How to treat depression, stress associated with infertility treatment
Your understanding can ease the emotional roller coaster.
Problems facing infertile couples
Gender differences in coping style. Men and women experience infertility differently.
The women in infertile couples often are distressed, whereas the men tend to remain more confident that some kind of treatment will work. This imbalance can leave the woman feeling unsupported and the man feeling confused about why she is so upset about what he sees as just a medical problem to be solved.
When a couple’s infertility has been attributed to sperm abnormalities, however, the man’s stress level can equal the woman’s. Women tend to feel stress regardless of which partner is “at fault.”25
Grief reactions. The “loss” of a child never conceived generally goes unrecognized but has psychological consequences. Both partners can feel:
- low self-esteem
- sadness about being unable to experience parenting
- doubts about their femininity or masculinity
- regret over unfulfilled dreams.
Table 2
Fictions and facts about infertility
| Fiction | Fact |
|---|---|
| Infertility is a psychosomatic disorder | An organic cause is found in 85% to 90% of infertile couples7 |
| Infertility is a female problem | One-third of infertility cases are caused by female factors, one-third by male factors, and one-third by male and female factors or unknown causes26 |
| Infertility is epidemic | The number of patients seeking infertility treatment has increased dramatically in 20 years, but the infertility rate is stable3,5,18 |
| Infertility is rare | Approximately 10% of U.S. couples of childbearing age are infertile3 |
| If you adopt, you'll get pregnant | Conception rates are no higher following adoption than among childless couples7 |
Employment. Infertility treatments are time- and resource-intensive, and patients often miss work. Even while on the job, a woman distracted by infertility or treatment side effects might not perform as well as she could. Worries about job security add to her anxiety.
Finances. Infertility treatment is expensive and is not always covered by insurance. The American Society for Reproductive Medicine reports that the cost of an IVF cycle averages $12,400, and success rates are 26 (see Related resources).
To continue treatment, couples may take second jobs, acquire loans, deplete savings, or accumulate debt. Many couples—even with extraordinary effort—cannot afford to start or continue advanced infertility treatments.
Spirituality. Patients who believe that infertility is God’s punishment for past sins may experience a religious crisis. Those affiliated with religions that restrict assisted-reproductive technology may feel forced to choose between doctrinal dictates and their dreams of becoming parents.
Case continued: A new ‘RESOLVE’
Mrs. S enjoys her association with the online support of RESOLVE. Through message boards, she shares her concerns with other women undergoing infertility treatment. She also finds support from friends, although she continues to set limits such as declining invitations to baby showers. She practices relaxation techniques at home.
Since she and her husband have joined the group for infertile couples, their relationship has improved. Mrs. S feels that he better understands her fears after hearing other women in the group being “just as emotional.” He no longer tells her, “It’s just a medical problem.”
- National Infertility Association (RESOLVE). www.resolve.org.
- American Society for Reproductive Medicine. www.asrm.org.
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The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
