Infertility: Navigating the Emotional Journey

For many couples the experience of infertility is the first life crisis they must confront together. Often we have expectations that pregnancy can be controlled. Early in the marriage or relationship birth control is available to prevent pregnancy, so most couples assume that when the time is right pregnancy will happen. The realization that there might be a fertility problem comes as a shock.

In reality, one out of ten couples has difficulty becoming pregnant. But most people assume they won't be that one unlucky couple. Couples who have been surrounded by fertile friends and families may have increased levels of shock as compared to those who have shared infertility experiences with others. Regardless, the diagnosis of infertility is often a cruel awakening.

It is important at this point in the journey for you to allow each other to feel the grief and frustration that naturally accompanies the realization that parenting may be more challenging than you expected. The grief of "not getting pregnant the old-fashioned way" is normal and needs to be discussed. Taking time to attend to the shock and disappointment that each of you may be feeling is vital to future coping abilities throughout infertility treatment.

Denial is often considered a negative coping mechanism. However, in many cases denial can actually assist you in pursuing treatment with optimism. Often couples do appear to be starting "down the creek without a paddle," due to lack of communication about the fertility issues.

For many couples, the experience of infertility is the first time in their lifes when they are unable to control the outcome. Often, the "if I work hard, I'll get it" philosophy serves as a motivation for pursuit of solutions. This commitment feels good if each partner shares the same beliefs with respect to potential treatments.

Denial can be a negative experience if each partner is in a different place with respect to optimism for the future. It is not uncommon for one partner to believe pregnancy is going to happen, while the other is filled with the belief that treatment will prove futile.

One way to help address this discrepancy is to develop a relationship with a physician who can give you honest information with regard to procedures and the realistic opportunity for success. When the pursuit of treatment is discouraged, continued use of denial can cause couples to "doctor shop" in an effort to find someone who will fix their infertility. Couples who experience continued inability to accept the infertility diagnosis, or are feeling different with respect to optimism for pregnancy, often find counseling beneficial. Counselors can serve as translators of medical information and provide a neutral sounding board for couples to discuss differences.

Anger is a very normal response to infertility. This can be directed toward a variety of individuals, including your partner, self, friends, family, medical providers and even spiritually. It is not uncommon for feelings of anger to occur when pregnancies are announced by friends and families, or when past experiences have caused your partner's infertility. Also, when previous health care providers have ignored concerns about fertility or have been slow to refer you to a specialist, anger with respect to their role in your infertility is common. Finally, those strongly religious individuals who have lived with the belief "if I'm a good person, bad things won't happen" can be angry about the lack of ability to control parenting.

Culturally, it is more common for men to express their anger and for women to suppress it. It is important each of you talk about your feelings and find ways to express your anger directly. Often exercise can help release the tension caused by anger. Many times anger does a great job of covering up other emotions that are difficult to express. Spending time clarifying your emotions, either alone or with a therapist, can help to diffuse the intensity of anger.