All over the world, infertility affects 10-15% of couples of reproductive age. It is defined as the inability of a couple to conceive after a year of unprotected sexual intercourse. This has been defined as a disease by the World Health Organization (WHO). It is expected that 84% of couples will conceive naturally within a year if they have regular unprotected sex (every 2-3 days). For couples who have been trying to conceive for more than 3 years without success, the likelihood of getting pregnant naturally within the near is 1 in 4, or less. For some women and couples, childbirth can be an expectation, a dream or a plan and they feel robbed of the dream. Getting pregnant isn’t always easy. The entire fertility process is an emotional roller coaster and it’s very easy to get discouraged. One moment you are daydreaming about starting or growing your family and then all of a sudden a roadblock dashes your hopes.
In recent years, the number of couples seeking treatment for infertility has dramatically increased. There is less information about effective psychiatric treatments for this population; however there is some data to support the use of psychotherapeutic intervention. This means psychological factors play an important role in the pathogenesis of infertility hence exploration of this is also an important task to tackle the problem which has a cultural and social impact. Anyone who has experienced fertility struggles themselves knows too well it can give lasting serious ramifications not only on people’s physical health but their emotional well-being.
Inability to conceive often leads to feelings of frustration, anger, guilt, resentment and inadequacy. Infertility has been shown to have a huge impact on mental health. Statistics show 90% of people struggling with fertility experience depressive symptoms of some sort and 42% report suicidal thoughts.
Experts once thought that only about half of all infertility cases had a physical origin and that, the rest were unexplained. But research indicates that most cases of infertility can be attributed to a physiological cause in men or women. 1/3rd of the time in the man, about 1/10th of the time in both partners. In another 10-20% of cases the bases of infertility cannot be determined.
Infertility may be caused by the following
1. Sperm disorders (>34% of couples)
2. Tubal dysfunction and pelvic lesions (about 30% of couples)
3. Ovulatory dysfunction or less frequently decreased ovarian reserve (about 20%)
4. Abnormal cervical mucus (<5%)
5. Unidentified factors (about 10%)
While the causes of infertility are mainly physiological, the resulting heartache often exacerbated by the physical and emotional signs of infertility treatment may exact a huge psychological toll.
Why infertility has a psychological effect on the couple?
Parenthood is one of the major transitions in adult life for both men and women. The stress of the non-fulfillment of a wish for a child has been associated with emotional squeal and feelings of worthlessness. Partners may have marital problems, become more anxious to conceive, and ironically predispose themselves to sexual dysfunction and social isolation. Marital discord often develops in infertile couples especially when they are under pressure to make medical decisions. Couples experience stigma, sense of loss and diminished self-esteem in the setting of their infertility. Less research has been done on men’s reactions to infertility but they tend to report experiencing less distress than women. However one study found that men’s reactions depend on whether they or their partners are diagnosed with infertility. When rounds of infertility treatments prove to be unsuccessful, couples can experience deep feelings of grief and loss.
Factors influencing psychological stress
According to a study done in Sweden, three separate factors seem to contribute to the psychological stress men and women experience as a result of their infertility.
1. Having children as a major focus in life
2. The female role and social pressure
3. Effect on sexual life
How to Fight the Shame and Stigma associated with infertility
The stigma that accompanies infertility is far reaching. The questions and comments come like clockwork. “When are you going to have a baby?” or “Don’t wait too long, your biological clock is ticking” In our society, it is expected couples procreate. It is perceived as unnatural if it doesn’t happen after a certain amount of time. Each of these questions feels like a punch to the gut that the stigma of being childless is tough to bear.
Compared to white women, women of color are more likely to experience infertility. In communities of color, there is this general idea that women are naturally fertile and there is a lot of importance placed on child bearing and being a strong mother. Furthermore, women of color might be more likely to be blamed for infertility or have their emotional pain and valid medical concerns dismissed or ignored by a physician. When a woman of color cannot fulfill that duty, it may be harder to seek treatment for infertility or her mental health because she is not getting support from her family.
In vitro fertilization is a complex series of procedures used to help with fertility or prevent genetic problems and assist with the conception of a child. During IVF, mature eggs are collected from ovaries and fertilized by sperm in a lab. Then the fertilized eggs are transferred to a uterus.
In vitro fertilization isn’t a mysterious medical procedure it once was. Even with this progress, there are still certain experiences that patients struggle with perhaps the reaction of family members and friends to the journey to parenthood are insensitive or judgmental.
Many fertility patients find they become the go-to resource for information about infertility once they discuss their family planning path with family and friends. This can be rewarding in the sense that it can deflate myths and misconceptions about fertility treatment and lead to more fruitful conversations.
The reality of infertility is, it is not your fault. In many cases, pinpointing why a couple is infertile is hard to do. Even if a root cause can be identified, many times there is no way to know what caused it. Additionally, all children are miracles, whether their parents went through rigorous fertility treatments or not. The stigma of being labeled infertile is not something anyone wants. Some couples want to avoid the stigma associated with infertility and will keep their difficulties to themselves. Either way, the only way to reduce the stigma attached to infertility is to encourage the conversation and to educate and empower couples whey they are facing difficulties with conceiving.
To couples facing fertility issues of various sorts, I would like to end with a quote by Barry Manilow.
And you begin again and sometimes you lose, sometimes you win, but you begin again. Even though your heart is breaking, in time the sun will shine and you will begin again
Thanks for reading