Infertility, Treatment, and Mental Health
Due to the traumatic nature of infertility, mental health conditions are linked with infertility and fertility treatment.
People may spend much of their adult lives trying to prevent conception. We take it for granted that we will conceive when we choose. Unfortunately for some, trying to have a baby becomes a traumatic process. Once diagnosed with infertility, couples encounter severe psychological distress and may require medical intervention and fertility treatment.
Fertility treatment includes:
In vitro fertilization (IVF)
Intrauterine insemination (IUI)
Surrogacy/gestational carrier
Egg freezing
Donor egg/donor sperm/donor embryo
Preimplantation genetic testing
The Link Between Infertility and Mental Health
A diagnosis of infertility puts immense pressure on a relationship. One partner may be struggling with feelings of guilt, the other may feel resentment. Even a healthy relationship can experience strife and tension. Along with stress and anxiety, the shared feelings are tumultuous and many.
The financial strain caused by fertility treatments is a burden for many undergoing treatment. It becomes even more so if repeat treatments are required.
It also has an effect on life in general – it interferes with work schedules, social activities, daily routines, and other relationships.
Fertility treatment has also been linked to mental health issues in people. While this can be a result of various medications that are taken during treatment, attention must still be given to the mental state of patients. If a fertility treatment is unsuccessful, you may feel deep grief and loss. Failed or repeat treatments can heighten existing mental and emotional distress. In repeat treatments, patients experience the cycle of intense emotion - hope, anxiety, helplessness, depression, disappointment – over and over again. Repeatedly cycling through this tumult of emotion can cause an increase in depressive symptoms.
Therapy should begin prior to any fertility treatment. Mental health and/or family and marriage counseling is recommended for couples who are facing infertility and using medical intervention to conceive.
How Infertility Affects Your Mental Health
Those dealing with infertility may encounter some or all the following:
Shock: A diagnosis of fertility is a hard thing to accept and process. People may be in disbelief for some time after receiving their diagnosis. Along with this comes the difficult acceptance of the fact that you can only conceive through some form of medical intervention.
Sadness: The inability to have a child causes deep sadness and pain. It is a traumatic diagnosis, and marks the beginning, for many who opt for it, of arduous processes of medical intervention.
Betrayal: You may feel a sense of betrayal towards your own body. It is not responding or behaving in the way you expect it to. It is not performing functions that are required of it and that you believe should be effortless. This also ties into a deep anger at oneself and the failure of the body’s systems.
Frustration: Getting a negative pregnancy test multiple times is truly disheartening. There is so much expectation, hope and fear while waiting for the result. Going through fertility treatment can also be an embittering experience. It requires a high commitment of time, resources and energy. There are doctor appointments, tests, injections that have to be taken at specific times, and medications which have physical and mood-related side effects. You may have to take time off work, be sore at an injection site, or feel overwhelmed by all the moving parts in the process.
Anxiety: Where do we go from here? Being diagnosed with infertility can leave many people confused about what to do. There is uncertainty around something that was assumed to be a sure thing. Also, there are a lot of unknowns in fertility treatment. People differ in the ways they respond mentally and in the physical response of their bodies. It is an expensive process, with no guaranteed outcome. It requires not only financial investment, but it also feels like you have invested your whole being into it.
Depression: Depression levels in patients with infertility are comparable to those in patients who have been diagnosed with cancer (Domar AD., Zuttermeister PC., Friedman R. 1993). Depression is a mental health issue that is directly linked to infertility, and more so in women.
Obsession around conception: Following ovulation schedules, doctor’s instructions, and managing the act of conception can become all-consuming. You may feel a need to do everything right. Sex is less an intimate act of pleasure and more often a scheduled, tense event. Intimacy becomes a loaded act with a definite end-goal (that is not linked to sexual pleasure).
