Infertility and its Impact on Mental Health

Maternal Mental Health: When we hear the phrase, we tend to restrict ourselves just to individuals who are going to, or have given birth. However, an extremely important aspect of Maternal Mental Health, and more specifically, Prenatal Maternal Mental Health, is how one’s mental health is affected when they are faced with the fact that they might be infertile. Hence, a dialogue about maternal mental health would be incomplete without understanding the implications that the inability to become pregnant might have on an individual’s mental health.

Infertility is defined as the inability to achieve a clinical pregnancy despite regular unprotected sexual intercourse for at least 12 months (WHO, 2013), with this lack of conception being caused by factors other than aspects like Postpartum Amenorrhoea. In case of a woman, being infertile can lead to some cognitive and psychological distress, which needs to be addressed. The psychological implications may span across guilt, that is often induced by how the same might “deprive” their partner of having a child (Hasanpoor-Azghdy, Masoumeh Simbar, Abouali Vedadhir, 2014). The experience of infertility may also be laden with a lot of embarrassment and humiliation, making the woman feel uncomfortable and distressed. Some studies have also established that women might feel anxious or scared due to the implications of infertility, and this may be coupled with concerns like stress, depression and grief, with the latter two being the most common (Covington, 2015). In some cases, women have also reported suicidal ideation caused by the inability to conceive. They might also be faced with feelings of loneliness and hopelessness, causing them to experience extreme psychological distress.

Infertility has also been found to lead to sexual dysfunction and concerns in the relationship with the partner. More often than not, couples view sex as a means to build an emotional connect. Experiencing infertility might cause both partners to associate sex with frustration and pain, which can cause further strain in the relationship. This can also lead to a drop in performance and a lack of interest or spontaneity in sex, as it could transition as a means of procreation rather than enjoyment.

The experience of infertility can also put a strain on the individual’s relationship with family and friends (Klock, 2011). This is often caused because one might isolate themselves from social situations due to the distress they experience. This can put the woman in a cycle of mental health concerns leading to strained social relationships, which further leads to increased psychological distress. Infertility often also leads to increased loss on the financial front, putting more stress and pressure on the individual (Klock, 2011). The experience of infertility is often also influenced by societal pressure and norms. It is not uncommon for women and couples to be discriminated against, or for them to be treated differently in social circles and groups. This can have a direct effect on the individual’s self-worth and confidence.

While some women do seek treatment for infertility, the process of treatment and therapy can be stressful in itself. Understanding the implications of alternative ways to conceive can result in certain levels of stress and shock. Women have also reported that feelings of failure associated with the inability to conceive or carry a child despite various techniques might culminate into a loss of self confidence and self esteem. While this process can be difficult, it can be combined with increased acceptance, along with social support and support from the partner.

However, as seen through this discussion, it is not uncommon for women to experience psychological distress through the experience of infertility. While the mental health of infertile women often goes unnoticed, it is important to acknowledge the grief and psychological distress that an individual might go through due to infertility. Infertility can be perceived as a loss, and just like the grief caused by other reasons, these feelings of grief experienced by the individual must be addressed, understood and processed. Individuals experiencing infertility can be supported from a social and community level. As mentioned earlier, social isolation and strain in relationships can be an offshoot of the concerns experienced during infertility, and it is integral that the social circles around the individual extend as much support to the individual and/or the couple while making them feel more comfortable. Lastly, if an individual who is experiencing infertility goes through mental health concerns, it is essential to normalise seeking help while reaching out to mental health professionals for the same. The mental health concerns caused by infertility can be addressed through therapy in order to help the individual cope with their concerns in an adaptive manner.

References

1. Covington SN, ed. Fertility Counseling: Clinical Guide and Case Studies. Cambridge, England: Cambridge University Press; 2015.

2. Hasanpoor-Azghdy, S. B., Simbar, M., & Vedadhir, A. (2014). The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study. Iranian journal of reproductive medicine, 12(2), 131–138.

3. Klock, S, Glob. libr. women's med., (ISSN: 1756-2228) 2011; DOI 10.3843/GLOWM.10413

4. Ezzell, W., North Carolina Medical Journal Nov 2016, 77 (6) 427-428; DOI: 10.18043/ncm.77.6.427

5. Cedars-Sinai Staff. (n.d.). Infertility and mental health. Retrieved February 13, 2021, from https://www.cedars-sinai.org/blog/infertility-mental-health.html

6. "WHO | Infertility". Who.int. 19 March 2013. Retrieved 17 June 2013.