Are Fertility Challenges Taking A Toll? All You Need To Know!
Introduction
After months of hoping and countless doctor appointments, you stare at the negative pregnancy test, feeling a familiar wave of disappointment. You never expected trying to start a family would be this challenging. The fertility treatments, the invasive questions, and the constant comparison to friends who are pregnant or have had their babies – all of it weighs on your mental health. You may find yourself withdrawing from social events, like baby showers, because it feels unfair, or you might notice that your relationship with your partner is under significant stress. This experience is not uncommon, yet many people are forced to face it alone.
Struggling with fertility can feel like an invisible weight, affecting not just your body but your mind. While physical challenges are more commonly talked about, the emotional toll remains in the shadows. How does the journey to parenthood impact your mental health and how can we find a way to heal along the way?
What is Infertility?
Defined by the American Society for Reproductive Medicine, infertility is an issue characterized by the inability to achieve a successful pregnancy due to a patient’s medical, sexual/reproductive history, age, diagnostic testing, or any combination of those factors. Infertility is diagnosed if you have not gotten pregnant after a year of unprotected vaginal sex for those under 35 or after six months for those over the age of 35.
In a study by Rooney and Domar (2018), it is estimated that 1 in 8 couples have trouble getting pregnant or sustaining a pregnancy (1). American College of Obstetricians and Gynecologists studies revealed that 10% to 25% of all clinically recognized pregnancies will end in miscarriage (2). These statistics highlight the prevalence of infertility in couples.
Causes and Timing
Fertility struggles are multifaceted and can be a result of many factors, whether physical, hormonal, or lifestyle. For example, lifestyle factors such as stress, smoking, alcohol consumption, environmental toxins, and/or underlying health conditions can affect fertility. Fertility issues can also arise with age as both the quantity and quality of eggs change. For men, fertility issues often relate to sperm quality, such as low sperm count or abnormal sperm form. Timing plays a role, as couples trying to conceive have to consider menstrual cycle regularity and ovulation timing.
Common Fertility Treatments
Seeking fertility support through treatment requires a significant amount of time and money with no guarantee of conception or successful birth. That being said, the treatments do offer hope and the possibility of building the family you have always dreamt of, with many people finding success from these treatments. Below are some forms of fertility support treatments available to couples:
- In vitro fertilization (IVF) involves retrieving eggs from a woman’s ovaries, inseminating externally, and inserting the embryo in the uterus.
- Intrauterine insemination (IUI) involves inserting a concentration of fast-moving sperm directly into the uterus at an optimal time to increase the chances of pregnancy.
- Surrogacy includes a third-party body carrying the embryo to term.
- Egg freezing helps individuals retrieve and store their eggs for future use.
- Donor egg/donor sperm can also be an option where a third party’s genetic material is utilized.
Understanding the medical options available is crucial for effective fertility support for women.
Symptoms of Infertility
Emotional Impact of Infertility
Intrusive fertility treatments can have a profound psychological impact on mood and well-being. The process often leads to losing control over one’s life, as conceiving may not be as straightforward as initially thought. Many individuals experience a loss of identity and feelings of incompetence, particularly due to societal expectations around motherhood.
Anxiety and Depression
In general, infertility often results in anxiety, depression, and stress, as highlighted by a study in Northern California—56% of women and 32% of men at the infertility clinic reported significant symptoms of depression. In a 2015 study, researchers concluded that patients with one treatment failure had higher levels of anxiety, and patients with two failures experienced more depression than those who hadn’t undergone fertility treatment. Alarmingly, suicidal thoughts or attempts were reported in 9.4% of women experiencing infertility.
PTSD
Patients who experience pregnancy loss often meet the criteria for Post-Traumatic Stress Disorder (PTSD). A study by Farren and Colleagues found that 28% of women showed signs of PTSD one month after Early Pregnancy Loss (EPL) or miscarriage. These findings emphasize the need for greater psychological support, especially focusing on PTSD as the research is limited.
Grief
The grief that accompanies fertility struggles can be multifaceted. This grief includes mourning not just the potential loss of a dream of parenthood but also the expectations associated with starting a family. Additionally, the cycle of hope and disappointment can feel like a loss already, reinforcing the emotional weight of reality and aspiration.
