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When Infertility Affects Your Marriage

Posted: 11/10/2013 11:00 pm

Hey man, are you and your partner having difficulty conceiving? Do you feel like she isn't the same woman you married? Does she seem obsessed? Emotionally fragile? Always sad? Angry? Don't worry, it's all normal!

As an infertility counsellor, one of the things I find myself doing most often with heterosexual couples is reassuring both husbands and their wives that her extreme reaction to infertility is normal. Typically, women are more upset about infertility than men. Men often become more concerned about their wives than about the infertility itself.

Women experiencing infertility often become completely fixated on conceiving. It is the first thing they think about when they get up in the morning and the last thing they think about before they go to bed at night. They often have difficulty concentrating at work and difficulty relaxing and/or sleeping. They are often tearful and moody. They can experience intense jealously and resentment towards others who are pregnant or have children. Often they withdraw socially to escape these unpleasant feelings. Women struggling with infertility sometimes lose pleasure and interest in the activities they once enjoyed and can start exhibiting symptoms of anxiety and depression.

The men supporting these women are often surprised and unprepared for their reaction. They often assume it is a sign that something is wrong with their partner. They worry that the woman they married will never reappear. They often don't understand why their partner is so upset about something that is totally beyond her control. They don't understand why she can't be happy for others' successes. To try to 'fix' the problem as best they can, many men will simply try to reassure their partners that it will all be OK. But in reality, he cannot know that this is true and these types of statements end up making women feel even more emotionally isolated. They assume that their husbands' less extreme reaction is because they are less invested in having a child.

The reality is, that men cannot 'fix' this problem. In fact, there is never a guarantee that anyone can. Even the best doctors and most advanced technology doesn't ensure a healthy baby every time. It is partly this uncertainty that makes women feel so anxious, scared and frustrated. What women need is validation of their feelings. I always advise couples to focus on having empathy for each other. There is no right or wrong way to react to infertility, the gender differences just are what they are. And all this is not to say that men don't get upset by it too. They do. Often they bury their own feelings out of fear of burdening their wives who already seem so fragile. What's important is to accept how your partner is feeling and be there for him/her.

What most people don't realize is that infertility is a major life challenge for those involved. It causes distress and disruption to people's lives comparable to a cancer diagnosis, job loss and divorce. It is not just about 'relaxing'. Infertility is often a medical problem requiring costly treatment. It can create a substantial financial burden for people; it can destroy a couple's intimacy; it can cause serious significant emotional distress and interfere with everyday functioning.

If you feel unable to adequately support your partner through your infertility journey, do not despair there are things you can do to help both of you get through it.

(1) Ask what you can do to help. Both men and women sometimes have no idea what their partner needs or wants from them. Ask. On the flip side, when telling your partner what you need, be specific. Don't just say, "Be more supportive." Explain exactly what being supportive means to you.

(2) Get outside help. There are counsellors out there, like myself, specifically trained to assist people dealing with infertility.

(3) Connect with others. Sometimes couples can feel incredibly isolated when they are struggling to conceive, especially if none of their family or friends have dealt with infertility. There are both in-person and online support groups designed to allow people facing infertility to connect with others going through the same thing.

(4) Practice self-compassion. Acknowledge that what you are going through, as a couple, is very difficult. Be kind to yourself and to each other. Be patient and forgiving with yourself and your partner as you move through this journey. Even if you do not share your partner's feelings about infertility, you can still stay close and connected. And that, in the end, will help you get through it more than anything.

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  • <strong>1. Your fertility is mostly determined by genetics, which influences how many eggs you are born with. </strong> Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.

  • <strong>2. Regular menstrual cycles are a sign of regular ovulation.</strong> Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).

  • <strong>3. Basal temperature charting does not predict ovulation.</strong> An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced. The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception. A better method is to use over-the-counter urine ovulation predictor test kits such as Clearblue Easy. These kits test for the hormone that prompts ovulation, which is called luteinizing hormone (LH).

  • <strong>4. Most women with blocked fallopian tubes are completely unaware they may have had a prior pelvic infection.</strong> About 10 percent of infertility cases are due to tubal disease, either complete blockage or pelvic scarring causing tubal malfunction. One major cause of tubal disease is a prior pelvic infection from a sexually transmitted disease such as chlamydia. These infections can cause so few symptoms that you may be completely unaware your tubes are affected. This is why fertility physicians will order a dye test of the tubes, called a hysterosalpingogram (HSG), if you have been trying and failing to conceive for 6 months or longer.

  • <strong>5. In most cases, stress does not cause infertility.</strong> Except in rare cases of extreme physical or emotional distress, women will keep ovulating regularly. Conceiving while on vacation is likely less about relaxation than about coincidence and good timing of sex.

  • <strong>6. By age 44, most women are infertile, even if they are still ovulating regularly.</strong> Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40's with fertility treatment are using donated eggs from younger women.

  • <strong>7. Having fathered a pregnancy in the past does not guarantee fertility.</strong> Sperm counts can change quite a bit with time, so never assume that a prior pregnancy guarantees fertile sperm. Obtaining a semen analysis is the only way to be sure the sperm are still healthy!

  • <strong>8. For the most part, diet has little or nothing to do with fertility.</strong> Despite popular press, there is little scientific data showing that a particular diet or food promotes fertility. One limited study did suggest a Mediterranean diet with olive oil, fish and legumes may help promote fertility.

  • <strong>9. Vitamin D may improve results of fertility treatments.</strong> A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.

  • <strong>10. Being either underweight or overweight is clearly linked with lowered levels of fertility.</strong> The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.


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