Vitalab councilor and social worker Bernice Lits understands only too well the overwhelming emotions a couple has to cope with when dealing with infertility, as she explains: “Most people take their childbearing for granted; we tend to scheme on how not to have children, rather than how to have them. Being told that yes, you do have a fertility problem, generates feelings of shock, anger and disbelief, just as would the diagnosis of any other serious medical condition. Suddenly, the couple find themselves in the midst of a major life crisis. It is an overwhelming shock when confronted with the reality that creating a family of their own is going to involve a lot more than they had ever imagined.”

One patient, when informed she had fertility problems, described the diagnosis as a blow to her self esteem, a violation of her privacy, an assault on her sexuality, a final exam on her ability to cope. She added it was “an affront to my sense of justice, a painful reminder that nothing can be taken for granted, my infertility is a break, in the continuity of life. It is above all, a wound to my body, to my psyche, to my soul”.

Unfortunately for couples dealing with infertility, it is not an issue well-understood by their peers and family. Lits explains that, as the general population does not have to cope with the feelings and trauma experienced with infertility, there is little empathy for the pain the couple is experiencing. Added to this is the fact that the losses associated with infertility – which generally involves ideas, dreams and hopes - may not be obvious or tangible. “A disease implies a state of being unhealthy, an impairment of the body or an infection in the body. If people get sick there is a kind of implied contract; you go to the doctor, you take medicine, you stay in bed and you get better. While infertility often mimics a chronic illness in the way it takes over peoples lives, it is not in the classic sense a disease. Infertility makes people doubt their bodies as, no matter how healthy a person may look and feel, infertility destroys the assumption of a healthy body. A person who is otherwise healthy might very well turn out to be infertile and there is no feeling better. In fact, they can remain infertility patients for a very long time.”

Another peculiarity of infertility is that, unlike any other medical condition, it directly affects two people at any given time, albeit in different ways. No matter where the problem lies it is the couple who is infertile. Both are affected by the outcome and must deal with the treatment together. Lits says that, for the couple, ongoing treatment creates a constant feeling of loss which permeates every aspect of their lives, robbing them even of sexual intimacy as a way to heal or share deep feelings and caring.

“The very nature of fertility treatment requires that you stick to a schedule and all spontaneity goes. Sex on schedule is a poor substitute for sex-on desire, and pressure to perform on schedule takes a rapid and predictable toll on most relationships. Eagerness to conceive does not make either of them a more enthusiastic sex partner. For one or both of them desirability may be affected by the sense that something is “wrong” with their sexual functioning,” says Lits.

For a couple, infertility encapsulates the worst conflict elements of any relationship. Having a baby now becomes a “job”, something that has to be monitored and managed. Other goals may become neglected. Couples may experience a sense of failure in the relationship, rather than a sense of achievement. It may be that he feels that she is over-reacting, while she feels that he is not sensitive enough. She becomes obsessed with learning about infertility and he feels ignorant and intimidated by such high powered medical information that she has obtained. The partner often feels helpless and sees his wife as completely changed. She is no longer the easy going, fun loving woman he fell in love with. Both start to experience a sense of loneliness and isolation.

Since ancient times infertility has carried a terrible stigma or a sense of being different from others, and even though infertility is now recognized as a medical condition, it does not make it any easier to accept. Infertility remains a dark secret for many couples and is a condition invisible to the outside world. Ironically, although a private pain, infertility often entails the loss of privacy as, in order to conceive, their most intimate details need to be examined. Lits says patients often express feeling exposed, that their bodies have been dissected in the course of their investigations and treatment. Questions and comments from family and friends are a further intrusion on their privacy

Infertility is an unwelcome, unscheduled and unexpected life transition. It presents as an acute trauma and is, in fact, a life crisis, a crisis that can continue for months, sometimes even years. Infertility causes a major disruption in daily life and as treatment progresses, exposes the couple to a roller coaster ride of extreme highs and lows, of hope and disappointment. It can call into question the most fundamental expectations a person has of themselves, their body and their life.

Because infertility is so diverse and complicated it is crucial that the couple attend an accredited fertility clinic that has a multidisciplinary team who will inform them and so help them through the process. The goal of the infertile couple is to learn to cope and adapt to their condition. Successful adjustment means attending to the negative effects, handling them when they occur and having some control over them so that they do not totally disrupt their lives. But, as Lits reminds us, getting through infertility treatment is a process in itself: “Couples learn about their own strength and resilience and in the end they can say to themselves, if we can get through this we can get through anything.”

About Vitalab Fertility Clinic

Issued on behalf of                         :               Vitalab Fertility Clinic

                                                                                Drs Jacobson, Gobetz and Volschenk

                                                                                Specialists in Reproductive Medicine

Issued by                                             :               Jenni Newman Public Relations (Pty) Ltd

                                                                                Account Executive

                                                                                011 506 7356      

                                                                                sue-ellens@jnpr.co.za