What is infertility?
The official definition of infertility is 'the failure to conceive after regular, unprotected sexual intercourse over 1-2 years.' By regular intercourse, they mean 2-3 times per week.
There are two main categories of infertility. Primary infertility is the inability to have any children at all, whereas secondary infertility is the inability to conceive or carry a baby to term following the birth of one or more children. Secondary infertility can be caused by many things including cancer, complications from previous pregnancies, impaired sperm production, function or delivery, damage to the Fallopian tubes and so on.
About 5% of couples in the developed world experience either primary or secondary infertility, with varying causes. About one third of the time, it is a physiological issue on the woman's part, another third of the time it is a physiological issue on the man's part, about one tenth of the time it is due to physiological issues in both the male and the female. In 10-20% of cases, the cause of the infertility cannot be determined. Despite this, only about 56% of people with fertility problems seek medical help.
There are also those who seek fertility treatments for a number of non-medical reasons. For example, those in a same sex relationship, those who do not have a partner, and so on.
What is the process of seeking fertility treatment?
As mentioned above, in order to seek fertility treatment, it is required that you have been attempting to become pregnant through regular unprotected sex for 2 years - however, the requirements do change depending on the age of the female, so it is best to get a personal consultation with a medical professional.
Treatments for infertility are becoming more common, with about 12,000 babies born from IVF each year in the UK.
There are is a wide-range of fertility treatments including;
Intra Uterine Insemination (IUI)
In Vitro Fertilisation (IVF)
IVF donor sperm
Intra Cytoplasmic Sperm Injection (ICSI)
However, before you can get to the treatments, it often feels like there are lots of hoops to jump through. Under the Human Fertilisation and Embryology Authority (HFEA), all fertility clinics are required to provide counselling before, during, and after any fertility treatment.
This is with good reason. The process of discovering that you are unable to carry children naturally is a massive shock and loss of the majority of people (we are focusing here on people who want and are trying to have children). Furthermore, the process of going through cycles of fertility treatments and still potentially not becoming pregnant, is a very trying time.
How can this process impact mental health?
Many people who want to have children, have always imagined that they would grow up, meet someone, and have a family of their own. Either because their childhood was so brilliant and they want to provide such a childhood for their own children, or because they survived their childhood and want to give their child something better. Discovering that you are unable to have a child naturally can feel like a failure - it is a loss of the path that they thought they would take.
It could be that you are losing the opportunity to have a child with your chosen partner, and this takes some re-configuring to get used to. The dynamics of the relationship may change, there may be some resentment, some guilt, sorrow, and so on.
Going through the process or fertility treatments, you are simultaneously holding on to two different positions; hope and loss. The loss is repeated, cumulative, and enduring - perhaps resurrecting past losses and anticipating future ones. There needs to come a point where you decide to stop trying and start living again. But when? When do you decide to accept the losses and give up the hope. Typically, couples do not come to this point together - there is normally one partner that gets here first while the other still holds on to the hope.
Generally, when it comes to discovering infertility, there is an overarching sense of a loss of control over one's body. If you have always believed that your body is able to do things a certain way, and one day you discover that it can't do that, you may feel betrayed by your body or out of touch with your body. There is perhaps a questioning of the natural order, of your core purpose in life.
We spend most of our teens and twenties trying our hardest not to get pregnant, because we believe that it is just that easy.
Oftentimes, when someone discovers that they are infertile, they start to see themselves as the problem. This translates a physical and medical problem into a psychological one - "I mustn't be entitled to have a child" or "this must be karma." You start to question the decisions and choices that you have made in life up until this point - did I wait too long? Did I work too hard? Did I cause myself too much stress? Was I too unhealthy? There is a lot of self-blame involved in discovering infertility.
3. Lifestyle and Relationships
Due to the nature of waiting for fertility treatments and being in a position where you are either nearing the top of the waiting list for treatment, or you are waiting to find out if treatments have worked or not, you are left in a limbo where you life sort of comes to a halt.
You feel unable to book a holiday, move house, change jobs, apply for promotions, and so on purely because of the fact that you might have to cancel that holiday to go in for treatment, or discover that you are pregnant when you are starting to re-model your house!
Your life is put on hold for however long you decide to keep seeking treatments. However, there is also a comparison of your life to those around you. You may feel that you are being left behind - perhaps your friends are starting to have children, perhaps they are even on child number two or three.
There can be a level of resentment between friends, a withdrawal from seeing them because it hurts too much or you don't know what to say, or they don't know how to behave, etc - there is a level of protecting oneself from this pain. You may feel betrayed by friends who are moving on with their life, despite understanding that it is only natural that they do so.
You may be inclined to lean more on your parents during the course of infertility treatments, however they may also be grieving the same losses as you - the loss of a potential grandchild, the loss of the opportunity to be a grandparent. There may also be a withdrawal on your part form your parents - especially if they are happily playing with your nieces and nephews. Again, there is an element here of protecting yourself from the pain of seeing what you cannot currently have.
Finally, there is likely to be a strain between you and your partner. You may both find your own ways of coping with the stress of going through fertility treatments, and it might be that these different coping strategies reduce your personal stress but increase you relationship stress. It might be that one partner finds solace in going out with friends and doesn't understand why the other doesn't do the same.
The other area of your relationship that is likely to suffer is the sex life. What was once perhaps an exciting part of your relationship may very well become a very clinical or even forced and non-enjoyable part of life.
Communication, as always, is the key here; we need to know what our partner needs from us and how to give it to them, and we need to explain to them what we needs and how they can support us.
What can you do?
As I already mentioned, communication is key. It is always key. Communication with your partner is especially important. It is important to let your partner know how you are feeling, how you are finding the process, and to find out how they are feeling. This is especially important when you experience the downs of fertility treatment - but it is also important to celebrate the little wins; being accepted for treatment, getting a date for treatment, and so on.
Confide in friends and family members what is going on for you. It is much more likely that they will understand why you can't attend certain events (such as their kid's birthday party) if they understand what you are going through. It is important that they understand that you aren't trying to make them feel guilty - you are happy for them and their little family, and you still love them - but it is just difficult for you at the moment.
Gather as much information as you can - talk to doctors and specialists, get a second opinion, if you can afford it then seek private consultations, and talk to others who have been through this before. It may be beneficial to seek out support groups to help you through the process of fertility treatments, or it might suit you better to seek out one-to-one counselling or couples counselling.
If you would like to book an initial counselling session with me, please contact me on firstname.lastname@example.org
#counselling #psychotherapy #counsellor #psychotherapist #therapy #therapist #mentalhealth #mentalwellness #mentalwellbeing #balham #therapyinbalham #counsellinginbalham #mentalhealthbalham #london #londonmentalhealth #therapyinlondon #therapistinlondon #londontherapist #paternityleave #perinatalhealth #perinatalmentalhealth #paternal #maternal #maternity #newdad #newmum #children #pregnancy #kids #work #policy #management #paternalmentalhealth #maternityleave #fatherhood #father #dad #mother #motherhood #family #ivf #infertility #fertility #fertilitytreatment