Infertility is a medical condition that touches not only physical but also mental aspects of your life. Infertility is often emotionally painful. Fertility challenges often lead to emotional trauma and put a strain on a relationship. While fertility treatments in the medical field may be able to help improve the likelihood of conception, seeking help via therapy while undergoing those medical treatments can be a helpful way to work through grief, anxiety, worry, or any other emotions that couples may experience as a result of fertility issues, especially in case that the medical treatment fails. Infertility counseling can be helpful for people experiencing fertility issues.
What is Infertility?
According to WHO – Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility affects millions of people of reproductive age worldwide – and has an impact on their families and communities. Estimates suggest that between 48 million couples and 186 million individuals live with infertility globally. Infertility is not always a women’s problem. Both men and women can contribute to infertility.
There are two types of infertility – Primary and Secondary. Primary is when pregnancy is never achieved by a person, and secondary is when at least one prior pregnancy has been achieved. In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others. Whereas, in the male reproductive system, infertility is most commonly caused by problems in the ejection of semen, absence or low levels of sperm, or abnormal shape and movement of the sperm.
What is Infertility Counseling?
The emotional pain couples experience when going through infertility can be severe and traumatic. Infertility can cause stress and anxiety. It can cause anxiety and conflict in a relationship. Those affected by infertility may also experience depression, feel hopeless or defeated, and experience low self-esteem or self-loathing.
Coping with infertility is hard, and needing help is normal. Seeing a therapist could help you cope with the emotional struggle of infertility. Couples therapy can help improve interpersonal communication and may make it easier for the couple to reach the decisions. Sometimes partners may disagree about the best course of treatment or one partner may feel hesitant to seek medical help, and a therapist can help a couple to address these concerns and help them come on the same page. Therapy may also be a useful place to discuss how long infertility treatments should be pursued or the amount of money that should be spent on attempting treatment. In many cases, infertility may affect other members of a family as well, such as children and grandparents. A couple might also have a hard time sharing news of infertility with other members of the family, or they may feel pressured to have children even when they cannot or pursue treatment options for infertility that they do not wish to pursue. Any of these issues may be addressed in individual therapy, and in some cases, family therapy may also be of benefit.
Types of Infertility Counselling
1. Information Counseling
Providing adequate information about the medical aspects of the treatment is primarily the responsibility of the medical doctor. However, patients need reassurance and they consult counselors to obtain more information concerning the social and emotional implications of the infertility treatment. It is often the task of the counselor to help these individuals collate and make sense of all the information to be considered while making appropriate decisions related to treatment and parenting options. This counseling helps couples restore their confidence and self-reliance.
2. Implications Counseling
Implications counseling should focus on the specific meaning of any information to the individual and highlight the consequences of treatment decisions – including termination – for every person who is involved in the process. This type helps couples to understand fully what the treatment means to them, how it may affect them, and its consequences. It may be especially important in the context of sperm and egg donation and surrogacy, but should be part of any other type of counseling as well.
3. Support Counselling
Support counseling aims to provide emotional support to patients experiencing distress. Distress can be caused by the frustration of the desire for a child, social and family pressure as well as the reproductive technology employed and its limited success rate. For example, during phases of intensive assessment, waiting periods, failure to achieve pregnancy, decision conflicts concerning treatment termination, the end of treatment, and so on. While the provision of emotional support should be part of any patient-centered care and treatment, support counseling should specifically focus on the resources patients themselves have in coping with emotional and physical distress and on working out new strategies of coping that might help in managing stressful situations. It is often the case that patients need support once treatment has ended. That is when the couple is no longer patients at the clinic.
4. Post-therapeutic counselling
This type is essential for couples to cope with the result of the treatment. Every time, the desired outcome may or may not happen. At that time, this counseling is helpful. It involves developing coping strategies to minimize distress and maximize problem-solving, addressing specific issues such as sexual, marital, or any other issues. This counseling helps the couple accept the situation and discuss alternative lifestyles.
Propose or Goal of Infertility Counseling
Research has shown that infertility can have a stressful impact on couples’ relationships and can affect their sex life as well. The phase is traumatic, and isolating and can impact how a couple communicates with each other and with the people around them. There can be a sense of loss and grief that can impact their life. Infertility can cause a sense of denial, sadness, and shock. There can also be feelings of fear, guilt, and abandonment from the partner or family members. Women can feel less feminine and men can feel less masculine because of infertility. It can also put stress on a relationship, feeling unhappy with themselves and their marriages. It is important to express the feelings of sadness, loss, and anger and to have good support from people around you who understand you well.
Here are a few goals of infertility counselling:
- Make a couple’s relationship better.
- Get away with the feelings of guilt, shame, hopelessness, denial, sadness, etc.
