The Emotions of Fertility

It seems so exciting. I'm going to have a baby! I'm buying sperm! I'm going to see the doctor!

It seems so scary. I'm going to have a baby! I'm buying sperm! I'm going to see the doctor!

No matter whether we dreamed about having babies when we were younger or not, the fact of inserting sperm into our bodies in a method less natural than clinical is not generally how we envisioned building our family.

And then there are the fears: miscarriage? multiples? my health? baby's health? Are we sure this is what we want to do? Are we sure we've waited long enough for our partner to show up, or our finances to shape up? These are the typical concerns and questions we face.

But less talked about are the deeper emotions of this process. Loneliness. Jealousy. Anger.

A married friend who doesn't yet know you are taking this path excitedly tells you that she and her husband are foregoing contraception at last and officially "trying."

A single friend succeeds on her second attempt. And you're approaching cycle six.

A work colleague announces her pregnancy and you hate her. The fact that she's pregnant. The romantic way she conceived. How simple it seemed. How excited everyone is for her. And her elated partner.

You agonize over springing for the expensive fertility tests and monitoring that insurance doesn't cover.

As one woman facing fertility issues said, "Most of my friends are in their late 30s now, and I see it happening to them. The excitement of expecting to get pregnant. The disappointments. Resisting treatment. Getting pregnant and miscarrying. It's devastating. In the process you lose that innocence. The story becomes one of paperwork and technology and medical visits."

Dr. Jeanette Truchsess, a St. Paul-based mind/body therapist, says, "The biggest stress for women is the loss of control. Everything else they've set their mind to they've been able to accomplish. This is often the first goal they can't achieve by hard work and smarts."

Patricia Mendell, a New York-based mental health counselor affiliated with the American Fertility Association, says that the majority of people who give up on fertility treatment do so because of the stress involved. Her role is to help people manage the stress so they can stay in the struggle longer. "It's like preparing for a marathon," she says.

The bright side of doing it alone

There is a bright side to conceiving without a partner. Many women who undergo the ups and downs of insemination attempts with a husband end up dealing with a great deal of marital conflict. The husband is emotionally withdrawn about his infertility. The wife wants to talk and learn; the man considers one short conversation adequate. Many women like to plan a year ahead; men tend to prefer to take it one step at a time. They need to agree on which family and friends to tell, what they will tell them, and whether to attend baby showers, birthday celebrations and kid-oriented holidays. They deal with grief in different ways. Sex on command can have long-term negative repercussions. Down the road, one of them might consider the non-biological parent less connected to the child, or disagree about whether to tell the child about being conceived with a donor's help.

Schedule conflicts

But there is plenty of stress to go around for the single woman, of course. A boss who doesn't know about regular doctor appointments can make it difficult. Business trips can interfere with timing. Some careers, such as teaching, don't easily lend themselves to disappearances, sometimes on a moment's notice when ovulation is occurring. Some women are in conservative environments where prospective single motherhood is not something to announce in advance. Can you make up stories about dental work, or does fibbing make you nervous? Making a concrete plan, with doctor and medical staff, can help alleviate the logistical stress. The physical toll on the body can be difficult enough without also having an idea of how to work it in.

Paying for it

Fertility can be such an emotionally taxing issue that it's hard to be clear-headed about the practicalities of paying for it. Mindy Berkson, director of Chicago-based Lotus Blossom Consulting, helps couples navigate the financial terrain of fertility treatment. "It can be incredibly stressful to be spending the college savings fund on something that others take for granted," she says. "But for many, building a family is not a luxury item, like buying a boat. You must create your family."

Some refer to their child as their Discover baby, with treatment and medications paid by credit card. If you hope to have more than one child, how will you build financial reserves? Have you factored in the risk of multiple births?

Social stress

As Truchsess points out, social isolation can be substantial. Women are likely to withdraw from a friend who suggests "just adopt," or "just don't have kids," without understanding the deeper emotions. They'll withdraw from parents who don't have the right words. From neighbors who are pregnant. From family activities that celebrate its children. From book clubs where parental pride is a frequent topic of conversation. From colleagues who gripe about missing a lot of work hours. From church members who make personal judgments that reproductive technology is unnatural.

The stress and depression of fertility issues can also hinder the ability to conceive. (See the next page.)

The long-term story

In the end, getting pregnant is only a tiny part of the story, even though it can seem momentous when you are struggling to achieve it. "If you want to be a parent, you will be," says the mother of one child conceived from donor insemination and one adoptive child. "There are great options out there to help us build our families. I'm a huge advocate for adoption. And there is so much life after trying. It's easy to lose sight of that."