Coping Strategies

How you can survive your fertility treatments

Part of the problem of "coping" with infertility is that we all have the notion that we should do it gracefully, with a minimum of tears and hysterics.

But, who told us that was coping? Who made the rules that said don't cry too much; don't show your feelings too much; don't let your feelings affect your work or relationships at all?

The next Important question is, why do we accept these rules? What's wrong with having our feelings? Grief is a natural process. Infertility is an on-going stressful crisis where we repeatedly experience grief. In short, it's a terrible experience we wouldn't wish on our worst enemies (most of the time, that is).

People can't experience fertility problems without being affected emotionally unless their feelings are so well protected that they're not in touch with them. Don't put yourself down because you get upset. Learn now that your reaction is normal. You've chosen the coping style that you know best. But, you can make things better. Start by identifying the positives about your coping style. Focus on how well you're doing. Give yourself lots of strokes for how well you've succeeded. For instance, many women put themselves down for feeling the need to talk to people a lot. Well, using support systems an excellent way of dealing with stressful life experiences. Most people don't know how to deal with such intense pain. So give yourself positive self talk about how good you are at reaching out for help. If you can't find the positives in what you are doing ask a friend, your partner. There's always a way.

Infertility often creates or exacerbates marital conflict. Find time to talk about it and decide if it's conflict within your relationship or if it's created by your infertility experience. Talk about the ways you've solved problems before and see if any of these work. If not, ask friends what they've done or seek out counseling. It is normal for marriages to have problems during this time. If you can survive this crisis together you can handle just about anything.

Friends and family members often seem insensitive and say or do things out of their ignorance, discomfort, or feelings of helplessness. Educate them when you are strong enough. Tell them how you feel. By explaining your feelings and letting people know how to help you will often get what you need. i.e.. "I really appreciate your wanting to offer advice. But, right now I have enough advice and what I need most is someone to listen and try to understand," is an expression of what many infertility patients feel, but cannot communicate Don't wait until you are in crisis or you'll tend to talk yourself out of dealing with them and they'll never learn what you need from them.

Medical caregivers have feelings about your infertility also and may react in a number of ways which may or may not feel good to you. Give them feedback about what feels good and what doesn't so they learn, and so your anger and resentment don't build. You'll be helping yourself right now and contributing to other infertile couples in the future.

Co-workers and employers may react also in hurtful ways or not understand your need for time off, your emotional ups and downs. Educate them where you can. Find supports in your workplace. Imagine you have another illness that doesn't have the social stigma of infertility and give yourself as much permission as you would in that situation to use your time as medically recommended, and expect others to honor this as well.

Remember what you've done in the past to make it through difficult times and see if it can work for you now as well: find time to have fun, read books, do nice things for yourself, buy things, meet new people, take exciting classes. Learn to do something you've always been afraid to try, develop a sense of humor about the infertility experience (this actually can be done on your better days), use this time to develop deeper and more intimate relationships with your partner and others you care for, go for counseling, join a support group or do anything else your heart desires. You deserve it!

The Emotional Effects of Infertility on the Couple Relationship

Men and women are affected by infertility in different ways. Most couples experience the struggle in much the same way. This is related to the traditional ways men and women have been trained to think, feel, and act.

Women are typically seen (by others as well as themselves) as the emotional caretakers or providers of the relationship. Women typically feel responsible not only for everyone's bad feelings, but also for anything bad that happens. When women try to repress feelings, their emotions can become more ominous, until finally they feel out of control. Their emotions can become a monster about to swallow them whole.

Women in infertile couples often protect their husbands (from their own pain and feelings of failure) by taking much of the responsibility for the treatments upon themselves. When I suggest that men accompany their wives for appointments, couples get concerned about issues like income loss, use of time, etc. While these concerns are usually relevant and important, they also serve the purpose of protecting husbands from their own responsibility (taking part in the conception process) and from their own feelings, which could easily be intensified by so much contact with the medical process.

