Infertility is typically characterized as being unable to get pregnant after a year of trying – and for many women this diagnosis can be devastating. And these issues are common. About 12% of women, have trouble conceiving or carrying a baby to term, according to the CDC. A woman under the age of 35, has a 48% chance of getting pregnant and a woman between the ages of 35 and 37 has a 39% chance according to the Society for Assisted Reproductive Technology.

In response, the CDC estimates 11% of women in the U.S. have sought infertility treatments. Women often turn to infertility treatments, which, while one of the marvels of modern medicine, can be emotionally taxing, incredibly expensive, and require an infusion of hormones that can further mess with your moods. And if you are not having success with the treatments, this can put intense stress on a relationship.

In response, the CDC estimates 11% of women in the U.S. have sought infertility treatments.

“You are in a vulnerable psychological state and in the beginning, you need to be aware of that for yourself,” says Dr. Grill a New York based therapist who has counseled individuals with fertility issues for more than 20 years. “As you are trying to get pregnant, every month that you don’t, it can be a real disappointment.”

Read on as Dr. Grill shared the coping strategies she thinks are particularly helpful for couples dealing with fertility issues.

Recognize that dealing with infertility issues can be very hard
Women often have deep-seeded feelings about having children. And if we decide we want them, it can often be very upsetting, when it doesn’t work. It can helpful for partners to recognize this in advance. “This is a very difficult time emotionally and you will be pulled in every direction because there is the high of the treatment, then there is the waiting period, and then there is the devastation if it doesn’t work,” Dr. Grill says. “So, I recommend people go into this knowing it is going to be hard.”

Understand that your sex life will become medicalized
When you undergo infertility treatments you are often handing your body over to doctors for a period of time. This can mean having sex on a schedule, which can reduce romance and lead to performance anxiety for men. Women often have to be the drivers of this sex schedule, which can put added stress on the relationship. “Instead of your partner or your husband as the one you are conceiving with, eventually it may only [be you and] the doctors,” Dr. Grill says. “And your husband will go and produce his sample in another room, and then you’ll receive the sample from him, and it really does have an effect on the relationship.”

Be educated about how hormones might affect you
Often during IVF treatments, patients are loaded up with a ton of hormones. And if you are someone who is already sensitive to hormones this can really affect your mood and emotions. Dr. Grill recommends you be aware of this, and talk to your doctor in advance about the hormones you will be taking and what impacts they might have on your mental and physical health. “Women are often on drugs and hormones that can really affect you physically, and make you feel crappy,” Dr. Grill says. “And sometimes doctors don’t always tell people this in advance.”

Be open with your partner
The emotional stress of fertility issues can have a direct effect on a relationship, and Dr. Grill encourages partners to talk honestly through their own feelings, vulnerabilities, and frustrations. “What used to be fun and romantic often feels like a job,” Dr. Grill says. “And it is all filled with stress. Every month that a couple doesn’t get pregnant it can produce a round of depression and they both feel like failures. The more that couples can talk about this the better.”

Think through all the possible outcomes
As upsetting as it is to face infertility, imagining how you would handle not being able to get pregnant can be helpful for reducing fear. “It really can become an obsessive quest,” Dr. Grill says. “Women just put their bodies through so much and they just spend so much money. And there is something to be said for asking yourself, how much more do I want to put myself through? Would I be ok with the idea of adoption? How about surrogacy? What would my life be like? Could I consider the idea of adoption? What would my life be like without a child? What does that mean to me?”

Find an outlet to discuss your feelings
Often the desire to have children can be connected with our own psychology, Dr. Grill says, and she has found that it can be very helpful to understand why someone really wants to have children. “You want to untangle your pathology from the desire to get pregnant,” she says. “You can really get caught up in ideas like, ‘If I have a baby then I can fix my own relationship with my mother,’ or the only way I can feel worthwhile as a human being is if I have a child.” But she has found that if you find a safe place to unpack there is often less fear associated with the outcome, whatever it turns out to be.

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