Fostering Relationships through Infertility

Relationships – irrespective of who they are with, or why they have formed – are critical to our wellbeing and mental health, particularly those relationships which are positive in nature.

Infertility and ongoing challenges with conception, and pregnancy can place a strain on any and potentially of our relationships, particularly as we become more entrenched and focused on treatment. Fertility treatment, once formalised, can dictate your lives in a way that we never expected, become like a second full time for, feeling like it leaves very little time for work and sleep, let alone continued commitment to the varied relationships in our lives

Coming to fertility treatment can be for difference reasons, including both social (more often same sex couples, single people) or for medical reasons (typically heterosexual couples). The stress and pressure of infertility treatment can have a significant impact on relationships, however the timing is likely to be different, depending on how you have come to treatment.

For heterosexual couples, commencement of treatment is often on the background of months, if not years of attempting to conceive, the experience is likely to have encompassed some form of grief, loss and stress even before formal treatment commences.

For single people or same sex couples, the decision to come to fertility treatment, is often (but not always) with less early presenting stress, and an active decision to start treatment in the context of needing donor eggs, sperm, or embryos to conceive.

Irrespective of the reasons you have come to fertility treatment, and who you have come with, the commencement of treatment can further signal feelings of “being left behind” our peers, family and friends, who have been until this time, and the same point in life as ourselves.

As treatments are navigated, more answers (although they can feel like more questions at times) come to light and new information around diagnosis may come to light., This can be particularly be felt by single people or same sex couples who have come to treatment with no supposed medical diagnosis for infertility, and find themselves not becoming pregnancy as easily or as quickly as they expected to.

As a result of these experiences, combined with the demand fertility treatments, we can see ourselves withdrawing from family, friends, navigating conflict or overwhelm within our intimate partner (and other) relationships and not caring for ourselves in the same way. All occurring right at a time when these support systems are likely more critical than ever.

Infertility treatment can have an impact on all our relationship in some form or another. Including relationships with:

Ourselves
Friends and Family
Intimate Partners

Below we will explore in more depth, some the reasons why these relationships might change or be impacted and what strategies we can implement to re-establish, reconnect and foster in and around our relationships.

Relationships with Ourselves:

Fertility treatments have the potential to bring about some very unhelpful, self-critical and negative thoughts about ourselves. For some this can culminate in feelings of anger towards ourselves, and in particular our bodies, or an overwhelming sense and feeling that we are failing.

We can feel that fertility treatments have left us “stuck” in a job we don’t love, or even like. That despite our best and consistent efforts to change diet, lifestyle and exercise to improve fertility, that we have “not done enough”. Fertility treatments can also lead us to feel like we are more and more isolated and on our own as everyone else’s life seems to be moving forward, leading to withdrawal, mood declining, anxiety increasing and overwhelm kicking in.

For many of us, we have grown up and been educated within the framework of hard work and perseverance = outcomes, achievement and reward. Infertility and fertility treatment fly in the face of this one, where effort does not equate to reward. In the context of the effort and reward/outcome concept not being overly relevant to fertility treatment, we can get caught up in negative thinking that we are “not good enough”, “not doing enough” or “failing” at something that seems to come easily to so many, leading to a negative relationship with ourselves and our bodies.

If you are noticing some of these thoughts and concepts creeping in, and noticing a more negative relationship with your body, some strategies to consider to improve this relationship.

Creating change and shift in our thinking – to alter the internal narrative r inner voice, particularly if it has become negative in nature about ourselves
1. Identification of Strengths – what strengths do you have? And how can you focus back on the, and build them back up again? If you are struggling with identifying your own strengths, as those close to you, or use the following Strengths and Values Questionnaire to help with direction: https://www.viacharacter.org/
2. Identification of what we are grateful for in the here and now – take time throughout your day to identify what you are grateful for in the moment, it doesn’t have to be big, it might be as simple as time in the sun, hearing your favourite song or completing a project at work
3. Self-Compassionate Talk – we are generally our own biggest critic, those internal thoughts are ones you would not say to others, and certainly would not allow others to say to you with out a response to tell them how inappropriate the comment was. Consider how you would speak to a friend or family member if they were having similar struggles, and turn that compassionate talk toward yourself
Change your morning routine – if you typically roll over and grab your phone and start to scroll, it’s time to make some changes. Those initial 10-15 minutes of awake time are critical for our brains, they are at their most flexible, so don’t fill it with news items and social media posts. Think about what else you can do first. Have your shower, make your morning cup of tea or coffee, spending 10 minutes journaling, doing mindfulness or yoga – anything but on your phone.
Self-Care – this can be anything! And it will vary greatly from person to person. However, without a little self-directed care and slow down, we become overwhelmed and frustrated. Consider activities such as a walk, bath, meditation, time with friends, improving sleep, food intake and movement. Take time think about what YOU identify as self-care, and purposefully make time in your week for it.
Making Time for Fun, Engaging in New, or Old Hobbies and Recreation – let’s face fertility treatments are not fun, and the fun in life can often be left aside. Prioritise time for fun – time with friends, family. Consider what hobbies you previously engaged in, or activities you have enjoyed and find time for these. Even consider what you may have enjoyed during your teens years and re-engage with these. Try something new you have always wanted to idea. Ideas in this area might include go-karting, drawing, painting, nights out with friends, cooking a gourmet meal. Spend some time brainstorming what’s right for you.

