Most couples enter the path towards parenthood expecting that it will occur without too much problem. After all, they spend most of their lives trying not to get pregnant and assume that when they consciously start trying, pregnancy will soon be achieved. As the months or even years go by without a baby, and efforts to achieve pregnancy are increased—from intrusive testing to high technology treatments—the path turns into the emotional roller-coaster of infertility.
Infertility can be a real test of a couple’s relationship and shake the foundation of a marriage. It can make a solid relationship stronger and weaken the core of a troubled one. Because infertility is a crisis, it is out of the realm of experience of most couples and thus challenges them to develop new strategies and coping mechanisms to deal with this life crisis. The good news is research has shown that, for most infertile couples, the experience strengthens their marriage by teaching them life-long skills to deal with problems. Since infertility is one of many challenges couples may face in their life together, the skills learned can be adapted to use at other difficult times.
Relationships, like anything you want to grow and thrive, have to be tended to flourish. They are like a garden that must be carefully planted and then receive adequate amounts of nutrients such as sun, water, fertilizer, and cultivation to blossom. If the garden is neglected too long or receives too much of these nutrients, the plants will wither and die. Relationships are also like a bank account—you can’t continue to make withdrawals without depositing something back or you will end up overdrawn. Infertility can be like a “withdrawal,” draining intimacy from your marriage and depleting your emotional resources. It can cause you to neglect your relationship, focusing all energy on the baby quest. In effect, infertility can create a life of its own in a marriage, causing you to lose sight of what brought you together in the first place and what is necessary for a healthy family to grow in the future.
For a marriage to survive the crisis of infertility, couples have to learn to continue to make “deposits” and “tend the garden.” Understanding the ways in which the stress of infertility can strain a relationship, couples must make special efforts to put positive energy into a marriage during this time. If you are an infertile couple, there are steps you can take to enhance your relationship so that it grows and thrives. The following are some suggestions to help you along the way:
Work as a team. No matter who is identified as “the patient,” infertility is a couple problem. Always approach the issues as a team, working together and finding ways to share responsibility regarding treatment. Avoid finger-pointing as nobody ever wins the blame game.
Plan playtime. Since dealing with infertility can feel like a full-time job, it is important to “take time off” by consciously make time for each other. Have regular dates where you can have fun and take a break from infertility. Vacations are also playtime, and having things to look forward that are under your control is positive. Look for ways to put nurturing energies in the relationship, making your partner a priority.
Separate baby-making from love-making. Infertility often puts strain on a couple’s sexual relationship and what was once fun has now become a tedious job. You may want to designate different rooms in your house for your intimate work versus play. Remember the ways you enjoyed sex early in your relationship and find ways to recreate it. Plan romantic encounters at non-fertile times, such as a bubble bath together or giving a massage. Understand that sexual intimacy does not have to mean intercourse and use your imagination to plan recreational sex.
Build a support system. Couples often have an unconscious expectation that their spouse will be able to take care of all their emotional needs. This is a daunting task during infertility and an impossibility for any relationship. Infertility can be an isolating experience and put undue pressure on a partner for providing all emotional support. Support from others can strengthen relationships, especially during times of stress. Encourage friendships for yourself, your spouse, and as a couple. Work towards balance in your support network by having friends both in and out of the infertility world.
Identify individual coping styles under stress. Know your own and your partner’s styles for dealing with stress. Learning how to accept differences in the way each of you handles and deals with your feelings can lessen conflicts. Like many things in life, men and women will feel and deal differently with infertility. However, different doesn’t mean better or worse; it only means not the same.
Allow breathing room in your relationship. Realize that marriages are fluid and in a constant state of change due to the many external and internal factors in your life, including infertility. During times of stress, try to give each other some space and distance to allow for transition. Understand that couples are seldom at the same place, at the same time, when at treatment crossroads.
Communicate the positives. Often we neglect to communicate our positive feelings to our partner, and all he or she may hear are negatives. Changes in behavior come more from positive reinforcement than from negative. Also, infertility may consume your life and engulf all your conversations. It may be necessary to put limits on the time you talk about infertility to designated periods, such as 20 minutes in the evening, so that it does not overtake all your communication.
Keep a sense of humor. No matter how tough things get, being able to find something humorous about the situation helps to relieve the tension. Laughing together is good for the health of your relationship.
Seek help before problems get too big. Infertility can put terrible strains on relationships and couples need to consider counseling as a resource of support and information to deal with problems. If you find that you are at an impasse or your usual coping strategies aren’t working in the relationship, counseling may help. Don’t wait until things get critical. Ask your doctor or visit the American Society of Reproductive Medicine website for a listing of mental health professionals specializing in infertility.
Contributed by: 
Sharon N. Covington, MSW, LCSW-C
Director, Psychological Support Services