Infertility is not only a medical problem

Published: 11-11-2020

Last modified: 21-09-2021

The beginning of trying for a baby is almost always associated with positive emotions. The couple is excited, does not anticipate any problems and believes that soon they will be able to enjoy the pregnancy and then the birth of the desired child. But sometimes months pass – a few, then a dozen or so months, and there is no pregnancy. The couple starts treatment for infertility, an emotionally stressful disease. What is the most difficult about this disease and what problems do people with infertility face?

The effect of infertility on the emotional and psychological sphere

About half of women and 15% of men admit that having problems trying for a baby is the most stressful event in their lives. The severity of the stress of infertility can be compared to the stress of losing a loved one or being diagnosed with cancer or a heart attack. Research indicates that only the diagnosis of AIDS is a greater psychological burden than the diagnosis of infertility.

Psychological problems in most people trying to conceive begin to appear after about a year of fruitless attempts. The longer the problems with conception last, the greater the stress and emotional problems are. Women become sad, irritable or have other emotional disturbances, and sometimes depression develops. Research results show that depression develops in almost 10% to even 30% of infertile women.

Women with reproductive difficulties often have less satisfaction with life and perceive it as less interesting. Additionally, they often feel socially unacceptable, which causes anxiety and guilt.

A mood swing is characteristic of infertility. Each month, the couple hope to make it this time, hopefully expect two lines on the pregnancy test, and every month they find they have failed again. Every month, a person with infertility mourns. She says goodbye to her child’s ideas, accepts that she is still not pregnant and hopes again that the next month will not start menstruation … Such a swing between optimism and hope and desperation and periods of depression can last up to several years . Psychotherapist Bogda Pawelec noticed that the monthly tension related to the expectation of pregnancy test results and the fear of time running out are the most difficult for people who have been trying for a baby for a long time.

Additionally, women often rate the chances of getting pregnant higher than it appears from the actual situation. Over-awakened hopes then cause even greater despair if fertilization fails again.

The psychological effects of infertility are greater the higher up in the hierarchy of needs parenthood is. It is also important how a person defines femininity / masculinity. Katarzyna Walentynowicz-Moryl’s research has shown that in women with infertility, there are four ways of defining femininity. First, femininity can be defined through the prism of family roles. Within this framework, we can distinguish two ways of defining femininity – as the role of mother or as the role of mother and wife. For women who define femininity in this way, infertility is especially difficult emotionally, because in their opinion, being unable to be a mother, they are not a real woman or are incomplete. Another way to define femininity is by reference to external appearance and personality traits. Such women believe that femininity is self-care, emotionality and affection. Faced with infertility, they don’t question their identity as women. The fourth way is to refer to the family, but also take into account other aspects of functioning. These people claim that a real woman should fulfill herself in family life, but also in professional life and have her passions. Such women also, despite difficulties, still feel like women. The author of the study also noted that some women have difficulties in answering the question of what femininity means to them. In her study, these women were in the process of suspending their efforts to have a child, which may suggest that it meant the suspension of their femininity and hence reluctance to talk about it. But not only women as a result of problems with procreation question their social identity. Men often equate fertility with sexual performance and for them fertility problems are an expression of a lack of masculinity.

Some studies show that women experience infertility as more difficult than men do, but research results do not agree on this issue. Men with infertility often feel lonely, the disease often affects their self-esteem and, according to some studies, infertility is just as stressful for them as it is for women, and according to other studies even more stressful.

It is also worth noting that many studies do not confirm emotional disorders and reduced quality of life in people with infertility. In some people, even higher levels of personal development can be observed and a positive impact on quality of life. Much depends on a person’s coping mechanisms. I will try to explore this topic in the next article.

Social aspects of infertility

Motherhood is often viewed as the fundamental social and biological role of a woman and as a complement to femininity. Many women from childhood are convinced that at some point in their life they will become a mother, it is natural for them and they cannot imagine any other option. Their closest family and friends often have a similar feeling. This is especially true of women from lower social strata where the traditional family model dominates, but not only of them of course.

