by Barbara Cáceres, Licensed Clincal Social Worker

You’ve been a faithful charter for quite some time, and now you’ve decided it’s time to start your family. There’s a certain thrill to using the fertile time, and you’re confident you’ll conceive that much-wanted child. But months pass, and it doesn’t happen. The initial excitement of “trying” turns into anxiety and questioning.

Most people take fertility for granted, and assume that they can plan to control childbearing. Yet approximately one in five couples will face fertility difficulties or infertility during their reproductive life. Regardless of the reason--and for many couples there may never be a definable medical reason--the couple does not conceive or experiences repeated pregnancy loss.

Couples struggling with fertility issues are faced with enormous pressures, and because it is essentially an invisible affliction, it is easy to feel isolated and alone. Feelings of anger, loss of control, shame and failure, altered self image, discouragement and questions of “Why me?” are common. The unrelenting stress and pressure of dealing with infertility can exact a heavy toll on a couple’s relationship, with significant impact on relationships with friends and relatives, physical and emotional health, intimacy, jobs and energy levels. In addition to dealing with the challenges of everyday living, couples must make decisions about fertility testing, medication, surgery or invasive treatments, assisted technology, adoption, or
living without children. Processing these issues can come to dominate life.

In a culture where few are bold enough to ask your annual income, nearly everyone will inquire about your fertility. The intrusiveness of painfully insensitive inquiries and thoughtless comments by others can be overwhelming. And if that isn’t enough, there are always baby shower invitations, Pamper commercials, shopping malls filled with strollers, pregnant women everywhere and a tendency by people to want to “blame the victim.” Your colleague at work brags for the hundredth time that all her husband had to do was look at her and she got pregnant (all four times). Couples struggling with fertility are probably too familiar with the stresses . . . what can they do to help themselves through this period of their lives? Here are some suggestions for weathering infertility:

• Find support. Seek out friends, family or colleagues who understand your feelings and can be responsive to you by truly listening, empathizing and offering support and protection over the long haul. A mental health professional acquainted with the special emotional needs of an individual or couple facing fertility difficulties may also be helpful.
• Protect your emotions. Learn to anticipate those persons or situations that you know will be painful or uncomfortable for you (baby showers, Baptisms, family gatherings, certain individuals or groups). There are so many situations in which you have little control over what you’re exposed to that making a decision to limit your involvement or politely decline may feel liberating, and one way in which you can regain some control over your life. Remember--your mental health comes first, and if people can’t understand why it’s difficult for you to be around them, it’s their problem.
• Prepare yourself for thoughtless inquiries. You may want to arm yourself with preplanned comebacks to deal with the insensitive remarks and obnoxious questions regarding your family size or fertility that crop up with alarming frequency. It may take some experimenting to find responses that work for you, but having premeditated answers can relieve you of emotional turmoil in the “heat” of the moment.
• Respect different coping styles. Any loss or crisis has the potential to create strain and deepen the bond in the marriage. Couples will generally handle infertility similarly to other crises, although infertility has the added dimension of isolation which may cause them to rely entirely on each other and draw them closer. Each partner may be in a different place emotionally or have different ways of handling their feelings, which can cause a sense of estrangement. Respect for these different coping styles, patience with each other, and good communication will help you survive as a couple through this difficult time.
• Use the “20 Minute Rule.” One infertility therapist has recommended limiting the time couples spend in infertility discussions (you can set your own time limit). This guarantees the spouse who may be reluctant to discuss these issues that the discussion will end, and assures the partner who wishes to talk that the conversation will take place.
• Schedule time off from infertility. It is easy to underestimate the effect of months of charting, medical procedures, treatments and disappointments. Taking a vacation from focusing on fertility may give you an opportunity to get back in touch with yourself and each other.
• Share responsibility for the work of infertility. Couples can expend a tremendous amount of energy on the work of infertility--treatment, scheduling, research into treatments and resources, dealing with insurance companies, grieving--while the woman is generally the one who undergoes treatment. Developing a plan for equitable division of labor so that both partners feel involved (even if some activity is largely symbolic) may alleviate one source of tension between partners.
• Take care of yourself physically. You may get a lot of advice from others, and chances are you’ll be told frequently to “just relax.” Although there is no proven connection between anxiety and infertility beyond the possibility of delayed ovulation (and therefore decreasing the number of chances of getting pregnant), you will certainly feel better during this stressful time if you are well rested and as relaxed as possible. Exercise, massage, meditation, getting out of town for the weekend, or other soothing activities may all enhance your feeling of well-being.
• Educate others. Depending on where you are emotionally in the process and how willing you are to share your experience, you may want to educate those people with whom you come in regular contact about the emotional aspects of dealing with infertility. On a small scale, this can be done by simply telling someone what they could say or do (or not say or not do) that would bring you comfort. Although it requires energy and initiative from you, it may help others to better meet your needs.

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Taken from News for Planners, St. Agnes Health Care Department of Natural Family Planning, Baltimore, MD Vol. 16,
No. 2. Reprinted with permission.