- Regain self-esteem
- Making wise decisions about life choices
- To get away with sexual trauma
- Understanding the couple’s emotions
- Explore, understand, and resolve issues arising from infertility
- Deal with problems effectively
- Give emotional support to the couple
How Fertility Counselling Can Help You Cope?
Counselors and therapists are aware of the challenges that accompany fertility issues and the common infertility treatments. In therapy, couples faced with infertility can discuss options and make decisions about how to proceed, whether through adoption, fertility treatments, artificial insemination, surrogate parenting, or separation in extreme cases. Therapy can also help couples deal with the feelings of guilt, and anger that may arise between partners when only one person is infertile. Infertility can cause stress and anxiety, low-self- esteem, self-loathing, etc. It can help you cope in the following ways –
- Accept and acknowledge the fact.
- Cope up with the feelings associated with infertility.
- Cope up with relationship issues
- Cope up with issues related to self.
- Cope up with sexual issues.
Fundamental Issues in Counseling
A person suffering from infertility will face complex issues which span biological, psychological, social, and ethical domains. Discussion of these issues in a counseling context
is often beneﬁcial for the patient.
The fundamental issues may include:
- Patients not giving themselves time to settle emotionally.
- Patients not giving enough time to the treatment chosen.
- Patients not accepting the situation.
- Patients wanting one and done solutions.
- Lack of resources.
Approaches are Typically Used During Infertility Counseling
When a couple needs infertility counseling services, medical staff and couples determine the timing and type of counseling that is most appropriate for their situation and the couple as well. Typically, providing psychosocial care and psychological help for infertile couples or individuals is seen as most beneficial. Also, Patient-centered care can be applied in two parts – first, information gathering and analysis as well as implications and decision-making counseling. Infertility counseling can cover three areas including implications and decision-making counseling, as well as supportive counseling and short-term crisis counseling. Psychotherapy primarily includes therapeutic counseling, but can also include crisis counseling that is long-term in nature.
Here are a few approaches used most commonly for infertility counselling:
- Information gathering and analysis
- Implications and decision-making counseling
- Support Counselling
- Crisis counseling
- Therapeutic counseling
Therapy for Coping with Fertility Issues
A fertility problem may be one of the most difficult challenges a couple will ever face. Acknowledging this is a key to coping says Kate Marosek. Therapy helps you cope with fertility issues.
Here is how therapy helps you cope with the fertility issues –
1) It helps you to identify and share your feelings – Sometimes, friends, family, and partners can’t help you the way you expected. At that time, counselors can help you to identify your feelings. Not only acknowledging, but sharing feeling is equally important. A counselor lets you share your feeling without judgment. S/he listens to you non-judgementally.
2) Therapy helps you get away with self-blame – Infertility often leads to self-blame and statements like – “I shouldn’t have waited. I’m being punished for terminating that pregnancy. I should have lost more weight or taken better care of my health. I shouldn’t have assumed that I could have children whenever I wanted.” Or “ I should have listened to my elders and took chance in time.” Therapy helps you focus on the present and erase ‘should haves’ or ‘could haves’
3) Therapy helps you make wise decisions – It might be any decision – about adoption or setting a limit on how long to try or separation, you understand the pros and cons because of the therapy and it helps you make the wise decisions for the lifetime.
4) Therapy helps you team up with your partner – Working together as a team is a key to getting away with the negative feelings in such tough times. Therapy helps you work together as a team instead of blaming each other. Working together to find practical ways to share the burden always helps.
5) Therapy supports you – Society often fails to recognize the grief caused by infertility. People tend to hide their sorrow, which only increases feelings of shame and isolation. Therapy supports you and understands your feelings well.
6) Therapy educates you – Therapy educated you about fertility issues. Asking questions and talking about the situation is always beneficial. Along with counseling, reading various materials on infertility helps you stay educated.
7) Therapy helps you engage in other activities – Being treated for a fertility problem can feel like a full-time job, so it’s important to keep up with some of the activities or hobbies that you enjoy. Sometimes, we are so submerged in taking treatment, that we don’t understand that we can have other hobbies as well. Therapy helps you to get back on track about it.
8) Therapy helps you balance optimism and realism – People around infertile couple often says them to be positive. But, sometimes they forget that treatment also has its limitations. So, it is necessary to balance out optimism and realism. Therapy helps you do that. Staying realistic can help you make smart choices as you work your way through the emotional minefield of treatment.
9) Therapy can help you cope with issues related to self – Infertility can cause issues of self-esteem, and self-loathing. Therapy helps you get away with those issues by rebuilding self-confidence.
10) Therapy helps to rebuild couples’ connection – Partners often react differently to the stress and grief because of infertility, which can create a negative connection between the couple. One partner may avoid the pain by withdrawing from the relationship, while the other may cope by intensifying emotions to connect with their partner. Therapy helps them reconnect by being on the same plateau.
