“We always dreamed of having a family of four.”
“We never thought we would have trouble getting pregnant.”
“I feel so alone and sad.”
“This is not the way it was supposed to be…”
but in fact, one in six couples experience infertility.
Receiving a diagnosis of infertility has been described as shocking and devastating. Emotional responses may range from denial to a sense of collapse. Through the roller coaster of the infertility path we feel helpless and desperately desire a way to regain control.
The diagnosis of infertility begins with a variety of medical tests and procedures. Ultimately, depending on the findings, medical treatments can vary from pharmacological interventions to assisted reproduction techniques such as in vitro fertilization to donor strategies. However, the medical aspect of infertility is one piece of a larger puzzle. Emotional stress is also a significant part of the process.
The stress of infertility and its effects
Often people undergoing infertility experience a variety of emotions. Feelings of worry, anxiety or even fear are common and are normal when people become involved in infertility treatments. For example, people might worry about the financial costs and the stress this might cause. During treatment, women often worry about giving themselves injections, or possible medication side-effects. Men often feel uncomfortable about their role in the in vitro fertilization process. Women also sometimes worry about coping with egg retrieval or just feel generally anxious about the procedures or the unknown.
Learning to cope with loss and grief is a very important part of the infertility process. Examples of loss include, miscarriage(s), unsuccessful cycle(s), and loss of the dream of having your own biological children. Such losses have been equated to symptoms of posttraumatic stress where individuals and/or couples feel a need to avoid reminders of the event, can feel numb, have trouble sleeping, become irritable and socially isolated. Taking the time to grieve such losses and seeking support from someone you feel safe with, are some ways to help you through this incredibly difficult period.
The feelings of helplessness and lack of control are often paramount for individuals experiencing infertility. Learning effective coping strategies to deal with stressors, and learning ways to reinstate control in our lives are valuable and helpful tools.
Ways to manage and/or cope
From the beginning try your best to educate yourselves about the treatment process. For example, prepare a list of questions you may have; speak with your doctors and nurses regarding the medical procedures and options; ask for information to be repeated if you don’t understand; go home and discuss these procedures and options with your partner; ask about the costs of the treatments and, if you have insurance, find out how much coverage you may have for medication, counselling and other costs.
Once in treatment, you may find it helpful to inform your clinic staff about what you need and prefer during your procedures (such as egg retrieval). That is, are you someone who prefers to be told what is happening step by step or do you prefer to know just the basics; do you need someone or something to distract you; would it help to have an ipod/mp3 with a book or music; and/or do you prefer your partner be in the room for support?
Coordinating appointments can often be a stressful and time-consuming process. It is therefore helpful to plan the “logistics” ahead of time such as whether you would like to inform your work place of what is happening and/or if you would like to take some time off work; who will travel to and from appointments with you and if you are not feeling well enough to drive who could do the driving; is it possible to restructure your usual schedule to accommodate the treatments including delegating certain responsibilities in your life.
While the above strategies are practical and logical, it is also helpful to incorporate self-soothing strategies throughout the process. Some people practice relaxation strategies such as slow deep breathing while reflecting on an image, word or thought that evokes calm, such as a vacation spot. Others prefer learning formal stress reduction techniques such as Progressive Relaxation or Controlled Breathing, Yoga or Meditation; and others turn to playing a musical instrument or keeping a journal. While stress in itself does not cause infertility, stress reduction exercises during fertility treatments have been shown to increase pregnancy success rates.
The sense of helplessness and lack of control throughout the infertility process can be highly stressful. It is therefore important to try to be self-nurturing and take charge of those things you can control… specifically, eat well, sleep well, exercise moderately and plan some enjoyable activities such as going to a movie or reading a novel.
While we are always hopeful that treatment will be successful, it is important to be aware and accept that disruptions may occur. It is therefore helpful to keep in mind that treatments can take time and disappointments may be experienced. If you have an unsuccessful cycle, try to give yourself time, both physically and emotionally by not immediately beginning another cycle. Remember, infertility and its treatment can be an exhausting and difficult process. Try not to minimize what you are going through. Some individuals may experience mild to moderate feelings of depression and/or anxiety. Others can feel as though they are in crisis.
Infertility counsellors are available. A trained professional can help you process the feelings and experiences associated with infertility and teach you effective stress reduction strategies. You don’t have to cope alone.
Dr. Julia Sen is a Registered Psychologist working in private practice in both Markham and North York, Ontario. She works with individuals and couples with various concerns, including depression and anxiety. Dr. Sen has a special interest in infertility and holds a certificate in infertility counselling.
Look for Dr. Sen’s next article: “Relationship stress: Coping with infertility as a couple” in the next edition of Healthy Living.