Men are traditionally seen as the financial providers of the relationship and are responsible for protecting the family from real or imagined dangers. Men usually feel more threatened expressing themselves since they’ve often been conditioned to repress their emotions. They are trained to be more instructional: to take charge, to make decisions, and to think without being sidetracked by emotions.

Males in infertile couples often feel overwhelmed by the intensity of their partner's emotions as well as an inability to access their own. They tend to focus their energy back into their work, a place where they feel they can have more success.

As a result of taking responsibility for the emotional impact of the infertility, the woman experiences intense feelings, such as: pain, anger, fear, etc. which, combined with the messages that her way of dealing with things is in some way dysfunctional or 'crazy', causes her to feel an anxious depression. As feelings spill out, she feels out of control and doesn't really know how to ask for what she needs, especially from the husband she is struggling so hard to protect. She may yearn for an emotional connection/interaction at one moment, and in the next, withdraw emotionally from her husband when she fears she has disappointed him.

Men find themselves in a position where, regardless how well they've been trained to solve problems, they are helpless to make this situation better for the woman and, as a result, may give off messages that she is "too" emotional or sensitive, hoping that this will calm her down. The wife hears this as criticism of her coping and caretaking skills rather than as an expression of her husband's fears.

This is the time when couples cling together for dear life, feeling that they've failed in the most basic of all roles: reproduction. Couples are hesitant to admit problems in their marriage, feeling that having difficulty coping would mean that their marriage is also a failure.

Luckily, there are ways that men and women can help each other balance thinking and feeling as they struggle side by side on their journey toward parenthood. The questions then arise: How then get what you need from your partner...How to be there for your partner? Here are some suggestions to help both partners during the infertility process:

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Coping With The Holidays

#1 - Coping With The Holidays

Holidays can be stressful, even in the best of circumstances. Expectations are at a peak. Pressure comes, both from the outside and within, to break out of the normal routine -- to celebrate, and to enjoy! But for the person experiencing infertility, holidays can be the most difficult time of the year.

You certainly can't make the pain of infertility disappear miraculously. But by planning in advance and acknowledging that the holidays may be uncomfortable, you can prepare yourself and improve your chances of having a pleasant holiday season. Here are some suggestions:

Be selective about accepting invitations to parties and holiday celebrations, especially the ones at which you know there will be a lot of children or pregnant women. Remember: you don't have to say yes.

Feel guilty about not participating in all the traditional family events. You've had a difficult year, and you need to concentrate on helping yourselves and each other get through the holidays.

Plan to spend time with other couples or friends who don't have children -- if family festivities are too much to bear this year.

If you find it painful to be around your young nieces, nephews, and cousins, consider arriving just in time for the holiday dinner rather than the night before or at the crack of dawn, when the children are scrambling to open their presents. You may also want to attend midnight services instead of the more family-oriented morning services.

Rely completely on old family traditions to fulfill your present needs.

Shop at smaller boutiques or by catalog if you find it difficult to face the constand bombardment of holiday cheer.

Do your holiday shopping at malls where families abound and hordes of ecstatic children line up to view holiday displays.

Spend time doing the things you like best: preparing a spectacular meal, taking long walks, going horseback riding or jogging, or curling up by a fire with a good novel.

Plan a special trip for just the two of you -- a ski weekend, or a few nights at a cozy country inn. You may have to put up with comments like, "How can you be so selfish?" or "Thanksgiving just won't be the same without you." But those remarks may be easier to bear than a holiday table packed with children.

Begin your own family traditions: a special ceremony or ritual that says that the two of you are already a family, and that you can rejoice in your love for each other, with or without children.

Pretend that there's nothing wrong and carry on with "business as usual".

Decide in advance how you will handle difficult and insensitive questions. You may even want to rehearse your answers. (You can decide to be honest with friends and relatives as to why you can't join certain celebrations and traditions which are just too painful right now.)

Express your appreciation to friends and relatives who have given you their love and support during the past year. Be sure to keep in close contact with your friends at RESOLVE; many of them are in the same boat and can understand and offer the support that perhaps your family cannot.

