Question 1

You often hear that infertility is the impetus for many relationships ending. Is it possible to strengthen a relationship while coping with infertility?

Sharon Covington · Accepted Answer

Absolutely! When faced with any life crisis, which infertility certainly is, there is an opportunity for regression and also for growth. While infertility may be the most difficult experience a couple has faced in life together, it likely will not be the only challenge they face in the years ahead. I tell couples about this being an opportunity to work on communication skills that will last them a life time, such as active listening and empathic reflection. And the good news is that research has shown that for many couples their relationship is strengthen through improved communication and consequently greater emotional intimacy as a result of their infertility experience.

Question 2

Should distress around infertility be approached as a couple problem?

Sharon Covington · Accepted Answer

The simple answer is "yes", whether this is an opposite sex or same sex relationship. If two people are wanting to create a family together and there is difficulty, then it is a couple problem. While one partner may be experiencing more distress, which often happens in relationships, both feel the pain, although often expressing it (or not!) in different ways. It is important to recognize these differences and use it as an opportunity to grow and strengthen your relationship as you deal with infertility.

Question 3

How can someone cope with infertility when having a child is their lifelong goal?

Sharon Covington · Accepted Answer

That is a very big question! For most people, the goal of having a child is driven by strong social, psychological, and cultural drives and influences that have occurred over one's lifetime. When that goal is thwarted, enormous feelings of grief and distress occur and the longer it goes on, the harder it gets. It has been said, "A feeling shared, is a feeling diminished".  Thus, seeking and receiving support from chosen friends and family members and/or trained fertility counselors is crucial. To identify a fertility counselor in your country, you may start with the International Infertility Counseling Organization [http://www.iico-infertilitycounseling.org/]. In addition, learning cognitive-behavioral techniques (CBT) to deal with the feelings of anxiety, sadness, and overall distress is an important coping skill. There are some wonderful free apps available today specific to coping strategies for infertility distress that can helpful: Ferticalm is developed for women [http://ferticalm.com/] and Fertistrong is for men [http://fertistrong.com/].

Question 4

When is the right time to give up on trying to have a child when it’s not working?

Sharon Covington · Accepted Answer

"When is enough, enough" is a highly personal and complex decision. Recent research on the psychological burden of infertility indicates that the #1 reason people drop out of treatment is due to running out of emotional energy and not due to what many people believed, the financial costs of treatment even in countries with full insurance coverage.  Studies have shown that the process of ending treatment and moving on without having a child takes approximately 3.5 years and involves disengaging from the pain of infertility treatment, processing the feelings from past, and reworking and reengaging with how the future will look. So "the right time"  to stop trying and move on is hard emotional work, takes time, is evolutionary, and can't be speeded though.

Question 5

How can I cope with grief over something that I never actually had (and therefore never actually lost)?

Sharon Covington · Accepted Answer

Grieving is the hardest work we ever do in life, yet is a testament to the one we loved and lost. It is made all the harder when the grief is invisible to others and, thus, an internalization of all our hopes and dreams of a baby that is longed-for but not here. We call this "prospective grief" versus "retrospective grief" when we mourn a living loved-one who has died and, yet, real memories and experiences can be shared with others who knew this person. Research has shown that in fact prospective grief over invisible losses, such as with infertility, a miscarriage, or death of a baby before or shortly after birth, are far harder to grieve and take far longer to resolve. Something that can help is to find ways to ritualize and mourn these invisible losses in more traditional ways. One thought would be to write a letter of goodbye to the child you never were able to have, and then releasing the letter in a stream, burning it in a fireplace on a cold evening, or planting under a tree in your backyard. Finding creative ways to express you grief and loss, such as writing a poem or creating a work of art that reflects your feelings is also helpful.

Question 6

What are the signs that issues with fertility are impacting the relationship?

Sharon Covington · Accepted Answer

Infertility can stain even the strongest of relationships and it is important for couples to pay attention to changes they are feeling. Some questions to ask yourselves: Are you feeling more distant from your partner? Do you find that you are arguing more or seeing things differently about issues you previously agreed on? Can you still find ways to laugh and have fun, separating from the all encompassing nature of infertility and its treatments? Are you feeling that you partner isn't understanding, supportive, or seeming more critical? Or are you being this way towards your partner, thinking the worst of him/her rather than the best?! As a couple, are you isolating yourselves from friends or family because it is too painful to with them? More than likely, a couple knows when fertility issues are impacting the relationship and should seek out help and support sooner rather than later. As has been said, "An ounce of prevention is worth a pound of cure!"

Question 7

Question 8

Question 9

My daughter is on her 5th round of IVF. How can I help her? She is so angry and in so much pain.

Sharon Covington · Accepted Answer

It is so difficult to see a child suffer and feel helpless in taking the pain away. When one in the family is struggling it effects the whole group, especially when the pain is expressed in a way that pushes people away. Being able to to acknowledge and empathize with your daughter's pain is very important, as well as not responding with platitudes that may diminish or negate her feelings. A number of years ago, Dr.  Linda Hammer Burns and I co-wrote an article for Resolve, the National Infertility Association, on "When Infertility Strikes the Family". I have attached the article as the information is timeless and provides some important things to consider as a family as well as things that might help you get through this experience.

Question 10

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