Having a child is seen psychologically as a “rite of passage to adult life”, “a fundamental part of sexual identity”, “the main purpose of marriage”. However, about -15% of couples of reproductive age have trouble conceiving.
The condition called inability to have children, infertility or infertility is defined as the inability to become pregnant after 1 year or more and is a serious problem that creates physical, emotional and financial difficulties. Many couples see and experience this as a major crisis. Societal pressures make the treatment process even more difficult for the spouses, as the infertility treatment takes a long time, is an expensive treatment, and the outcome of the treatment is uncertain.
Often, spouses try to hide their conflicts about infertility and fulfill their daily responsibilities.
Many couples facing this crisis experience a series of emotional changes; such as depression, powerlessness, hopelessness, exhaustion, frustration, anxiety, shame, guilt, anger, low self-esteem, withdrawal, and social isolation.
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In short, not only the mental health of couples, but also the dynamics of their relationships are changing. Existing problems such as poor communication skills or economic problems may increase. The sexual satisfaction of the spouses also decreases. Sex can become mechanical and emotionless, just a job to get pregnant. Treatment costs are another source of stress for spouses in this process. Another source of conflict is what treatment options they will try, when they will stop treatment, whether donor (transplant) eggs or sperm will be used, whether there will be adoption, and if so, how. Childless couples also face criticism from others in this process, and this further reduces their self-esteem and self-image.
In many cases, spouses mourn the loss in different ways: one spouse may want to talk openly about the loss, while the other spouse may want to avoid anything that reminds them of the loss. There are significant differences between men and women in terms of approaches, problem solving and coping styles. In women, sadness, depression, anxiety, hopelessness, disappointment, shame, feelings of guilt or inadequacy, and infertility are common. The woman may try to find out what she did to cause infertility and blame herself unfairly. In many societies, a woman’s capacity to have children is associated with her identity as a woman, so a woman may not feel like a woman, and as a result, many women may fear separation from their spouse. On the other hand, the traditional male role also includes having children, which can lead to feelings of embarrassment. Some men, on the other hand, are worried that they will not be able to continue the lineage of the family.
In this challenging process, spouses should be optimistic about the outcome and at the same time realistic about the possibility of not achieving the desired outcome. An open, honest and balanced communication between spouses is important in terms of addressing and solving problems and determining common views.
Partners should be supported and informed that changes in sexual intimacy are temporary and will return to normal after treatment ends, unexpected consequences (eg, multiple pregnancies), risks to the health of the mother and baby, how long it will last, and the cost. Sharing their thoughts and feelings together, getting support from relatives, friends and professionals, helps fill their lives and relationships with other things (like taking walks together, going to the movies, taking walks in nature, being with friends in social situations), making sex fun (candles, nice music, etc.). romantic films, etc.) will be useful in this process.
The support of a mental health professional is important in assessing spouse’s strengths and vulnerability, coping ways, and belief systems. Spouses can learn ways to better understand each other and communicate more effectively. Techniques such as coping with stress, reducing anxiety, controlling depression, coping with disappointments during medical treatments, feelings of guilt, worthlessness and failure, improving communication skills, breathing exercises, relaxation exercises can help at all stages of treatment.
