Friday, 11 October 2013

How Infertility impacts emotional effect of couple relationship

Infertility is a medical problem that results in the inability to conceive a child or carry a pregnancy to full term. A couple is usually diagnosed as infertile after one year of frequent, unprotected, sexual intercourse. It is estimated that 10 to 15% of couples are infertile. About 35% of infertility cases can be traced to physical problems of the woman and 35% have causes in the man. In the remaining 30% of cases, infertility is either unexplained or is caused by problems in both partners.

The inability to have children can be one of the greatest challenges that a person or couple will ever face. It affects people emotionally, physically, and financially. It can place tremendous stress on a couple’s relationship and on their relationships with family and friends. On a physical level, the experience of being examined and tested monthly, weekly, or even daily is embarrassing, exhausting, and very expensive. Medications often have side effects, and daily injections may be required. Surgery is often necessary, and sometimes several procedures are needed.

As the process continues over months and years, the couple’s privacy is invaded time and again, physically and emotionally. One or both of the partners learn to put aside their feelings as they lie on the examining table, have fluids taken, or give sperm for the tenth, twentieth, or fiftieth time. At the same time, family, friends and coworkers are waiting to see if this month will bring good news. The couple becomes used to hearing, anything new? with an expectant smile. They also hear comments like, maybe you should take a month off and just relax or a vacation would do you good or these sounds like a good problem. At least you can have fun trying. To make it even worse, throughout this experience, the couple regularly hears of others who have become pregnant. In fact, it sometimes seems as if the whole world is pregnant.

These experiences often make the infertile person feel like a failure. The feelings come up each time there is a treatment failure or when yet another friend or acquaintance announces a pregnancy; after each expensive procedure or round of treatment, when no pregnancy results, the disappointment turns to devastation. Many infertile people become depressed and anxious. The strain in the marriage and among family members sometimes becomes unbearable. The self-esteem of one or both partners plummets. They often feel lonely, sad, and angry. The long series of disappointments that many experiences can cause a numbing effect and depression can result. If one partner has the medical problem that is causing the infertility, he or she often feels guilty and may even offer the other a divorce. At the same time, the infertile person may fear that the other partner will leave the relationship.

 All of these changes can make people feel emotionally distant and needing to avoid 1ntimacy. Some people cut themselves off from friends and family. They look for ways to avoid attending social gatherings and family events, fearing that they will be subjected to discussions about pregnancy, children, or infertility.  Socializing with friends and family who have children or who are pregnant is a special challenge. Sometimes these feelings are intensified, especially for women, when they are taking large doses of drugs that can affect their emotions.

Men and women are affected by infertility in different ways. Most couples experience the struggle in much the same way. This is related to the traditional ways men and women have been trained to think, feel and act. Women are typically seen, by others as well as themselves, as the emotional caretakers or providers of the relationship. Women typically feel responsible not only for everyone's bad feelings, but also for anything bad that happens. When women try to repress feelings, their emotions can become more ominous until they finally feel out of control. Their emotions can become a monster about to swallow them whole.

Women in infertile couples often protect their husbands from their own pain and feelings of failure by taking much of the responsibility for the treatments upon themselves. When it is suggested that men accompany their wives for appointments, couples get concerned about issues like income loss, use of time, etc. While these concerns are usually relevant and important, they also serve the purpose of protecting husbands from their own responsibility in the conception process and from their own feelings, which could easily be intensified by so much contact with the medical process.

Men are traditionally seen as the financial providers of the relationship and are responsible for protecting the family from real or imagined dangers. Men usually feel more threatened expressing themselves since they have often been conditioned to repress their emotions. They are trained to be more instructional to take charge, to make decisions and to think without being sidetracked by emotions.

Males in infertile couples often feel overwhelmed by the intensity of their partner's emotions as well as an inability to access their own. They tend to focus their energy back into their work, a place where they feel they can have more success.

As a result of taking responsibility for the emotional impact of the infertility, the woman experiences intense feelings, such as pain, anger, fear, etc., which, combined with the messages that her way of dealing with things is in some way dysfunctional or "crazy", causes her to feel an anxious depression. As feelings spill out, she feels out of control and doesn't really know how to ask for what she needs, especially from the husband she is struggling so hard to protect. She may yearn for an emotional connection/interaction at one moment and in the next withdraw emotionally from her husband when she fears she has disappointed him.

Men find themselves in a position where, regardless of how well they've been trained to solve problems, they are helpless to make this situation better for the woman and, as a result, may give off messages that she is "too" emotional or sensitive, hoping that this will calm her down. The wife hears this as criticism of her coping and care taking skills rather than as an expression of her husband's fears.

This is the time when couples cling together for dear life, feeling that they've failed in the most basic of all roles: reproduction. Couples are hesitant to admit problems in their marriage, feeling that having difficulty coping would mean that their marriage is also a failure.
Luckily, there are ways that men and women can help each other balance thinking and feeling as they struggle side by side on their journey toward parenthood. The questions then arise: How do I get what I need from my partner? How can I support for my partner during this difficult time?
Here are some suggestions to help both partners during the infertility process:
·         Communicate openly with each other.
·         Realize there's no right or wrong way to feel. Getting in touch with your feelings will help you know what you need. Once needs are identified, clearly and specifically tell your partner how to help you.
·         Ask your partner what she/he needs rather than assuming that you can/cannot give it.
·         Recognize the psychological and emotional differences between men and women.
·         See if you can teach each other some of the skills you've learned from your own life experiences as man or woman.
·         Share more in the process of treatment. Share both the burdens and joys of your different perceptions/experiences of infertility. It will help to balance the intensity and bring you closer with a deeper respect for each other.

Emotional Self-Care during Infertility treatment
Emotional Impact of Infertility almost no one expects to be infertile. Most people think they will grow up, get married, and have children, just like everyone else around them. So when a couple learns that they are infertile, they are often surprised at how devastated they feel.
 So why do they feel so badly? Most couples gradually come to realize that it is a distressing experience. Many eventually seek the help of a team of professionals, realizing that it is a good idea to create a support network and take advantage of the help that is available. When one or both partners start to feel the impact of infertility, it can be a good idea to seek the services of a mental health professional, especially one who understands the issues associated with infertility.

Since these issues are so complex, it is important to find a counselor who has experience and training in dealing with the impact on individuals, couples, and families. Many couples also find relief in support groups where they can meet regularly with other infertile couples, share experiences, and support each other.

 Infertility is primarily a medical problem, but during treatment it is important to address the emotional implications of infertility. Joining a support group or seeing a qualified counselor is especially important at any of the following points:
·         When you begin a new phase of your treatment.
·         After a course of treatment has failed.
·         When you are faced with difficult decisions about treatment.
·         When you are thinking about options such as surrogacy, egg or sperm .donation
·         When you are considering stopping medical treatment.
·         When you are thinking about adopting.
·         When one or both of you have troubling feelings that won’t go away.
·         When you experience strained relationships with your partner, friends or family.
·         When you avoid being with others because of the infertility.


Although a mental health professional cannot influence the outcome of the medical treatment, he or she can help the couple get through the process by helping them communicate better with each other and gain support from family and friends.

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