Coping with Infertility

What is infertility?

By definition, infertility is the inability to get pregnant after 1 year of trying in women under age 35 or after 6 months of trying in women over age 35. Around 5 to 10% of couples in the United States have difficulty getting or staying pregnant. 

Infertility can occur in men or women. Approximately one-third of infertility cases are related to problems within the female and one-third to problems within the male. Around 10% of infertility involves problems with both partners and 10 to 20% of infertility cases do not have any known cause. 

Infertility can be primary or secondary. Primary infertility refers to when a couple has a hard time conceiving their first child. Secondary infertility happens when a couple has already had a child, but experiences difficulty conceiving or carrying additional children. 

Stress and infertility

Infertility can be a stressful and overwhelming experience for couples. People dealing with infertility may experience higher levels of anxiety and depression. The emotional toll can lead to isolation from friends and family, marital issues, and problems with intimacy. 

Infertility can be emotionally challenging for many reasons:

  • People may feel responsible for their difficulties getting or staying pregnant, which can cause feelings of guilt, shame, and worthlessness. 
  • Fertility treatments can be overwhelming and costly. Women undergoing fertility treatments may feel the emotional impact of hormones and side effects from medications. 
  • Couples may have a hard time agreeing on decisions and dealing with their stress, which can lead to more conflict.
  • The experience of infertility is uncertain, which can lead to a perceived lack of control. 
  • People experiencing difficulty trying to conceive may feel distant from loved ones, especially other people who have an easier time having children. 

Surveys and studies on the emotional impact of infertility have found that couples may feel as depressed and anxious as people dealing with cancer or heart problems. Women tend to have a harder time coping with infertility, but men are affected too, especially if they are deemed to be the cause. Women who have a history of depression are also at higher risk of depression during fertility treatment. 

Couples may have a hard time coping with the physical, emotional, and financial costs of infertility treatment.

The relationship between fertility, anxiety, and depression

Research studies on the link between fertility and stress have found conflicting results. Many professionals believe that infertility is related to stress and encourage couples trying to conceive to focus on reducing their stress. Some research studies have found that lowering anxiety can increase the chances of getting pregnant, but other studies have not found this to be true. 

The longer that couples struggle with infertility, the higher their levels of stress. One research study found that couples who had been dealing with infertility for 2-3 years had the highest levels of depression and anxiety. The researchers found that during the first few years of trying to conceive, couples were hopeful. However, they gradually became more hopeless as they approached the third year of trying to conceive. Couples who struggled with infertility for many years and had made a decision to either adopt, use a surrogate, or not have children had lower levels of depression and anxiety.

Getting help for infertility

Over the past few decades, the number of treatment options available for infertility has increased significantly. Medical treatments focus on helping you conceive. Psychological treatments focus on helping you cope with the stress of infertility. 

Medical treatments

If you’re experiencing infertility, you should seek help from both an OBGYN and a reproductive endocrinologist, which is a doctor that specializes in fertility. Your doctor will conduct a thorough examination and testing of one or both partners to help determine the cause. The type of treatment that your doctor suggests will depend on the cause of your infertility, your age, length of infertility, and your own preferences. An in-depth look at the different options available for infertility are beyond the scope of this article, but some common medical treatments include:

Medications

Fertility medications may be prescribed for men or women. Medications for women can help balance hormones and stimulate ovulation. Medications for men can increase sperm count, production, and quality. 

Surgery

Surgery to improve fertility may be performed on men or women. Men may benefit from surgery if they have a sperm blockage. Women may benefit from surgery if they have endometriosis, uterine fibroids, uterine abnormalities, scar tissue, damaged or blocked fallopian tubes, or polycystic ovarian syndrome (PCOS). 

Intrauterine insemination (IUI)

This procedure involves sperm being injected into the uterus during ovulation. IUI can be done using your own sperm or donor sperm.

In vitro fertilization (IVF)

During IVF, eggs are removed from a woman’s ovaries and fertilized with sperm in a lab. One or more embryos are then put into the woman’s uterus. IVF is a form of assisted reproductive technology (ART), which is a medical procedure where both an egg and sperm are fertilized.

