How To Keep Your Relationship Strong When Dealing With Fertility Issues

When a couple has trouble trying to conceive, it often comes as a shock, a complete derailment of plans. Loneliness and disappointment are common feelings. So, too, are anger and frustration. No couple facing infertility will experience it in quite the same way, but it is critical that they learn how to get through it together. After all, infertility is a disease, notes Dr. Jenna Turocy, M.D., an OB-GYN at Columbia University Fertility Center and assistant professor of obstetrics and gynecology at Columbia University. Though it’s often not spoken about enough in this sort of way, viewing it as such can help contextualize the many medical decisions, procedures, and emotions one goes through when dealing with it, not to mention the considerable strain it places on a relationship.

“When people have certain goals and realize those goals have to shift, it can be traumatizing to a couple,” says Turocy.

It’s common for couples to feel isolated or overwhelmed as they come to terms with infertility and seek other treatments or alternatives to biological parenthood. Social aspects add to the struggle and heartache: Seeing other couples out with their babies or reading birth announcements on social media tends to sting, leading to sadness and anger.

Infertility is often described as a sort of invisible grief, as loved ones often don’t know when couples are trying to have a baby. Each month that passes without conception dashes hope and starts the private grieving process anew, says Deborah Simmons, Ph.D., a reproductive therapist in Minneapolis.

Couples may be unsure of how to support one another as they process their own feelings, and conflict is likely. It’s normal to feel short-tempered, withdrawn, or depressed when struggling with infertility. The stress may cause past mental health issues, such as depression or anxiety, to resurface. Certain fertility treatments may cause hormonal changes such as mood swings, all of which contribute to various challenges.

“Regardless of which partner has the medical issue, both people struggling to conceive are equally impacted,” says Jon Summers, a paramedic in Melbourne, Australia, who, with his wife, Laura, raise awareness about male infertility via social media and co-authored the upcoming book The Man’s Guide to Infertility. “Infertility affects men emotionally and physically, and it has a major impact on every area of life for both men and women.”

No matter where partners are in their fertility journey, the experience can be traumatic, and both individuals need an incredible amount of support. Here are some things to keep in mind about the ways infertility affects relationships, and how couples can weather them as a team.

1. To Take Care Of Your Partner, You Need To Take Care of Yourself, Too

If men receive an infertility diagnosis, they often don’t handle the news very well, Summers says. It can impact their sense of masculinity, and they can feel like they’re letting their partner down.

“And then if the partner has to go through fertility treatment with the injections and everything else, I think some men feel very guilty about that,” he says. “I’ve wished I could do the fertility treatment in place of Laura — the injections, the surgeries, the losses — but unfortunately, it doesn’t work that way. The best I can do is look after her and do whatever I can to make everything else easier for her.”

Simmons notes that many of her patients also feel shame and embarrassment about infertility, as though they’re failing at their biological imperative to impregnate or pass along their family name. Their feelings about infertility can be much deeper than is often acknowledged.

“Many men desperately want to become fathers and can feel socially left out when they can’t,” she says. Doctors and therapists typically focus more on the person who will physically carry the pregnancy, or experience miscarriage. So men are often perceived more as support providers than people in need of support themselves.

“I always ask men how they’re supporting their partners, and after they tell me, I ask, ‘Who is supporting you?’” Simmons says. “They often get tears in their eyes and say no one is helping them. One man just burst into tears.”

Men raised with more traditional gendered expectations are more likely to internalize feelings, which can cause some confusion or hurt in their relationships, Simmons says. Because women are more often socialized to express their emotions, they might wonder why their partners aren’t crying or talking about how sad they are about their fertility struggles.

People process stress and grief differently, however, so it’s helpful for partners to remember that just because someone is quiet doesn’t mean they aren’t grieving.

“When my mom died, I went out and gardened,” says William D. Petok, Ph.D., a Baltimore psychologist who specializes in the treatment of infertility, clinical associate professor of obstetrics and gynecology at Sidney Kimmel Medical College, Thomas Jefferson University, and a past chair of the Mental Health Professional Group of the American Society for Reproductive Medicine. “It happened to be spring, and she had taught me to garden, so that was meaningful to me.”

Although couples will need emotional support from each other, it’s important to also have a support system outside the relationship, Petok says, whether it’s a friend or family member, therapist, or support group for men experiencing infertility. RESOLVE is an excellent resource for finding groups, and there are online resources on Facebook and Reddit as well.