Psychological Symptoms
If you’re struggling with infertility, you might experience symptoms including:
Shame
Disappointment
Fear
Elation
Joy
Heartache
Relief
Unintended Jealousy or resentment towards pregnant individuals
Feelings of inadequacy or incompetence
Numbness
Disbelief
Anger
Guilt
Sadness
Hopelessness
Depression
Anxiety
Feeling of loss of control over your life
Loss of identity
Suicidal thoughts
Stress
PTSD
Grief
Physical Symptoms
You might also experience physical symptoms with these psychological symptoms, like:
● Fatigue
● Trouble sleeping
● Difficulty concentrating
● Loss of appetite
● Episodes of crying
● Suffering relationships with others
● Self-harm
Traditional Expectations of Gender
Women often face societal pressure around fertility due to traditional gender roles that dictate motherhood as a core aspect of identity. As a result, women may feel explicit or implicit pressure from family and friends to become pregnant, which leads to emotional distress.
Having children is often seen as an important aspect of what defines a family. In marriages or relationships, those without children may face pressure from family, as lineage and legacy may be significantly important to their family or culture. It is crucial to understand that struggling with fertility does not define one’s value or capabilities; reaching out for support and practicing self-compassion can help untangle these feelings.
Men may also face societal pressure around infertility, which is often less discussed. Men might hesitate at the idea of getting tested or speaking with their physician about fertility struggles since fertility is often socially linked to masculinity. This can lead to avoidance of the topic overall and internalization of inadequacy as well as under-reported mental health issues. Additionally, men may feel helplessness or increased frustration if they are unable to actively contribute during the process of their partner’s pregnancy or fertility treatments.
Impact on Relationships
You may experience a heightened sensitivity and strain in your relationship with your partners. For example, fertility struggles can lead to feelings of blame or guilt, as well as a sense of responsibility for why a successful pregnancy is not happening as easily as expected. Additionally, there may be tension regarding treatment or future plans. Lastly, your partner might emotionally withdraw rather than openly discuss feelings, creating distance in your relationship. Here are other ways that can support both you and your partner:
Acting as a Team
Involving a partner in conversation about what you are going through is essential to successfully supporting one another and maintaining a healthy relationship. As partners, you should be actively involved in the emotional, mental, and decision-making processes to strengthen your bond and navigate challenges together. Approach the conversation with empathy and remind each other that this is a shared challenge, not an individual struggle.
Validating emotions
You and your partner will likely experience a range of emotions but it is important to validate each other's feelings without judgment. You may navigate fertility challenges differently but understanding and respecting each other can help prevent misunderstandings and feelings of neglect.
Managing Pressure around Intimacy
Fertility treatments and timed intercourse can be stressful when it comes to intimacy. Try to plan date nights, express affection, or find ways to connect that don’t center on conception. For many couples, sex becomes mechanical during fertility treatments. Talk openly about how you feel and explore new ways of being close without the pressure of conception.
Creating Boundaries
It is also important to set boundaries regarding what you want to share with family and friends about the fertility journey. Fertility issues can be an incredibly personal and emotional journey. Discussing these challenges with family and friends can become overwhelming, especially when faced with well-meaning but intrusive or unsolicited advice.
Setting clear boundaries is essential to protect your emotional well-being. This includes communicating about what topics are off limits to create a supportive environment while allowing you and your partner to navigate your fertility journey with autonomy.
Navigating Fertility Issues
Surviving a pregnancy loss can be a difficult and emotional journey. The grief associated with miscarriage, stillbirth, or other forms of pregnancy loss can impact many aspects of life. It is important to recognize that pregnancy loss is a deeply personal experience. Remember that there is no “right” way to grieve and each person experiences emotions differently. The emotional weight of such a loss is real and it is crucial to validate your own feelings.
Embracing self-compassion, leaning on supportive relationships, and honoring the memory of the lost pregnancy can contribute to a meaningful recovery.
