Comments OffOctober 27, 2014by admin

Coping with Infertility

Anyone who has gone through infertility will testify to the fact that the process, no matter however long it lasts, is very stressful.  And, infertility patients get more than their share of advice such as:  1) They are taking “this” too hard, 2) They need to just forget it all and relax, and 3) They are becoming obsessed with having a baby.  Why isn’t infertility treatment like the treatment of any other health problem?  Why does it cause so much more stress than other problem situations?  Perhaps one of the answers to why it is so stressful can be answered with a chart on the following page, the Social Readjustment

Rating Scale.  This scale is designed to measure how much stress a person has undergone in a given period.  Several dozen events that were deemed stressful (positive or negative) were assigned a point value system, depending on the amount of adjustment the event required.  In looking at the processes involved in infertility treatment the following life events were identified:

Life Event Stress Points
Death of a Close Family Member 63
Change in Health of a Family Member 44
Sex Difficulties 39
Change in number of arguments with Spouse 35
Revision of Personal Habits 24
Personal Injury or Illness 53
Change in Financial Responsibilities 38
Total 296

It should be noted that these are the most common life events associated with infertility and you may have other life events in addition to these common ones associated with your particular situation.  In general a total score of 150 or less is considered to be normal; 150-199 corresponds to mild stress; 200-299 is considered a moderate crisis; and 300 or higher indicates a major life crisis.  Needless to say that infertility treatment coupled with the stress of everyday life events puts a couple at the crisis level!

You will notice that the death of a family member is listed in the events of infertility.  as one therapist noted, every month that you try and do not become pregnant, you are losing a family member….your long-awaited baby.  Recognizing the grief process that takes place in infertility helps to understand your coping mechanisms and the way that you are dealing with infertility.  Death and dying specialist, Kubler-Ross, identified five sequential stages of the grief process.  The first of these stages is denial . . . In infertility, you are always pregnant until you can deny it no more.  Most infertility patients spend the last half of their cycle feeling the signs of pregnancy.  It is almost a coping tool in itself to deny another month’s failure until you must face it.  The second stage is anger.  at the beginning signs of an impending period your mood changes and you are mad at the world.  Now, with only a day or two left in this cycle, you must face that denial will not work much longer.  Then comes bargaining….Oh, God, if you’ll just let me be pregnant I’ll….Then the tell-tale sign happens and you can no longer deny nor bargain…the fourth stage is depression.  The fifth stage of the grief process begins around day 4 or 5 of your subsequent cycle, and is referred to by Kubler-Ross as acceptance.  This is when you are gearing up for another round of tests, shots, IVET, or whatever the next cycle brings.  The amazing thing about infertility patients is that they must go through the entire grief process every month, month after month, and sometimes years on end!  No wonder that infertility poses such stress on the couple!

Another way of coping that couples inappropriately try with infertility is through defense coping mechanisms.  Defense mechanisms are a way of deceiving oneself about the causes of the stress in an effort to reduce anxiety, pressure, and frustration.  Some of the more common defense mechanisms include denial, intellectualization and displacement.  Denial is the mechanism that some couples utilize that allows them to continue treatments long after they have been told that treatment should cease.  In this type of situation, couples refuse to acknowledge the painful reality.

Displacement is a redirection of repressed feelings toward substitute objects.  Many couples take out their frustrations on each other.  Unfortunately, this is extremely counter-productive, since this is a time that each of the partners needs mutual support. Other examples of displacement include screaming at co-workers and fighting with siblings and parents, none of which really resolves the conflict and frustration that is felt.

In looking at the ways that individuals can positively cope with the stress of infertility, three strategies are suggested:  1) Confrontation, 2) compromise, and 3) Withdrawal.  In confrontation coping, infertility patients acknowledge that there is a problem for which a solution must be found.  The hallmark of confrontational style of coping is making the intense efforts to find the problem and to “fix” the problem.  This may include everything from testing to drug therapy to IVET therapy.  It is not uncommon for these patients to want to push the doctor at every month’s meeting to come up with the new plan of action. These patients are also the ones who do independent reading and usually try to help in the plan of action.  (Drives the doctors crazy!)