Be caught off guard by unexpected or embarrassing questions about your plans for having a family.

Feel that you have to disclose all the details of your situation!

Try to help others in need. Visit an elderly or bedridden relative; volunteer at a hospital or nursing home; or participate in a holiday program to help the homeless. Cheering up other victims of the holiday blues has a rejuvenating effect.

Close yourself off to positive feelings and new experiences. You may find that you have a special ability to make other feel good, even though you're not feeling upbeat yourself.

Set aside time to share your feelings with each other. Allow yourself to feel sad, deprived, or depressed. Infertility is a major life crisis and you are entitled to those feelings. Talk with each other about your feelings. Your spouse may be able to help you through the rough times.

Get caught up in the whirlwind of the holidays and forget about each other. You need each other's comfort more than ever.

Remember to capture the "spirit" in each holiday which makes it special. Participate in activities which bring meaning to you at this time; create the joy intended in celebrating the holiday for its own sake.

The period from Thanksgiving to New Year's is difficult for many - the single person with no family celebrations to anticipate, the recently bereaved, even the young mother trying to create the perfect holiday. But knowing that others are also miserable doesn't make things better if you're infertile and facing a season for children without a much-wanted child.

At the Thanksgiving table as the family waits for an announcement, it's hard to be grateful for anything. At the mall, surrounded by package-laden mothers pushing strollers and herding wide-eyed toddlers past holiday displays, it's difficult to hold back tears. At the family gift exchange where nieces and nephews are the center of loving attention, it's almost impossible to find the joy that used to come with the season. New Year's Eve, once a sparkling adult occasion of excitement and promise, becomes an evening of regret for the past year's unfulfilled dreams.

These problems won't disappear, and the winter holidays will probably not be an entirely happy time while you are working through infertility. However, there are things you can do to minimize the pain.

Practice answers to difficult questions. If you have anticipated a question and rehearsed a response, you're less likely to be startled to tears and more likely to be able to answer quickly and change the subject.

Pick and choose your holiday "fun". You really don't have to go to every party. Just this year, consider skipping the tree trimming and cookie exchange - "children welcome" - and make something decadent for your newly-married friend's dessert-tasting instead.

Consider a winter vacation. Go to a romantic inn or an island resort - eat in restaurants inappropriate for children, do things you won't be able to do when you have a small child.

Indulge yourself. Do whatever makes you happy. Spend an evening in front of the fire, take a long bubble bath, have the perfect dinner, take a day off to read a mystery. Whatever lifts your spirits, do it, as a gift to yourself.

Do something for someone else. Volunteer in a soup kitchen, take cookies to a nursing home, be an "angel" and buy presents for a child whose holiday would otherwise be bleak, invite someone who's all alone to share your Thanksgiving meal

Dealing with your family may be the most difficult part of the season, because everything is so intensely personal. Patterns of behavior established in childhood affect your relationships today, and often it's just impossible to act like the reasonable adult you've become in an atmosphere where you feel again like a dependent child. The key to improving this situation is establishing new patterns. Some suggestions:

Give yourself some space. If you travel to spend part of the holidays with your family, consider staying in a hotel or with friends rather than with your parents or siblings in a home where all activities will focus on the needs, and interests of children.

Limit your participation in the family celebrations: Perhaps you can come in at the end of the gift-opening, or skip it altogether; come for Thanksgiving dinner, but leave after dessert.

Consider some degree of openness about your infertility. If you think you might be ready to let family members know, this could be the right time. You might speak to one or two members ahead of time and let them spread the word, or simply answer probing questions honestly.

Schedule one-on-one (or two) time with children you really care about. Take them to a special movie or out to lunch so that you can enjoy them and your relationship away from the family and its "public" child-focused activities.

There's not much point in trying to force yourself to enjoy the traditional holiday as you've always known it. For now, consider changing your focus a little, to make the season better suit you. If you have a personal holiday - a birthday or anniversary during the winter, spend some time planning to make that the high point of your own season. If not, emphasize a special celebration of a public hol-iday - have an adults-only New Year's brunch, plan a Valentine's getaway weekend, institute an annual Groundhog's Day picnic.

Malls are terrible places for the infertile any time of the year; during the winter holidays they're just appalling. So before you gear up for an encounter with masses of pregnant women, gorgeous children, and elves, consider the alternatives.

Catalogs. You can buy just about anything from a catalog today, from cartoon character sheets to inflatable dinosaurs. This is a useful option especially if you must buy "as-advertised-on-TV" children's toys. Spend an hour with one of the big catalogs and save yourself time and anguish.

Unusual Gifts. Birdfeeders, music boxes, picture frames and flashlights are just a few examples of "different" gifts available in specialty stores outside the malls. Another idea: fill a box with crayons, markers, paints, clay and other art supplies or with ribbons, lace, remnants, buttons and silk flowers for dress-up.

Hobbies. A jar of pennies and a coin book, or a selection of stamps and a beginner's album will give pleasure throughout the year, as will music or karate lessons, or a subscription to a special interest magazine.

Books, tapes, and videos. A copy of a book, song, or movie you loved as a child could be a very special gift for a young relative; store employees are happy to recommend other choices for any age group.

Don't shop. Could you contribute to a joint gift or provide the funds and let your mother or brother do the shopping? This is done all the time for reasons that have nothing to do with infertility; it could mean happier holidays for you and the children you love.

Because they celebrate the very thing we want most, Mother's Day and Father's Day can be especially painful to those who are infertile.

Because the focus is so specific, the impersonal aspects of these "parenting" holidays may actually be more difficult to handle than family gatherings. The flowers in church, the discounts at the ball game, the free drinks in restaurants make it seem that everyone is a mother or father, that those who are not parents simply don't belong. It is possible, though, to avoid most of these public celebrations of parenting without holing up at home feeling sorry for yourself. Some suggestions:

Consider skipping church services. Watching while each mother receives a rose, remaining seated while fathers stand to be recognized, listening to a sermon on the joys of parenthood can feel like punishment and that's not why you go to church.

Focus on adult activities. Visit an art museum or an antique store, see a movie that's not for children, take a walk in the woods. Don't even consider a restaurant that advertises on these days; try a serious ethnic restaurant or one that's too formal for children.

Spend part of the day with others who have no children. Go backpacking with another couple, or invite friends over for pizza and videos.

If you live near your parents, plan ahead so that you can honor them without making yourself miserable. For instance:

Consider celebrating with your parents at another time. If the family party is just too much for you, ask your parents to come to dinner on Friday or Saturday, and spend the evening talking about the happiest moments of your childhood.

If you decide to go, consider letting someone else give the big family dinner. Keep your involvement to a minimum, even if you're the eldest, especially if you're the only sibling without children. Giving this kind of party can seem like penance for your childless state.

Keep the emphasis where it belongs. Ask each family member to share a favorite childhood memory at dinner, put together an album of family photos, write a thank-you letter to your mother or father.

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Coping Financially

Decide how much you're willing to pay

To cope with the anxiety caused by the high costs of treatment, force yourself to face facts about your finances. It's no wonder that couples often feel anxious about money, especially since some women need to go through multiple cycles before becoming pregnant.

Sit down together and develop a financial plan. Start with your insurance: Find out exactly what it does and doesn't cover. If it covers some or all of your treatments, decide whether you or your partner will monitor the paperwork and negotiate with the insurance company. Then look at all your assets and determine how much you can spend and on which treatments. You should always have a plan B because nothing, especially infertility treatments, is certain.

Do you have the money?

No one wants to put a price tag on having a baby, but the reality is that you have to. It is very hard for couples to accept the fact that money could play a role in having a baby — procreation is a fundamental right of humankind. But you always have to save some resources for plan B. Even if you can stomach mortgaging your home and draining your retirement savings to have a child, it's not practical. You may want to do some financial planning and consider the cost of adoption, donor programs, surrogates, or other options that guarantee parenthood before you go for broke on more costly fertility treatments such as IVF.

