Helping Couples and Families Cope with Infertility

As the seasons change, we are reminded of the changes in life and family building. For heterosexual couples facing infertility, transitioning from IVF to third-party reproduction-engaging a donor or surrogate to conceive, or for queer couples navigating infertility challenges, the pursuit of family building can evoke a profound sense of loss for what was once hoped for but now feels out of reach. Exhaustion, frustration, and conflicts with loved ones may ensue.

It is common for fertility patients to anticipate support from family and friends through each change. This expectation is typically reflexive and leaves the fertility patient disappointed when their loved ones do not see the world the way they do. When positive experiences occur, responses are often unanimously good, with little conflict. However, when treatment does not work out as planned, or when the fertility patient chooses what may seem like an unconventional path, responses may not be universally supportive at a time when the fertility patient is most in need of support.

Research has shown[1] that people undergoing fertility treatment unsuccessfully can have similar levels of depression as cancer patients. Therefore, when the road to family building necessitates unpleasant next steps, it is natural for the patient to feel depleted from the accumulated stress of fertility, and saddened by the next steps that were not anticipated or their first choice.

Roman Kraft/hotstash

So how can one proceed with treatment and secure the support of their loved ones? One approach involves understanding one’s emotional state, and then negotiating with others. Clarity about your feelings and point of view can be very useful in grounding yourself and setting you up for productive discussions with others.

If you are confused about how you are feeling, it is likely your discussions will be infused with feelings from past losses and conflicts. Once the fertility patient and their partner are clear about their positions, they can become a united front, and aligned in their purpose. From this position, unsolicited advice and hurtful comments can be more easily deflected.

The model of change[2], used often in the addiction field, can be a useful framework for shedding light on where you are, and help you communicate your plans for the future:

• Pre-contemplation
• Contemplation
• Preparation
• Action
• Maintenance

Each stage may vary in duration and there is no “right” way to navigate these steps. Each person must honor their unique journey and allow room to pause or revisit a step.

It is understandable to initially reject the next step or ignore it because accepting it may feel unacceptable. Yet even attempting to move through this list is a move forward in the process. In absorbing the possibility of a new reality, the process of moving forward has begun, and eventually, the next step will be the new norm.

Moving between stages may feel stressful and elicit a desire to stop or skip a step. Change is not binary and often requires integrating a new reality before the next can be considered.

We can no more force a seed to become a flower overnight than we can become instantly comfortable with a particular treatment or choice of donor, and then expect the people we love to be on the same page. It may be hard to imagine the flower when you are looking at the seed, but it is in there.

Almost everyone who wants a child can eventually have one. Those are pretty good odds. The road may be complicated and feel unfair (and it often is), but if we understand where we are, and then share our feelings with our loved ones we may find more clarity for ourselves, collaboration with others, and a feeling of empowerment. From that place, the road to parenthood may be smoother and more attainable than we thought.