The infertility blues

The saying goes: “When poverty walks in the door, love flies out the window”, but poverty is a non-starter when compared to infertility. When infertility walks through the door, your money, happiness, sex life and general mental wellbeing can fly out the window! Jokes aside, infertility diagnosis and treatment is a difficult road that can have a brutal impact on any relationship. What is especially troublesome, is that it is not often discussed, so many people who suffer from infertility get blindsided by the impact of the diagnosis and treatment.

So, what is infertility exactly? According to the Infertility Awareness Association of South Africa (IFAASA), a couple is regarded as infertile when they have not conceived after 12 months of regular unprotected sexual intercourse. I have personally suffered through the trials and tribulations associated with infertility for almost a decade – and although I am eternally grateful for the end results, it wasn’t a pleasant journey. In fact, it was an emotional roller-coaster fraught with extreme highs and lows, that left me feeling lonely, sad and empty inside. What makes it especially difficult is that it seems that unless you have been through it, it is not well understood, as more often than not, your responses, feeling and perhaps even behaviour, are not logical to the outsider.

My story is not an unusual one – in fact, it is more common than you would expect: according to News24, infertility affects men and women almost equally, and occurs in 15% to 20% of the South African population, which roughly translates into one in every six couples. These figures are on par with global fertility trends as outlined by the World Health Organisation, showing that infertility is a common worldwide phenomenon.

“A life-changing experience, infertility diagnosis and treatment can seriously challenge a person’s sense of self and identity. Although the experience is highly varied, it can often cause the onset of a variety of strong emotions, including intense feelings of anger, sadness, despair, shame, inadequacy, isolation, jealousy, and grief,” says clinical psychologist Daniella Renzon, adding, “The experience will impact many areas of your life, but perhaps one of the most severely impacted, will be your sexual relationship with your partner.”

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 This can be influenced by several different factors, including:

• Not feeling like it: Many individuals feel like a failure and experience a sense of shame because their body doesn’t work like it is “supposed” to. Infertility may cause you to feel broken, defective, and inferior – the opposite of feeling sexy and desirable.
• Dealing with social stigmas: Although relatively common, infertility still carries a social stigma and remains taboo. Ultimately, the connections between manhood, womanhood and sexuality are all closely interlinked, and can be negatively impacted by infertility. In many cultures, women remain especially vulnerable to the negative social stigmas attached to infertility, and are often subject to ostracisation, abuse, having financial support withdrawn, or even their marriage annulled.
• A focus on function: Fertility treatment can be a real passion-killer as the focus shifts from pleasure to the biological practicalities involved in conception. Instead of the magic of foreplay, intimacy, spontaneity and orgasm – the build-up and focus is rather on the likes of perfectly timed intercourse, sperm count, follicle count, diminished ovarian reserve, depth of the endometrial lining, vaginal mucous, and uteruses, and so on. This shift in focus can lead to sex feeling too mechanical and predictable, making it seem more like a chore than a satisfying intimate encounter.
• Fertility medication: It doesn’t help that many common medications used to treat infertility, such as Clomiphene (Clomid), Leuprolide, and Gonadoptropins for example, can affect mood, sleep, and sex drive. And let’s be honest, feeling irritable, hormonal, and tired are not good ingredients for “getting it on”.
• Feeling stressed out: Increased stress levels can be termed as the ultimate “hard no” when it comes to sex. Stress can increase the production of the hormone Cortisol in the body, which can suppress our sex hormones, creating a lower libido. Infertility treatment is satiated with high levels of stress: it is emotionally polarising, the treatments are invasive and relentless, and there is of course the stress associated with the high cost of the treatment itself.

So, what can be done?

Although infertility can have a terribly negative impact on your sex life, there is one thing that it can improve, and that is your trust and intimacy as a couple. “Perhaps instead of focusing on what has been temporarily lost, a possible solution would be to discover new ways to nurture your relationship so that you can both get through the storm together,” suggests Renzon.

Here are some tips:

Start a conversation: The first place to start is to discuss the issues associated with your infertility diagnosis and treatment, so that you get a good understanding of what you both need individually. Find out what makes you both feel loved, considered, cherished, appreciated and happy? You should also discuss what makes you feel insecure, triggered, and judged. Talk about your dreams, disappointments, and actions on possible outcomes of the treatment.

Rekindle intimacy: Rekindle the intimacy, which often gets lost during the shuffle of infertility. This doesn’t have to be intercourse – it could be cuddling, holding hands, sending a loving text message or sharing a kiss.

Organise some magic: Put effort into arranging special moments together that are out of the ordinary. These will help you both be more present and take your mind off infertility. Some ideas include arranging a surprise date night, a weekend away, a picnic, a couples massage, or cooking your partner’s favourite meal for example.

See a therapist: Individual counselling, and especially couples counselling, should be a compulsory part of any infertility diagnosis and treatment journey. A good therapist or psychologist should be able to temper expectations and provide you with the best tools to help you manage your experiences. They can also guide you through the deep sense of grief and the chronic stress that is associated with infertility diagnosis and treatment.

Take the holistic road: There are many non-prescribed practices that you can do as a couple, which will not only bring you closer, but that will also help with infertility treatment. These include practicing mindfulness, yoga, acupuncture, reflexology, massage, meditation, and of course, exercise. Finding self-help groups online can also go a long way to advise and console those going through infertility.

If I can offer one piece of advice to couples who have been recently diagnosed or who are in the eye of the storm with regards to treatment, it would be to value your togetherness above all. When it comes to infertility, you are on this journey together, and teamwork really pays off in the end – which is why this quote by Jodi Sky Rogers from her book, Mending Softly: Finding Hope & Healing After Ectopic Pregnancy Loss, is so powerful: “Something profound happens when you wake up in a calm green pasture on the other side of the treacherous storm that you thought would end you. You discover who you are beyond the unimaginable. You discover what you are made of. Suddenly, the thing that may have broken you becomes the very thing that empowers and emboldens you.”