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Pregnancy Loss

A miscarriage is any pregnancy that is non-viable (wherein the fetus cannot survive or is born before the 20th week of pregnancy). Miscarriage occurs in about 15-20% of all recognized pregnancies, and usually occurs before the 13th week of pregnancy. Of those miscarriages before the eighth week, 30% have no fetus associated with the sac or placenta. This condition is called blighted ovum and many women are surprised to learn that there was never an embryo inside the sac.

After an isolated spontaneous miscarriage, the chance of having a successful pregnancy in the future is quite high. Repeated miscarriages occur in 0.5-1.0% of all pregnancies. In those women with repeated miscarriages, medical evaluation is advised to identify the reasons for these miscarriages. In women with two consecutive miscarriages, the risk of having another loss is between 35-40%. In those women with two non-consecutive losses, the risk of another miscarriage is between 15-20%.

It must be emphasized that exercise, working, and intercourse do not increase the risk of pregnancy loss. Bed rest and staying off your feet probably do not prevent miscarriage although this advice is commonly given.

Over the past several years, there has been a lot of interest focused on the role of the immune system in pregnancy and miscarriage. It is estimated that between 20% and 25% of all repeated miscarriages are due to immunological problems The immune system consists of cells and proteins that usually help the body fight infection and remove damaged or abnormal tissue. It consists in part of proteins called antibodies, that circulate through the blood looking for abnormal cells. Sometimes, in normal healthy women, antibodies are produced that attack seemingly normal cells and body tissue. The presence of these antibodies has been associated with compromise of an otherwise healthy placenta. Since the placenta is critical for nutrient support to the baby, severe compromise can cause an early pregnancy loss.

Currently, most practitioners will not initiate an extensive medical evaluation for a single pregnancy loss since the chance of having a normal pregnancy subsequent to an isolated miscarriage is 80-90%. For women with recurrent pregnancy loss, an evaluation will focus on the pattern and history of the prior miscarriages.

The treatment of recurrent miscarriage depends on what is believed to be the underlying cause. This often is not as simple as it sounds. Careful evaluation may turn up several potential factors which alone or together may be responsible for the losses. If a chromosomal problem is found in one or both spouses, then counseling as to future risks is the only option. There is currently no method to correct genetic problems. If a structural problem is encountered with the uterus, surgical correction could be contemplated. It should be emphasized that just because a structural abnormality is found, it does not necessarily mean that it caused the miscarriage. Removal of a fibroid or uterine septum does not guarantee a future successful pregnancy. Adequate control of diabetes and thyroid disease is critical in trying to prevent recurrent pregnancy loss in women with those conditions. For women with antibody problems, certain medications have been found to be useful in achieving successful pregnancy outcomes. Blood thinners, such as heparin, baby aspirin, IVIg Therapy and even the addition of steroids can, in some cases, prevent further pregnancy loss.

The use of progesterone to increase the blood levels of this hormone is commonly used for patients with recurrent pregnancy loss. This is especially true if it is found that the hormone concentration is low during the critical time of implantation. Some practitioners may even give this medication when the progesterone level has been tested and found to be normal. This is done because it has been shown that the progesterone level can fluctuate from month to month.

In dealing with recurrent pregnancy loss, it is important to realize that even though apparently obvious problems can be corrected, a miscarriage can still occur. In other patients, nothing may be done and a healthy baby is born. This is not to say that attempts should not be taken to correct identified abnormalities that have been historically associated with miscarriage. However, no treatment can be guaranteed. Even with repeated miscarriages, there is still a very good chance of achieving a successful pregnancy. Early pregnancy and pre-pregnancy counseling can help identify risk factors and allow the practitioner to provide any special care that may be needed.

"THE TRUTH IS..."

