Updated: Aug 14, 2020
Amongst all the hardships happening right now, some of us are dealing with our own personal struggles of infertility. As we discussed in our last blog, infertility is common, with around 9% of couples being affected around the world. Here, we will discuss how infertility affects mental health and share with you some of the latest treatments for infertility. As National Infertility Week approaches, it is our hope to end the stigma of infertility. It is important to talk about issues of infertility, and we hope that you feel comfortable sharing your unique challenges and stories. We support you here at Huddle Up Moms and share your struggles.
DISCLOSURE: This information is not meant to be all-encompassing and should not replace seeking advice from your health care provider for specific questions, solutions, and concerns about your health! The purpose is to spark curiosity and gain some insight into your health.
THE MANY FACES OF INFERTILITY
Infertility can profoundly affect an individual’s mental health. Each passing month can bring a roller coaster ride of emotions. Hope, anticipation, and excitement might come early in the month as the couple gears up and tries to conceive. Later in the month, a negative pregnancy test might bring anger, guilt, sadness, worthlessness, or other intensely negative emotions. Additionally, as you watch other women around you conceiving and having children, you may feel as if you’re the only person struggling with this issue. This may lead you to feel isolated, stressed, or out of control.
When couples begin fertility treatments, this can bring many long and exhausting visits to the doctor and extreme financial expenses. Also, the hormone shots that are typical infertility treatment may bring about huge mood swings. In fact, many of the side effects of medications prescribed for infertility are psychological symptoms such as irritability, anxiety, or depression.
Loss of a sex drive:
Additionally, couples may lose interest in sex or have to abstain from sex due to infertility treatments. With so much time spent dealing with your reproductive organs in a medical or technical way, having sex might just be the last thing you want to do. Couples may lose their drive or desire for sex, and this, in turn, may make the couple feel less emotionally connected.
Mental health issues:
After many months or years of trying, this onslaught of emotions may lead to fatigue, exhaustion, and significant impairments in mood. In fact, the most common mental health issues that infertile women report are anxiety and depression – with levels similar to those who have been diagnosed with cancer. And if you have a preexisting mental health issue, you may be even more at risk to develop these negative mood changes.
Infertility can also be linked to grief as many infertile couples deal with miscarriage or the loss of the fetus – perhaps even having to endure repeated loss. Because of medical complications, some women may additionally have to endure the loss of their own reproductive organs, such as the fallopian tubes in the case of ectopic pregnancies.
Lack of communication:
On top of this, many women struggling with infertility keep this information private and do not share their stories with family or friends, making the experience even more challenging. I’m sure that each of you has your own stories to share and could each add numerous other psychological hardships that infertility brings.
What should I do if I am feeling this way?
Because of these complicated emotions that arise with infertility, it is now recommended that a mental health expert, such as a psychologist or licensed clinical social worker, plays a vital role in infertility treatment. Having a therapist on board can help guide you through these challenges on a week to week basis. As you go through this journey, you may frequently need to deal with new challenges. New feelings may emerge in each situation. Therefore, having a trained counselor to talk to can be of integral importance for your mental state. This especially true if you feel you are unable to talk to your partner, family, or friends. You can even seek out a counselor who specializes in issues of infertility. Additionally, seek out infertility support groups. We are now offering an infertility support group that you can join. Our first online offering is April 18th at 10 am EST.
You can register for our infertility mom meetup group here: https://virginiatech.zoom.us/meeting/register/tJArduGsrTwvAcL7ZNOx8v05PorcbQDgNg
Take home message: The stress of infertility can lead to serious mental health issues. If you are dealing with issues of infertility, consider making an appointment with a therapist or counselor.
If you are dealing with issues of infertility, there are many options for couples. Scientific and technological advances have brought about many treatments for infertility. We share some of these with you here and encourage you to talk to your OBGYN about other possible treatments.
1. Medication may be a first-line treatment. These medications act to increase ovulation or stimulate the development of mature eggs, and because of this, taking these medications may increase the likelihood of twins or triplets. Some of these medications are taken orally, some are injected, and some are taken as nasal sprays. The following are some examples of medications that might be prescribed for infertility.
Clomiphene citrate or Clomid® may be prescribed for individuals with polycystic ovary syndrome (PCOS). This medication causes increased ovulation by acting at the level of the pituitary gland.
Letrozole or Femara® increases ovulation by lowering the level of progesterone, which subsequently increases the level of Follicle Stimulating Hormone (released from the pituitary gland).
Human menopausal gonadotropin or Menopur® (also Repronex® or Pergonal®) acts directly on the ovaries to stimulate the development of mature eggs.
Gonadotropin-releasing hormone (GnRH) will be used during in vitro fertilization to prepare the uterus for embryo transfer.
Metformin or Glucophage® will be used if you have diabetes or are insulin resistant. This medication might also be used if you have PCOS. It acts by lowering androgen levels and stimulating ovulation.
2. Intrauterine insemination is also known as artificial insemination. In this procedure, sperm is directly inserted into the woman’s uterus. Prior to this procedure, medication may be taken to stimulate ovulation and to enhance the chance of fertilization. This technique is often used for mild male factor infertility or for couples with unexplained fertility.
3. Assisted Reproductive Technology (ART) is an all-encompassing term that refers to treatments where the fertilization of the egg happens outside of the woman’s body. The most common type of ART is in vitro fertilization. Early in this process, the woman will take a series of oral and/or injectable medications to stimulate ovulation. The mature eggs will then be retrieved from the ovaries. In the laboratory, the sperm will then be added to the eggs for the purposes of fertilization. After this, the embryos will start to develop. Finally, the embryos (normally 2 or 3) will be transferred back into the uterus. All additional embryos will be frozen for later use. Around 14 days after embryo transfer, the woman will be able to take a test to determine if she is pregnant.
On paper, this all sounds quite straightforward. However, the reality of going through these treatments is quite complex and can be wrought with emotion for the couple experiencing these medical procedures. Often, many rounds of in vitro fertilization are needed for a full-term pregnancy. In fact, women who conceive with in vitro fertilization go through an average of 2.7 cycles. If you are under 35, the success rate for in vitro fertilization is around 40%; however, as we age, the success rate significantly decreases. Importantly, success rates vary between clinics so make sure you get a good recommendation. Advocate for yourself by asking what the fertility success rate is at the clinic of your choosing.
What about infertility treatments for men?
Infertility issues are often due to male factor infertility (with estimates up to 50%), and so treatments exist for men as well. Fertility treatments for men may involve medical or surgical procedures. Intracytoplasmic sperm injection is one type of ART for males that entails an injection of a single, ideal sperm into the mature egg. If you are a man and you suspect you have male factor infertility, you should reach out to a urologist who specializes in infertility issues.
Take home message: Many treatments exist for infertility. If you suspect you are infertile, make an appointment with a Reproductive Endocrinologist in your area and see what options are best for you and your partner.
Remember that this process will take time, but the journey is worth it. Keep your eye on the future and continue to think positively about what is to come. If you are having trouble staying positive, seek out a mental health professional to help you during this difficult time. We are interested in hearing from you, so please reach out, share your stories, and join us for our upcoming infertility support group on April 18th.
For more information, join us at our educational panel on infertility on April 21st at 7 pm EST where you can hear from several experts on the latest in infertility. You will be able to ask your questions to physicians, scientists, counselors, and other experts in the field.
Sign up for our educational panel here: