Infertility and Mental Health
Infertility Effects Mental Health of Both Women and Men
The holidays can be stressful for many people. But those struggling with infertility may feel increased sense of loss, sorrow, anger, and anxiety during this season. More family and friend functions and the end of another calendar year can be triggers and reminders of what infertile couples don’t have or haven’t achieved yet.
Infertility affects 10-15% of couples and/or potential mothers and/or fathers of reproductive age worldwide. The number of people seeking fertility treatments has grown due to factors such as postponement of childbearing, development of improved fertility treatments and outcomes, as well as de-stigmatization of fertility treatments and increasing awareness of options. Increase of use of these services has led to investigation of psychological effects of infertility as well as prolonged fertility treatments on psychological well-being.
Both men and women can experience depression, anger, anxiety, marital stress, sexual dysfunction, and social isolation due to infertility issues. They often feel a sense of defectiveness, incompetence, and incompleteness due to their infertility issues. They may feel stigmatized and experience loss of self-esteem. In general, women experience higher levels of anxiety. Men’s distress can be dependent on the intensity of their partner’s response. In men who experience infertility themselves their anxiety and distress matches rates of female incidences.
Psychological Distress and Infertility Treatment
While much anxiety, stress, and depression results from infertility itself, the process of undergoing fertility treatments also adds to these negative feelings. Studies show that couples undergoing a second or third round of IVF, for instance, were more depressed and had lower self-esteem than those going into their first round of IVF. And significant number of decisions to discontinue treatment are due to psychological factors. This leads to the question, is negative psychological state a cause or effect of infertility.
Is Stress, Anxiety, and Depression a Cause or Effect of Infertility?
Studies show that fifteen to over fifty percent of couples facing infertility have major depression. And couples with infertility issues have significantly higher rates of anxiety, between 8-28% higher than fertile couples. It is not clear however, that anxiety and depression or other psychological disturbances cause infertility. Studies cannot distinguish between depression and other influences such as cigarette smoking, alcohol use, decreased libido, or body mass index.
Does Psychological Intervention Aid in Increasing Fertility Rates
Although it is not conclusive whether psychological factors cause infertility, studies do show that stress is associated with lower success rates in women undergoing fertility treatments. Several studies show that cognitive behavioral group psychotherapy and support groups help improve psychological state and increase fertility rates.
A study by Domar, including 52 infertile women, concluded that a 10-week group behavioral treatment program significantly reduced anxiety, depression, and anger (Domar 1992). In a year-long follow-up, Domar compared pregnancy rates of women undergoing assisted reproduction who were randomized to a group who received cognitive behavioral therapy (CBT) designed to decrease depression and anxiety, a support group, or to no group treatment. Viable pregnancy rates were 55% for the CBT group, 54% for the support group, and 20% for the controls with no treatment (Domar 2000). A study where the intervention group received couples counseling directed toward education and addressing stress throughout their IVF cycle and a control group, who received only routine medical care, found the intervention patients had lower anxiety and depression scores and significantly higher pregnancy rates (Terzioglu 2001).
From this research we know that the best thing for people dealing with infertility is to have a support system. Support can come in many forms including friends, family, specific support groups, online organizations, group and individual therapy, and prescription treatment options. I’ve gathered resources below to help you on your journey.
When to seek support when experiencing infertility
The following feelings or actions may be symptoms that indicate that you need professional support:
- Prolonged, persistent feelings of sadness, guilt, or worthlessness
- Isolating from others
- Loss of interest in normally loved activities and relationships
- Depression
- Anxiety and agitation
- Mood swings
- Constantly thinking about infertility
- Physical and/or emotional problems connecting with your partner
- Difficulty focusing
- Increased use of alcohol or drugs
- Change in appetite or sleep patterns
- Thoughts of suicide or death
Where to find emotional support when experiencing infertility
Support can come in many forms. Books can provide information and insight and/or understanding around emotional aspects of infertility and help you feel less alone. Support groups can reduce the feeling of isolation and provide opportunities to learn and share with others experiencing infertility. Individual and couples counseling can allow a professional to support you and your partner though this challenging time, give you coping mechanisms, and help form solutions.
Resources for emotional and psychological support for those experiencing infertility
- Choice Moms: An organization to help single women who proactively decide to become the best mother they can, through adoption or conception, choicemoms.org
- LIVESTRONG Fertility: A national LIVESTRONG initiative dedicated to providing reproductive information, support, and hope to cancer patients and survivors whose medical treatments present the risk of infertility, www.livestrong.org
- Frank Talk: A peer-support Website dedicated to helping men deal with erectile dysfunction, FrankTalk.org
- InterNational Council on Infertility Information Dissemination, Inc. (INCIID), inciid.org
- North American Council on Adoptable Children: An organization committed to meeting the needs of waiting children and the families who adopt them, nacac.org
- Parents Via Egg Donation: An organization created to provide information to parents and parents-to-be and to share information about all facets of the egg donation process, pved.org
- Pop Luck Club: The Pop Luck Club has evolved into a substantial voice, helping to support the growth of our wonderfully diverse LBGT community, popluckclub.org
- RESOLVE: A national infertility support organization, Resolve.org
- Single Mothers by Choice: Offering support and information to single women who are considering motherhood and to single mothers who have chosen this path to parenthood, singlemothersbychoice.org
- Magazines: Fertility Road, Fertility Magazine, Conceive Magazine, Gay Parent Magazine
- ASRM (American Society for Reproductive Medicine): https://www.reproductivefacts.org
- The Fertility Institute List of Support Groups for Men and Women: https://fertilityinstitute.com/blog/infertility-support-groups/
- Fertility Out Loud Support Community: https://www.fertilityoutloud.com/
If you have suicidal thoughts or are in immediate risk
If you or someone you know has suicidal thoughts, get help right away through one or more of these resources:
- Reach out to a close friend or loved one.
- Contact a minister, a spiritual leader, or someone in your faith community.
- Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor.
- Make an appointment with your doctor or a mental health professional.
- Call 911
Danielle Older, MSW, LISW-S, CCTP
Danielle is one of our maternal mental health therapists and the founder of River Root Counseling. Her therapeutic style is individual, evidence-based, and unique to best serve each individual client. Danielle will work with you, at your pace, cheering you on and empowering you as you accomplish your therapeutic goals. Danielle values the therapeutic relationship and works to make each session beneficial and helpful for her clients. Danielle is a mother herself and understands the roller coaster that parenting, and motherhood, can sometimes feel like.
Call River Root at 330-595-4563
Licensed Independent Social Worker with Supervision Designation (Ohio) – I.2002068-SUPV
Certified Clinical Trauma Professional (CCTP)
Bachelor’s of Social Work – University of Akron
Master’s in Social Work – Edinboro University of Pennsylvania
Schedule a consultation here.