1. The truth ISN'T that you will feel "all better" in a couple of days, or weeks, or even months.
The truth is that the days will be filled with an unending ache and the nights will feel one million sad years long for a while. Healing is attained only after the slow necessary progression through the stages of grief and mourning.

2. The truth isn't that a new pregnancy will help you forget.
The truth is that, while thoughts of a new pregnancy soon may provide hope, a lost infant deserves to be mourned just as you would have with anyone you loved. Grieving takes a lot of energy and can be both emotionally and physically draining. This could have an impact upon your health during another pregnancy. While the decision to try again is a very individualized one, being pregnant while still actively grieving is very difficult.

3. The truth isn't that pills or alcohol will dull the pain.
The truth is that they will merely postpone the reality you must eventually face in order to begin healing. However, if your doctor feels that medication is necessary to help maintain your health, use it intelligently and according to his/her instructions.

4. The truth isn't that once this is over your life will be the same.
The truth is that your upside-down world will slowly settle down, hopefully leaving you a more sensitive, compassionate person, better prepared to handle the hard times that everyone must deal with sooner or later. When you consider that you have just experienced one of the worst things that can happen to a family, as you heal you will become aware of how strong you are.

5. The truth isn't that grieving is morbid, or a sign of weakness or mental instability.
The truth is that grieving is work that must be done. Now is the appropriate time. Allow yourself the time. Feel it, flow with it. Try not to fight it too often. It will get easier if you expect that it is variable, that some days are better than others. Be patient with yourself. There are no short cuts to healing. The active grieving will be over when all the work is done.

6. The truth isn't that grief is all-consuming.
The truth is that in the midst of the most agonizing time of your life, there will be laughter. Don't feel guilty. Laugh if you want to. Just as you must allow yourself the time to grieve, you must also allow yourself the time to laugh. Viewing laughter as part of the healing process, just as overwhelming sadness is now, will make the pain more bearable.

7. The truth isn't that one person can bear this alone.
The truth is that while only you can make the choices necessary to return to the mainstream of life a healed person, others in your life are also grieving and are feeling very helpless. As unfair as it may seem, the burden of remaining in contact with family and friends often falls on you. They are afraid to "butt in," or they may be fearful of saying or doing the wrong thing. This makes them feel even more helpless. They need to be told honestly what they can do to help. They don't need to be told, "I'm doing fine" when you're really NOT doing fine. By allowing others to share in your pain and assist you with your needs, you will be comforted and they will feel less helpless.

8. The truth isn't that God must be punishing you for something.
The truth is that sometimes these things just happen. They have happened to many people before you, and they will happen to many people after you. This was not an act of any God; it was an act of Nature. It isn't fair to blame God, or yourself, or anyone else. Try to understand that it is human nature to look for a place to put the blame, especially when there are so few answers to the question, "Why?" Sometimes there are answers. Most times there are not. Believing that you are being punished will only get in the way of your healing.

9. The truth isn't that you will be unable to make any choices or decisions during this time.
The truth is that while major decisions, such as moving or changing jobs, are better off being postponed for now, life goes on. It will be difficult, but decisions dealing with the death of your baby (seeing and naming the baby, arranging and/or attending a religious ritual, taking care of the nursery items you have acquired) are all choices you can make for yourself. Well-meaning people will try to shelter you from the pain of this. However, many of us who have suffered similar losses agree that these first decisions are very important. They help to make the loss real. Our brains filter out much of the pain early on as a way to protect us. Very soon after that, we find ourselves reliving the events over and over, trying to remember everything. This is another way that we acknowledge the loss. Until the loss is real, grieving cannot begin. Being involved at this early time will be a painful experience, but it will help you deal with your grief better as you progress by providing comforting memories of having performed loving, caring acts for your baby.

