Infertility, IVF and Depression

fertilityInfertility Information

Infertility is a condition of the reproductive system that prevents the conception of children. 1 in 6 Irish couples will have difficulty conceiving on their own and will have to seek help and advice.

Conception and pregnancy are complicated processes that depend upon a number of factors, including: 1) the production of healthy sperm by the man, 2) healthy eggs produced by the woman; 3) unblocked fallopian tubes that allow the sperm to reach the egg; 4) the sperm’s ability to fertilize the egg when they meet; 5) the ability of the fertilized egg (embryo) to become implanted in the woman’s uterus; and, 6) sufficient embryo quality.  Finally, for the pregnancy to progress to full term the embryo must be healthy and the woman’s hormonal environment adequate for its development.  If just one of these factors is impaired, infertility can be the result.

It is a common assumption that infertility is primarily related to the woman. In reality, only one-third of infertility cases are related to the woman alone. Statistically, one-third of infertility problems are related to men and the remaining one-third is a combination of fertility factors involving both partners or unknown causes. Unknown causes account for approximately twenty percent of infertility cases.

There are many variables and different conditions that can affect a couple’s fertility and a number of these relate to lifestyle as well as physical or medical conditions.

Common Causes

  • Damaged or blocked fallopian tubes
  • Ovulatory problems
  • Abnormalities in the cervix or uterus
  • Low sperm count
  • Poor sperm motility
  • Malformed sperm
  • Blocked sperm ducts
  • Age
  • Smoking
  • Alcohol
  • Weight
  • Infection
  • STD’s like Chlamydia
  • Early menopause

Stress does not cause infertility, but may delay ovulation by the suppression of hormones needed for a healthy conception and pregnancy.  A recent study showed that women who were the most anxious and depressed prior to their IVF treatment cycle were 93% less likely to conceive than the least distressed women. Other research (Skillman, NJ Oct.19,2009), has shown that women who participated in a stress management programme prior to or during IVF treatment had a 52% greater pregnancy rate than women who did not participate in the programme (American Society of Reproductive Medicine’s 65th Annual Meeting).

We are starting our families much later in life here in Ireland for a variety of reasons and unfortunately the downside of this growing trend is the rise in age related fertility problems.  Women reach their fertile peak in their 20′s and experts say that chances of conceiving decline with age, particularly after the age of 35, it is usually at 0% over the age of 45.  For age related infertility problems there are a variety of treatments available.  The risk of miscarriage is also increased with age (the risk of miscarriage at age 25-29 years is 10% while the risk at age 40-44 is 34%).  Also advanced maternal age is associated with an increased risk of congenital abnormalities in any resulting children. Age related fertility problems not only has normal emotional responses to infertility but for some there is extra guilt or anger that they waited.  Age also has an effect on men’s fertility, age affects sperm and coital frequency but age is not as high a factor as it is for women.

When should we seek medical conception help?

It is recommended for couples where the women under 35 begin testing after trying to conceive unsuccessfully for 12 months.The recommendation for couples where the women over 35 is to begin testing after trying to conceive unsuccessfully for 6 months.   Anyone who has a history of problems (endometriosis, pelvic inflammatory disease, chlamydia, fibroids, cystic fibrosis, etc) should consult their doctor if they have any concerns or worries.  Approximately 85% to 90% of infertility cases are treated with conventional therapies such as drug treatment or surgical repair of reproductive organs.  Assisted reproductive technologies such as in vitro fertilization (IVF) account for the remaining infertility treatment options.  If your mental health is suffering at any time then please contact Nurture.

Emotional Effects

Infertility can cause enormous stress and anxiety and emotional pain for both partners individually and as a couple. Having the support you need and good coping skills can help you and your partner get through this difficult challenge.  Many people find it helpful to talk with someone who is impartial and can help understand or see things from a different perspective.

