It goes without saying that infertility is a life-altering experience for couples. Many couples who struggle with infertility can attest to the toll it takes on relationships, careers, family planning, and self-esteem. And while numerous medical treatments for infertility are becoming available, the emotional aspect of infertility is often overlooked. Ultimately, infertility is not just a medical problem. It is also a condition with both social and emotional consequences.
There are seven emotional stages of infertility. While these stages can be generalized to many couples, it should be recognized that given the very personal nature of this struggle, every couple's experience is different and unique.
Stage One: Concern (6 to 8 months)
This is where it all begins. A couple decides that they will begin to try to get pregnant. The birth control is stashed away in the medicine cabinet; the condoms are no longer needed. Most couples will not get pregnant immediately (and this is to be expected) however after six months of trying, they find that they are still not successful. At this point, many women will seek the help of their family doctor. After the traditional battery of tests have been performed (ultrasounds, internal examinations, blood work, etc.), the doctor concludes that while not necessarily downright infertile, she will have difficulty conceiving.
Stage Two: Denial (6 months)
While not outright dismissing the doctor's opinion, it is still hard to swallow, and some women find themselves feeling skeptical. A lot of women think of all the various reasons they may not be getting pregnant: poor eating habits, lack of real effort, poor cycle timing, stress levels, and the list goes on. So with a new steadfast resolve, the attempts at conception continue. This time, extra attention is placed on monitoring of cycles, eating well, stress management, etc. After approximately a year of trying to no avail, a sense of fear begins to set in.
Stage Three: Anxiety (can last from a few months to a year)
At this point, the couple has realized that their problems with infertility extend beyond their immediate control. Many women experience a drop in self-esteem: feeling as though their infertility somehow symbolizes their failure as a woman. This stage is also characterized by feelings of depression, anger, and self-blame. Relationships between partners and loved ones may become strained, and it is as though life has been put on hold—all the while, the women can hear their biological clock loudly ticking away.
Stage Four: Intervention (up to 2 years)
After the initial sting wears off, it is time to take a more medically focused aggressive approach to conception. Specialists are consulted, and different treatment options are discussed. In order to determine the most effective treatment, it is vital that all potential causes of infertility be examined—this includes having the male partner examined as well. Alternative therapies are also considered. Towards the end of this stage, it feels as though all efforts and options have been exhausted yielding no results, and despair begins to set in.
Stage Five: Despair (up to 2 years)
At this emotional stage of infertility, it is very common to feel a sense of defeat. The struggle with infertility does not remain contained within the marriage or relationship, either—it seeps into every other aspect of their lives. Social situations where children will be present or discussed become increasingly awkward and emotionally challenging to handle. It seems as though every other couple has already begun to start a family. Children are everywhere; happy parents continuously talk about them—in effect, the couple coping with infertility can never forget that they are missing out. There is also a certain amount of internal conflict: on the one hand, a stubborn determination to become pregnant, and on the other an overwhelming sense of depression and constant defeat.
Stage Six: Mourning (up to a year)
There is a certain sense of finality that often accompanies this emotional stage of infertility. The realization that they will never be parents, for example, feels very much like a loss—a loss of something that was meant to naturally happen, a loss of the opportunity that so many people say is unlike any other life experience. Some couples grieve the loss of babies lost through miscarriage or still-births, while others grieve the loss of a baby that was never conceived at all.
Stage Seven: reorganization (on going)
During the final emotional stage of infertility, couples take inventory of their situation. It is time to explore the remaining options and determine both what is desirable and feasible. Couples can explore options such as surrogacy, sperm banks, open or closed adoption, or to live child-free. Weighing the costs and benefits for any of these options can be emotionally challenging, not to mention potentially financially stressful. Access to resources and information can make this stage a lot easier, combined with the support and guidance of friends, family members, and professionals.
All couples coping with infertility go through some form of these stages however it is important to point out that the best way to manage these stages is by developing a strong support team. Of course your team already would consist of your spouse, your doctors and possibly some close family and friends. Also consider adding a nutritionist to help you make good eating decisions, a personal trainer to keep you physically in shape for the challenges ahead and a fertility coach to help you make sense of it all. Infertility can be emotionally draining but having a support team can get you through it.