Intrusive thoughts: Infertility can lower a person’s self-worth. These kinds of thoughts are related to the negative impact of infertility on a woman’s femininity - “I will never have a baby,” “the infertility is all my fault,” or “my husband is going to leave me for a fertile woman.” (Rooney, K.L., Domar, A.D 2018)
Lack of control: People believe that they will have a child when they decide it’s time. When this is thwarted, they may feel like they have no control over their body or over what is considered a ‘natural’ process. If they decide to undergo fertility treatment, this control is then passed into the hands of doctors and assisted reproduction specialists.
Helplessness: Nothing you do seems to work! You are watching your ovulation cycles, having sex accordingly, eating the ‘right’ foods, doing the ‘right’ mental and physical exercises – but it is not working. A sense of hopelessness sets in. In addition, knowing the reason why you cannot conceive gives you at least a place to put the ‘blame’. It gives you an answer as to why this is happening to you. But when someone has unexplained fertility, it is a source of great emotional distress. It seems so random and arbitrary, and adds to the bitterness you may feel towards yourself, your partner, and medical treatments.
Disappointment: Receiving a diagnosis of infertility is, among other things, very disappointing. As it is when fertility treatments do not result in a pregnancy or live birth. For women who have been trying to get pregnant, getting their period is a disturbing and emotionally fraught event.
Emotional exhaustion: Infertility and/or fertility treatments drain you of your emotional energy. You may go from one extreme of emotion, such as deep despair, to the exhilaration of hope within minutes. In time, your ability to manage the constant psychological highs and lows may become impaired.
Shame: For some, there is a sense of shame or stigma attached to infertility and its treatment. The desire to keep it secret adds to the tension and isolation some couples may already be feeling. People may also encounter societal or cultural expectations about having children, and are made to feel guilty and inadequate for not being able to do so.
Self-blame: There are a lot of what-ifs and should haves that come into play here. “What if I had taken this supplement? What if I had gotten acupuncture? What if I had been more careful? I should have followed the doctor’s instructions better…We should have consulted more specialists…I should never have engaged in unhealthy habits…I should have gotten more rest…I should have eaten healthier...” This thought cycle can be persistent and oppressive.
Blame towards partner: People do often feel anger or resentment towards their partner – whether overtly or covertly. You may blame them for the diagnosis, for what you feel they did incorrectly, or you may be unhappy with their role during fertility treatment. You may even blame them for being infertile.
Stress: There is no denying that extreme stress pervades all the challenging emotions and thoughts around infertility and its treatment.
Guilt: You may feel guilty that you cannot have a child, or that you have spent so much on fertility treatments. People often have intense feelings about their inability to have a child with their partner, or to give their parents a grandchild.
Inadequate: People dealing with infertility and its ramifications for themselves, their larger family, and societal expectations may have feelings of inadequacy. This in turn has a detrimental effect on self-esteem and confidence.
Overwhelmed: The medical jargon, procedures, side effects, and doctor visits involved in fertility treatment is a lot to take on. You have to be organized, go by a certain calendar, and continue to function in daily life along with this. It can at times seem like just too much to handle.
Jealousy: You may find it trying to be around other parents and their children. The media portrays ‘complete’ families in a certain way, and it can be challenging to have a constant barrage of visuals coming at you.
Panic attacks: There is so much riding on a successful fertility treatment that sometimes the stress can overcome you. One of the most stressful phases of a fertility treatment like IVF is the waiting period between embryo transfer and the pregnancy test results.
A diagnosis of infertility can be heart-breaking. Fertility treatments are emotionally, mentally, and physically exhausting. It is important for people with this diagnosis and/or who are undergoing treatment to seek the help of mental health services. Family and marriage counseling and therapy can give you the tools and support you need to ease the mental health symptoms caused by this kind of trauma. If you seek help with any of the issues discussed in this article, please reach out to us. Trust Mental Health has a diverse team of therapists qualified in Fertility Counseling and Support. Contact us today for a free 15 minute consultation.