Dealing with infertility: How partners could support each other

Infertility treatments can be intense, taking a physical and emotional toll on both the partners. Here are some ideas to help you and your partner get through this hard time.

By Aarthi Arun

Dealing with infertility: How partners could support each other

Nisha (name changed) is a successful software engineer who married the love of her life, Tarun. When they decided to start a family after three years of their marriage, things didn't go smoothly. Nisha's mother, who has been scolding her for not trying for a baby sooner, became anxious. Even before the couple could try for a full year, as is often prescribed, Nisha's mother dragged her to a gynaecologist. The doctor gave a prescription for some hormone tablets and asked Nisha to control her stress levels. Nisha caught the anxiety from her mother; reading off the Internet only made things worse. She started to obsess over their lifestyle, their health, and their daily lives, directing Tarun at every step, micro-managing every action of his. It all became too much for Tarun, so he started spending more time at his work or with his friends. Nisha couldn't understand his indifference, his attempts at shutting her out. She feels angry and frustrated that Tarun would not acknowledge or appreciate all the effort she was putting in to have their baby.

Sounds familiar? Infertility is not an easy condition to handle- from expensive treatments to raging emotions to handling family members' concerns and judgements, it can wreak havoc on your health and sanity. Whether it's running between doctor's appointments or meticulously timing your lovemaking or trying one treatment after another, dealing with infertility can be mentally, physically, and financially exhausting for both the partners.
According to recent studies, around 10 to 15% of Indian couples suffer from infertility, which loosely comes to 28 million couples. But, in most of the infertility cases, it is women who are often blamed. There is an added pressure on them due to cultural stigma and stereotyping. A 2019 research among infertile men and women at the Institute of Mental Health and Neuro Sciences (IMHANS, Kozhikode) confirmed this. The study found that depression among infertile women was higher compared to infertile men, and the fertility-related quality of life was higher for men than women. Unfortunately, this is so despite the fact that male partners are responsible for infertility in half of the cases (WHO, 2012). There is also something called unexplained infertility that affects 10% of infertile couples. With unexplained infertility, both the partners are in prime health, yet they will have difficulty in conceiving a child.

Psycho-social impact of infertility

Conceiving a child and continuing their progeny come naturally for most of the people. When there is a problem with that, both partners can suffer from poor self-esteem. Women are additionally at-risk for experiencing body dissatisfaction.
In Indian society, families are tightly knit, and family members can be of immense help. At the same time, they can be overwhelming, especially when you need privacy. No matter who has the issue, it is usually the woman who goes through the intensive and intrusive treatments. Thanks to the preconceived notions of our society, the blame for not bearing the child, by default, falls squarely on the woman's shoulders. From physical, psychological and societal angles, it is the woman who often takes most of the brunt.
“Infertility is not an individual’s problem; it is rather a condition which impacts the couple. The most essential time when the wife/husband experiences difficulty is during the initial diagnosis and when treatment starts to fail or not give expected results," says Dr Shoba James, a marital therapist from Bengaluru.
Also, with all the menstrual cycle calculations and scheduled sex, the intimacy between couples can soon become a chore instead of being something fun and natural. As they say, strong marriages get stronger during difficult times, while weaker ones fall apart under all the stress. So, it is important to understand, acknowledge and support each other when going through infertility. If not, your marriage will start to hang by a thread with all the undue strain from treatments and family members' expectations.

Here is how you can support your spouse during the physical and emotional ordeal of infertility:

Reassure
A piece of 'well-meaning advice' from a relative or friend can make your partner feel anxious or depressed. Comments like 'You waited till it was too late', 'You always put your career in the first place' or 'You should watch your weight' can negatively impact your spouse's emotional health. So, be there to reassure your partner. With a different set of beliefs, values and life experiences, your spouse can be very different from you. Keep this in mind, and respect your partner's wishes. Always remember, you and your spouse are in the same team, pursuing the same goal. Most of the time, all your spouse needs is your listening ear and your shoulder to lean on.

