The fertility trap: How to heal your relationship during treatment

Going through IVF, or having trouble getting pregnant, can intensify cracks in a relationship.

Many couples going through IVF are so focused on achieving a pregnancy that they find themselves in the fertility relationship trap. Sexual difficulties, relationship conflict, financial stress, infidelity, and even addiction issues are all lesser-known 'side-effects' of assisted reproduction. For these reasons, it's extra-important that couples struggling to conceive make an effort to communicate with each other as much as possible. Couples who stay in denial, suppress their feelings, or who simply don't deal well with conflict, are statistically more vulnerable to their relationship breaking down. Research has repeatedly shown that couples who take care of their individual physical and mental health and communicate clearly with each other cope more constructively with stress, grief, and the feelings of powerlessness that fertility problems can bring. Psychologists have found that there are some classic patterns that couples go through when they find they can't conceive:

• Becoming aware that there are problems getting pregnant.
• Seeking help, medical advice, visiting specialists and doing things to try to optimise fertility.
• Immersing themselves in tests and fertility treatments, considering all options such as egg and sperm donation.
• Achieving resolution through either pregnancy or becoming parents, deciding to end treatment, or coming to terms with living child-free.

A large number of couples struggling to conceive deal with the emotional fallout of going through any - or all - of these stages. Men and women often cope very differently and this fallout, making the fertility rollercoaster of emotions even harder. Women Because women are usually the focus of the medical procedures, hormone and fertility treatments and pregnancy, their sense of grief and loss with the dreaded arrival of a period or after an unsuccessful fertility treatment differ significantly from their male partner. Women going through fertility problems or unsuccessful treatment often feel they have 'failed' their partner and family in some way. Some may even feel that they have failed at being a woman, particularly if they come from a background where there is a lot of emphasis on being a mum. It’s vital that women talk through all of these feelings, but also that they remember that fertility problems do not define them and that their other half chose them for more than childbearing reasons! Men Many men find their emotions connected to what their partner is going through during fertility treatment or miscarriage. A lot of guys initially assume that they will not be affected by fertility treatment simply because of their gender, i.e. she goes through treatment so it doesn't impact on me, but it can be distressing to see the woman they love in emotional pain coupled with the loss of unsuccessful attempts to conceive, physically invasive treatments or miscarriage. It is not only women that develop powerful attachments to the dream of parenting and pregnancy; men do too, but they may not show their emotions in the same way. Some men share their feelings, while others throw themselves into work or other activities and want their partner to prematurely 'move on'. Men need to realise that being strong for their partner is great, but there is also strength in dealing with their own thoughts and feelings and moving forward together. Families Fertility problems are an individual, couple, and family issue. A lot of couples have families who are helpful during fertility challenges but unfortunately, in some families, people may (despite their best intentions) say things that are hurtful. Couples can meet with total avoidance, reduced contact, silence, and insensitive or unwanted advice from family members. Gently educating, or providing some information, and setting clear boundaries can help couples to cope in these situations. Sometimes, families feel as if they have a 'right' to know about progress and while some couples keep certain details private (to help cope with intrusive behaviour) others want to communicate more openly about what they are going through. Either way, it is important for the couple to say what they do and don't want - or need - from family members; partners can 'tag‐team' or ask each other's family/friends to not 'ask' e.g. "we will let you know any news when we have any." Some people want to pass on difficult news directly, while others choose indirect methods like texts or emails, and ask for some space before being able to talk on the phone. On the other side of the coin, couples can forget to allow for their family members' grief‐during infertility; unsuccessful treatment, miscarriage, or the choice to adopt/foster, or living childfree can be difficult for some family members to absorb, especially those from an older generation. Giving space for their feelings is important, but couples should set limits if they feel pushed to do something they have already decided they do not want to do. Going through fertility problems can really expand the idea of family - it takes time for a couple to decide how to resolve the infertility journey and expand the notion of who ‘family’ are. Some couples need to include 'chosen' family in their journey, i.e. friends and supportive people who can step in when other family members are unavailable physically or emotionally. For couples, families and social groups with strict cultural or religious ideas about what family is and who 'belongs', education and time can be needed for them to adjust to new ideas like donor conception, adoption/intercountry adoption, fostering or childfree living. Friends When it comes to friends, work colleagues, and other acquaintances, couples should discuss their boundaries regarding information sharing - guys may not appreciate having their low sperm count details discussed with the neighbours! It is possible to negotiate a balance of using support while maintaining privacy; this can offset the intrusiveness and loss of control that comes with fertility problems. It is okay not to attend christenings/birthdays/children's parties and other social events if one partner or the couple is just not ready. Politely passing on well-wishes and then taking space may be necessary, but there is a difference between taking space and permanent isolation that can be damaging in the long term.