10. The truth isn't that you will be delighted to hear that a friend or other loved one has just given birth to a healthy baby.
The truth is that you may find it very difficult to be around mothers with young babies. You may be hurt, or angry, or jealous. You may wonder why you couldn't have had that joy. You may be resentful, or refuse to see friends with new babies. You may even secretly wish that the same thing would happen to someone else. You want someone to understand how it feels. You may also feel very ashamed that you could wish such things on people you love or care about, or think that you must be a dreadful person. You aren't. You're human, and even the most loving people can react this way when they are actively grieving. If the situations were reversed, your friends would be feeling and thinking the same things you are. Forgive yourself. It's OK. These feelings will eventually go away.

11. The truth isn't that all marriages survive this difficult time.
The truth is that sometimes you might blame one another, resent one another, or dislike being with one another. If you find this happening, get help. There are self-help groups available or grief counselors who can help. Don't ignore it or tuck it away assuming it will get better. It won't. Actively grieving people cannot help one another. It is unrealistic, like having two people who were blinded at the same time teach each other Braille. Talking it out with others may help. It might even save your marriage.

12. The truth isn't that eventually you will accept the loss of your baby and forget all about this awful time.
The truth is that acceptance is a word reserved for the understanding you come to when you've successfully grieved the loss of a parent, or a grandparent, or a beloved older relative. When you lose a child, your whole future has been affected, not your past. No one can really accept that. But there is resolution in the form of healing and learning how to cope. You will survive. Many of us who have gone through this type of grief are afraid we might forget about our babies once we begin to heal. This won't happen. You will always remember your precious baby because successful grieving carves a place in your heart where he or she will live forever.

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Dealing with Loss (*Judi Corbett's Dealing with Loss Due to Infertility)

Dealing with the loss of a loved one is never comfortable or easy to handle. We all face losses through out our lives, but some losses are severely misunderstood.  The losses from infertility are recurring and often continue on for many years. They are unseen and unfelt by most of the people who are near and dear to us. Totally invisible to those who are not close. Our loved ones may be as involved as they can be, but it is still our bodies that take the brunt of the loss. It is our bodies that give us the constant reminders that we have failed. Unfortunately we must live with these bodies everyday. And we must face these losses every month. Even husbands can not fully understand the pain that a woman feels each month when she does not conceive. Many try, but often the pain they feel is because they know we are suffering. Even those of use suffering from this grief feel it differently, no two people feel grief in the same manner. People seem to be unaware of the bereavement needs of the infertile population. Each month is a constant reminder of the loss and inability that one must encounter. Each friend who has a new baby, each sibling that has a child, each person who brags about their child (or complains about it), every tiny smiling face at the store or park, every person that just seems to smile and get pregnant. These are all constant reminders of something we can't have. Between lack of knowledge, life in general and the basic insensitive things that people can say, it can be pretty rough on the infertile individual or couple.

How does one deal with these losses? Many keep trying regardless of the cost and length of time, others give up. Infertile people have a different level of grief, but regardless, they are still bereaved. They do still suffer from the "Five stages of grief", it just is not understood by the majority of people who have children, or just plain don't want them. Unfortunately little is available to help the grieving infertile person, either in physical supports, or even written materials. It is such a small group of people who suffer from this problem, that focus has primarily been placed on bereavement issues that affect the majority of society. Even the most trained grief counselors usually have little or no background on dealing with this kind of loss, as a result, they are afraid to assist the infertile individuals that require assistance.

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5 Stages of Grief (*Judi Corbett's Dealing with Loss Due to Infertility)

The 'Denial and Isolation" are certainly there. Some people never give up hoping and trying. There are people who have financed everything far and beyond any hope of economical recovery. Time frames have numbered up into the teens for some, many women are in their mid 40's and still trying. Others have sacrificed their long term relationships to have a baby. How does one draw the line. To what extent will people go to have a little one of their own. Only the individual knows, but than even many of them are not sure. For many it is a child, or they will never stop. It is a big and tough step to finally accept that we can not produce even one child of our own. Yes, there are other options out there for us, but do we want to use them? Do we want to accept the fact that we will never give birth to our own biological child.