Don't play the blame game
You may have wanted to start a family earlier, but your spouse decided to wait. But, now is not the time to bring it out and blame your spouse for infertility. Along the same lines, don't point fingers at your spouse's habits like smoking or his sedentary lifestyle. When people go through infertility, they subconsciously start doubting their femininity or masculinity and feel inadequate. Most of them also feel it is somehow their fault that they can't have children. As such, your spouse is going through a lot, and the blame games will further crush his/her self-esteem. So, work as a team and analyse your lifestyle for improvements. Did your doctor recommend your spouse to lose some weight? You can offer to go for jogging or cut down on junk food along with your spouse.

Set clear expectations
Once you get the official diagnosis, it can be a long road ahead. Depending on your condition, you may need anything from simple counselling to complex procedures like IVF. Infertility treatments can be expensive, so it is essential to discuss your financial situation beforehand with your spouse. You have to decide upon how much you're willing to spend before you can call it quits. The American Pregnancy Association puts the success rate for IVF for women under the age of 35 between 41 to 43%. The number falls to 25% after the age of 40. So, have a plan about how long you're going to try. With a lot of ambiguity during infertility treatments, having clear goals can make your long journey bearable. Are you open for adoption if things don't pan out? Can you imagine having a childless life? The modern medical advancements have made it easier for couples to have children. The odds are in your favour- it is highly likely that you will greet your bundle of joy soon. However, be prepared for plan B too.
“Speaking up about the situation and maintaining open communication with parents/in-laws is often the best way to overcome negative emotions. Having a child is often been referred to as the goal of a marital relationship and this is true in pro-natal cultures. Involving the family members during medical consultations and giving them a clear picture of your plan of action (who is infertile, the treatment options, what is the expected result and plans about adoption/surrogacy, etc.) will maintain harmony within the family,” suggests Dr James.

Be available
Try your best to show up with your spouse for every doctor's appointment, even if you're not actively going through the treatment. You're both in it together. If you can’t make it for an appointment, request your spouse's mother or your sibling or a friend to accompany your partner, though remember that they cannot replace you. “Partners can support each other by going to diagnostic evaluations together, discussing and deciding the type of treatment and by being open for getting support through therapy. Many partners feel that spending time together and being present for consultations help bring them closer,” advises Dr. James.

Express and acknowledge feelings
Hormones play a vital role in infertility treatments. So, it is not unusual for your spouse to feel irritated, angry or upset for every little thing. According to a British study published in the Journal of Reproductive and Infant Psychology, infertility adversely affects women more than men. More than half of the women who participated in the study reported having marital problems after their infertility diagnosis. If your wife is having a bad day because her friend is having her second baby, acknowledge her feelings. Brushing them off will only isolate your spouse from you. Even if you have no words to comfort your spouse, just listen, and give her a safe place to vent. Don't try to stifle your own emotions -- if you're grieving, feel free to share it with your wife.
Though men may not freely express their emotions, they go through similar issues like low self-esteem and stigma as women when diagnosed with infertility. But, men may process the feelings differently without being vocal about it. Your husband may not be willing to talk or vent about the issue like you. If he needs space, give him that.

Learn to say No
When you're getting a negative pregnancy test for the 6th time in a row, an invitation to your cousin's baby shower is no longer an obligation. So are the endless birthday parties and functions that revolve around children. If you or your spouse can't bear to attend it, feel free to ignore it. Explain the situation to your family and friends, they will empathise with you.
For many people, it is difficult to understand infertility. Some may simply ask you to try harder or just adopt a child, while others may go on and on about their children oblivious to your feelings and pain. Being around such people can stress your spouse out. It is okay to avoid them.

