Infertility is more common than people realize though not often discussed. The American Society of Reproductive Medicine (2020) has defined infertility when either, one or both the male or the female, are unable to contribute to the conception due to structural problems, ovulation issues, semen or egg quality issues, lifestyle factors or medical conditions or treatments. Over the years, there has been increased medical interventions, Assisted Reproductive Treatments, that provide hope yet no guarantees. The decision-making process is quite complex involving not only medical concerns but psychological ones as well. The diagnosis can be traumatic and the range of emotions can include shame, grief, loss, a sense of failure, despair and fear. The longer and more in depth the treatments stress increases, personal resilience decreases and the likelihood of relationship satisfaction decreases.
I dreamed about having a baby from the time I was quite young playing with my own Rub A Dub Dolly. Being a parent can be part of the core of our identity and when this idea is threatened a myriad of emotions and thoughts flood us. Quite frequently couples discuss having children early on while dating before they even commit to a long-term relationship or marriage. For many couples, this is a goal or a life dream. Finding out that there are infertility problems can bring on many emotions including stress, anxiety and depression. It can be especially difficult for women as they may see this as their fault or one of their primary roles in the relationship. The commitment to infertility treatments involves many factors not limited to time, finances and emotional fortitude. The couple may come to different conclusions about when to stop trying or what is even the cause of the problem. Those couples experiencing infertility struggles with no known physical cause are the most likely to benefit from couples counseling and it can actually increase their likelihood of getting pregnant.
“Couple therapy is indicated when infertility is unexplained as it is more likely to improve pregnancy rates when it is idiopathic in nature rather than medical and structural.” –Jessy Thompson
Even well-intentioned friends and extended family may offer comments that fuel feelings of inadequacy or distress. These lead to the couple keeping things to themselves and feeling more alone. Individual, group and couples counseling have been effective in helping individuals cope with the growing distress. One of the key factors to be explored is the meaning making that effects the individuals’ identity in the couple relationship.
Different Coping Strategies
We all have individual ways of coping with our problems. When infertility issues arise, it is no different. Each partner in the couple relationship may cope in their own unique ways. One example, is the individual may withdraw and isolate. The other may seek out increased connection and support and want to talk about their struggles openly. Though these coping strategies may work for the partner’s individually, they may cause problems to the relationship. It is especially distressing when one isolates and the other is seeking connection. Another common form of coping is to minimize, down play or suppress the uncomfortable thoughts, feelings and behaviors associated with the infertility. Though this may help the individual distract themselves from pain, the partner will often protest they are alone in the struggle. Problems can arise within the extended family, friendships and community. Due to the increase of isolation, heightened stress and less time with increased medical appointments, the couple needs each other more than ever.
The Power of Coming Together
How couples communicate and come together during the period of infertility treatment, can affect their own individual adjustment and the relationship adjustment. If the couple learns how to keep communication open during this time, safe and connecting the likelihood of depression in their partner decreases. In therapy, individuals can learn their own emotion regulation skills, identify their needs and how to approach meeting those needs in healthy ways. In couples therapy, the couple learns not only how to individually cope with the stress but better ways to support their partner in couples coping as a team. Research has shown promising results specifically when treating infertility through a systemic and attachment lens.
“The outcome of this research also demonstrates that couple therapy of six or more sessions is indicated for couples who present with a lengthier infertility history, which is impacting their relational and emotional wellbeing.”—Jessy Thompson
“This review also provided exploratory evidence that some therapeutic approaches are more effective than others. Emotionally focused therapy seems particularly promising, with a reduction in all psychological and relational problems, demonstrating the importance of using an attachment lens which accounts for how partners depend on one another in times of distress;…” –Jessy Thompson
Getting Help at a Time of Need
Chaves, Canavarron and Moura-Ramos (2018) emphasize the difficulty of navigating the distress of infertility and the way the members of the couple support each other may affect the experience of infertility and their adjustment. They go on to say, the results of their study highlight the importance of men having coping strategies that involve their partner for the marital adjustment of couples as well as for men’s emotional adjustment. They also emphasize how important it is for men to be involved in the fertility treatment process reinforcing that infertility is a couple process.
If you are ready to seek couples counseling for an additional layer of support during a difficult, yet meaningful time please reach out today.
American Society for Reproductive Medicine (2020). Fact Sheet: Infertility. Retrieved from http://www.reproductivefacts.org/globalassets/rf/news-and-publications/bookletsfact-sheets/ english-fact-sheets-and-info-booklets/defining_infertility_factsheet.pdf
Catarina Chaves, Maria Cristina Canavarro, Mariana Moura-Ramos (2018), The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility. https://doi.org/10.1111/famp.12364
Thompson, J. (2021), The Effectiveness of Couple Therapy on Psychological and Relational Variables and Pregnancy Rates in Couples with Infertility: A Systematic Review. Aust N Z J Fam Ther, 42: 120-144. https://doi.org/10.1002/anzf.1446