Woman's hands holding a pregnancy test, waiting for a resultInfertility, or the inability to conceive a child, is often emotionally painful. In some cases, infertility may lead to grief that can be as intense as the grief of losing a living child. Those experiencing fertility issues may find it helpful to speak to a therapist.

Understanding Fertility Issues

Difficulties becoming pregnant may occur as a result of issues with any of the steps in the process of becoming pregnant: the release of the egg, the joining of egg and sperm, the egg's passage through the fallopian tube, or implantation. Fertility issues affect both men and women.

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A woman who is diagnosed with infertility is generally between the ages of 15 and 44 and unable to become pregnant after one year of attempting to conceive. Twelve percent of women in the United States experience difficulty becoming pregnant or carrying a pregnancy to term, and 6% of married women are reported to be infertile. A study from the Center for Disease control found that 7.5% of all sexually active men saw a fertility doctor at some point in their lives, and that 18% of these men were diagnosed with some type of fertility issue.

Diagnosis and Treatment of Infertility

A variety of factors can contribute to infertility, and fertility doctors will generally examine both partners. Some of the most common causes include problems with ovulation, blocked fallopian tubes, unhealthy eggs or sperm, low sperm count, hormonal imbalances, and the effects of age on the body and reproductive system. Infertility may also result from medical conditions, habits such as smoking or excessive alcohol use, and environmental toxins. Sometimes, fertility issues have no clear cause, but in these cases fertility treatments are still sometimes helpful and have the potential to resolve the issue.

Doctors can attempt to treat fertility problems with medication, surgery, natural remedies, dietary and lifestyle recommendations, or some combination of treatments. The treatment prescribed often depends on the reasons for the infertility. Other options may include procedures such as artificial insemination, hormonal treatments to increase ovulation, sperm donation, and assisted reproductive technology (ART), which includes processes such as in vitro fertilization (IVF) and the use of donor eggs or embryos, among others. For infertility issues that cannot be treated by medicine, a surrogate, a woman who agrees to become pregnant with her own eggs and the provided sperm, or a gestational carrier, a woman who carries the provided egg and sperm in her own uterus, might also be options.

The high cost of fertility treatments may be a barrier to some. Fertility pills typically cost at least $50 a month, and artificial insemination can cost between $300 and $700 per procedure, but most treatments are far more expensive, and insurance may not cover much or any part of the cost of some procedures. Furthermore, the treatments may not be immediately successful, and several months of treatment may be necessary.

Therapy for Coping with Fertility Issues

Fertility challenges can lead to emotional trauma and put strain on a partnership. While fertility treatments in the medical field may be able to help improve the likelihood of conception, entering therapy while undergoing these treatments can be a helpful way to work through grief, anxiety, worry, and other emotions that may be experienced as a result of fertility issues, especially in the event that treatments fail.

Many counselors and therapists, especially marriage and family therapists, may be aware of the challenges that accompany fertility issues and the common treatments for infertility. Some counselors may even specialize in therapy for fertility issues. In therapy, those faced with infertility will be able to discuss options and make decisions about how to proceed, whether through adoption, fertility treatments, artificial insemination, surrogate parenting, or even separation. Therapy can also help couples deal with the feelings of guilt or anger that may arise between two partners when only one person is infertile.

A recent diagnosis of infertility can potentially cause stress and anxiety, and both the wait for a diagnosis and attempts to find a fertility treatment that works can cause anxiety and conflict in a partnership. Those affected by infertility may also experience depression, feel hopeless or defeated, and experience low self-esteem or self-loathing.

When a couple is affected by fertility issues, couples therapy can help improve communication and may make it easier for the couple to make decisions that work for both partners. Sometimes partners may disagree about the best course of treatment or one partner may feel hesitant to seek medical help, and a therapist can help a couple navigate these concerns. Therapy may also be a useful place to discuss how long infertility treatments should be pursued or the amount of money that should be spent on attempting treatment.

In some cases, infertility may affect other members of a family, such as children and grandparents. A couple might also have a hard time sharing news of infertility with other members of the family, or they may feel pressured to have children even when they cannot or pursue treatment options for infertility that they do not wish to pursue. Any of these issues may be addressed in individual therapy, and in some cases, family therapy may also be of benefit.

Other Support Options

A support group may be helpful in dealing with the effects of a diagnosis of infertility. In these groups, a wide variety of people can share their experiences, suggestions, coping tips, doctor recommendations, and options for new treatments. Social support can also play an important role in helping people move past stress, particularly if they feel judged or inadequate because they are dealing with fertility issues. Simply having the option of discussing one's difficulties with others who are similarly affected may be of significant help.

Family and friends may also be a source of support, but it may also be difficult to connect with those who are expecting children when one cannot conceive or who may say things that are well-intentioned but may come across as insensitive. It may be helpful to encourage friends and family to become informed about infertility, as they can be an important source of support when one is experiencing anxiety and stress.

Case Examples

  • Couple experiences communication issues after news of infertility: Janie, 29, and her husband, Paul, 30, seek couples therapy to deal with their recent discovery that Janie cannot, in all likelihood, bear children. Paul appears to be supportive, but Janie is terrified he will leave her. Their marriage and family therapist helps them to explore options for raising a family and helps Paul to admit to some feelings of resentment and confusion about what to do. His admission at first upset Janie, as it seems to confirm her fears, but she soon comes to appreciate his honesty and begins to feel better after his disclosure. Paul’s ability to talk about his ambivalence helps him to work through it and reach a place of acceptance and renewed commitment to Janie.
  • Stress and anxiety after infertility diagnosis: Malia, 32, enters therapy a few months after being diagnosed with infertility due to problems with ovulation. She and her partner have decided that Malia will first try taking medication and then, if the medication does not work, discuss other financially viable options. Malia is hopeful, but she tells her therapist that her mother, who strongly desires grandchildren, is pressuring her to pursue every option available, but Malia knows that course is not financially feasible. She also reports some feelings of depression and anger toward friends who are pregnant, planning baby showers, or talking about their children and admits that she finds herself withdrawing from anyone who has children, not wanting to answer questions or be pitied. With her therapist, she explores ways to work through these feelings and decides to begin keeping a journal to vent her frustration and upset. Malia also discusses with the therapist ways that she might talk to her mother about her realistic options and what to say to her friends when they make insensitive or pitying remarks.


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