In 1991 the Human Fertilisation & Embryology Act was agreed and in that act it recommends that counselling should be available to all women and men undergoing fertility treatment.  Nurture Health offers a confidential, independent counselling service to all our clients before, during and after treatment.

Not all couples will conceive and appropriate counselling can be of great value in assisting a couple to cope with this.

Symptoms & Effects

  • Couples will often feel a sense of loss and disappointment, and the feeling of emotions and events being out of control.
  • lack of energy (especially when you have an unsuccessful cycle on medical appointment days or when you will see a pregnant friend);
  • headaches;
  • irritability (snapping at people or making mountains out of molehills);
  • insomnia.
  • extreme sadness.
  • inability to concentrate.
  • After several months of unsuccessful attempts to get pregnant or stay pregnant, feelings of shock or numbness may result.
  • Anger usually results from feeling vulnerable or helpless or both. Helpless feelings result from the lack of control that you may feel over your life plan, your body, and your future.
  • Anger can consume you, coloring your everyday thoughts and experiences. You may feel emotionally guarded, pulled between tears and sadness or anger and rage.
  • Shame is a painful feeling associated with faltering self-esteem, and a sense of inadequacy, defectiveness and helplessness.
  • Anguish, self-doubt, and chronic sadness converge as couples come to think of themselves as failing, not only in realizing their own dream to reproduce and nurture, but failing their spouse, parents, and siblings as well.

What Causes Infertility-Related Depression?

Infertility is a very stressful and emotional condition, having a strong impact on your sex life, relationship, sense of self-worth, and daily life. In the midst of testing and treatments, infertility may literally feel like it has become your entire life, as you go to and from doctor appointments.  All of this stress can potentially contribute to the development of depression.

Depression is more common with persons who have a family history of depression, who experienced depression before their fertility struggles, or those who lack a support network.  Infertility can frequently cause feelings of shame and embarrassment, which may make it more difficult to talk to friends and family about your struggles. This isolation makes depression more likely.  Nurture Health offers a confidential, independent counselling service to all our clients.

Not achieving pregnancy, or failing to have children through adoption or other means, does not mean you’ll feel depressed the rest of your life. It is possible to find happiness in life again. However, if depression has taken hold, it’s unlikely to resolve on its own.

Researchers have found that after failed IVF, certain couples were still grieving up to three years later. Counseling can help you get through the grieving process and take back your life after infertility.

What Is the Difference Between Depression and Regular Sadness?

It’s completely normal to feel sadness when dealing with infertility. You may get hit with the blues when your period comes, when a fertility test comes back with bad news, when treatments fail, or upon diagnosis of infertility. You may also feel sadness when reminded of your fertility struggles, like when someone close to you gets pregnant or has a baby.

One difference between sadness and depression is sadness lifts after some time, while depression lingers, it involves other symptoms, and interferes with your life. How serious the depression is depends on how much it affects your daily life.

Signs of depression include:

  • Sadness that lasts for weeks or months.
  • Feelings of hopelessness and helplessness.
  • Frequent crying or tearing up.
  • Frequently irritated or intolerant of others around you, specifically people who you used to enjoy being around.
  • Lack of motivation, struggling to get work done at work or around the home.
  • Difficulty sleeping, either sleeping too much or unable to sleep well (insomnia).
  • Difficulty with eating, either overeating or experiencing low appetite.
  • Struggling with experiencing pleasure in life, including a low interest in sex.
  • Frequent feelings of anxiety or worry.
  • Thoughts of dying, self-harm, or suicide. (If you’re considering self harm or taking your own life, please get help immediately.)

If what you’re dealing with seems like “regular sadness” and not full blown depression, don’t let that stop you from seeking help. Many things that help those with depression, like counseling, support groups, and mind-body therapies, can also help with the infertility blues.

You are not alone and it really is okay to talk about it

If you are experiencing infertility and need someone to talk to please click here to see how to contact us. We share in your hopes of having a family and understand how difficult infertility is for a couple trying to conceive. Our professional counsellors are here to listen and offer support.