Written by Mandy Rodrigues – Clinical Psychologist

Infertility can be a difficult and emotionally challenging experience for many people. It can cause stress, anxiety, depression, and other mental health concerns. The difficulty is that many couples do not seek support. This could be because they do not think this will change their reality or feel they should be coping better or are not aware that infertility counselling is available. Couples feel isolated. Either they do not share their parenthood plans, or others do not know how to support them. As the science of infertility improves, so the emotional journey can become more overwhelming.

Many years ago, there were fewer options, with fewer choices. This did not make the journey any easier, but the decision-making was less and there were fewer ethical concerns. Patients now have options including donor conception, surrogacy, freezing of gametes and tests like Pre-Genetic Testing, which can all be overwhelming decisions to make. The world of infertility has more recently highlighted the necessity of counselling for individuals and couples undergoing any form of Assisted Reproductive Treatment (ART). In fact, it is a requirement for the clinic to gain accreditation to operate in South Africa and many places around the world. Certain ART processes require at least one session with a fertility counsellor.

These include:

  • Sperm, egg, and gamete donors.
  • Recipients of donated eggs, sperm, or gametes.
  • Surrogacy.

Before even presenting at a clinic, the couple usually has been trying for some time. Babymaking might have become a chore.  Something you have been avoiding all your earlier adult years has become out of your control.  We are educated about avoiding unplanned pregnancies. We choose the right time to have a baby, and suddenly this is out of our control. Initially, the couple presents as surprised, but they then try to establish a way to manage their fertility. They may decide to time ovulation or stop smoking or even eat better. But when this does not work, they feel helpless. This may already impact numerous areas of your life, including your intimacy, your relationships, and your work.

You go through a cycle of loss as you do in grief. Each month that passes by you go through the two-week wait, only to be met with shock and disbelief that it hasn’t worked, trying to understand or bargain with yourself as to why this didn’t work. You then experience anger. This anger can be displaced by your partner or by others around you. You feel overwhelmed by others falling pregnant and might start avoiding friends and family. You may start feeling all consumed by falling pregnant.

By the time you realize you are the 1 in 6, your self-esteem has been challenged, leaving you with a sense of self-doubt. You feel guilty towards your partner, and perhaps towards those around you who are trying to support you. You may feel a sense of shame. The sum of shame and guilt is anger and withdrawal. You might find yourself constantly angry at the world or you may simply withdraw from everyday events.

Fertility triggers are any situations or events that make you think about your infertility. These can include social media posts, baby showers, family gatherings, or even walking into a shopping mall. Imagine a trauma where you are potentially threatened in your car. If you do not deal with the fear and anxiety, you may develop a fear of anything that remotely reminds you of the potential high jacking. Infertility can be a traumatic experience for many people, and it is possible for some individuals to develop post-traumatic stress disorder (PTSD) because of their infertility. 

PTSD is a mental health condition that can occur after a person experienced or witnessed a traumatic event.

PTSD is characterised by symptoms such as:

  • increased anxiety which we call arousal
  • flashbacks
  • avoidance behaviours

This is why you notice:

  • every pregnant woman in the mall
  • every baby announcement on social media

Everything has the potential to make you think of that which you so desperately want.

Men and women cope differently with infertility. In general, men tend to express more optimism and their biggest loss is the previous intimacy you shared. They also feel helpless as to how to help you. They might start withdrawing or participating in more hobbies or dedicating more time to work in an attempt to avoid a situation for which they cannot find a solution. Women tend to voice their feelings of loss and worry about the possibility of not having a child… ever.

When a couple feels stuck or helpless, whether it be at the onset of trying, at six months into the process or after multiple failed attempts or a pregnancy loss, they should consider seeking advice from a fertility counsellor. It is a good idea to speak to a fertility counsellor even prior to planning parenthood so you both know your expectations and what medical science has to offer.

Psychological support can be an important part of treatment, as it helps individuals cope with the emotional and psychological impacts of infertility.

Here are some further reasons why psychological counselling may be necessary when going through infertility:

  • Emotional support: infertility can be an isolating experience, and it can be helpful to have a safe and supportive space to talk about your feelings and emotions. A fertility counsellor can offer emotional support, validation and empathy to help you navigate the emotional rollercoaster of infertility;
  • Coping strategies: infertility can bring a range of emotions including grief, anger, frustration, and anxiety.  A fertility counsellor can provide coping strategies to help you manage these emotions and develop healthy ways of coping with infertility;
  • Relationship support:  infertility can strain relationships, particularly with your partner. A fertility counsellor can help you and your partner communicate effectively, support one another and strengthen your relationship;
  • Decision making:  infertility treatment often involves difficult decisions, such as whether to continue with treatments or pursue alternative options such as donor conception or adoption. A fertility counsellor can help you explore your options, make informed decisions, and provide support during the decision-making process.

Overall psychological counselling can be an essential component of infertility treatment. There is no harm or shame in speaking to a counsellor about a trauma. Infertility is a trauma. It should be offered the same support, empathy, and guidance as other forms of trauma. 

Please contact SASREG for an accredited fertility counsellor.