The Many Faces of Grief in Infertility

“There is a unique pain that comes from preparing a place in your heart for a child that never comes.” ~David Platt

Ever since she could remember, Jenny’s dream was to be a mother. She fantasized about cuddling infants, chasing toddlers at the park, kept a list of names she liked for future children, and subconsciously observed mothers she admired–taking note of things she wanted to integrate into her own parenting. Fast-forward 20 years: She was in another doctor’s office receiving yet another negative pregnancy test. She and her husband were delivered the news: They were up against infertility and would need specialized treatments in order to have children.

Infertility affects 15 million people in the U.S. annually. These individuals and couples ride the roller coaster of hope and disappointment each month in an emotional quest to start a family. They grieve the loss of a “normal” pregnancy” and have to face the mental, relational, and financial issues that accompany infertility. As April 21–27 is National Infertility Awareness Week, I want to dedicate a blog post to the education and awareness of this widespread struggle.

Simply stated, infertility is the inability to conceive children. You may be surprised to learn that infertility affects women and men equally. It can be caused by a number of things including advanced maternal age, ovulation disorders, blockage of the fallopian tubes, other women’s health issues like uterine fibroids and endometrial polyps, or male factors that affect the sperm (like low sperm count or mobility, or abnormal sperm). The American Society of Reproductive Medicine recommends that women under 35 begin infertility test only after trying to conceive unsuccessfully for 12 months, or six months if the woman is over 35. It is completely normal for that pregnancy test to not read positive after a month or two trying; remember it may take several months to conceive. Many couples find that they are more relaxed when trying to conceive if they believe that everything is normal.

Luckily, there are several options available nowadays for infertility treatment. These options include: 1) education to make the most informed choices; 2) medication to encourage egg development or ovulation; 3) intrauterine insemination (IUI), where sperm is placed into uterine cavity to promote easier penetration with eggs; 4) In Vitro Fertilization (IVF), where eggs are collected and then fertilized by sperm outside the body; 5) third party reproduction like sperm or egg donation, embryo donation, or gestational surrogacy; 6) surgery to correct an abnormality; and 7) adoption.

In addition to affecting the body, infertility takes a toll on the mind and mental health of those experiencing it. Parenthood is one of the most anticipated transitions in adult life for both men and women; anger, stress, depression, grief, and anxiety are common responses to infertility. Couples experience stigma, sense of loss, and diminished self-esteem in the wake of their infertility. In couples struggling with infertility, women show higher levels of distress than their male partners; however, men’s responses to infertility closely approximates the intensity of women’s responses when infertility is attributed to a male factor. Both men and women can experience grief, loss of identity and feel defective and incompetent.

The infertility journey can wreak havoc on even the strongest relationships. Many couples experiencing infertility report marital problems including disconnection, frustration and even sexual dysfunction. Because infertility brings feelings of grief and mourning, it may take time for either individual (or both) to even consider other options in the quest to start a family. Furthermore, infertility can cause social isolation from peers who are blessed with normal, healthy pregnancies. They likely will not understanding that their friends are literally grieving the loss of a healthy pregnancy and unborn children. Even the closest friends may struggle to relate to the infertility experience and offer unwelcomed platitudes like, “It will just happen.”

Infertility can lead to financial strain. Insurance coverage varies by state and by plan, but often requires hefty out-of-pocket payments. Many couples spend thousands of dollars on specialist consults, medications, and assisted reproductive technology like IUI and IVF. These multiple appointments can put strain on employment as well. This understandably causes great stress on individuals and couples.

The reality is that infertility takes a severe toll on the mental health, relationship quality, and financial situation of those experiencing it. Thankfully, awareness is increasing and help is more readily available. There are support groups and cognitive behavioral group psychotherapy groups–both of which have been found to decrease stress and mood symptoms and increase fertility rates. There is also medication for those struggling with mental health issues amidst the infertility journey.

Lastly, and perhaps most importantly, mental health treatment is available. For those facing infertility, therapy is not just an option; I consider it to be a necessity. Infertility is a life-altering journey that requires strength and resilience to address the mental health, relational and grief issues that may arise along the way. Outfitted with the right tools and a strong mental health foundation, you will be well-prepared to weather the emotional turmoil that can accompany infertility and its treatment. Please do not hesitate to reach out with questions or schedule a session with me at your earliest convenience. I am here for you!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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