Parenthood is one of the most anticipated events of an individual or a couple’s life. The anticipation of being a parent should be one of excitement and hopefulness; however, this is often not the case when couples experience infertility. The loss of an unborn child and the inability to become pregnant can be excruciatingly difficult for both women and men.
What is Infertility?
Infertility most commonly refers to the inability to become pregnant after one year of having unprotected sex (“Infertility Definitions”, 2018). Additionally, women who have never had a child and who are not able to maintain a pregnancy would be classified as having primary infertility. Secondary infertility is the inability to achieve pregnancy or have a live birth after once having a child. Infertility is experienced by approximately 6% of married women aged 15 to 44 (“Reproductive Health”, 2017).
Mental Health Issues of Infertility
Infertility impacts every aspect of a woman’s life. Psychologists use the theoretical perspective of the biopsychosocial model to understand and help individuals struggling with infertility. Biopsychosocial considers the biological, psychological, and social factors that impact mental health.
Obviously, infertility has biological implications. There are numerous reasons why a woman might not be able to become pregnant or carry a child to birth. She will often undergo several medical tests to diagnose the cause for her infertility. Unfortunately, unexplained infertility is not uncommon. Women often struggle when they are confronted by their inability to have a child. They question their health and may feel betrayed by their own bodies. The decision to undergo infertility treatment is difficult, as the process can be lengthy, expensive, and, at times, painful.
Once confronted with infertility, a swell of emotions can arise. From this time onward, women experience a range of emotions. As with any challenge in life, every person handles these trying times in their own way. Some women cope well, while others struggle. Patience, planning, and persistence are not so easily maintained.
Reproductive trauma refers to the traumatic experiences that infertility and pregnancy loss cause (Jaffe & Diamond, 2015). We don’t often think about trauma with infertility; however, symptoms of post-traumatic stress disorder, are common. Unwanted memories, flashbacks, emotional distress, isolation, hypervigilance, and negative thoughts are just some of the ways in which reproductive trauma can surface.
Terms to Know
Given that infertility and reproductive issues are medical in nature, many terms exist to describe treatments and procedures. Becoming familiar with these assists with understanding how your body may respond to pregnancy and your reproductive choices.
- Assisted reproductive technology (ART): Medical treatments that facilitate pregnancy. Typically, gametes or embryos are manipulated to improve the chances of fertilization. In vitro fertilization is the most common ART treatment.
- Chemical pregnancy: A medically confirmed pregnancy that does not continue to birth.
- Donor sperm: Sperm collected from a fertile male that is used to fertilize an egg. This sperm would be used to create an embryo(s) and the male would be the biological father but may not be the father who parents the child.
- Donor eggs (oocyte donation): Eggs collected from a fertile female that is used to form an embryo. The female would be the biological mother but may not be the mother who parents the child.
- Egg freezing: A medical procedure that freezes unfertilized eggs from a woman with the intention of using the eggs in the future for fertilization. Some women choose to freeze “healthy” eggs while they are younger so that they can be used later to produce children.
- Embryo donation: Embryos that are donated from a couple to help another couple or person have a baby.
- Gestational carrier (surrogacy): A woman who allows an embryo that was formed from another woman be transferred into her own healthy uterus. The gestational carrier usually has some contractual obligations as she carries the baby to birth. Individuals and couples who cannot sustain a pregnancy may use surrogates. Also, gay men often use surrogates.
- Intracytoplasmic sperm injection (ICSI): A very tiny needle is used to inject a sperm directly into an egg to facilitate fertilization. If a healthy embryo is formed, then this would typically be placed into the woman’s uterus. This procedure is commonly used for men with infertility issues.
- Intrauterine insemination (IUI): Artificial insemination is a fertility treatment that involves placing sperm directly into the uterus to facilitate fertilization. The purpose is to increase the chances that the sperm will get into the fallopian tubes to fertilize an egg.
- Miscarriage: A pregnancy that spontaneous terminates with the loss of an embryo or fetus before 20 weeks of gestation.
- Oocyte: The female reproductive cell, or egg.
- Preimplantation genetic testing (PGT): A test to analyze the health of an embryo before it is transferred into the uterus. This test screens for chromosomal disorders and genetic diseases. This is a common test while undergoing infertility treatments to facilitate the development of a healthy pregnancy.
Engaging in mental health counseling while dealing with infertility or pregnancy loss can help. Both individual and couple’s therapy provide a space in which to deal with the intense emotional upheaval, to learn new ways of coping, and to explore moral and ethical dilemmas. Due to the complex nature of infertility and pregnancy loss, one should seek a psychologist who specializes in infertility. He or she is more likely to be helpful in working through the many issues faced by women and men dealing with infertility and loss. Some ways in which psychologists can help are:
- Assist couples in dealing with relationship conflict
- Provide psychoeducation and foster exploration on issues related to in-vitro fertilization(IVF), ovum donation (egg donor), donor insemination, embryo donation, adoption, surrogacy, and a child-free life
- Teach coping skills, such as mindfulness and relaxation techniques
- Explore and resolve emotional issues related to parenthood and infertility
- Provide emotional support when dealing with depression, guilt, anxiety, and grief
As a Health Psychologist, Dr. Mazzei understands the complexities of infertility and helping individuals and couples through the challenges of conceiving. She is familiar with infertility medical procedures and terminology so that you can feel comfortable sharing intimate details about your experience.
Dr. Mazzei focuses on exploring the reproductive story that each person develops. Male or female, gay or straight, everyone has a unique perspective and narrative. Attending to this story, along with developing coping strategies, making positive lifestyle changes, and exploring reproductive decisions, is the focus of counseling. Additionally, Dr. Mazzei offers hypnosis for infertility and other effective treatments, including EMDR, Cognitive Behavioral Therapy (CBT), and Acceptance and Commitment Therapy.
If you are struggling with infertility and reproductive concerns, Dr. Mazzei is here to support you. Please contact us to get started with counseling.
Infertility Definitions and Terminology. (n.d.). Retrieved March 07, 2018, from http://www.who.int/reproductivehealth/topics/infertility/definitions/en/
Jaffe, J., & Diamond, M. O. (2015). Reproductive Trauma: Psychotherapy With Infertility and Pregnancy Loss. Washington: American Psychological Association.
Reproductive Health. (2017, March 30). Retrieved from https://www.cdc.gov/reproductivehealth/infertility/index.htm