A study using a standard psychology questionnaire discovered that American infertile women felt as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack, according to Angela Lawson from the Department of Obstetrics and Gynaecology at Northwestern University.

Likewise, another study conducted at a fertility clinic by researchers from Harvard University, found that 50% of women and 15% of men deemed infertility as the most upsetting experience of their lives. The lower percentage for men may be attributed to men’s reactions depending on whether they or their partners are diagnosed with infertility. If diagnosed as infertile themselves, they consequently experience the same low self-esteem and depression that women face, regardless of who is infertile.

The unknown side effects of being infertile

Medication impacts mental health greatly. Many of the drugs used, especially hormonal drugs can cause serious side effects. Synthetic oestrogen clomiphene citrate, for example – used to improve ovulation and increase sperm production – causes anxiety, broken sleep, mood fluctuations and irritability. More potent drugs can also cause depression, mania and problems in thinking.

Another common problem is the expectations of women and their age, that they can have children later, as treatments like in vitro fertilisation (IVF) exist. However, the success rate for IVF decreases with each passing age, and it is increasingly older women who seek the treatment. This is expounded by the fact that it can take anywhere between three to six years – if not longer – for IVF to work. Women under 35, have an average success rate of 32.3%. But, for women between the age of 43 and 44, it drops to 5%; and then to only 1.9% for women aged 45 and older.

For a generation of women who were taught that they can have it all – family and career, learning that you are unable to have children can feel like failure. Writer and arts producer, Jessica Hepburn, 47-year-old, who endured 11 failed cycles of IVF before accepting that it would not work for her says, "infertility is treated as a clinical problem. But what’s not considered is the psychological trauma which starts the moment you discover you have a problem.”

Expectedly, finance is also a tremendous pressure. For Hepburn, the unsuccessful treatments cost a total of GBP70,000; whereas, 48-year-old Justine Bold is still paying off the GBP50,000 bill for her treatment. Additionally, insurance usually does not cover any fertility procedures leaving infertile individuals angry and hopeless.

Broken relationships: A risk of wanting a child desperately

The difference of expectations of infertility treatments between a man and a woman can create difficulty for couples to know when they should stop trying.
The difference of expectations of infertility treatments between a man and a woman can create difficulty for couples to know when they should stop trying.

The relationship between infertile couples is often compromised as well. Bold, like many other women, has separated from her partner due to the ordeal of three miscarriages, five rounds of IVF and years of financial pressure.

“Having a baby was more of a focus for me. My partner started to resent it. The fertility drugs made me feel fat and emotional. It became harder to deal with the grief that was accumulating each time I had a miscarriage or an IVF cycle failed,” explains Bold.

For men, they are usually more willing to accept that children will not happen. This can translate into a difference of expectations between a man and a woman, creating difficulty for couples to know when they should stop trying.

"Going through IVF is definitely a catalyst for separation," says Hepburn. "Infertility is treated as a clinical problem. But what’s not considered is the psychological trauma which starts the moment you discover you have a problem.”

Undergoing the fertility process can also disrupt the sex lives of couples. A study conducted by researchers at Stanford University found that 40% of women struggling with infertility experienced low libido, despite never having the issue before.

Bold elaborates that "there are long periods where you can’t have sex after treatment or feel too sore. Years of timing sex around ovulation also takes a toll as it destroys spontaneity."

Fertility problems can wreck other relationships as well. Family and friends are often keen to provide well-intentioned advice and opinions, but may be difficult for the couple to deal with. Couples dealing with fertility problems may also avoid interacting with friends and family who are pregnant or have children, as it can be too painful.

Breaking the cycle of cause and effect

Women with sleep disorders may be more than three times as likely to experience infertility as those who sleep well.
Women with sleep disorders may be more than three times as likely to experience infertility as those who sleep well.

Furthermore, Taiwanese researchers discovered a cycle of cause and effect between sleep disorders and infertility. The group of researchers from the Tri-Service General Hospital and National Defense Medical Centre in Taipei, Taiwan examined data on 16,718 women newly diagnosed with sleep disorders between 2000 and 2010 and a comparison group of 33,436 similar women who did not have sleep problems.

They found that women with sleep disorders may be more than three times as likely to experience infertility as those who sleep well. Those who suffered sleep disorders were also more likely to have a variety of other chronic health problems such as high blood pressure. Individuals with sleep disorders were also more likely to have irregular menstrual cycles, thyroid issues, depression and anxiety, factors that further increase infertility.

The American Society for Reproductive Medicine advises patients to seek counselling to increase coping strategies, psychotherapy to provide relief to those suffering from mild to moderate depression, and at a last resort, consume medications such as antidepressants and anti-anxiety medications.

“It is important for patients and clinicians to weigh all these factors when making medication decisions,” it concludes. MIMS

Read more:
The commercialisation of fertility
Quality vs. quantity: Does egg count determine a woman’s fertility
Study: Women suffering from PCOS more likely to suffer from mental health issues

Sources:
https://www.reuters.com/article/us-health-fertility-sleep-disorders/sleep-problems-tied-to-female-infertility-idUSKBN1E92XO
https://www.iol.co.za/lifestyle/health/the-darker-side-of-fertility-treatments-12428126
https://www.health.harvard.edu/newsletter_article/The-psychological-impact-of-infertility-and-its-treatment
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253550/