Unknowingly, family or friends can reinforce this image. Hearing statements like "I just had to look at my husband to get pregnant" can be very hurtful. Some mothers have told their daughters "I don't understand -- I never had a problem getting pregnant". This statement, which may have meant to reassure the daughter that there cannot be a major problem because it would have been known previously in the family, only serves to make the infertile daughter feel defective or estranged from her mother.
Research has shown that women going through infertility rated themselves as having higher levels of depression than women going through cancer treatment. How can infertile women rate greater levels of depression than cancer patients? We all know we can get sick, even with terrible diseases like cancer, but not that we may be infertile.
I believe that infertility causes our self-esteem to take a hard knock because there is nothing in life to prepare us for its emotional blow. We grow up assuming we are fertile; most couples with whom I work have been actively using contraception to prevent pregnancy. It feels like we should be able to control our fertility -- after all we have always assumed we could control to have a baby. Infertility robs us of our control and choices, leaving us vulnerable to depression and feelings of hopelessness. For the infertile partner in a couple, feelings of guilt and responsibility can arise. It is not uncommon to hear an infertile partner offer (only half-jokingly) to divorce their partner so that they can have a child with someone else.
Stress may also arise from uncertainty in the future. Many times patients share with me "I could do this for years if they would just tell me that in the end I will get pregnant". Barbara Eck Menning, the founder of Resolve, a non-profit group dedicated to the support, education and advocacy of people with infertility, described infertility like being in "limbo." Couples postpone vacations "in case" they are pregnant. Women will put off buying clothes with the hope that they will be pregnant and not need them. Other women will stop all caffeine, alcohol and heavy exercise.
Infertile couples are living in limbo not knowing what the future holds. They also live in limbo because they do not always know when they need to be available to run into the doctor's offices. Men may find their work schedule impacted because they need to be available for timed intercourse or to provide a specimen.
Many couples experience a change in their sex lives while trying to battle infertility. Sexual intimacy may be replaced by scheduled sex. I frequently hear men joke that they feel like a "sperm donor" during sex. "My wife wanted my sperm and not me last night," one man quipped.
Couples may also feel that sex and pregnancy are no longer related. This may be the case if the couple is going through insemination or through assisted reproductive technologies. To this couple, sex may represent something that has failed them. "It seems pointless and indulgent" is a phrase I hear from couples who feel like their sex lives have changed. Women may also feel that their bodies are changed for the worse by the medications. Certainly, if you are having an ultrasound every morning and your ovaries are enlarged, you may feel less sexy or sexual than usual.
Treating infertility takes time. Appointments, research, bloodwork, ultrasound examinations, medications and emotions all take a lot of time. For those individuals who are working, doctors' appointments, phone calls to and from the doctor's office, procedures, and conferences can take a serious toll on their work availability and productivity.
During some procedures, women may be in their doctor's office for 3 to 7 mornings in a row for monitoring. Co-workers may wonder what is going on and the infertile women may be faced with losing her privacy or losing her co-workers patience and support. Certainly there are employment situations where an infertile woman's desire to be pregnant may have an impact on her promotions.
Stress arises from trying to balance privacy and practical considerations and the everyday demands of treatment and work obligations.
The stresses that infertility treatment can put on one's schedule is well-illustrated in the example below: