The Stress of Infertility

Emotional support is a key part of the treatment process

Like many baby boomers, Joanne Cohen-Katz delayed childbearing— and didn’t think it would matter. “Even in my late 30s, I was told, ‘Don’t worry,’” says Cohen-Katz, a psychologist at Lehigh Valley Hos- pital and Health Network. Ready for pregnancy at age 41, she was dis- mayed to learn “the odds were very low due to my age.”

Cohen-Katz and her husband went through several months of fertility treatments, including daily injections to stimulate egg production. By the time they decided to adopt, they’d experienced every up and down in the “roller coaster” of infertility. “All the pain and difficulty disappeared into the past the moment I got my son,” she says. But the experience gave her insights and wisdom to share with other couples struggling to conceive.

The physical side of infertility is fairly well-known. “We can usually diagnose the problem in a month or two,” says Wendy Schillings, M.D., infertility specialist at Lehigh Valley Hospital and Health Network. “About half the time it’s male-related and half the time female. But more than one factor is often involved. And 10 percent of the time, the infertility can’t be explained.”

Specialists like Schillings offer an array of treatments, from drugs to high-tech in-vitro fertilization. But they also know that emotional support is a vital part of the process. “You’re making a major commitment of time, money and energy,” she says, “and the results are far from guaranteed.”

Cohen-Katz remembers well the emotional turmoil of each monthly cycle of hope, despair and more hope. “It takes on a life of its own, like being on a train you can’t get off,” she says. “Just like a major illness, infertility can take over your relationship.”

The constant re-evaluating (“Should we keep trying?”) creates stress for the couple, especially when they don’t agree. “One may be much more gung-ho about a baby than the other,” Schillings says. “They may also differ about using donor sperm or eggs, or adopting.”

At root, an infertile couple is coping with the painful issue of loss. “There are so many different kinds you can’t begin to list them,” Cohen-Katz says. “Loss of your identity as a man or woman who ‘should’ be able to reproduce...loss of that perfect-family fantasy we all grow up with...loss of status in your larger family if you can’t provide grandchildren.”

The result for some couples is a temporary bout of depression. Cohen-Katz treats many would-be mothers and wishes she could help more of their partners. “Women are far more likely to seek mental health treatment, but the issues—blame, low self-esteem, a sense of failure—are the same for men,” she says. “If they can’t talk about or come to terms with these issues, it can create hidden depression.”

What if the couple does manage to conceive? Amidst the joy, they’re probably extra-nervous about the pregnancy, Schillings says. And given the higher risk of multiples with some fertility treatments, they may face complex ethical issues (“What should we do with the embryos that aren’t used?”) and worries about the finances and stamina needed to raise twins.

Ask Cohen-Katz if any of that matters now and the answer is clear. “Being a parent is the most thrilling thing in the world,” she says. “It’s not about how you get there; there’s a lot in life you can’t control. The key is to remember the essence of what you’re looking for. For me, that means creating a family and sharing my love.”

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