Relationships with Friends and Family

These relationships can be particularly tricky to navigate. Maybe you have told all your friends and family of infertility and treatment, maybe you have told some of your friends and family, or maybe you have told no one.

There is no right or wrong in the decision to tell or not to tell, only what is right for yourself (and your partner if you have one). If you have discussed your difficulties and plans, maybe they have been heard with empathy, offers of support and love, or maybe they have been responded to with criticism, negativity, or high levels of inquisition and pushiness about “what next” and “where are you up to?”

As infertility continues, and treatments commence amongst the juggle of work, treatment, and attempts to rest, there appears to be no time left for calling, contacting, and spending time with friends and family. Maybe you have had to miss parties, events or nights out due to scheduled appointments or surgery.

More than likely a number of friends and family will be in the place you thought you would be – pregnant or with a young baby or child. Leaving you feeling overwhelmed or upset at the thought of spending time with them, avoiding baby and children related celebrations. Or maybe there is that perpetual underlying fear of the next “announcement.”

All of these experiences can lead to reducing contact with friends and family, avoiding phone calls, making excuses for not attending, reinforcing those failure, “not good enough” or “left behind” thoughts we experience.

If you are noticing this is occurring than the following strategies might be helpful to try and reconnect with friends and family:

Communication – communication is truly the basis for all relationships working more effectively. However not all of us want to tell family and friends of the plans for fertility treatment, as it is incredibly person.
1. If you do make the decision to tell – think about those people who are going to be a positive support, less likely to ask too many questions, or place more pressure on you through treatment
2. If you decide NOT to tell – make plans as how you are going to navigate inability to attend events or last-minute cancellations – friends and family are likely to become worried something is very wrong if this happened repeatedly, so consider some well thought out but logical rationale for excusing yourself
Find the friend who has “been there” – of you have a friend or family member who has had their own experience with fertility challenges, these can be the gold to confide in. They will (mostly) have a better understanding of how you are going, be patient with you if you are struggling, and less likely to make unhelpful or inappropriate comments. They are also likely to be a source of profound information from a personal perspective.
Boundaries – these are incredibly important, particularly if friends and family are aware of treatment. The increased pressure (some) friends and family can place on you as a result of the own excitement, or curiosity, can be taxing. Additionally, pregnancy announcements, or attending social events such as baby showers or 1^st birthdays might be significantly overwhelming for you. Consider requesting or saying the following with relation to boundaries in communication and interaction:
1. We want you to be aware as we know treatment can be stressful
2. Please don’t ask as where we are at, we will tell you when we have an update
3. I really want to hear good news if you have it, but can you please send it by text so I have some time to process the information on my own
4. We would love to come to the baby shower/1^st birthday, but please don’t be offended if we don’t come at the last minute or leave early
The Cheer Squad – infertility and infertility treatments are tough, find the friends who can be the cheer squad. Not the “rah-rah” type with pom-poms, but the type that allow us to discuss our fears and worries, who can draw our attention to the positive things occurring, the strengths we bring to challenging times, and who can provide gentle encouragement through challenging experiences.
Purposeful Connection – we have acknowledged we can withdraw from friends and family which can then have a negative impact on relationships. Relationships are good for us, while we think we do well in isolation, most of us don’t. Life is busy, but try to prioritise the relationships with friends and family, make active time with them – whether it is a quick coffee, and long lunch or a day out. These a source of significant renewal and resilience building for us all.

Relationship with our Intimate Partner

If you are coming to treatment with a partner, the likelihood is there is some forma strain on your relationship. Sex has become timed, structured and “on-demand” losing most of its fun, and intimacy, it becomes a chore rather than enjoyable. Life becomes placed on hold because of fertility treatments, holidays cancelled, conversations dominated by fertility talk, when the next appointment is and what you can and can’t do in the coming weeks.

While differences in the way we cope have always been there, fertility treatments can bring these differing coping mechanisms to the forefront, and conflict might arise as we feel the other person doesn’t “get” us or what we need. We can become short tempered, and frustrated with each other.

