The Mental Health Impact Of Fertility Treatment
Every year on 10 October, #WorldMentalHealthDay is commemorated worldwide, with the aim of raising awareness of mental health issues and mobilising efforts in support of better mental health.
In support of this global day, the Medfem Fertility Clinic team would like to add our voices to raise mental health awareness by sharing information about the impact of fertility treatment on mental health from our own Dr Mandy Rodrigues – resident clinical psychologist at Medfem Fertility Clinic – who spoke about this topic at the recent Fertility Show Africa 2023.
Mental health conditions affect one in eight people globally, and this impacts their physical health, their well-being, how they connect with others, and their livelihoods. On #WorldMentalHealthDay, experts have an opportunity to highlight issues that affect mental health, and certainly infertility and fertility treatments can have a significant impact of a couple’s mental health.
At the recent Fertility Show Africa 2023, Dr Mandy Rodrigues shared not only her own experiences with infertility but also insights into the mental health impacts that infertility and fertility treatment can have on a couple – from the day they find out about their fertility challenges until the end of their fertility journey.
The loss of choice
Dr Rodrigues pointed out that society is all about choice nowadays. People can decide, for example, their sexual orientation and even the gender they identify with, as well as their family structure. In fact, the right to choose when, how and how many children they have has been recognised as a universal human right.
For couples struggling with infertility, losing the ability to achieve a pregnancy without medical assistance is a great shock, and it can seem devastating. For some, having children can still be achieved through fertility treatment. But understanding the physical, emotional and financial challenges – and the mental health impacts of fertility treatment – some may decide not to go ahead.
Most couples who go through the treatment recommended by a fertility specialist will achieve success. But for some couples the treatment may not be successful, even after several attempts.
The diagnosis of infertility, deciding whether or not to have treatment and the treatment itself, as well as the outcome of the treatment, all impact on a couple’s mental health.
In fact, even in one of the most advanced countries, where the government pays for as many as six IVF cycles, the majority of couples complete only one IVF cycle. This shows that even when cost is not a factor, many couples can only tolerate or go through one IVF cycle because of the emotional and mental health effects it has on them: from the shock to the anger and the bargaining, and to the depression and helplessness, and the desperate attempts to make sense of what happened. Sadly, many couples don’t realise that these are normal emotions and mental health issues that can be expected during fertility treatment, and especially when the treatment is not successful.
When you first find out…
A diagnosis of infertility can be an immense shock to a couple, and brings a lot of implications emotionally, for couples’ relationships and all aspects of their lives.
Most of us grew up being encouraged to practice safe sex, and this resulted in people simply believing they always have a choice as to whether they’re going to have kids or not. Even today, not many people know about infertility, or that fertility decreases with age or that it is a medical condition that can be treated.
As a result, many women in their late 30s or early 40s, find themselves facing age-related fertility problems. Most of them didn’t want kids when they were in their 20s or 30s, not knowing that their ability to fall pregnant naturally decreases quite rapidly after age 35. And now that they do feel the readiness and the maternal instinct, they are unable to conceive naturally.
When they understand that the choice is no longer theirs, a helplessness sets in, and these couples realise they aren’t in control anymore. And it challenges every aspect of their personal lives – how they eat, what they do, what work and career choices they make – whether they buy the new house or emigrate, or whether they stay in a job for the maternity leave or quit. Some people put their whole lives on hold.
Certainly, it affects your relationships, especially with a partner but also with friends and family – those with kids and those without.
We often see partners no longer communicating with each other and being scared to express their expectations of each other. We also see independent coping, when couples try to avoid one another about the topic. We also see couples starting to avoid situations where they are exposed to babies and children.
Starting the fertility journey
After the initial shock of being diagnosed as infertile, couples face a number of very difficult choices regarding whether or not to seek the treatments available, and which treatments to choose.
Certainly, among the factors that influence these decisions is the type of treatments required, as well as the cost and success rates of each. For some, knowing their options could lead to a decision to accept their condition and not seek treatment. For others, the decision may be to go ahead with the treatments, no matter what it takes. Either way, making these life changing decisions can be extremely challenging in terms of mental health.
During the treatment process
While many couples understandably fear a failed fertility treatment cycle, it is often not only the final success or disappointments that take their toll on mental health, but also the ongoing and intense rollercoaster of emotions that marks each step in treatment process.
As one Medfem patient describes it: “It’s exciting to embark on IVF and I’m sure many women can agree with me, it’s the one month you cannot wait for your cycle to start, because it feels exciting. You want your cycle to start because then you start on this very exciting journey and you have high expectations.” There is hope. Even exhilaration. But at the same time, patients are nervous, even terrified.
In addition, if you are taking hormone medication as part the treatment, there are further influences on your emotional and mental state. Many patients say they feel great, even ten days after starting hormone treatment, but then their mood suddenly crashes. And before they know, it is time for aspiration, and even if that is a success, they immediately start waiting anxiously for news about the embryos in the lab. And after an embryo is implanted, there is the longest two week wait, which many patients say is the worst part of IVF treatment.
During the IVF process, there can also be seemingly devastating news long before the end of the treatment process is reached. Maybe at the first scan already, or maybe you get to aspiration before a problem is encountered, or you only get bad news when the embryos are already growing in the lab. This is called an abandoned cycle. But emotionally, it is as great a loss as a failed treatment cycle.
For some couples, after the rollercoaster of going through all the processes and emotions, the treatment cycle is not successful. The loss feels devastating and couples go through what is basically a grief cycle.
The impact on mental health is huge. It is important for couples to allow themselves two or three days to feel these emotions. Some people will decide to stop, to accept their infertility and to move on. Some will say they are never going through it again, but with time decide to try again or try a different treatment. Others will continue on their fertility journey.
Making these tough, life changing decisions will also take its toll on mental health.
How to cope
The challenging emotional rollercoaster ride that fertility treatment can be, tough as it is, doesn’t mean that patients will not be able to cope.
There are a number of strategies that you can use to cope better with the stresses and mental health impacts of fertility treatments. These include, among others, working with experienced fertility experts, keeping a realistic perspective, and breaking the process up into small steps. You can read more about these strategies in our article Mental Health Coping Strategies From A Fertility Expert.
At Medfem we believe in helping you reach your family dream through:
* World-Class Fertility for Everyone – we believe in making world-class fertility treatments available for everyone
* A Positive Fertility Journey – It is our joy and commitment to give you a positive outcome to your fertility journey
* Delivered With Empathy & Caring – So you may have a fond memory, of a feeling of empathy, caring and being part of the Medfem family
If you would like to meet one of our fertility specialists at Medfem Fertility Clinic, simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.
Our Fertility Specialists can also meet with You During a Virtual Consultation Via Zoom or Skype. Click here to book a virtual consultation now.
We look forward to meeting you at Medfem Fertility Clinic!