Infertility is a medical problem that results in the inability to conceive a child or carry a pregnancy to full term. A couple is usually diagnosed as infertile after one year of frequent, unprotected, sexual intercourse.

It is estimated that 10 to 15% of couples are infertile. About 35% of infertility cases can be traced to physical problems of the woman and 35% have causes in the man. In the remaining 30% of cases, infertility is either unexplained or is caused by problems in both partners.

Why Infertility Can Be Devastating

The inability to have children can be one of the greatest challenges that a person or couple will ever face. It affects people emotionally, physically, and financially. It can place tremendous stress on a couple's relationship and on their relationships with family and friends.

On a physical level, the experience of being examined and tested monthly, weekly, or even daily is embarrassing, exhausting, and very expensive. Medications often have side effects, and daily injections may be required. Surgery is often necessary, and sometimes several procedures are needed.

As the process continues over months and years, the couple's privacy is invaded time and again, physically and emotionally. One or both of the partners learn to put aside their feelings as they lie on the examining table, have fluids taken, or give sperm for the tenth, twentieth, or fiftieth time.

At the same time, family, friends and coworkers are waiting to see if this month will bring good news. The couple becomes used to hearing, "Anything new?" with an expectant smile. They also hear comments like, "Maybe you should take a month off and just relax," or "A vacation would do you good" or "This sounds like a good problem. At least you can have fun trying." To make it even worse, throughout this experience, the couple regularly hears of others who have become pregnant. In fact, it sometimes seems as if the whole world is pregnant.

These experiences often make the infertile person feel like a failure. The feelings come up each time there is a treatment failure or when yet another friend or acquaintance announces a pregnancy.

After each expensive procedure or round of treatment, when no pregnancy results, the disappointment turns to devastation. Many infertile people become depressed and anxious. The strain in the marriage and among family members sometimes becomes unbearable. The self-esteem of one or both partners plummets. They often feel lonely, sad, and angry. The long series of disappointments that many experience can cause a numbing effect, and depression can result. If one partner has the medical problem that is causing the infertility, he or she often feels guilty and may even offer the other a divorce. At the same time, the infertile person may fear that the other partner will leave the relationship. All of these changes can make people feel emotionally distant and needing to avoid intimacy.

Some people cut themselves off from friends and family. They look for ways to avoid attending social gatherings and family events, fearing that they will be subjected to discussions about pregnancy, children, or infertility. Socializing with friends and family who have children or who are pregnant is a special challenge. Sometimes these feelings are intensified, especially for women, when they are taking large doses of drugs that can affect their emotions.

Emotional Self-Care during Infertility

Almost no one expects to be infertile. Most people think they will grow up, get married, and have children, just like everyone else around them. So when a couple learns that they are infertile, they are often surprised at how devastated they feel. After all, they reason, they don't have cancer or a deadly disease (in most cases); it's just infertility. So why do they feel so badly? Most couples gradually come to realize that it is a distressing experience. Many eventually seek the help of a team of professionals, realizing that it is a good idea to create a support network and take advantage of the help that is available.

When one or both partners start to feel the impact of infertility, it can be a good idea to seek the services of a mental health professional, especially one who has experience working with the issues of infertility. Since these issues are so complex, it is important to find a counselor who has experience and training in dealing with the impact on individuals, couples, and families. Many couples also find relief in support groups where they can meet regularly with other infertile couples, share experiences, and support each other. Such groups are offered through organizations like RESOLVE, a national infertility support organization. RESOLVE also provides referrals to medical practitioners who specialize in infertility. Visit http://www.resolve.org for information.
Infertility is primarily a medical problem, but during treatment it is important to address the emotional implications of infertility. Joining a support group or seeing a qualified counselor is especially important at any of the following points:

• When you begin a new phase of your treatment

• After a course of treatment has failed

• When you are faced with difficult decisions about treatment

• When you are thinking about options such as surrogacy, egg or sperm donation

• When you are considering stopping medical treatment

• When you are thinking about adopting

• When one or both of you have troubling feelings that won't go away

• When you experience strained relationships with your partner, friends, or family

• When you avoid being with others because of the infertility

Although a mental health professional cannot influence the outcome of the medical treatment, he or she can help the couple get through the process by helping them communicate better with each other and gain support from family and friends.