Sponsored: An in-depth look at infertility

Couples struggling to conceive report a sense of loss, loneliness and relationship stress. Understanding these emotions is key to surviving a difficult time (and those nosey questions).

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Photo: iStockphoto

It was 2005 when then-26-year-old Valerie Misir and her husband, Ravi, first did the deed without protection, to try and have a baby. “I remember the thrill of knowing that I could get pregnant,” she says. But for the Winnipeg newlyweds, the thrill was short-lived. They didn’t conceive that time, and pregnancy tests were still turning up negative after 12 months. Misir asked her doctor for a referral to the closest fertility clinic.

“We started the workup, including sperm testing and checking hormone levels. I was waiting to have a hysterosalpingography (also called an HSG test, a series of X-rays used to examine the uterus and fallopian tubes) when, a year and a half after we started trying, we ended up conceiving on our own.” Nine months later, Isaiah was born.

Since it took them longer than expected to become parents, the couple decided to go for a second baby six months after Isaiah’s birth. “Again, it felt daring. And again, nothing happened,” she says. After another year of negative pregnancy tests, Misir made a beeline back to the fertility clinic. This time, exploratory surgery uncovered endometriosis and repaired a uterine septum (which divides the uterus in two, making it difficult to carry a baby). Over the next three years, Misir tried an ovulation-induction medication (which resulted in ovarian hyper-stimulation syndrome and took a few weeks to subside) and intrauterine insemination (IUI). All in, the couple spent $12,000 on treatments. Eventually, Misir had a successful embryo transfer, only to lose her twins — a boy and a girl — at 18 weeks gestation.“Every month, my sadness grew,” she says. “I would curse and cry at maxi pad ads. It was a cumulative, lonely grief — the kind a husband doesn’t really seem to understand.”

The physical, emotional and social anguish women experience when they can’t get pregnant is tough for those who haven’t suffered with fertility issues to comprehend. According to 2013 research in the Journal of International Women’s Studies, women who can’t conceive without help report experiences of being excluded and misunderstood by their partners, family and friends.

When Today’s Parent, in partnership with EMD Inc. Canada (a company that provides drug therapies that focus on the medical needs in fertility, endocrinology and neurodegenerative diseases), surveyed our readers earlier this year, we found out that one in three respondents had, or are currently having, trouble conceiving. Many of those who completed the survey shared stories about the emotional toll couples go through when dealing with fertility issues, and told us that it wreaks havoc on relationships of every kind.

The stress of trying to conceive weighs heavily — and differently — on each partner. “Don’t go through with it unless you understand there will be ups and downs; it can be a very long process,” one reader told us. Another gave this advice: “Tell your family — there is nothing worse than being badgered about when the first grandchild is going to arrive. Tell your workmates and ask them to bear with you. Have sex for fun sometimes — there’s nothing that will kill a marriage faster than doing it just to have a baby.”

“Coping with fertility issues can cause hostility and conflict,” confirms Debra Broadbent, a social worker at The Fertility Clinic at London Health Sciences Centre at University Hospital in London, Ont. “There tends to be a difference in how men and women cope with feelings associated with infertility, and these differences can be misinterpreted, resulting in hurt feelings and increased tension.”

For example, men often feel obligated to fix the situation, and find it hard to deal with their own sadness while worrying about their partner’s. “Sometimes couples will blame each other. More often, though, each person questions whether the problem lies with them, and they feel guilty for not being able to provide a child for their partner,” Broadbent says.

When Toronto mom-of-one Wendy Liu* and her husband, Jason, were going through fertility treatments — a course of ovulation-induction meds and multiple IUIs — to get pregnant with their son, Liu says they didn’t often discuss the situation. “Jason had a low sperm count and motility issues. We rarely talk about things until they blow up. We both had shorter fuses during that time, and we were very anxious,” she recalls. Some couples go to the other end of the spectrum and feel more connected to each other, but it takes work. “Since they’re both going through the hardest thing they’ve had to deal with, and they’re both grieving and feel their dreams for a family are gone, they can come together and strengthen their relationship,” says Jennifer McDermott, an individual, couple and family therapist in Barrie, Ont. Broadbent adds that some couples view infertility as a “journey” to go on together. “Partners learn how to communicate and problemsolve other options that could be considered to build a family. They learn that there is no right or wrong way to cope, and they work at learning how to support each other within each of their coping styles,” she says.

