Infertility is a complicated issue that impacts the whole person with both short-term and long-term consequences. The effects of infertility often look different for each individual/couple based upon the cause, which partner is infertile, whether or not treatment results in a live birth, if the couple endures miscarriages, still birth, infant loss, where the couple is in the process (still getting treatments, choosing to adopt or remain child-free) and whether the couple maintains healthy communication in the process. As with all traumatic life events, having a compassionate social support system is always helpful.
An explanation of each of the areas on the chart above are included here as well as some ways to cope and encourage health and well being for each of the areas. These areas will be expanded upon in greater detail in future blog posts which can be found at www.embracinghealing.com.
This document is meant as a resource to aid in understanding the topic of infertility and to offer helpful ideas to assist in creating wellness. This is in no way a replacement for mental health counseling. I encourage you to seek your local mental health professionals if you need more support. If you are in crisis call 911 or go the nearest emergency room.
No matter what insurance you have and how much it covers there is no doubt that fertility treatments, procedures and doctor appointments will take a toll on the budget. If the couple has limited resources and insurance does not cover the medications and procedures, this can create a limit as to how much the couple can do to have a family. It can make a couple feel a lack of control to choose treatments and number of attempts thus adding to the desperation of making each attempt successful.
Included in the financial strain, employers may not be understanding of the scheduled appointments and the frequency of them during certain parts of the fertility process. This can become difficult in certain situations as disclosing why you will need to miss work is a very personal and private situation thus taking away the ability to separate work from private life. Also, some employers may not allow for repeated absence due to staffing issues. Determining ahead of time how the process will work with your employer can alleviate some stress when deciding how to proceed.
One way to create a sense of control over the financial aspect of treatment is to decide ahead of time how much you will spend for the treatment process. Also, some fertility clinics offer payment plans/financing to help couples during the process. It makes sense to ask questions up front to help in the decision-making process.
There are so many social and cultural impacts either temporarily or throughout the lifespan it would be impossible to list them all. Social and cultural implications can be seen anytime a couple faces typical situations where they may feel “left out” or atypical. Holiday gatherings where there is an emphasis on parent/child involvement like Christmas or Halloween are examples of this. Culturally typical events like baby showers and gender reveal parties can also be difficult for a family facing the fertility struggle. Sometimes just going to the grocery store and seeing a newborn baby after having a miscarriage can be very hard. These “normal” moments in time become a part of the very heavy burden of infertility. Included with the sadness, feeling left behind and loss are constant reminders of what the couple does not have. And very often the flip side of that enters as well; shame and guilt for having envious thoughts or angry and sad feelings.
As you can see, this is not something that you can just avoid all together, rather you can help yourselves cope by making a conscious choice to take care of yourself. If you cannot go to the baby shower, send a gift and do something nice for yourself that day. While we cannot expect that the world will change for us and we will be protected from all that triggers negative feelings, we can prepare for those things. Plan ahead and create a signal with your spouse that lets them know you need support or to leave the gathering early. Create new traditions for traditional holidays that allow you and your significant other to take a break and honor the place that you are at in your life. Connect with other couples going through a similar experience via a support group or perhaps you know someone.
Identity can be defined as the way a person thinks of themselves, how they are viewed by the world and their defining characteristics. There are many points in development where this can shift and change some or a lot depending on what is going on in the environment, or people that we are connected to. Though there are certain truths that do not change I believe that we spend our lives always trying to hone-in and know who we are and what we stand for. When a traumatic event happens such as infertility the long-held identity as a woman or a man can be challenged, especially if you are the one that has the fertility issue.
Additionally, it can be a long-held dream to grow up, fall in love and have children. It can become increasingly more difficult when the “dream” doesn’t happen as planned or at all. This leaves couples individually and together begging the question, “Who am I now if I cannot have a child?”
This is one of the hardest moments for couples as it requires some sort of effort to regroup and change the anticipated life plan depending on the outcome of the fertility treatment process. It is helpful for couples to join a support group for couples to help them with coping skills and talking to others with similar issues. Counseling is also a great way for couples (or individuals) process the stresses and frustrations involved in the infertility process.