As for the isolation feeling. Thank goodness for the computer age. We see children every where. It is easy to hear of those who are pregnant, but those who are infertile keep it quiet. If we do know someone who is infertile, do we approach them? Each situation is different and what if one has tried for years and the other one is successful right away??? So, the best thing is to keep to yourself, or is it? Certainly not for the ones who really need to talk to someone. Places like 'Fertile Thoughts' help people meet with others who are going through the same thing. World wide, you can find lots of people who have been there, or are there with you. The support and information is what we all need, the computer allows us this chance to talk to others who are dealing with similar losses. We get to make close friends who somewhat understand what we are dealing with. The internet helps many of us deal with what we are going through everyday.

The 'Anger' can't help but surface. 'Why me and why now' are questions continually asked. Many infertile people have lived good health lives, never put their fertility at risk and suddenly it affects us anyhow. What did I do to deserve this? Well nothing! Life is cruel, why won't God let this happen? Why does that horrible person get to have babies? Why do some people just keep popping them out and putting them all into the system? It just isn't fair. Probably no one could love or want a child more than those of use suffering from infertility. People who neglect or abuse children get to have them and we don't.

Than if we choose to adopt, we are put through even more grief. Unlike all those who can produce children, we have to be totally scrutinized or we can't have a child. Again, what did we do? And than the wait that many have to deal with. It is not uncommon for those wanting babies to have to wait for 7-10 years, in some places, to get one. But than maybe this entire issue is one that needs an entire paper itself.

'Bargaining' definitely occurs. The deals that some people will make to be able to keep trying. How many times do they tell God what they will sacrifice for this one little gift? How many times do we tell him how we have tried to do right with our lives and that we deserve this one little thing? What kinds of deals get made with our partners, just to get them to cooperate? Often one partner wants this more than the other and so we make deals to try to get them to help this happen! What will people do to have a child? Most of us would never believe some of the negotiations that get made just for a successful pregnancy. The fertile individuals of the world could never begin to understand the sacrifices an infertile person would be willing to make, just to have a child!

Do infertile people suffer from 'Depression'? Unquestionably! In addition to becoming depressed from one loss, infertile people continue to have it hit them, each and every month. Over and over, they lose the child they wanted, the future, they planned, the family they dreamed of. Plus, they are dealing with continually changing hormones. With the continual exposure to everyone else's successes, depression is a very key factor for the infertile couple or individual. The hormonal changes alone can lead to depression. Never being understood by the world is extremely depressing.

It is not uncommon to come into contact with infertile individuals who are being treated for depression. This is one of the key reasons that those wishing to adopt must be able to have grieved and dealt with the infertility. Dealing with a loss of any type is very depressing, specially when it happens over and over with out a break! Unfortunately we must deal with infertility for the rest of our lives, regardless if we adopt, choose to live child free or actually are lucky enough to produce a healthy child. We have faced a lot of losses!

'Acceptance'? Many people do finally accept that this is the way they have to live life. Some adopt, some choose to live without children. Different things aid in this acceptance. Sometimes it is money, sometimes it is time (age factors). For some it may be due to a failing relationship (from the stresses placed on a relationship due to continual, often consuming, trying), others may be a result of the intensity of treatment (they just can't emotionally move on to the next step). Many people physically accept that they are unable to conceive, but many never accept it and suffer further grief. Regardless how we deal with the final result, we have had to grieve and do most of it alone!

Many people are unaware that infertile people are often in a constant state of grief, that they just seem to keep bouncing on to the next time they get let down. Most specialists in grief are not suffering from infertility, nor are most of their clients. As a result, it is a quiet secret with no one to talk to. 

Go ahead and grieve. You have to do this! They are not you and they are not where you are in life. Most have never experienced the pain that you have. Do not let people tell you what to do, you are the only one who can decide what is best for you. Try if you feel you should, and quit when you want. You are under enough stress, so do not let others dictate to you. Most importantly educate others on the way that you feel, and what you are going through. 

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Last modified: October 08, 2010