Infertility is a complex, life changing process that is difficult to understand unless you've directly experienced it. Infertility deeply changes how you feel about yourself and how you interact with others. It is a major life stressor with a diversity of experiences felt by those affected: 1 in 7 heterosexual couples have difficulty conceiving and require fertility treatment. 10 percent of women have difficulty conceiving or maintaining a pregnancy. Same sex couples and choice parents will need third party reproduction to have a family. Resolution is complicated, and it can be helpful to increase support when feeling overwhelmed by primary or secondary infertility concerns.

Wanting to conceive a child and unexpectedly learning that you cannot is a major stressor. You may experience grief or depressive feelings from repeated fertility trials and monthly cycles of hope and disappointment. Feelings of despair and sadness increase with the loss of hope over time that a pregnancy will finally end the unpredictable fertility process. Complications from pregnancy loss can be traumatic and cause severe distress. Complex feelings may occur in third-party family building around the loss of genetic connection to the child.

Identity concerns may arise from not being able to achieve the expected adult developmental task of becoming a parent. This confusion of one's sense of self, along with the loss of no longer fitting in with friends who are pregnant or new parents, results in many women feeling stuck between two worlds.

Infertility is associated with substantial levels of stress due to the strain of the constant unknown. Women report higher levels of anxiety and take on a greater feeling of responsibility for fertility, resulting in shame and guilt. Waiting periods, trying to do everything perfectly, hoping this cycle will be the one, while projecting a happy face can take a toll on self-care. To manage stress, it is helpful to utilize a mind/body approach that encourages wholeness, relaxation and mindfulness.

Single women and same sex couples may experience additional complex feelings due to the involvement of donors or gestational surrogates and societal or legal stressors. Fertility equality disparities may exist in fertility medical coverage for LGBTQ and single people. The involvement of a donor in fertility treatments may bring up attachment issues due the absence of a direct biological link to both same sex parents, or lack of a desired partner for choice parents. Parents may also experience anxiety while navigating the presence of a third-party donor or gestational surrogate, or when discussing their child's conception.

The unanticipated stressor of secondary infertility can be a frustrating and painful experience as plans to increase family size do not go as planned. Some women experience secondary infertility once they have used all remaining frozen embryos from an IVF to try for baby number two. Other women may have had an easy time conceiving a first child and feel overwhelmed by the difficulty of trying to conceive a second child. Regardless of which path, many women report feeling misunderstood or dismissed by others in the desire to add to their family, stuck between the fertile and infertile world.

Women of reproductive age with a cancer diagnosis may be faced with fertility preservation decision-making. There can be a sense of urgency to figure things out before starting cancer treatment. Some women will undergo cryopreservation to help preserve fertility for future family building. Other women may already have a child, yet wish to add to their family post-cancer treatment and need to consider fertility options or third-party family building. Decision-making and waiting can be overwhelming, on top of cancer treatment and recovery, temporary or permanent menopause transitions, and everyday life responsibilities. Many complex grief emotions around desired family size may arise. It can be helpful to get extra support during this time.

Childfree living but not by choice involves complex, ambiguous grief that others may not understand. Existential concerns arise as women focus on a search for meaning as fertility treatments extend over time and become increasingly difficult to resolve. For some, existential inquiry becomes significant once the decision is made to end fertility treatments and ultimately, stop trying to conceive. It is helpful to make space for grief feelings, and explore values and beliefs regarding identity shifts and changing life perspectives to find ways to reconnect to a childfree life filled with meaning and connection. 

• Continue to live your life: this moment does not have to define you.

• Honor your own needs during medical treatment and reproductive challenges.

• Turn toward your partner for support, not away.

• Respect differences in coping styles between you and your partner.

• Utilize caring, empathetic friends and family members for support.

• Express your true thoughts and feelings through individual therapy or couples counseling.

• Join a support group to normalize feelings and connect with others who have similar experiences.

• Practice deep breathing and mindfulness, or consider acupuncture or yoga to reduce stress.

• Learn cognitive tools and mindfulness-based coping skills to observe thoughts, feelings and body sensations without judgment.

• Spend time outside in nature and reconnect to the greater world.

I welcome individuals who need support navigating the intense emotional response to reproductive challenges. I understand the emotional, medical, psychological and relational aspects of infertility, third party family building, childfree living, reproductive cancers, and menopause transitions. I am a professional member of RESOLVE, PSI and ASRM. Please contact me for an initial consultation.

Additional Resources

RESOLVE: The National Infertility Association
https://resolve.org/

The Menopause Society
https://menopause.org/

Young Survivor Coalition
https://youngsurvival.org/

Childfree - Not by Choice Support Group
https://resolve.org/support-groups_topics/child-free-not-by-choice-childless/