men are stressed by infertility, it often comes out as being irritable or overcompensating by spending more time at work or at the gym. Women, on the other hand, may be more likely to feel vulnerable and tearful. Since women often have activity limitations because of the treatments, they may not be able to find the same escapes as men.

    The two partners may grieve setbacks in different ways. These differences can be particularly pronounced because women are on hormone therapy often do not feel like themselves. This can be an emotional time under any circumstances, but even more so with extra hormones and the stress of infertility treatments.

    For men, the best suggestion may be to be a listener; not every problem must be solved, and often all the woman wants is for you to hear her out. Follow her lead, offering a shoulder to cry on or an evening out if that is what she says she wants. (Of course, the same is true if the roles are reversed.) Although the woman's body usually experiences most of the treatment, the man can stay involved by driving to procedures that require sedation, dealing with the insurance company, picking up medications at the pharmacy, or giving injections.

    It's important to take breaks from talking constantly about infertility so that it doesn't become your whole life instead of just a piece of your life. It may be best not to share with very young children that you are trying to conceive. Older children may sense that something is going on, so sharing age-appropriately is recommended. Most importantly, do not lean emotionally on your children and remember that they need you to be a fully functioning parent.

    Effects on sexuality

    For most couples, infertility makes sex feel like a burden. If they are using a combination of fertility medications and timed intercourse to combat infertility, they may feel like they have to have sex at the appointed time whether they feel like it or not. Others may feel that the only point of sex is to have children, and lose interest when they realize their sex is never going to lead to pregnancy.

    Many people feel they start the process of infertility with a healthy sexual relationship that deteriorates through the course of treatment. A sex therapist can help a couple learn to communicate about sexual needs and learn new skills to handle the disappointments and frustrations.

    Support groups

    In support groups, people are able to connect and get support from other people who are in a similar situation. It is common for women who are going through infertility to feel that their friends don't really understand. Infertility is so private and personal that people often feel they have no one they can talk to about it besides their own partner. Even then, husbands often don't need to talk about infertility as much as women do, so women experiencing infertility may build up anxiety that they feel they can't talk to anyone about it. Women in support groups say it can be helpful to talk and share with others who are having the same experiences.

    Some support groups last for a set period of time; others may be ongoing, so you can continue dropping in for as long as necessary. Often people who start going to an infertility support group continue until they resolve their infertility, either by getting pregnant or deciding to end treatment.

    Support groups may be available for people with specialized issues - for example, women who have not had any children yet or those who consider using donor sperm or donor eggs. A pregnancy support group may help with anxiety about finally being pregnant after difficult treatments.

    Feelings of guilt

    Many people feel guilty about their infertility. Often, the doctor is able to work out whether it is the woman or the man who has the disorder leading to infertility, and that person may feel he is letting the other partner down. Being the one with the disorder can affect a person's self-confidence, self-worth, and feelings about being a man or woman. Being reassuring can help the partner with the disorder feel better.

    Many women also feel guilty if they had a pregnancy termination or abortion when they were young and can't get pregnant now; this might lead to the feeling that they gave up their chance to have a child. Counselors say that after you acknowledge this feeling, there is little benefit in dwelling on this; it won't make it any easier to get pregnant now. The same is true if sexually transmitted disease led to the fallopian tubes being blocked. An attitude of acceptance and forgiveness is best.

    Depression

    Research has shown us that up to 40 percent of women pursuing treatment are considered clinically depressed. This is over twice the incidence in the general public. Some women shut out their friends, or avoid making friends with people who have children.

    Infertility may make you feel like you can't sleep, eat, or think. It can also make you feel anxious and sad. If infertility is affecting your ability to function, it may make sense to talk to your doctor about getting mental health treatment. This may include counseling and in some cases antidepressants.

    When to stop or take a break

    Many people start to feel emotionally spent after about two years of infertility treatment. The older the woman, the more urgency the couple may feel because of declining egg quality. Donor eggs remove the time pressure, but people can still feel as though their lives are on hold until they resolve their infertility. This can make it difficult to know when it's time to take a break or change treatment options.

    Some indications for taking a break from treatments may be if the couple's relationship is at risk, or when partners feel they have lost the sense of who they are, or their sense of humor. This may also be the point when other options—for example, adoption—may start to look more attractive than continuing fertility treatment.

    Telling children about their genetic origin

    Most experts recommend telling children the nature of their genetic origin, such as if they were born from donor eggs or sperm. The fact that a child isn't genetically related to one or both parents is medical information that may be important later, and waiting to tell a child until his or her late teens may make the child feel betrayed. While it used to be more common to keep assisted reproductive technology secret, more parents are open with their children now.

    It is best to tell the child bits of information at teachable moments—starting with mentioning that mom had a hard time getting pregnant and a team of medical people helped (while, of course, telling the child how happy his parents were when he was born). A good time to tell the child about the donor might be before a vacation so the child can ask questions during a relaxed time, rather than trying to process it when parents are running off to work.

    It's probably a good idea to refer to the donor as a donor rather than a genetic mother or genetic father, which can be confusing. Usually children end up taking this kind of information in stride; it's the parents who are relieved to be able to be open and honest.

    On the other hand, some people may decide never to tell the child or anyone that a donor was involved. The most important thing is to act with the child's best interests in mind. Some families plan never to disclose the information.

    Adoption

    After a few years of unsuccessful infertility treatment, many couples reconsider their desire to have a genetic child and adopt. They may even question why they endured so many years of medical treatments that didn't work.

    Before beginning the process of adoption, people who have been going through infertility treatment should take time to grieve the loss of having a genetic connection with their child. For some people, that takes a long time; others come around to the idea quickly.

    It may be encouraging to know that almost everyone who wants to adopt and is qualified eventually succeeds. The most common paths are through an adoption agency or a private adoption attorney. Some parents find a child through family or friends, by putting out the word that they are looking to adopt. Some may put up a website or a toll-free number for friends to distribute so a pregnant woman can learn about them and call at any time.

    In open adoption, there is some contact or possibility for contact with the birth parents. While this used to be rare, it is now generally viewed as being in the child's best interest. This is the more common type of adoption domestically.

    In closed adoptions, there is no ongoing relationship with the birth parents. This is the usual situation in international adoption.

    Last reviewed on 03/31/2007

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