2. Be Present, But Don't Try To Fix It

“Sometimes men try to be ‘strong’ for their partners and don’t show how moved they are by their partner’s pain,” says Lucille Keenan, Psy.D., a clinical psychologist who specializes in fertility and reproductive health issues in Raleigh, North Carolina. “And they quickly get uncomfortable feeling helpless, so they go into ‘fix-it’ mode. But often a woman just wants to have her partner with her and not trying to make her feel better.”

It can be helpful to hear something like, “I love you, and it hurts me to see you hurt because I love you so much,” Keenan says. Or, “I wish I could make it better. I’m here, I’m not going anywhere, and we will get through this together.”

“The general idea is that he is staying present to her feelings,” Keenan says of this example. “Don’t ‘fix’ unless specific action is asked for. The time will come many times over when he can help in tangible ways because [fertility treatments are] often a grueling physical process.”

3. Show Compassion (Even When It’s Hard)

It’s challenging to deal with intense emotions. But it’s especially important for men in heterosexual relationships to remember that their partner is likely being taken on a wild hormonal ride, Keenan says. Try not to take it personally and get reactive when negative feelings are expressed.

“Instead, offer compassion and a gentle reminder that it hurts to hear that you don’t care [for example], because you do,” Keenan says. “And it won’t ever be appreciated if you point out that it’s just the hormones talking — the feelings are very real and real intense.”

Also important is to avoid devolving into blame or accusations when talking about fertility issues. Try to remember that you both have the same goal of conceiving and that each of you is doing the best you can in the moment, says marriage and family therapist Diane Gehart, Ph.D., professor and coordinator of the marriage and family therapy program at California State University, Northridge.

If you feel an urge to criticize your partner for current or past behaviors that could affect your chances of conceiving, for example, Gehart advises finding someone else to vent to and then returning to your partner with a clearer, more positive outlook.

4. Be Prepared To Face Intimacy Issues

When couples are trying to conceive, sex becomes something that’s scheduled, monitored, and imbued with stress and pressure. For many people, therefore, sex can start feeling less fun and more like work, says New York City fertility specialist and reproductive endocrinologist Dr. Michael Guarnaccia, M.D.

“During the fertility treatment process, sexual intimacy takes on an entirely different connotation, which can lead to sexual dysfunction in men and women,” Guarnaccia says. “I let couples know these issues are common.”

It’s easy to get caught up in the utilitarian nature of procreation, so couples should make an effort to make each other feel desirable and appreciated, Keenan says.

And although stress generally isn’t great for a couple’s sex life, they shouldn’t worry that a normal amount of stress will hurt their chances of conceiving, Guarnaccia adds.

“Daily stress doesn’t have a major impact on women’s ability to conceive unless it’s so extreme that she starts losing weight or stops ovulating,” he says. “It’s a fallacy that when women are in an IVF cycle, for example, that they have to stop everything, all exercise, yoga, and Pilates. Whatever techniques you normally use to deal with daily stress, just keep doing that.”

Couples who have been struggling with fertility issues for a long time, and might be exploring other parenting options, might benefit from a change of setting as well, particularly if they’re more visually oriented, Gehart says. A room in which you spend, or spent, a lot of time trying to conceive might feel painful for a while, so having sex in a different room can help shift your mindset. Some couples, she says, might find redecorating the bedroom helpful as well after struggling with fertility, to signify a fresh start.

5. Schedule Specific Times To Discuss The Path Ahead

It’s helpful to schedule time to talk about fertility but also to schedule time to focus on other things entirely, Turocy says.

“We suggest having ‘Baby-Making Meet Ups,’” Summers says. “This means setting aside time every week or even every day when you’ll have a conversation about where you are in your fertility journey, hopefully over a nice meal or at a special place like a park or the beach. It means that both partners understand when it’s time to talk about fertility and when it’s not.”

It can take couples up to a year and a half to conceive, if they do at all, Guarnaccia notes. So there needs to be an ongoing discussion about how far each of you is willing to go, physically, emotionally, and financially, in your quest to have a baby. Along the way, couples should prioritize supporting each other any way they can and making sure they get the individual support they need as well.

“You have to be proactive and acknowledge this is going to be a difficult stage in your life,” says Summers, who, after he and his wife completed 15 rounds of IVF and two surgeries, recently became a father to a baby girl. “Plan ahead for how you’re going to manage your stress, your health, your finances, and your relationship. You can get through infertility, but you have to take steps to protect and look after yourself and your partner as much as you can.”