Have Fun
An American study published in Human Reproduction in 2014 found that women with a high level of stress experience delayed conception or suffer infertility in the future. Another study by a group of Italian researchers found that psychological stress in men can contribute to poor semen health. Case in point? Staying calm can drastically increase your chances of having a baby. Constantly keeping track of the ovulation dates or being poked and prodded at the doctor's office can quickly get on your spouse's nerves. Be mindful about this and find ways to channelise the stress.
“In highly sensitive situations like infertility treatments, it is essential to remain hopeful, happy and expect a good result (conceiving and delivering a child). Spending quality time, continuing to engage in activities that the couples enjoy and having a good sexual relationship (recreative sex rather than procreative and timed-sex) will aid the couple in having a balanced and happy relationship. Work out, travel and take time to just be happy,” urges Dr James.

Parent Speak
I had trouble conceiving a baby for five years. My in-laws were very religious, and they took us from one temple to another to pray for a baby. Though I didn't particularly believe that was going to help, I went with them out of my respect for them. This soon became something like a trip for me and my husband. We spent quite a lot of time together during these trips. With both of us working full-time, it was hard to connect at home. Over time, I also started to pray, and I think that calmed me down and gave me hope. Thankfully, I didn't have to go through any intrusive treatments -- only some medication. We are now proud parents of a 5-year-old boy.
-Meenakshi, Chennai

When sex becomes a carefully planned act, you and your spouse can quickly lose the spark in your love life. Take a break once in a while and enjoy intimacy for fun and bonding. You can even plan a short break every 3 or 6 months to break away from the routine. In your pursuit of parenthood, don't forget the big picture. When you're finally blessed with a baby of your dreams, she is better off in a stable family with two parents who are in love with each other.

Appreciate your spouse
This simple thing can go a long way for your spouse. Physical reassurance like a gentle squeeze of your spouse's hand or a pat on the shoulder or even a hi-fi after treatment can cheer her. Offer your heartfelt gratitude to each other for going through painful injections and gulping down numerous tablets to have a progeny. Also, try to see things in a positive light with a sense of humour to quell the sombre mood.
Along with the physical pain, infertility treatment can put you and your spouse on an emotional rollercoaster. It is natural to feel frustrated, angry, and helpless. Every time you see a happy family, you will be forced to ask the question -- 'why us?' If either or both of you are gloomy most of the time, losing interest in the things that you have enjoyed before, it is time to see a therapist. A marital therapist can help you and your spouse find ways to cope and offer you some suggestions to support each other.

Dealing with infertility: How partners could support each other

In a nutshell

  • Infertility can have negative impacts on a couple's physical and mental health
  • Infertility affects both men and women, however, women are more affected both in terms of physical treatments and emotional issues like anxiety and depression. Women are also the ones who are commonly blamed by the family and society for infertility
  • The couples going through infertility should remember that they are a part of the same team and are working towards the common goal of having a healthy baby
  • Having a positive attitude, discussing options and being there for each other can make your spouse's life easier

What you can do right away

  • In the next two months, plan to go on a short weekend break to a nearby destination
  • Designate 20 minutes per day to vent out your spouse's feelings about infertility. You can also buy a punching bag and keep it handy!
  • Think about your spouse's favourite hobbies. Gift her a set of relevant supplies to give her a creative outlet. This can be anything like gardening, painting, cooking, photography, etc.

About the author:
Written by Aarthi Arun on 10 August 2019.
Aarthi is a writer from Chennai, who currently calls Toronto her home. She has donned many hats from a photographer to a librarian to a software engineer, but she has learnt the most in the role of a mother. She loves long walks with her 6-year old, likes creating lego masterpieces and reading adventurous stories with him.

About the expert:
Reviewed by Meghna Singhal, PhD on 12 August 2019.
Dr. Singhal is a clinical psychologist with a doctorate degree from NIMHANS (Bangalore) and holds a post-doctorate in parenting from the University of Queensland (Australia). She is Head of the Content Solutions Zone at ParentCircle.

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