The intellectual part of wellness deals with how a person grows and learns throughout the life. Infertility can sometimes be the focus of learning that a person does. For example, reading books about how to increase chances, fertility diets, etc. As with all medical procedures and problems, knowledge can create a sense of power.
The high cost of fertility treatments can leave individuals without the ability to go back to school and do things that would advance them in their career which can feel limiting or can feel like making a choice between pursuing a family or advancing your career.
One way to help with this is to expand areas of learning and researching to include other interest areas such as gardening or cooking, etc. Perhaps even join a book group at a local library. Maybe create a plan to take part time classes rather than whole programs so that choosing between career and creating a family maintains creativity rather than stuckness.
This area of our existence refers to the belief in a higher power or force that is there for us to rely upon. This includes a variety of religions, and even the universe. No matter what we choose to call this greater force, there is no doubt that fertility problems can challenge a person or couple’s faith.
Many people reported that their faith has grown stronger, especially in cases where there was success either through treatments or adoption. For others their faith is challenged time and time again with treatments, miscarriages and infant loss.
This is an area as well where some treatments for a variety of reasons are not accepted by some religions such as IVF. This leaves couples little choice about how far they can go getting treatments and still maintain a good connection to their church.
One way to help here is to talk to your religious leaders (priests, pastor, etc), perhaps there are support groups at your local church for grief and loss, etc. Many people report that praying or having some ritual that maintains that connection to faith and hope in times of struggle can be helpful.
Emotions can be very challenging during this period of time in a person’s life and even beyond for many years depending on the variables and how supported a person/couple were during the process to each other and from their family and friends.
There are many factors to consider here as well, the medications that contain hormones affect emotions, and the monthly cycle of ups before the pregnancy test and the low let down after. The attempts to maintain all of their emotions within the self to be able to live and work and appear okay can be difficult at times.
Grappling with infertility is a tumultuous time of attempting to remain positive and hopeful when this may include miscarriages, surgeries, stillbirths, and even no success getting pregnant at all. There are many emotions involved from joy, hope, happiness and relief to sadness, frustration, shame, and anxiety. Grief is very common.
Some ways to take care of yourself is to do yoga/meditation, get a massage, eat healthy foods, get exercise, be kind to yourself and when you do something hard honor that with a manicure or a movie night with your partner.
The important thing to remember here is that joining a support group, seeking professional help, and talking to others in a similar situation can help normalize the heaviness of the emotions and help create coping skills. Seeking professional counseling support is often a good idea as part of the treatment team as well, especially when the emotional side of things feels overwhelming.
The physical demands of fertility treatments can be challenging. There are hormones that create side effects such as weight gain, bloating, pain and discomfort. There are tests and procedures that come up and sometimes and invasive and uncomfortable. Keeping track of cycles and temperatures and noting changes to know when the most optimal time to get pregnant is becomes the focus. Many people report that they become very aware of any change in their body that occurs even after treatment ends.
It is important to maintain a positive and healthy relationship with your body during this process. Eating healthy, exercise, yoga, massage, acupuncture and relaxation/mindful techniques can help you cope with the physical aspects of the process.
Relationships are very often impacted by infertility and challenges to becoming a family. Siblings and peers may be having children easily while a couple is struggling and that can put a strain on the relationships. Whether or not the couple chooses to disclose that they are having trouble can also create misunderstanding.
At times relationships need to fall by the wayside as people may not be supportive or it becomes hard for the couple to spend time with couples that have children. They are in a different place in life. Although it may not be a malicious separation, rather a timing issue, it can feel like all the people that the couple had before are slowly no longer around.
The couple’s relationship can also struggle if they are in a different place emotionally or if they have different ideas about how far they will go in the process. There are several different ways that the relationship can be challenged also, depending on how each of them grieve and if one partner or both have the fertility problem.
Some things to keep in mind here are that there is no right way to do this and sometimes distancing from some relationships is necessary for a period. Honestly, some relationships may suffer permanent damage in times where there is a lack of empathy for the couple’s plight. Make friends with people going through what you are going through. Many fertility clinics offer support groups, yoga and meditation, and other programs that can help couples connect.
Written by: Penny Lupo MS LMHC CCPT
For further information, please visit embracinghealing.com