Marriage
The Impact
of Infertility on a Marriage
This is a month with one of the most celebrated holidays of the year. What is it celebrating? A birth. It is also a month when people of many religions gather for celebrations. At nearly every table there will be lots of children, many born since last year's gathering. In approximately one of every six of those homes there will be a couple who has been unsuccessfully trying to have a child for a year or more, the standard definition of having an infertility problem. Often these couples are suffering in silence, having not told family members what they are going through. Even if there is awareness, there is little anyone can do to ease the pain that the couple will experience in watching the activity of the children that they so desperately seek for their own lives.
Reproductive problems come as a shock to a couple and trigger a process that is incredibly traumatic. Even if they are ultimately able to have a child, the marriage may have already suffered such damage that it is never the same. This column is ultimately a plea for all those involved to recognize the need for couples to receive counseling throughout the process in order to help reduce the destructive impact on each spouse and their relationship. It is not simply a medical problem. It is a devastating psychological problem, one involving strong feelings of guilt, anger, shame, powerlessness, anxiety, isolation and alienation.
Dreams are shattered. The expectation of being productive and creating a family is very powerful for most couples and few are able to face the growing awareness of a problem without becoming angry at self or other. But that is only the beginning. Once the couple enters the medical system, they typically experience themselves treated like objects of study, not humans in pain. Their sex life becomes a scientific experiment, no longer an expression of love. It also becomes an act that is always going to be judged as a success or a failure, not as an intimate act. It is anything but intimate, since it must be done by a set of rules established by physicians and, like children, they must report in to get their grade. Only the stakes are so much higher.
It may involve husbands giving painful injections to their wives or racing to a hospital with semen. It means women being plied with hormones that make them feel like someone else. It consumes all aspects of their lives. Each month centers on one question - are you pregnant? The wife's body becomes a laboratory. Semen and eggs are studied, stored, and experimented with in the hopes of generating a conception. Even conceiving doesn't stop the trauma. Now comes the fear of not carrying to term, since miscarriage is often an outcome. Of the 80% of couples with an infertility problem who seek medical assistance, only 55% ultimately bear a child. Another 35% will adopt. Oh yes! Let's dispel one myth right here. Only 4% of couples who adopt go on to become pregnant. Somehow we have come to believe this is a common occurrence, which it is not. By the way, of that 55% who do conceive, only 60% of those couples can directly attribute the conception to the medical intervention. So, in effect, only about one in three couples with infertility problems who seek medical help actually get pregnant as a result of that help.
But this isn't really a column about statistics. It is about the incredible disappointment and shame and pain and blame that couples go through. It is about the loss of privacy and the breakdown in communication and the sometimes permanent loss of the joy of sex. It is about higher-than-normal divorce rates or marriages that just never regain their intimacy. It is about images that are burned into the minds of each wife and husband of terrible moments that have the power of the most traumatic of war memories carried by soldiers. This is about life and death. And even when there is life, the marriage often still suffers a death.
So I implore the medical professionals who work with these couples to integrate counseling into their services right from the beginning. I urge mental health professionals to become more knowledgeable about these issues in order to be an effective resource. I ask couples who discover that they are having a problem becoming pregnant and are going to begin a process of seeking help, to include couples counseling as part of the help requested. One excellent resource for couples and professionals is a national organization called Resolve, which happens to be located in nearby Somerville, MA (617-623-0744). They have a network of support groups around the country and a website (www.resolve.org) that is filled with helpful information. But nothing is going to be as helpful in reducing the negative effects of this traumatic experience as a quality counseling process that guides a couple through the various emotional stages generated by the struggle to have a baby.
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