It is worth noting the people we are closest to are the ones we let out “true” selves show the most, we spend our days hiding the emotions of infertility from colleagues and friends who might not know, and let the day of emotion rip with our partners as we let off and out the building emotions from the day.

We can feel we are becoming more and more disconnected from our partner as we seem to be diverging into different spaces yet supposedly working towards the same end goal – having a baby – which has become a weight and a chore. Frustration can occur and disconnect starts to settle in.

If you are noticing strain within your intimate partner relationship the following things can be helpful to try and implement together:

Understanding of differences in coping styles – how we cope under stress and with anxiety can be very different. Due to the differences in the way we cope, it can seem our partner is uncaring or uninterested, but this is not the case, rather we have individual coping responses. Conflict can arise, and reinforce the feeling your relationship is failing when we perceive or believe we are not being supported, however we can have different ways of coping, which is why we many not feel like we are being supported, as it not the same coping style as our own. Often, we have never realised our coping styles are different, as it has not been problematic or led to conflict within our relationship.
1. Watch the following video, “It’s not about the Nail”, and see if you can identify with one of the two coping styles presented within it: https://www.youtube.com/watch?v=-4EDhdAHrOg&ab_channel=JasonHeadley
2. Coping falls predominantly into two different forms – problem focused or emotion focused coping. When we come with one of each of the styles of coping it can seem that our partners coping is mismatched to our own, by understanding how each one of you copes, hopefully it promotes more compassion for each other. The two coping styles are defined as:
  1. Problem Focused Coping – I can see the issues, and I want to find the solution, generalised to men (but not always). When a challenge arises if our dominate form of coping is to solve the problem then fertility treatments can leave us feel frustrated as there is not a potential solution when can enact
  2. Emotion Focused Coping – I want to talk about what is happening, I want to share my feelings, I want you to hear me and my experience. I don’t typically want you to change it. This is more generalised to women, and will likely lead to less frustration as a coping style as we are not trying to find the solution, rather navigating the process as it presents
3. So often we can get lost in our own experiences, even with a partner, and start to walk the path of infertility on our own. Consider the following questions, spend time talking about your own experiences and REALLY take the time to really hear the answers:
  1. What are you most worried about?
  2. What do you need from me?
  3. How can I support you?
  4. What can we do together that is not about fertility?
4. Limiting talk about fertility treatment. This one may seem slightly counterintuitive; however, fertility treatments have a tendency to dominate our conversations to the extinction of other topics! By limiting how much time is taken speaking about them it can free up space for other conversation. Set a maximum time you are BOTH willing to speak about treatment and infertility per day. Then divide that in two, if you set 20 minutes, it means you EACH have 10 minutes to speak. By setting a limit and dividing the time it encourages a few things
  1. Equality in conversation
  2. Reducing one-sided conversation, and over domination by one person
  3. Reduces “waffle” and increases salient and important information being provided
  4. Increases joint effort in treatment discussion
  5. Improves the capacity for problem solving
  6. Increased capacity for emotional validation
5. Scheduling time together that is not fertility related. This can be a challenging prospect initially, particularly when life has become so dominated by fertility treatment and related activity. Think about the activities you have previously enjoyed together, or create new time and ways to spend time together – get out and walk, have date nights, picnics, and time to slow.
6. Book that holiday or time away! While it may seem impossible, make plans for the future, book a holiday or time away. Life can become incredibly on hold when engaged in fertility treatments. Make some time for time away together and plan time out from all aspects of life to recharge and reset.
7. Intimacy – intimacy is not just about sex, although it can certainly be a part of it. Focus on bringing intimacy back into your relationship, reduce the phone time, increase the time together with dinners, shared interests and some of the activities we have discussed above, reconnect and remind yourselves about WHY you are in your relationship

If you would like further information or after one-to-one, or couple intervention and support I can be contacted at https://www.seedsforhope.com.au/

Lisa Ransome, Perinatal and Reproductive Psychologist and Australian and New Zealand Infertility Counsellor (ANZICA), works with individuals and couples from pre-conception through to the post-partum period. Lisa has extensive knowledge and training in the spaces of infertility, pregnancy loss, pregnancy after loss and infertility. Lisa is able to provide support and intervention for couples and individuals accessing donor-conception treatment, as well as providing support to those who are navigating childlessness-not-by choice, after fertility treatments. Appointments are available either in person, or by telehealth services.

Lisa can be contacted through the following ways:

Website seedsforhope.com.au

Email lisa@seedsforhope.com.au

Instagram: https://www.instagram.com/seeds_for_hope/

Facebook: https://www.facebook.com/SeedsforHopePerinatal