11) Therapy prepares couples for the treatment – During the therapy, the counselor educates couples about what to expect psychologically during the treatment and ensures both partners are comfortable with the decision to tell them that it can be a physically and emotionally taxing process.
12) Therapy helps with sexual trauma – Often, infertility leads to sexual trauma because of the missed rate in pregnancy. Therapy helps you deal with it either along with the help of a Psychiatrist or alone by therapy.
When Do I Need To See An Infertility Counselor?
Counseling can be considered if the person is feeling depressed, anxious, or so preoccupied with your infertility that you feel it is hard to live life productively. Seeking the assistance of a counselor is essential if you are feeling stuck and need to explore your options. Signs that you might benefit from counseling include:
- Persistent feelings of sadness, guilt, or worthlessness
- Social isolation
- Loss of interest in usual activities
- Loss of interest in relationships
- Depression, prolonged sadness
- Mood swings
- Constantly thinking about infertility
- Marital conflicts due to fertility issues
- Sexual issues due to infertility such as difficulty with “scheduled” intercourse
- Difficulty concentrating and/or remembering because of the preoccupation with thoughts
- Increased use of alcohol or drugs
- Thoughts about suicide or death
How Do I Find An Infertility Counselor?
You may start by asking your physician for referrals to trained mental health professionals in your area. Often, infertility hospitals also have a panel of counselors. You may ask them for the services as well. Counselors may be psychiatrists, psychologists, social workers, psychiatric nurses, or marriage and family therapists.
2: Infertility Counseling: FAQs
Infertility counseling is a relatively new field and thus, people can have numerous questions about it. Let us address a few FAQs about infertility counseling –
Q.1 What to Expect in Infertility Counseling?
Infertility counseling is an integral part of the treatment process. In a therapy session, a therapist tries to identify the potential source of anxiety and works on it to overcome the same. Each session is tailor-made to the specific needs of the couple. The couple might be facing issues of helplessness, self-blame, moral dilemma, sexual crisis, low self-image, and extreme emotions if there have been unsuccessful attempts at pregnancy earlier. The counselor will help you learn coping mechanisms to feel better about yourself and trust the treatment procedure.
Even though you are taking counseling sessions regularly, you need a lot of patience. You can expect emotional turmoil while undergoing the treatment. Giving yourself time is the key to being emotionally stable. Expect a lot of time, and patience to spend. Expect being emotionally unstable, moody in these days.
Q2. How do you mentally deal with infertility?
Infertility can be physically as well as mentally traumatic. It can take an emotional toll. There is a lot of guilt, and self-blame involved. Dealing with infertility can be ough due to a lack of support from others especially from the partner if only one partner is infertile. Seeking help from a counselor, attending support groups, and reading various materials related to infertility can help you deal with it mentally.
Q3. Can psychological issues cause infertility?
The answer to this question is yet unclear. The relationship between stress and infertility has been debated for years. Women with infertility report elevated levels of anxiety and depression, so it can be said that infertility causes stress. What is less clear, is whether or not stress causes infertility. Psychological disorders such as depression, anxiety, OCD, Panic attacks, etc. which create extreme levels of anxiety in an individual, can affect infertility. It can be said that stress causes infertility. Along with stress, drug or alcohol abuse, sexual disorders or trauma can also contribute to infertility.
Q4. Is infertility a trauma?
The simple answer to this question can be – Yes; Infertility is often called complex trauma. Infertility changes how you see yourself and the world and causes the trauma that affects the individual and the people around them as well.
Q5. Where Can I Get Support?
Getting help from your closed ones can be difficult in case of infertility. You can get support via various platforms. A few examples are – Referrals from your physician, friends, family, or infertility centers; various magazines; you can also search online for various resources along with different support groups actively working in your city.
Q6. What Should I Look for in an Infertility Counselor?
A counselor should have experience in couples counseling or deal with trauma and other mental conditions. S/he should hold at least a master’s degree in Psychology. However, there are no official rules or regulations that set what level of training a counselor dealing with infertility needs. There are various accredited courses, qualifications, and workshops available to counselors to improve their knowledge of a particular area. You may wish to check to see if a professional has had further training in couples counseling.
Infertility counseling can be beneficial in many ways—from helping you sort through your options to helping you cope with the stress and trauma of infertility. Sometimes, you need a therapist who is familiar with infertility and fertility treatment options. This is especially true if you’re trying to sort through your options. But if you mainly need support for emotional challenges, any qualified, compassionate counselor can help. You don’t have to go through this infertility journey without help. Seeking help for infertility is okay and needs to be normalized! There are trained counselors out there to help you. If you want to seek extra support, reach out for it. Seek help, Do not hesitate about it, because you are not alone!
Online Counselling for Infertile Couples in India
We at WAITT provide top infertility counselors to help you get away with your infertility trauma. Click on the link to book a session with us.