Health

Infertility: What is the Emotional Cost?

What is the Emotional Cost?

How do you calculate the cost of tears, hugs and sleepless nights? What about counseling for the guilt, stress, fear and pressure to get pregnant? And, what does it cost to be polite to people’s rude questions

Internal Stress

Navigating infertility can be like the five stages of grief—it starts with denial, then shock that it’s not working, and then acceptance that it’s time to seek help. Unfortunately, dealing with the emotional roller coaster of the potentially long process is challenging.

“Infertility is always a very sensitive issue. Many women are ashamed to admit this diagnosis and often do not want to be labeled as such, especially when all of their friends are having babies. The pressure comes from all sources,” says Dr. Emily Thomson, of Hampton Roads OB/GYN.

“I was a train wreck for years. It affected every single aspect of my life, and most decisions I made, including my nutrition, social life, family relationships, work relationships. It took over my life,” says Molly Tanner, 40, from Hampton.

Adding to that already-challenging situation is that infertility is taken less seriously as a disease. RESOLVE, the National Infertility Association, lists a number of emotional effects of infertility including: irritability, insomnia, extreme sadness, anger, guilt, shame and inability to concentrate. The influx of hormones during treatments doesn’t help matters either.

“Emotionally, the first cycle murdered me. IVF does a number on your body. Your self-esteem is usually affected. Physically, I was exhausted and drained,” says Candace Fox, 34, from Virginia Beach.

Marriages Often Don’t Survive Infertility

“You have two people with different coping skills, trying to understand what the other is going through. Even if they’ve been together for a long time, they may never have had a crisis together. And infertility is not acute. It can go on for a long time and it can be unrelenting stress,” said Helen Adrianne, licensed clinical social worker in New York who has worked with infertility for 37 years.

A large Danish study in 2007 estimated that couples who experience infertility and have failed treatment for it, are three times more likely to divorce or break up than those who don’t. Marriages can be affected by a conflict over what to do when fertility is impaired from who should undergo medical testing, to how to proceed. One partner may want to look into adoption, while the other may want to pursue artificial reproductive treatment.

“I think people may underestimate the strain on the relationship. It’s so hard to deal with, personally. You feel shame, like you are broken, like you are a complete failure. You wonder, ‘Will my husband leave me for someone who can?’ says Candace Wohl, who runs an infertility support group. “And there’s the male factor, he has the same emotions but usually deals with it differently. There’s a communication strain, and men are less likely to seek a support group to talk about it,” says Wohl.

“I would say the most important thing is to talk to each other about how you are feeling. It’s important not to blame your spouse and to recognize that your spouse married you, not your fertility,” says Fox.

“We let our marriage fall to the wayside as we dealt with our grief of living with infertility and losing our pregnancies. We were in and out of counseling for five years. It finally clicked and we decided to navigate infertility together, even though we had very different coping mechanisms. I am so grateful (and a bit surprised!) that we made it through intact,” Tanner says.

In some cases, it does bring the couple together, depending on how they decide to frame it.

“I think infertility has the chance to either tear you apart, or bring you together. Thankfully, it brought us closer together. I think after making it through infertility, we can make it through anything!” says Anne Nowinski, 31, of Virginia Beach.

“In our particular case, IVF brought us closer together. Many people nearly divorce over it. In my case, both my husband and I had issues so neither of us had to shoulder excessive guilt or blame about infertility. We really saw it as us versus the world,” says Fox.

Infertility Affects All Relationships

It’s not just marriages that are affected—there are parents wondering when they’ll become grandparents, and peers to contend with who are announcing their own pregnancies. A large number of infertile couples don’t “go public” with their diagnosis. A 2009 study from Schering Plough found that 61 percent of couples try to hide fertility troubles from friends and family.

“We were silent for 3 years. In 2012, that’s when we came out about it, by starting a blog. We needed to talk about it, and our families didn’t know how to deal with it. But it helped us to explain our absences. ‘Here’s why we can’t…’” says Wohl.

“I pulled away from not just anyone having children, but anyone who may even be considering building their family. I couldn’t deal with the possibility of hearing a pregnancy announcement. I ‘hid’ so many friends on Facebook five years ago,” says Tanner.

Several women mentioned challenges with people who gave well-meaning but uninformed advice.

“People say ‘just adopt’ without knowing how challenging and expensive it is. Adoption is not a cure-all, and can cost a lot of money. I’ve heard about disaster-adoptions — where children have been taken away, sometimes after years with their adopted parents. You want a child that will be irrevocably yours,” says Wohl.

Understanding infertility as a disease and real challenge is an important part of supporting people dealing with it.

“I felt it was important to be open about it. I posted infertility blogs on Facebook. Several people from high school contacted me to talk about their own struggles. I felt a good deal of support most of the time, but I had a friendship break up over it, too,” says Fox.

Tanner says it affected every single relationship in her life, and that’s an important reason to learn about infertility — to understand how to help, and to avoid making insensitive comments. 

Advice on if it’s you experiencing infertility:

  • Know that you’re not alone and find a support group.
  • Try to stay positive, but also allow yourself to grieve your expectations and the loss of normalcy in your family-building pursuits.
  • Talk about how you are feeling with your partner.
  • Consider sharing what you are going through with your closest friends and family.
  • Ask the people you tell to read about infertility and get educated.

Advice if it’s your friend who is experiencing infertility:

  • Be there, listen and don’t give unsolicited advice.
  • Don’t pry; they’ll share the details they are comfortable with.
  • Educate yourself about infertility and don’t be flippant or try to minimize the issue.
  • Do not try to hide your pregnancy from them. It’s helpful to let them know before you announce it if you are close friends, via email so they can process it.
  • Understand that people can be happy for your pregnancy, even if they are sad for themselves.
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About the author

Natalie Miller Moore

Natalie runs Moore than Words, a health communications consulting firm in Williamsburg. She loves to learn and write about health, particularly relating to patient experience and research.