Emotional aspects of infertility
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Most people simply take it for granted that they will be able to have children. In fact, one in six couples trying to have a baby will experience problems in doing so (1). Infertility is often described as a life crisis, creating upheavals similar to those associated with a death in the family or divorce. People are often shocked when they discover that they are infertile and commonly go through a period of disbelief. Others rush into treatment without first coming to terms with the diagnosis. The overall impact of infertility on individuals differs greatly, and is influenced by factors such as cultural background and the importance a person places on having children in their life.
Infertility and women
Individual women have different experiences of infertility but there are several feelings that are common. Women may feel a sense of anger at not being able to have children and resentment towards other pregnant women. They may also have feelings of guilt, regarding their infertility as punishment for putting their career first, using contraception, or for a previous termination.
Some women may feel uncomfortable around children and consequently start to isolate themselves from family and friends who have children. Increasing isolation leaves the women without social support networks to help them overcome the feelings of depression and frustration commonly associated with infertility. Christmas, Easter, Mother’s and Father’s Day become painful reminders of their infertility instead of celebratory occasions.
A woman may develop feelings of hatred or disgust towards her body, perceiving it as inadequate, dysfunctional and diseased. Similarly, a woman’s sense of femaleness is often closely associated with pregnancy and motherhood. Infertility, therefore, may have a serious impact on a woman’s sexual identity, leaving her feeling less sexually attractive or asexual (2).
Infertility and attempts to overcome it can lead to a loss in perspective. Women may put everything else in their lives on hold, putting all their energy and time into getting pregnant. They may delay making changes in everything from their careers to their current housing situation, deciding to wait until after they have 'had the baby'.
Infertility and, in particular, medical treatment programs can place women on an emotional rollercoaster of hope and then despair. Women may often go through a cycle of hopefulness leading to disappointment at the arrival of their period.
Infertility and men
Many of the medical treatments for infertility focus on the woman’s body which can leave men feeling helpless and left out of the process. If the couple’s infertility is due to a sperm dysfunction, the man may feel that he is impotent or lacking in masculinity. The strong societal link between fertility and virility causes many men to keep their infertility a secret, in turn increasing their feeling of isolation (3). While women may find some support from female friends, it is not uncommon for men‘s male friends to show little understanding.
Infertility and relationships
Infertility can also place a great strain on a relationship, particularly in cases in which the problem lies with one partner. The infertile partner may constantly fear being left for another (fertile) person, while the fertile partner may blame or feel anger towards their partner. Frequently there are differences in a couples’ expectations concerning children, with women more likely to express a greater need for a child. Differing levels of enthusiasm are often apparent in couples where one partner has children from a previous relationship. Coming to an agreement on what fertility tests to perform, what treatment options to pursue and when to stop treatment can all cause conflict in the relationship. If one partner does not want to begin or continue with treatment, the other partner may feel as though they are being denied the chance to have a child and become resentful.
Treatment for infertility also frequently interferes with a couple’s normal sex life. The initial discussions to identify possible fertility problems involve disclosing many personal details regarding one’s sex life. Similarly, the loss of privacy associated with tests such as sperm counts and the post-coital test can destroy feelings of intimacy. Timing sex around ovulation can make it feel like a chore than something pleasurable. The lack of spontaneous sex and sex for enjoyment rather than procreative purposes can lead to sexual dysfunction such as erectile problems in men and vaginal dryness in women.
Although infertility is potentially the source of much strain on a relationship, many couples also report that going through the experience has made their relationship stronger. Couples that have shared the physical and emotional stresses of infertility may feel that it has brought them closer together and has cemented their relationship. Successfully coping with infertility can result in couples feeling confident that they can tackle any future problems.
Infertility and family/friends/employers
Infertility can also place a strain on relationships with family and friends. Families, in particular prospective grandparents, may place added pressure on people by publicising their expectations for grandchildren. Enquiries from in-laws can be especially stressful and the daughter or son-in-law may feel that the comments are intrusive. Friends who are unaware of the full implications of infertility may appear unsympathetic and offer unhelpful suggestions such as "go on a holiday" or comment on the fun involved with "trying". Friends and family with children may assume that people with infertility do not wish to be reminded about children and so will avoid announcing their own pregnancies or issuing invites to social events like children’s birthday parties and baby showers.
Employers may not fully understand the issue of infertility and are, therefore, unsupportive. An employee may find it difficult to arrange time off work to undergo diagnostic tests and treatment. Similarly, they may not feel comfortable revealing why they require the time.
Positive strategies
For some couples and individuals, becoming informed, consulting a counsellor or therapist and joining a support group can help in coming to terms with infertility and coping with the stresses of treatment programs. Different coping strategies will suit different people and be appropriate for particular stages of the infertility experience.
Becoming informed
Obtaining information about infertility and the various treatment options available helps people to feel that they are more in control of the situation. Reading material on the topic also allows people to make informed choices about tests and treatments and to confidently ask their health practitioner any questions they may have.
Counselling
Visiting a counsellor who is experienced in infertility issues will enable people to openly discuss their feelings about being infertile. They can also voice their fears and concerns about approaches to treatment, as well as the possibility of remaining childless. Counselling may be particularly beneficial to couples whose relationship has suffered as a result of infertility. For couples experiencing disruptions to their normal sex life, advice from a sex therapist may be useful.
Support groups
Many people confronted by infertility find that consulting or participating in a support group can be very helpful. A support group can provide information on infertility and infertility treatments as well as contact with other people with similar problems. Being able to talk to people who have been through the same ordeal reduces feelings of isolation. Support groups offer strategies for coping with particular problems associated with infertility and can also offer a sense of hope through sharing other people’s success stories.
Accepting infertility
When a couple receives treatment for infertility, whether it be medical or alternative therapy, they must decide at what point to discontinue treatment if a pregnancy is not achieved. The advancement of new medical techniques in treating infertility can make setting these limits difficult.
While some couples may not consider treatment, simply accepting their situation, other couples may spend years trying every possible technique available to realise their dream of having a child. Undergoing infertility treatment is not only emotionally and physically demanding but can also be financially costly. It is, therefore, important for couples to come to an agreement, preferably before treatment is started, on the types of treatments, number of attempts and overall length of time they will spend trying to have a child. A couple should also consider their financial position and agree on what they can afford to spend on treatment. Deciding when to stop treatment can allow people to learn to accept their infertility and pursue other options such as adoption or living a child-free life.
References
1 Hull, M et al qtd in Prosser, C. Determining the causes of fertility problems Nursing Times 1997 Vol 93 No 45 p48-50
2 Harkness, C. The inFertility Book: A Comprehensive Medical and Emotional Guide San Francisco: Volcano Press 1987 p16-17
3 Zoldbrod, A. Psychosocial aspects of male infertility ACCESS National Newsletter Spring 1997 p5
Further help and information from Women's Health Queensland Wide
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Further reading
This factsheet was originally published in February 1999. It was revised by Kirsten Braun and the Editorial Committee in April 2002 and May 2006.
Last Modified:
May 31, 2006
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