›› COPING AND INFERTILITY

1. EDUCATION: Educate yourself regarding the normal and natural responses to infertility. Everyone going through infertility can feel like they are in significant crisis. Learning about these normal reactions can help by normalizing your experience.

2. ISOLATION: A common response to infertility is isolation, the couple separating themselves from their support system of family and friends. This occurs because they anticipate that others will have a negative reaction to their infertility and/or will make statements that may increase your distress. The key to overcoming this isolation is educating others about infertility and teaching those closest to you how they can support you. Take on this task at times that you are able to do so. The benefit to you later will be invaluable.

3. SHUTTING DOWN: Many people try to manage the infertility crisis by closing off their feelings. This choice is made for many different reasons. Sometimes people feel shame, often they experience feelings of not belonging to the larger group (the fertile or "normal" group) and therefore anticipate rejection. Platitudes such as "just relax and you will get pregnant" leave infertile couples feeling like it is their fault they are not pregnant. However, we know that the best way to cope with a crisis is by allowing your emotions to have a time and a place for expression. Take the time to have your tears, your anger, your disappointment, even your feelings of hopelessness about having a child so that you can move through these emotions. Doing so will enable you to move onward to address the tough decisions you face and to be more available to support one another during the infertility crisis.

4. DIFFERENT EMOTIONAL REACTIONS: Make room for each of you to have different emotional experiences. It is rare that a couple experiences the same emotions at the same time or maneuvers through an emotionally distressing event in the same way. WE ARE ALL UNIQUE! To expect that each of you will have the same emotional experience simultaneously will set you up for disappointment with one another and add to feelings of disconnection that may occur during the infertility process. Couples find it more helpful to share with one another what they are experiencing and to acknowledge the differences. This approach fosters each partner feeling like they are being listened to and supported, thus maintaining the emotional connection that is so important to couples during the infertility crisis.

5. LIMITING INFERTILITY TALK: Discuss how much time each day the two of you will spend talking with one another about your infertility process. Limiting the time a couple spends together focused on infertility allows the couple to maintain and sustain other aspects of their relationship. It also helps a couple remember and hold on to more of who they were before the infertility crisis. As a result, the couple is better able to stay out of the infertility abyss that can occur as infertility concerns occur over time.

6. COMMUNICATING: Work diligently at embracing where you are in the moment and communicating your needs to one another directly. Don't expect your partner to be a mind reader. Remember, both of you are in crisis. It takes both of you speaking your needs for you to successfully meet each others needs. We are more likely to get our needs met if we vocalize them.

7. REALISTIC GOAL SETTING: It helps to set realistic goals about managing the stressors of infertility. You cannot become an expert in managing the distress and stress inherent within infertility. Use different tools until you find a set that is helpful to you. Remember, it takes practice using the tools to achieve the best benefit. Keep in mind that what works for you may be different than what works for your partner.

8. KNOW THYSELF: Know your self and what triggers your stress buttons (e.g. specific comments, exposure to infants, a certain movie, times when you have just undergone a procedure, etc). Discover and implement a plan to manage these times. Through monitoring your own signs of stress, you can become empowered to successfully tackle the stress. By doing so, you can more likely reduce the severity of distress as well as the length of time you remain in a distressed state.

9. MAKE AN INFERTILITY PLAN: As a couple, take the time to develop your plan to address infertility. Short and long term plans are important as each of you may have quite different perspectives on what medical steps you are willing to take to resolve the infertility issues. Having a short and a long term plan helps reduce the stresses if infertility is not remediated quickly. It also enables the couple to discuss and discover what each other's limits may be. Tackling the emotional reactions inherent in exploring a short and long range plan in the early stages of infertility generally results in the reduction and management of stress. This is difficult to do in the early stage of infertility because couples have a lot of hope that the initial infertility interventions will result in successfully building their family by having a biological child. However, if the initial infertility intervention is not successful, couples are quickly faced with making decisions about "what is next?" It is at this time that most couples find that it is helpful to have a more in depth discussion regarding a short and long range infertility plan.

10. Embrace health behaviors. Eat well and avoid alcohol, caffeine or other stimulants. Have a positive exercise program to release physical and emotional tension. Meditation, yoga or acupuncture can help people reduce stress.

11. POSSIBLE TECHNIQUES SUMMARIZED: Once you know yourself and what triggers your distress, here are some techniques that you may want to explore:

• Meditation
• Relaxation Techniques
• Keep your support system strong and wide-depending only on each other for support will deplete both of you
• Eat Well
• Exercise regularly (as medically appropriate)
• Take time to relax/escape individually and together
• Enjoy a massage
• Develop healthy and positive ways to provide distractions for yourself and with one another
• Take advantage of support through the on-line program RESOLVE: The National Infertility Association
• Seek couples therapy if either of you are feeling distressed beyond your tolerance
• Limit the amount of time the two of you talk about infertility

This "COPING AND INFERTILITY" sheet is a synthesis of recommendations found in a variety of sources. These include:

American Society for Reproductive Medicine, www.asrm.org
RESOLVE: The National Infertility Association, www.resolve.org
R. Diamond, D. Kezur, M. Meyers, C. Scharf, and M. Weinshel, Couple Therapy for Infertility
S. Covington, and L. Burns, Infertility Counseling: A Comprehensive Handbook for Clinicians

Prepared by: Diann Shannon, Psy.D., Licensed Clinical Psychologist, LLC