The key to dealing with the emotional strain of infertility is to present a united front. You and your spouse must discuss and agree upon the major points of your diagnosis, treatment, and resolution options. With time, patience, support, and knowledge, most people eventually come to terms with their infertility either through medical resolution, adoption, or choosing to live child free.

Most people assume that when the time is right, they will simply decide to have children and will get pregnant shortly after they stop using birth control. As each cycle passes, the anticipation that the couple felt in the beginning of this process is replaced by concern. Couples are likely to feel shock and dismay when they realize they can't conceive as easily as they originally thought. Most people live under the false assumption that if they work hard enough and put forth an honest effort that they will always be successful. Because of this widely held belief, most couples initially struggle with denial, not even wanting to admit that there could be a problem.

Questions start creeping to the surface-What if we can't have children? Could we be sterile? Whose fault is this, his or hers? It is normal for couples to encounter a wide range of emotions before actually acknowledging that they may have a fertility problem.

Emotions

The woman is often the first to realize that the fertility problem may exist. Sometimes she is aware for a long period of time before expressing concerns to her partner, so when she finally does mention the possibility of a problem, the man may attempt to dissuade her thinking or cause her to doubt her gut feeling.

The man might need to be convinced that medical intervention may be necessary. This is especially true if the woman has been thinking that there is a problem for several months/cycles. She has had time to think about and mull over medical possibilities. This combined with the fact that we believe reproduction to be a "natural right" sometimes makes it difficult to convince the spouse of medical intervention.

Feelings of frustration, anger, denial, guilt, blame, self pity, and jealousy often begin to surface. The blame and guilt factors are typically male responses to infertility. Our society prides itself on male prowess...references in popular culture to things like "he's not shooting blanks" and the ability of the male to impregnate the female somehow being tied to his manhood are foreign to female thinking. Anger and denial tend to dominate the female mindset and can make it difficult for both parties to seek medical attention.

Emotions and disagreements in the marriage become magnified. This is true with any crisis. Money, religion, in-laws-all of these things magnify small disagreements in the marriage. Do not live in denial- the crisis of infertility WILL cause confusion and doubt and fear and pain. You will struggle through this issue in many different stages and ways. Try to not abandon each other in the process.

Coping Strategies

Communication with others who are or have experienced difficulty conceiving will help you realize that you are not alone. However, it's important to remember everyone is unique and your situation is not exactly like anyone else's. RESOLVE is a national organization that has an extensive amount of data about emotional coping and connecting infertile people to support structures.

If you are over 35 years of age and have been trying to conceive for 6 months or longer or are under 35 and have been trying for 1 year or more, you should make an initial appointment with your doctor. It is important to hit this challenge head on and get an accurate diagnosis as soon as possible. It is also important to consider the type of doctor that you see for your diagnosis and treatment. Your OBGYN physician deals primarily with pregnancy and delivery, whereas a Reproductive Endocrinologist (RE) is primarily concerned with getting women pregnant. Check with your insurance company to see if coverage is available to see an RE.

Be prepared for the fact that your feelings and your partner's feelings may differ at times. You will go through so many different emotions and stages in this process that you need to be understanding and know that your attitude and options will change frequently as will your spouse's

Expect to feel a mixture of fear, anxiety or relief when you seek help from your doctor. The key to dealing effectively with this struggle is to STAY INFORMED. Educate yourself constantly about your condition, treatments, and available resources. Stay on top of your own healthcare and do not deny your inner feelings. You know your body better than anyone.

Communication with your partner is critical during this time. This will often be difficult, but it is crucial to staying in touch and on the same page. This is the same case with your healthcare provider. You must honestly express yourself to your spouse and your doctor about whatever you are feeling and thinking.

I know that this one sounds futile, but try to redirect your focus on positive things such as a favorite hobby or new activity. Don't let the struggle to conceive a child consume you from the inside out. It is important to maintain perspective and continue growing as a human being and within your relationship with your spouse.