Liu and Jason eventually recognized this need during their infertility struggle and made a concerted effort to cheer each other on. “We were supportive of each other when faith was hard to find. It usually happened that when one of us was losing hope, the other was feeling more optimistic.” One of the most common issues couples have, though, isn’t about support – it’s about the way their once-exciting sex life changes. “Scheduling, tracking and having sex for procreation can become the focus in a relationship. It’s described by many as a ‘chore,’ and disappointment is expressed about the loss of intimacy and spontaneity,” says Broadbent. “Sometimes my husband commented that it wasn’t fun anymore because it had turned into a game with rules and timing,” Misir admits. “There’s nothing worse than saying, ‘Honey, I’m ovulating. Let’s go.’” McDermott, who underwent fertility treatments to conceive her twins, says the main thing to remember is to share emotions, validate feelings, and to put boundaries around the time and place to talk about the process. “Partners should also try to maintain balance by doing individual activities, as well as something fun as a couple. There has to be a life outside of fertility issues,” she says.

No one – especially women who want nothing more than a baby — likes being in the line of fire when nosey aunts and aspiring grandmas start shooting intrusive inquiries about when they’ll get to welcome a new baby. And, truthfully, the last thing anyone trying to get pregnant wants to see is someone else’s baby bump.

“Friends and family were popping out babies all over the place. It’s hard not to notice when your world revolves around trying to conceive. I was truly happy for healthy moms and babies, but I was also jealous,” says Misir. “It was the hardest after we lost the twins. Pregnant women who looked about as far along as I had been made me cry more tears than I knew I had. We stopped going to church. I didn’t want to see families with multiple children and pregnant bellies.”

Broadbent says that dealing with questions about having a family — and seeing friends, relatives, co-workers and even strangers getting pregnant — can be a serious emotional battle. “These women often speak about being genuinely happy for the other person, but their own feelings of sadness, anxiety and envy tend to surface. It’s important to find a balance between doing what they need to take care of themselves while being mindful of not becoming isolated,” she says. If that means you have to send your regrets and well wishes to an acquaintance’s baby shower, that’s OK. “If a celebration arises and it’s essential for you to attend, set a time limit or create the opportunity to leave early,” Broadbent suggests.

Parents who already have a child, and who may be trying for another, commonly experience lots of questions. There’s a good chance someone in your life has asked, “When are you planning to get pregnant again?” Liu and her husband, who are now trying to adopt, are often asked whether or not little Aiden will be a big brother. “At first, we’d said yes because we just assumed it would happen again on the medication, like it did with Aiden,” she says. “Now that we’re adopting, we do tell people, but we’re careful about what we say. Some people don’t have a filter, and we don’t want to answer a ton of questions about it.” When Liu was trying to get pregnant the first time around, she worked in a paediatrician’s office, and only a handful of family and friends knew her situation. “I found it very isolating and lonely, especially at work. In fact, I was starting to think about quitting my job so I wouldn’t be around babies all the time.” While McDermott agrees that removing yourself from hard situations is fine, she warns that this behaviour shouldn’t take over your life. “Women should respect how they’re feeling, but be mindful and seek help if feelings of sadness or hopelessness interfere with everyday tasks, or if sleep and appetite are disrupted.”

One thing to consider, advises Michal Regev, a registered psychologist and marriage and family therapist in Vancouver, is to be open with your partner about what you’re both willing to share with the people in your life. “There may be a difference of opinion in how to tell and who to talk to about the problem,” she says. Consider shushing inquiring minds with something general like, “We’re working on it.”

A few months after they lost the twins, the Misirs transferred a frozen embryo, and, in March, they welcomed their daughter, Amy. “We still have six embryos that remain on ice at the clinic, so we’re thinking of doing it again in the next year,” Misir says. “I wasn’t planning on telling the world… but I no longer feel like I can’t discuss it.” Misir says it was hard to handle friends and co-workers telling her that if she’d just “relax and quit trying,” she’d get pregnant. “That made me mad. I heard I needed to ‘get drunk.’ Or adopt. Or ‘be happy with one child.’ Most people are curious and kind — but some are judgmental and harsh. Nobody plans to walk this road. Listen to their stories with an open mind and heart.”

*Names have been changed.

A version of this article appears in our September 2013 issue, called “The roller-coaster ride of infertility,” p. 92-4.

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