Cassie Destino, Fertility Doula and Founder of IVF Support UAE
The other day my husband and I were in the car after dropping the kids off at school and we got to talking about how our lives would be different if we had made other choices. What if we had stayed in Abu Dhabi instead of moving up to Dubai in 2016? What if he had stayed with the company he used to be with that didn’t make him happy? And the big one: what if our fertility treatment hadn’t worked and we never had kids? My husband asked me if I thought we would still be together and I realized that I actually had no idea.
Fertility treatment can be brutal on a relationship. For starters, all the spontaneity of lovemaking goes immediately out the window. Often a couple has been trying to get pregnant on their own for a while before starting their fertility treatment so they may already be used to that. There is a grief to knowing that the “old fashioned” way will not result in a pregnancy, and it can really change the way each partner thinks about intimacy. Especially when you may have spent a great deal of effort when you were younger trying to ensure that you don’t get pregnant. Knowing that won’t be the way you will conceive can be upsetting. It isn’t surprising to know that studies show that men in infertile couples tend to experience less intimate satisfaction. While women are less satisfied in their entire marriages. The pressure of trying to conceive - something that is so tied up with intimicay, can be a huge burden to overcome for couples. Many couples report that even years after the conclusion of their fertility journey that intimicay no longer has the same joy that it used to.
Many women also experience a sense of guilt and shame if she is unable to become pregnant. Especially if the issue lies with her. She may feel that she is not “woman” enough for her partner and that she is letting him down. Depending on how her partner responds to her if and when she expresses these thoughts will have a huge impact on how the relationship proceeds. If there is family pressure to produce a grandchild or a cousin or in when someone has a partner who already has a child from a previous relationship that just adds to the pressure. I have written before about the decision to tell or not to tell about your fertility journey and when you choose not to share it widely all the support for the entire process lands on your partner’s shoulders. That is a very difficult position to be in. As if navigating infertility wasn’t stressful enough, now you and your partner may only have each other to talk to about it. Talk about pressure!
Sometimes making the decision to seek fertility treatment can be very divisive in a relationship. For many people the idea of an IVF is what I always referred to as the “nuclear option.” Even discussing calling a doctor can create a rift in a couple, especially if the issue isn’t age related. One of you may think you have plenty of time and that you should relax and just see what happens, while the other one feels anxious to move forward with treatment. And because IVF is so costly that can be even more difficult. One person may think that they shouldn’t be spending so much money until it is undeniable that treatment is needed while the other one feels that they are there already. As a reminder, the guidelines are that if you have been trying to conceive for a year or more without success, or six months if you are over 35, then you should seek treatment. Also, anyone with symptoms or risk factors of infertility should speak to a doctor right away.
No discussion of the stresses of fertility treatment could be complete without addressing the financial strain of IVF. Because they are so very expensive and do not have any guarantee of success it can be difficult to commit to the process for some. And when you factor in that it takes an average of 3 IVFs to bring home a baby, that strain becomes even more significant. Having a clear understanding of your specific situation and how fertility treatment can and cannot help you is vital. Most doctors are good at evaluating your chances and communicating that to you but it’s really important that you always ask questions about what your personal likelihood of success is. Having a clear idea of what you and your partner are able to commit to financially can help to relieve a lot of stress. You may decide to take out a loan or use a credit card to fund your treatment and having discussions about that may be uncomfortable but they will benefit you if you can both get onto the same page.
When I was having my IVF treatments I was very clear with my husband that I wanted to keep going until we had a baby and he very fortunately agreed. We decided before our first IVF that we would commit to 3 IVFs without discussion. If the first one failed, we moved on to the second. If that one didn’t work, we did a third. If the third one was also a failure then we would sit down together and revisit our decision. We were very fortunate that our twins were born from our third IVF, so we didn’t get to that point, but the relief of knowing after each failed cycle we were going to proceed directly to the next one was profound for me. But we were lucky that we agreed. That is not the case for everyone.
In my practice I have supported couples with very different approaches to their infertility. What I often see is a woman very motivated to do whatever it takes to become a mother and is willing to go through significant pain and discomfort to achieve that, and a man who really hates watching his partner suffer so much and just wants it to stop even if that means not having a baby. This can be so damaging to a relationship if these two cannot find a way to communicate to each other about what each one really needs from the other. If a couple stops treatment because one or the other one didn’t want to do it anymore it can cause serious resentment issues later on in the relationship. I am certainly not a marriage counselor but I highly recommend that a couple seek professional support if they see that they are facing these issues.
There is an anxiety that I hear again and again in my support work: what is fertility treatment changes my marriage? To that I always say that of course it will change your marriage. Just like choosing which city to live in does. Just like getting a new job does. Just like being sick or injured, living through a global pandemic together, losing a parent, getting a new puppy, deciding on a new car, and hopefully, becoming parents together. All of these things change a marriage. Not changing should never be the goal. Life is about growing and changing. Don’t fear it. Instead, focus on how it can bring you closer and make you stronger. It’s old hat but the key is communication communication communication. How can your partner know what’s in your heart and on your mind if you cannot find a way to communicate it to them? My fondest hope for all the people I support is that they go on to become parents and this struggle to get there becomes only a part of the beginning of that adventure. The way you handle this part of it says a lot about the kinds of parents you will be.
I’ll never know for sure how our infertility journey affected my own marriage because there are just so many variables that I can never fully understand. We learned that we could be tested and broken hearted and still find comfort and solace in each other. We found ways to laugh even when we felt like crying. You’ll never really know the destination of the road you didn’t travel down but I think we managed to navigate just fine.
If you need external support, find it! It is always worth putting in an effort to make things easier on you in the long run. The Lighthouse Arabia are an excellent place to start if you are looking for mental health support. If I can help you please reach out to me. Together we can get you the support you need.