Coping with infertility
Coping with infertility:
The pressure to raise a family can be enormous, and the thought of not being able to have children can make many people feel something is wrong with them. We talked to respected mental health professionals who work with people dealing with fertility problems to find out which coping strategies really work.
Recognize that a fertility problem is a crisis
A fertility problem may be one of the most difficult challenges you’ll ever face. Acknowledging this is a key to coping, says Kate Marosek, a licensed clinical social worker who has counseled people with fertility issues in the Washington, D.C., area for more than 20 years.
“It’s normal to feel a monumental sense of loss, to feel stressed, sad, or overwhelmed,” says Marosek. “Don’t chastise yourself for feeling this way.” Facing and accepting your emotions can help you move through them.
Identify and share your feelings
If you’re always putting up a brave front, others won’t understand what you’re going through, and you’ll feel even more alone. It can be helpful to sort out your thoughts and feelings by writing them down in a journal first, and then sharing whatever feels comfortable with trusted friends or family.
Don’t blame yourself
Resist the temptation to get angry with yourself or listen to the little voice in your head that says negative things like, “I shouldn’t have waited. I’m being punished for terminating that pregnancy. I should have lost more weight or taken better care of my health. I shouldn’t have assumed that I could have children whenever I wanted.”
“People can get caught in negative thinking patterns that only make matters worse,” says Yakov Epstein, a psychologist at Rutgers University. “Instead of berating yourself, look forward to how you are going to manage the situation.”
When you start feeling like you “should have” or “could have,” remind yourself that your fertility problem is not your fault. Even if you could have made different decisions in the past, they’re behind you. Focus on the present.
Work with your partner as a team
If you have a spouse or partner, help each other through this time (and don’t blame each other for your difficulty getting pregnant).
This doesn’t mean you need to feel the same thing at the same time – expecting to have the same emotional experience or ways of coping is one of the most common pitfalls for couples facing fertility problems. It does mean paying attention to what your partner’s going through. “If you’re taking care of each other emotionally, you can unite to fight the problem,” says Marosek.
Work together to find practical ways to share the burden. If you’re undergoing treatment, your partner can take care of the insurance paperwork. If one of you needs injected therapy, the other can administer the shots.
Find out as much as you can about your fertility issue. Ask your doctor questions and talk to other people in your situation.
Staying educated is especially important when you’re dealing with a fertility problem because the technologies behind the treatments are complicated and change quickly. “You’ve got to understand what’s happening medically,” says Epstein, “or you won’t be able to make informed choices.”
Explore our fertility problems section to learn the basics, and see our resource guide for a list of helpful books, websites, and organizations.
Set a limit on how long you’re willing to try
Some people decide from the get-go that they won’t go to extreme measures to have a baby. Others spend years and thousands of dollars exhausting all their treatment options.
It’s your decision when to stop trying to conceive, but you’ll feel more in control of your life if you start thinking in advance about how far you’re willing to go to get pregnant.
Start by discussing your medical odds of getting pregnant, which treatments you’re not willing to try, and your end goal. (For more help with this choice, read about making the decision to end fertility treatment.)
Decide how much you’re willing to pay
In vitro fertilization (IVF) averages $12,400 a cycle – and you may need to have more than one before becoming pregnant.
To cope with the anxiety caused by the high costs of treatment, sit down and develop a financial plan. Start with your insurance: Find out exactly what it does and doesn’t cover. If your plan covers some or all of your treatments, decide how you’re going to monitor the paperwork and negotiate with the insurance company.
Then review your assets and determine how much you can spend and on which treatments. “You should always have a plan B,” says Alice Domar, a psychologist and associate professor of obstetrics, gynecology, and reproductive biology at Harvard University Medical School who specializes in helping people with fertility problems. “Because nothing, especially with fertility treatments, is certain.”
Get support from professionals and other people with fertility problems
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.
“Finding other people who are going through the same thing can help you see that fertility problems are widespread and your disappointment is understandable,” says Linda Klempner, a clinical psychologist at Women’s Health Counseling in Teaneck, New Jersey.
Share stories and advice about fertility problems with others in the BabyCenter Community or find a support group in your area.
If you’d like to talk to a therapist, look for one who understands reproductive medicine. “Fertility problems are very complex, and if a therapist does not understand the medical issues, he or she won’t be able to help,” says Epstein. Look for a referral through Resolve: The National Infertility Association or the American Society for Reproductive Medicine.
Help others help you
Find articles and books about infertility to pass on to close friends and family, so they can better understand what you’re going through and how they can be supportive.
Just say no to baby-focused activities
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 family get-togethers and other social events or at least to have a good cry afterward.
To avoid hurt feelings, send a gift but order children’s books online or email a gift certificate to save yourself an upsetting trip to the toy store or baby boutique.
Balance optimism and realism
“You need to be optimistic to go through a procedure,” says Epstein, “but if you’re too hopeful – if your hope is unrealistic – you’ll be setting yourself up for a huge fall.” By keeping current on the technology and your diagnosis, you can have a good understanding of your chances of success with each treatment.
The variety of medical technologies available today leads many patients to keep trying month after month, year after year. But about a third of women treated for fertility problems will be unsuccessful in having a biological child, and often must make peace with that before they can move on with their lives. Staying realistic can help you make smart choices as you work your way through the emotional minefield of treatment.
Take care of yourself by pursuing other interests
Being treated for a fertility problem can feel like a full- or at least part-time job, so it’s important to keep up with some of the activities or hobbies that you enjoy.
“It won’t be easy,” says Marosek, “especially if you’re doing something like going in for a blood test every other day, but look for ways to take care of yourself.” She recommends that people get a massage, exercise – anything that can offer relief from the focus on fertility treatment.
If your old activities are painful – maybe all your friends are parents now – look for new diversions. If hiking sounds appealing, do that. Or take a class in painting, dance, or something else that’s always interested you.
And remember, laughter really is the best medicine. See a funny movie, head out to a comedy club, or reread your favorite funny novel.
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 BabyCenter 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.