Infertility

The Effects of Fertility Challenges on Couples

Julie* and Dan met at university while they were pursuing their graduate degrees, and were married after two years of dating. They spent three years touring South America, and returned to Canada as work opportunities came up for both of them. They were successful in their careers and decided to postpone their plan to have children until they were financially well-established. Five years into their marriage they agreed it was time to start a family. They were looking forward to raising children together.

After trying and not conceiving for six months they consulted Julie’s physician, who referred her to an ObGyn. A few months and numerous tests later, they received the news that Julie was not ovulating regularly, which explained why they were not conceiving. The ObGyn prescribed a medication to regulate ovulation. After 4 months Julie got pregnant but sadly they lost the pregnancy at 9 weeks; They were heartbroken. However, the ObGyn was very encouraging when he told them that these things happened to many couples and that they should continue trying while Julie was on the medication.

Julie did not conceive again and the couple became increasingly worried and upset. They were preoccupied with their inability to conceive and Julie became irritable and moody. Their relationship suffered. They were often short tempered and snapped at each other for minor reasons. At some point Julie’s sister suggested they saw a couple’s therapist. At first, neither of them thought it was a good idea. After all, they had a pretty solid marriage and were dealing with a real problem If only that problem was resolved, they thought, they would not need any counselling. However, when one of their fights ended in Dan sleeping on the couch for two nights, they decided to seek professional help for their relationship.

Fertility problems affect about 15% of couples. The problem may lie with the woman, the man, or both. Many couples struggle with infertility for lengthy periods of time and, like Julie and Dan, their relationship may take a toll as a result The following are a few ways in which fertility issues may affect the couple relationship:

• Different levels of commitment and involvement. In many cases, one partner is more interested, more invested or more affected by the problem than the other. For example, in Julie’s and Dan’s case, Julie was not only the one with the fertility problem, but she was also more preoccupied by the problem and her mood was more seriously affected than was Dan’s.
• Making a baby vs. making love. When fertility problems exist over a lengthy period of time, many couples lose spontaneity with sex and start focusing on the “right times” for having sex with the goal of making a baby always on their minds. This may take away the joy and pleasure of sex and unite the couple more for the business of achieving their goal than expressing love and desire.
• Life “on hold.” When a couple encounters fertility challenges, they tend to focus only on getting pregnant. Other projects and goals may be pushed aside and that may take a toll on the relationship, especially if one partner is reluctant to give up or postpone a certain project.
• Financial concerns. Fertility treatments may take a toll on a couple’s financial resources and may even become a financial drain. Financial concerns may create stress which, in turn, may negatively affect the relationship. Ongoing high levels of stress are linked to high levels of distress in couple relationships.
• Social pressure and interaction. Many couples who are dealing with fertility issues complain about pressure from friends and family. Unwelcome questions and unsolicited advice may become a bone of contention between partners, especially if pressure comes from one side of the family and not the other. Many couples also note that they become less and less interested in socializing with friends who do have children and may suffer from social isolation. Social isolation may result in tension between partners.
• Depression and anxiety. In some people, pre-existing mood or anxiety problems may worsen with the added fertility issues. Having to deal with mood or anxiety disorders on top of fertility issues may negatively affect the quality of life and seriously affect the couple relationship.

Tips for Couples Undergoing Fertility Treatments

1. Keep the communication flowing. Make sure to really listen to each other and to share information. It is important to listen to each other with open mind and heart and truly seek to understand the other. It is always better to face issues than to avoid them, so be ready to hear things that you may not like but still have to deal with.
2. Support each other. Undergoing fertility treatments is often very stressful. Be each other’s main support by validating each other’s feelings and affirming you are in this together. Making special gestures to show your love and concern may also help.
3. Get others’ support. It is important to have understanding friends and family members who can avoid judgment and criticism and offer love, support and a listening ear. Do your best to keep a distance from others who contribute to stress. You may need to help each other by blocking these people from time to time: “I’m sorry, she can’t come to the phone right now” or “He’s out running errands” can go a long way in helping you to keep stressful communications to a minimum, at least for a while.
4. Plan fun activities together. It is important to be able to still have fun and closeness together during this stressful time. Plan a weekly date and go out together. Exercise together (exercise is a very effective stress buster), plan a romantic evening at home and have sex just for love and fun. You can say to yourselves: “this one is just for us.”
5. Seek professional help. If you have tried to help yourself and/or the relationship and you still experience a lot of stress, it may be a good idea to seek help from a psychologist or a marriage and family therapist.

Remember Dan and Julie? They decided to see a therapist who was recommended by Julie’s doctor of Traditional Chinese Medicine who was treating her at the time. The therapist helped them develop better communication skills and identified their cycle of interaction, or “dance” so that they could work on changing it into one that helped to enhance their relationship, rather than sabotage it. Dan and Julie’s relationship became stronger and more harmonious and they were much happier. In December 2009, they welcomed Ellie, their first baby girl, conceived via In Vitro Fertilization, into their family.

Written by: Dr. Michal Regev, Registered Psychologist & Marriage and Family Therapist, Vancouver, B.C. For more information about Dr. Regev, please refer to her About Dr. Regev page.

Further Readings

• Hoenk Shapiro, C. (2010), when you’re not expecting: An infertility Survival Guide. Wiley.
• Swire-Falker, E., (2004). Infertility Survival Handbook: Everything you never thought you needed to know. Riverhead.

*All the names in this article are fictional