How Fertility Issues Impact Mental Health

couple standing front to back loosely holding hands

I will never forget the fertility struggles my husband and I faced as we attempted to conceive our first child. We were both young and healthy. I had regular menstrual cycles, no reproductive issues (that I knew about), and always assumed that getting pregnant would happen instantly. Each month we tried to get pregnant, I was shocked that the little plus sign on the pregnancy test never appeared – not even once.

But my shock turned to despair when – after 18 months of trying and a million, sometimes very invasive fertility tests – we were told that my husband had a low sperm count. The first doctor we saw told us that his count was so low that our only hope of conceiving would be to use IVF, which we could not afford. I remember lying in bed, looking at the ceiling, feeling a level of hopelessness in my bones that I had never experienced before.

I felt detached, depressed, and wrecked with grief. I had always envisioned myself a mother, and the idea of that possibly not happening – or at least in the way that I hoped it would – made me feel like I was losing a piece of myself, my identity at its core.

Grief, Depression, Anxiety, and Infertility

It is not uncommon to feel a profound sense of grief as you deal with fertility issues. If you learn that a pregnancy may not be possible for you – or that the probability of a natural pregnancy is very small – it’s natural to grieve. You have lost a particular vision of parenthood, perhaps one that you cultivated since you were a child.

Common reactions to infertility, according to Harvard Medical School, include “shock, grief, depression, anger, and frustration, as well as loss of self-esteem, self-confidence, and a sense of control over one’s destiny.” As the MGH Center for Women’s Mental Health points out, even after the initial feelings of shock and grief pass, mental health concerns can persist, with infertile couples experiencing heightened levels of “anger, depression, anxiety, marital problems, sexual dysfunction, and social isolation.”

The MGH Center for Women’s Mental Health reports that depression among infertile couples is often significantly higher than their fertile counterparts, up to 15%-54%. Infertility can increase anxiety symptoms as well, with 8%-28% (of couples who struggle with fertility) experiencing increased levels of anxiety and stress.

If you think that only women suffer over the turmoil that infertility brings, think again. Although women typically experience these symptoms at higher levels than men (possibly because they are more likely to express them than men), studies have found that men who are diagnosed with a fertility issue themselves experience similar rates of mental health challenges.

Social Isolation and Infertility

I remember that one of the most difficult aspects of dealing with infertility is that everywhere I turned, someone else was getting pregnant seemingly effortlessly. It was difficult to socialize with other pregnant couples – although I loved babies with all my heart – being around them or holding them was sometimes too painful.

It’s common for couples facing fertility issues to isolate themselves from social situations that may be triggering. They may find even online pregnancy announcement or baby pictures difficult to handle. This kind of social isolation is understandable, but it can also exacerbate feelings of depression and anxiety.

Relationships often suffer as well. You may feel the need to distance or temporarily cut yourself off from friends who are having babies. You may want to stay away from family members who probe about your plans to have a family, or who give unwanted advice about getting pregnant. “Just relax, and it will happen,” was something I heard all too often, and it was not only hurtful, but not one bit helpful.

Your relationship with your spouse can also become strained while you face fertility and navigate fertility treatments. You may isolate yourself from friends and family members, which can inadvertently strain your own relationship. If you opt for fertility treatments in order to get pregnant, this can add stress to your life and lead to marital problems, including “anxiety-related sexual dysfunction,” as Harvard Medical School points out.

Managing Your Mental Health When Facing Fertility Challenges

I was lucky in that just having my husband make a few lifestyle changes caused his sperm count to increase. I got pregnant rather quickly after that and had zero issues getting pregnant a second time. (Side note: this also goes to show that getting more than one medical opinion is highly advised, as the first doctor we saw thought IVF was our only option.)

Medical assistance

Nowadays, there are many treatment options for couples experiencing fertility issues, and there is reason to have hope. According to RESOLVE, the National Infertility Association, about 44% of women experiencing fertility issues seek medical assistance, and of those women, 65% will eventually go on to give birth. Not all fertility issues must involve high-tech procedures like IVF: 85 – 90% of cases can be resolved with drug therapy or surgeries.

Yet these treatments can be quite stressful – physically, emotionally, and financially. Although many couples facing fertility issues do eventually go on to have a baby, the road to get there may be long, and tending to your mental health during this time is a must.

Support groups

Many find comfort in connecting to others who are dealing with infertility, because often it’s a struggle that only those who have been there truly understand. There are both online and in-person opportunities (such as support groups sponsored by RESOLVE) to connect with fellow infertility sufferers.

Therapists with Infertility Experience

A therapist who has experience with infertility issues can help tremendously, more and more therapists are gaining expertise in helping people navigate these particular stresses. Learning and adopting relaxation techniques like meditation and mindfulness can be wonderful, especially as you deal with the possible discomforts of fertility treatments.

Stay Strong, You’ll Find a Resolution

Most of all, it’s important not to lose hope. There will be a resolution to your fertility struggle, whether that means giving birth to your own child, having a baby via surrogate, adopting, or finding peace with not having children of your own. Your vision of parenthood may not look like you imagined it would – that’s OK – and in time you will find peace with what is.

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