For many people, parenting is also important religiously. It can be seen that all major religions consider procreation necessary for the fulfillment of marriage.

The importance of parenthood in society makes infertility a particularly difficult disease for those affected. Patients feel stigmatized and alienated from breaking the patterns of functioning developed by the culture. Women are often seen as “deficient” because they fail to fulfill their basic socio-biological obligations (such opinions are much less likely to apply to men).

People who struggle with infertility are often seen as people who want to avoid responsibility and prefer to pursue a professional career and spend money on vacation rather than fulfill themselves as parents. Such opinions are very hurtful for people who in fact dream about a child and have been trying to get it for several years. Unfortunately, it happens that people struggling with infertility make their friends perceive them this way. Treating infertility as an expression of a lack of femininity or masculinity makes this disease embarrassing for many people. When kindly asked about a child, often simply out of curiosity, they incorrectly answer that they do not want children. Being ashamed of their illness, they lead to an even greater sense of stigma and deprive themselves of the support they could receive.

Unfortunately, it also happens that admitting infertility also causes social rejection. Bogda Pawelec met in her psychotherapeutic work with people who heard from a close family that infertility is a disgrace. She also noticed that mother-in-law has often the least acceptance.

Couples who, after unsuccessful attempts to have a baby, have decided to abandon further efforts, do not want to adopt, and have decided to live without a child are also in a difficult situation. Many women then lose friends who cannot accept the possibility of being happy without children.

Losing friends is a common problem for people with reproductive problems, not only because they are not accepted by others. In a situation in which children are born to friends, people who still do not have a baby feel alienated after some time. They begin to lack common topics for conversation, add jealousy or envy that others have succeeded and shame over such feelings towards friends. In addition, some infertile women have an aversion to pregnant women and children, and avoid the company of them because it is too emotionally difficult for them.

The social distance that often occurs in people with infertility is also caused by the cognitive focus on procreation. The whole life of an infertile couple revolves around treating this disease, which leads to less interest in people and, as a result, even greater loneliness.

Influence of infertility on marital relationship

Infertility is a very difficult situation for any couple trying to conceive. Research indicates that the disease often results in decreased marriage satisfaction and a weakening of the relationship. Spouses find it difficult to honestly discuss reproductive problems and to show affection, and the longer treatment takes, the more alone they feel in their marriage. As treatment continues, fears of abandonment or thoughts of divorce arise. Moreover, women often feel guilty about their partner, even when the cause of the infertility is unknown and they do not know whether it is on the side of the woman or the man.

Infertility significantly affects the sexual sphere. Intercourse begins to concentrate on conception, it takes place on specific days, which kills spontaneity and reduces pleasure. Sometimes it leads to secondary sexual dysfunctions – potency disorders in men or coldness in women.

However, infertility does not always have a negative effect on the marital relationship, and sometimes the opposite – it strengthens the relationship. Research shows that it is especially noticeable in couples who have decided to undergo IVF or fertilization with donor sperm. This may be because such treatments have many requirements and limitations, and only couples who are emotionally attached can cope with the challenge.

References:

1. Bidzan Mariola, Psychologiczne aspekty niepłodności. Oficyna wydawnicza Impuls, Kraków 2006. ISBN 83-7308-808-3
2. Pawelec Bogda i Pabian Wojciech, Niepłodność: Pomoc medyczna i psychologiczna. Smak Słowa, Sopot 2012. ISBN 978-83-62122-39-4
3. Walentynowicz-Moryl K. (2014). Kobiety „niestuprocentowe”? Sposoby definiowania kobiecości przez kobiety doświadczające pierwotnych trudności prokreacyjnych. Dyskursy Młodych Andragogów, 15, 245-261. (pdf at icm.edu.pl)

Author: Maja Kochanowska