Infertility places extraordinary stress on a marriage. In addition to the medical challenges associated with infertility there are numerous emotional and relationship challenges that develop as a result of infertility. Unfortunately, very few physicians educate couples about the emotional aspects of infertility or about how infertility treatment can impact a marriage. Many couples aren’t even aware that their relationship is deteriorating until it reaches a breaking point.
When couples begin trying to conceive, they do so with the hope and expectation that becoming pregnant will take some time but that it will eventually happen. The first shock occurs when conception fails to occur in the time frame they and their doctors have set (usually a year). At this point, one or both partners becomes worried. Typically, this is when the couple seeks medical consultation.
A diagnosis of infertility is usually unexpected and almost always disappointing. Infertility introduces greater uncertainty into the family planning process. Once a couple has been diagnosed as infertile, they are usually referred to an infertility specialist who recommends a course of treatment. While treatment is stressful for both partners, there is a qualitative difference in the type of stress each partner experiences.
Women often develop anxiety around their menstrual cycles. Each month they experience guarded anticipation. If their menses occurs, they become disappointed and even more anxious about their prospects for becoming pregnant. This often places stress on the husband who also experiences anticipation and disappointment alongside his wife. However, in addition to coping with his own feelings, husbands witness and struggle to cope with their wife’s increasing anxiety and disappointment.
This recurrent cycle of anticipation and disappointment can wreak havoc on a relationship. It’s not uncommon for women to become somewhat controlling about having sex during ovulation. They may be irritated or demanding towards their partner if he’s unavailable at the appropriate time.
Men may begin to experience anxiety related to having sex. The feeling that they have to perform on demand and under pressure, can effect their ability to obtain or maintain an erection. This may further frustrate the woman who may respond to this perceived obstacle by becoming angry or accusatory. This introduces an undercurrent of anger, resentment and anxiety between the partners. These are not optimal conditions for maintaining a good sexual relationship, let alone a good emotional relationship.
In addition to the above relationship dynamics, infertility treatment is expensive. Spouses are not always in agreement about how long to pursue treatment, how much to spend on it, the kinds of interventions to pursue or the alternative of adoption or not having children at all if the treatment fails.
Last but certainly not least, infertility is physically uncomfortable and sometimes painful for women. Hormonal changes can exacerbate moodiness. The longer treatment proceeds without success, the greater the level of anxiety and disappointment experienced by one or both partners.
One of the alternatives to the increasingly charged spiral I’ve described above is for couples – especially women – to try to move away from the monthly focus on their menstrual cycles. A longer term view that places the health of the marriage in the forefront can work to keep a marriage healthy and insure regular sexual contact.
It is important for couples not to allow their entire relationship to become focused on procreation. Regular date nights, romantic weekends and other “baby free” zones of relating are an important balance to the often intense process of trying to have a child. It’s also a good idea to decide on a time line for pursuing treatment. Otherwise the process may feel endless which can be quite discouraging.
It is advisable to create family alternatives that take into account the possibility that treatment may not be successful. This may include adoption, becoming more involved in the lives of the children that already exist in your extended family, or deciding not to have children at all. If this last option becomes the one you choose, the two of you may need to develop specific plans for how you want your life to evolve.
Some times couples whose relationships have deteriorated during the process of infertility treatment, decide to place procreation on the back burner while they concentrate on rebuilding their relationship. While this may feel like a setback, it may also be necessary.
The best strategy for dealing with infertility is for both of you to make your relationship the priority. Remember - there can be no family without the two of you!
Johanna Nauraine is a psychotherapist in private practice. She specializes in premarital, marital and divorce therapy, infertility, addictions and career coaching. Read her relationship articles at: http://johannascouch.com