IVF can be done using your own or donor egg and sperm. If you’re using a donor, the egg and sperm will be fertilized and implanted. IVF can also be carried by a gestational carrier or surrogate, who is a woman who can carry the pregnancy for you. If you’re using a surrogate, you may be able to use your own sperm and egg to form an embryo or one created from donor egg and sperm. 

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Assisted reproductive technology (ART) is a medical approach to treating infertility.

Psychological/emotional treatments

If you’re having a hard time coping with infertility, you may benefit from seeking psychological help in the form of therapy or counseling. Some research studies have found that reducing depression, anxiety, and stress can increase your chances of a successful pregnancy. 

You may benefit from therapy or counseling if:

  • You’re experiencing negative emotions, such as depression, anxiety, or anger, almost every day.
  • Your emotions are impacting your health, work/school, relationships, or other areas of your life.
  • You are resorting to unhealthy or dangerous ways to deal with your emotions, such as abusing drugs or alcohol. 
  • Your emotions are affecting your sleep or appetite.
  • You have thoughts of suicide or harming yourself. 

Therapy and counseling can help you learn how to cope with stress and anxiety associated with infertility, as well as other challenges that you may be facing. It can help you process and decide between different types of fertility treatments and family-building options. Couples or family therapy can also help you and your partner improve communication and work out differences of opinion. 

You can find a local therapist that specializes in treating infertility by visiting Postpartum Support International (PSI), which provides a directory of local providers. You can narrow down your search by provider’s gender, specialty, and treatment orientation. 

Psychotropic medications, like antidepressants and anti-anxiety medications, can help if your symptoms are moderate to severe. If you’re considering medication, talk to your provider about the safety of taking certain medications while undergoing fertility treatments and during pregnancy.

How can I help myself cope with infertility?

You can take steps to help yourself and your partner cope with the emotional impact of infertility. Consider the following tips for reducing stress:

Relax

Relaxation strategies can help you cope with stress around infertility. You can use techniques that have worked for you in the past or try something new. Some ideas include a few minutes of mindful breathing (sitting comfortably, focusing on your inhales and exhales, and trying to let your thoughts go), yoga, and journaling.

Stay healthy

It’s easy to neglect your own health while going through fertility treatments, but taking care of yourself is important. Aim to get some form of exercise at least every other day and eat a balanced diet of fruits, vegetables, protein, and whole grains, with as little processed foods as possible. 

Breath through unsupportive comments

While coping with infertility, you may have friends, family, medical providers, and even strangers make unhelpful and even hurtful comments. They may ask you about having a baby or question your family planning choices. When faced with any negative comments or questions, take a long deep breathe. Next, acknowledge your feelings about the comment or question. Do you feel angry or hurt? Then, take one action to cope with these feelings, like venting to someone who understands, going on a walk, or meditating. 

Connect with others

Trying to conceive can be a lonely experience. Connecting with other people experiencing similar struggles or anyone who is non-judgmental and understanding is important. You can find support by searching for infertility support groups. Postpartum Support International (PSI) and Resolve, a part of the National Infertility Association, offer listings of local and online infertility support groups.

Infertility can be an emotionally and physically challenging experience for anyone who wishes to become a parent. Making efforts to connect with other supportive people, taking time for self-care, and seeking professional help, if necessary, can help you cope with this very stressful experience.

Sources:

Deka, P. K., & Sarma, S. (2010). Psychological aspects of infertility. British Journal of Medical Practitioners, 3(3), 32-34.

Domar, A. D., Broome, A., Zuttermeister, P. C., Seibel, M., & Friedman, R. (1992). The prevalence and predictability of depression in infertile women. Fertility and Sterility, 58(6), 1158-1163.

Harvard Medical School. (2009). The psychological impact of infertility and its treatment

Ramezanzadeh, F., Aghssa, M. M., Abedinia, N., Zayeri, F., Khanafshar, N., Shariat, M., & Jafarabadi, M. (2004). A survey of relationship between anxiety, depression and duration of infertility. BMC Women’s Health, 4(9).

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