Medication
According to the American College of Obstetricians and Gynecologists, there are antidepressant medications that are safe and effective options for individuals trying to conceive, providing support during the emotional challenges of infertility. However, certain medications to treat infertility may be associated with symptoms of anxiety, depression, and irritability. This makes it difficult to distinguish between the psychological impact of infertility itself and the side effects of the treatment.
During fertility treatments themselves, the side effects of treatments can heighten emotional stress as well. As the monthly cycles continue, the hope and disappointments related to menstruation, ovulation, or taking pregnancy tests can create increased sensitivity.
It is essential to discuss the potential side effects of all treatments and medications with a healthcare provider to discuss and understand the emotional and physical toll of these treatments.
Developing Coping Mechanisms
Below are some techniques you may find useful as you navigate through your journey.
Journaling: Write down your feelings, fears, and hopes.
Mindfulness and meditation: Practicing mindfulness and creating a dedicated space to still your mind daily may help reduce anxiety
Support groups: Joining a support group can provide a comforting space to share experiences and feelings with others who are going through similar situations
Leaning on friends: Discuss your needs with friends and the boundaries of what you’d like to discuss. You may find it helpful to have regular check-ins.
Self-Compassion: Finding words and affirmations for self-compassion will be self-soothing. Here are some examples:
“It is okay to feel overwhelmed; I am doing the best I can in this situation.”
“My feelings are valid.”
“It is natural to feel different emotions during this journey.”
“I deserve to be kind and patient with myself as I navigate this journey.
Honoring the memory of your loss: There are many ways to tangibly honor your loss. Here are some examples
Creating a tradition of remembrance
Holding a ceremony
Planting flowers or a tree in their memory
Professional Support
It is important to consider therapy if you are feeling any of the symptoms discussed especially if these symptoms are getting in the way of your day-to-day life. Counseling provides a safe space to process all your feelings and gives you the tools you need to heal and make the best decisions for you and your partner. The combination of all the frustration, grief, and sadness can take a toll on your connection with your partner. Therapists can discuss healthy coping mechanisms and stress management to alleviate the emotional strains on your relationship. This can encourage teamwork during your fertility journey and facilitate communication in order to address feelings of blame or guilt.
Conclusion
If you are experiencing fertility challenges, it is common to feel isolated and hesitant to share your story. It is important to remember that you don’t have to face this alone. Access to mental health resources is an essential aspect of fertility support for women, men, and non-binary individuals who are facing emotional distress. If fertility struggles are putting a strain on your relationship, counseling can provide a neutral space for both of you to express your concerns. There are resources available to help you. Our Trust Mental Health team of BIPOC therapists provides specialized support to help you process your emotions, including IVF/Fertility therapy, relationship counseling, and individual therapy. They can guide you through understanding the mental health effects of the fertility journey. We offer both in-person and online therapy options. If you’re in California and need fertility-related counseling, schedule a free 15-minute consultation with us.
Key Points:
Infertility affects many couples, often diagnosed after a year of unsuccessful attempts.
Causes can include age, hormones and lifestyle factors.
The psychological impact is significant as many experience anxiety, depression and even PTSD following pregnancy loss.
Societal pressures can increase feelings of inadequacy and worthlessness
Fertility struggles can strain relationships but open communication and emotional validation can help support one another
Seeking Professional support can aid in healing
FAQ
How does fertility affect mental health?
Fertility struggles can have a profound effect on mental health. The uncertainty of not being able to conceive can cause significant stress on the individual. Worrying about the future, feelings of inadequacy or struggling with disappointment after unsuccessful attempts can result in anxiety and depression. Fertility struggles can also create tension in relationships as partners might feel helpless not being able to express their feelings may lead to misunderstandings.
When should I seek medical advice for infertility?
You should seek medical advice for infertility after not conceiving after a year of unprotected sex for those under 35 or after six months for those over the age of 35.
How to cope with fertility struggles?
Coping with fertility challenges involves seeking professional help. Our TMH team can provide a safe space to process your emotions and develop healthy coping mechanisms. You can also join support groups that help you connect with others facing similar challenges. It is important to acknowledge your feelings without judgment and remind yourself that your feelings are valid.