Coping With the Emotional Stress of Infertility

If you're having a hard time coping with infertility, you are not alone. Research has shown that the psychological stress experienced by women with infertility is similar to that of women coping with illnesses such as cancer, HIV, and chronic pain. Studies have found that men are at risk for anxiety, depression, experiencing physical aches and pains related to emotional distress, sexual dysfunction, and decreased self-esteem. These psychological effects may occur regardless of “who” is infertile, whether the couple is facing male infertility, female factor infertility, both male and female infertility, or unexplained causes.

Infertility is not an easy situation to deal with. You may feel social pressure to have kids or feel judgment from well-meaning friends, family members, or even strangers. Some may offer tips that are not all that helpful or suggest that your anxiety is somehow to blame (not true).

Moreover, you may be plagued by feelings of inadequacy, emptiness, or failure that interfere with both your quality of life and the quality of your relationship.

The one way to help yourself is to acknowledge your feelings and identify the things that are causing you the most stress. By doing so, you can begin to build coping strategies to better overcome these feelings.

The emotions associated with infertility come from both the inside and out. In many communities, the demand to have children is instilled at a very early age, often with a sense of urgency from those who will remind you that the "clock is ticking."

When faced with this sort of emotional stress, it is important to separate the feelings and expectations that have been thrust upon you from those you have thrust upon yourself. One often plays to the next. For example, couples may compare themselves with peers who have had kids. This may fuel feelings of self-doubt and anxiety.

While some couples are brought closer together as they face infertility together, others find themselves drifting apart. Marital distress is common with infertility and may lead to the unreasonable perception that everything will be right if there is a child and everything will be wrong if there is not.

The relationship may be further strained by the actual process of trying to conceive. Scheduling sex for ovulation can make intimacy feel chore-like. Studies have found timing sexual intercourse to conceive may lead to problems with sexual performance, for men, and a decrease in overall sexual satisfaction, for both men and women.

If fertility treatments are involved, the expenses can further punctuate the sense of failure a person may be experiencing, especially if the costs are putting the couple into financial straits. Treatment costs range from hundreds of dollars to tens of thousands of dollars, and trying to pay those bills—or attempting to decide whether to go into debt for them—can lead to stress in both partners.

More often than not, the emotions associated with infertility are not caused by one thing and one thing alone. They are often tangled in expectations from inside and outside.

Overcoming this requires you to identify and name the emotions you may be feeling. These may include:

• Feelings of failure or inadequacy
• Feelings of loss
• Feelings of guilt
• Feelings of being judged
• Feelings of shame
• Jealousy or anger
• Fear of rejection or abandonment
• Loss of self-esteem
• Financial stress

Once you have identified your feelings, consider what those feelings are about, where they are coming from, and to whom those fears are directed.

It is one thing, for example, to feel guilt. But guilt about what? Are they your feelings or feelings based on expectations from others? And to whom do you feel guilty? Your spouse? Your family? The future you had imagined for yourself?

By asking yourself these questions, you may be able to start understanding these emotions and share them with someone who can help.

Research has found that being open about infertility and seeking support from the outside can help both men and women cope with the emotional distress.

Sometimes, the best place to find support is your spouse, but this is not always the case. The accumulated pressure you may both be feeling can make it difficult to sort out your emotions together. Seeking support from outside the relationship can be beneficial to you both.

Be sure to reach out to friends and family, but be careful in your choices. You may find that the source of some of your negative feelings may come from those closest to you. Support groups may also be helpful, allowing you to voice feelings and thoughts you’ve been unable to share elsewhere, and receive understanding from those who have truly been there.

Don’t be afraid to seek professional help from a counselor. You may see a therapist individually or together as a couple, depending on your needs. While you don’t have to specifically see a therapist who is overly familiar with infertility, it can be helpful (and even required) if you need help making informed decisions. For example, if you are considering egg donor IVF or surrogacy, your clinic may require a number of counseling sessions before moving forward.

Ultimately, the goal is to find acceptance of your own feelings and those of your partner. Infertility is not easy. Try to be compassionate with yourself and your partner as you experience this life challenge together.

Whatever happens, don’t let infertility take over your life. In some cases, you may want to consider taking a break from trying to conceive. A break can give you time to remember who you are beyond your fertility, give you a reprieve from the stress of actively trying, and provide space to learn coping strategies.

If you’re worried that you don’t have time to take a break (since fertility decreases with age), talk to your doctor. You may actually be able to take a step back for at least a few months, and this may make a huge difference in your emotional wellbeing. 

Most importantly, know that this difficult time will pass. No matter how your infertility resolves—with you eventually conceiving and having a baby, adopting, or having a childfree life—things will get better. Time, counseling, and support from your friends and family will help.