Fertility and reproduction are highly valued in all cultures, and wishing for a child is considered to be a basic human evolutionary thought. For women, motherhood is an important developmental milestone and a universal desire, which is held in high esteem.
Infertility: A Life Crisis
Infertility can be defined as 12 months of timed, unprotected intercourse without resulting in a conception. Research has shown that 40 per cent of infertility in an infertile couple can be attributed to reasons related to female infertility (like PCOS), 40 per cent to the male factor (like reduced sperm count) and 20 per cent could be a combination of both or due to an unkonwn cause.
A failed attempt to concieve, naturally or after treatment, can be devastating and psychologically draining to both the man and woman. It is often associated with social, emotional and sexual stigmas, leaving both with heightened feelings of incompetence and defectiveness.
Dr Sunil Jindal, Reproductive Medicine Specialist and Andrologist
Dr Sunil Jindal, Reproductive Medicine Specialist and Andrologist, Jindal Hospital & Fertility Clinic, Meerut, says, “I have always felt that the path from infertility to the joy of parenthood is unpredictable, but in the end, is the story of champions who never give up. You are actually a born champion.” He shares his insights below.
Psychological Distress And Infertility: Cause Or Effect?
The tag of being ‘infertile’ appears to have a similar reaction as grief, and follows a similar pattern viz., surprise or shock, denial, anger, bargaining, and finally, acceptance. When couples seek medical advice after failing to concieve naturally, they specifically need to know why they are infertile and find out a plausible cause for it. They are constantly attempting to control feelings of guilt, anger and despair as they undertake assisted reproductive techniques (ART), which is usually the last resort.
Researchers initially felt that psychological distress may be a factor that causes infertility, however, they ultimately realised that psychological distress was a consequence, and not a cause for infertility. Later, it was demonstrated that even the process of undergoing infertility treatment can impact emotional well-being and this needs to be handled with care.
Couples undergoing fertility treatment are often faced with the burden of social expectations, strain on marital relationships and financial constraints, all of which can impact the chances of a successful treatment. Studies have shown that both men and women undergoing ART are prone to depression during the treatment duration, especially when it comes to the two-week waiting period before the pregnancy is confirmed.
Another important emotional reaction to infertility and its treatment often experienced, is ‘depression’. Infertile women opting for ART are often depressed, have low self-esteem and self confidence, which may coincide with the phases of the treatment cycle or may be precipitated by an event (like a friend’s pregnancy or IVF failure), often leading to treatment discontinuation.
The outcome of infertility treatment i.e. a successful pregnancy, is influenced by psychological factors such as mood and stress. Studies have proven that emotionally distressed women undergoing ART have lower chances of a successful pregnancy as compared to those with a positive mindset.
All of these researches have led to the development of interventions that are designed to help alleviate the psychological distress and depression that couples experience while they go through infertility treatment, especially ART.
Impact Of Mind Body Interventions To Cope With Infertility And Its Treatment
Dr Jindal says that the aim of Mind Body Interventions (MBI) is to improve the quality of life during treatment, optimise infertility treatment and increase the chances of a successful pregnancy. A path breaking study demonstrated that a behavioural treatment program which included cognitive behavioural therapy and involvement in a support group, were compared to a control group who did not receive any psychological interventions. The results demonstrated that 55 per cent of couples who underwent cognitive behavioural therapy and 54 per cent of the couples who were part of the support group ended up with a viable pregnancy, as compared to just 20 per cent of the control group. Patients who underwent therapy also had lower anxiety and depression scores.
Improving The Health Of Your Mind And Body
A healthy mind body relationship is crucial at all times in life, but it is most important when you are undergoing infertility treatment because it has the ability to make the difference between a sucessful or an unsuccessful pregnancy. Founder & Director, Ferti9 Fertility Chains and winner of the APJ Abdul Kalam Award 2020, Dr Jyothi Budi shares a few pointers to improve your mind-body health to help you steer through IVF or ART treatment and improve your chances of success.
Dr Jyothi Budi, Founder & Director, Ferti9 Fertility Chains
Identify Your Feelings
You may experience a mix of emotions like anger, jealousy, envy, hurt, shame, guilt of not living upto expectations, fear of failure, abandonment or being judged, etc., while seeking treatment for infertility. A tangled web of expectations from yourself and those around you may seem to weigh you down. To overcome these feelings, it is important to first identify them.
The next step is to consider where they are coming from and where they are directed. Ask yourself why you’re feeling guilty, what is the guilt about, who is your guilt directed against, where is this guilt coming from, and how can you stop feeling guilty. Answers to these questions can help you understand your feelings better and will enable you to share these with someone who can help.
Identify Your Core Circle
Seeking support has proven to be a game changer in most cases of infertility. Identify people who genuinely empathise with you and ask them to help you sort your emotions. A ‘go to’ person can be of immense help when you are feeling down.
Seek Professional Help
Do not be afraid to seek help from a counselor or a therapist. Remember, being mentally and emotionally stable will help increase your chances of a successful pregnancy. Most IVF or ART centres provide counselling to help you cope with the situation.
Adopt A Healthy Lifestyle
A healthy body is a great dwelling place for a healthy mind. Eating a healthy diet and exercising regularly, including yoga and meditation, can work wonders not only for your body, but also your mind.
Reproductive science has evolved a great deal in the last two decades, giving hope to thousands of couples. Yet, many couples find the entire process mentally and physically strenuous. It is important to be compassionate to yourself and your spouse during the inevitable ‘ups and downs’ of infertility treatment. A healthy mental state may make all the difference to your treatment!