Couples Navigating Infertility

Just recently, on my way home from my private practice, I stopped by a doctor’s office to thank
them for their recent referrals. On my way in, I picked up a mask by their front desk and put it
on. As we all know by now, these medical masks have a particular smell. That’s when it all came
rushing back to me: The failed pregnancy tests, the IVF treatments, the continuous doctor’s visits
concerning our unborn child, and all the surgeries that my wife underwent after a very difficult
delivery for our second son. I took a deep breath, realized what was happening to me at that
moment, and then I was able to go into the office as normal.

I was experiencing a flashback, triggered by the smell of a hospital mask.

Navigating infertility can be traumatic and quietly upends our lives. After my wife and I underwent years of infertility and complicated pregnancies ourselves, I devoted much of my time and energy as a couple therapist and researcher on couples navigating infertility and reproductive loss. I’m here to tell you – infertility and reproductive loss is hard enough as it is, but it doesn’t have to destroy your relationship.

Infertility Can Be a Form of Trauma

Infertility is a form of reproductive trauma. This is a collective term, inclusive of all the forms of
deleterious and difficult circumstances that couples may find themselves in on their journey to
becoming parents. Recently, the CDC states that 1 in 5 couples in the United States experience
infertility – a drastically sharp increase from the “1 in 8” statistic that has become so infamous
over the years. In my recent study published in Psychological Trauma: Theory, Research,
Practice, and Policy, my colleagues and I found that individuals in our sample of women who
went through infertility and reproductive loss had a PTSD provisional diagnosis rate of 43%.
This is much, much higher than the 5% prevalence rate of PTSD in the general population.
That’s significant.

Disenfranchised Grief

One of the hardest parts about this statistic is that many couples navigating infertility may not
have a socially sanctioned way to express their trauma, or even recognize that they are
indeed feeling grief and trauma at all. Dr. Kenneth Doka calls this “disenfranchised grief”. Doka
defines disenfranchised grief as any grief associated with loss which may not be socially viewed
as a loss. For the individual experiencing disenfranchised grief, Doka says that “the constant
refrain is: ‘I don’t have a right to grieve’”.

For those of us navigating infertility, this disenfranchisement often comes through the
intellectualization of our pain. We’ve heard it before, right? The well-meaning advice, such as
“have you tried adoption?” or “just relax and it will happen!” leaves us feeling like we are crazy
– or, that we want to punch someone in the mouth.

Keep in mind, it is okay to give others a script for how to support us. For many of us going
through infertility, we have to coach others in giving us empathy. Saying things such as “I
appreciate your advice and positivity, but goodness, I just need someone to listen and recognize
my grief” can work wonders.

Being in the Boat with Your Partner

Getting this emotional support from those in our social circles during infertility is absolutely
crucial. But it is even more crucial to get this support from our partner. My wife and I published our story of navigating infertility in the Journal of Couple and Relationship Therapy, where we dissected our relationship in the hopes of helping other couples avoid our relational mistakes or mimic how we supported each other. In this writing, I described my own experience of infertility as being alone in a tiny boat during a massive storm in the middle of the ocean. I feel alone, lost, and scared that these huge waves are going to overtake me. But then, I turn to the back of the boat, and I see that my wife is there with me.
It is so incredibly important to remember that your partner is grieving too, and that you can
grieve alongside your partner. In my experience, though, I have seen many individuals turn to
their partner during the storm of infertility and others abandon ship.

Going from ‘What the Hell Was That?’ To, ‘What Was That?’

One of the biggest things that leads to us metaphorically abandon ship is mismatched grieving. In
other words, one partner is at one stage of grieving (or maybe, not grieving at all) and the other
partner is at another stage. One partner may be experiencing really, really intense emotions
rooted in trauma, while the other is “just trying to stay positive”. This mismatched grieving can
cause disenfranchised grief even in the couple relationship. Suddenly, when there is a big
emotional reaction rooted in infertility or reproductive grief, the other partner may react with
“what the hell was that?!”, we become emotionally flooded, and then there is unproductive
conflict. Or, maybe, one partner intellectualizes the emotion by trying to find the silver lining
(such as “we still have another transfer we can try”, or “the doctor is hopeful that IVF will
work”).

As a couple therapist working with couples navigating infertility, I spend a lot of time working
with couples on changing the “what the hell was that?!” to a “what was that?”. When we can just
have a stance of curiosity with our partner, be present in the moment, and recognize that they are
experiencing grief and trauma, we can have more space to simply listen, be empathic, and be
supportive.

A part of this process is recognizing that intense emotions in our partner might bring us anxiety.
We might see that our partner is really grieving or is being retraumatized in their infertility
experience, and this makes us incredibly tense. It can even make us emotionally flooded. It is
extremely important to remember that you cannot fix the trauma in your partner – but you can
support them. When you see a big emotion in your partner, remember to:

– Take a deep breath
– Stay curious
– Name their emotion
– Just listen – don’t give advice or try to keep it positive

Self-soothing is incredibly important here. Sometimes, I tell partners to picture their anxiety in
that moment as a cloud, and just take a second to watch that cloud go by in their mind. Once we
take just a second to say goodbye to the cloud, we can just be present with our partner and
support them emotionally.

Supporting Each Other During Infertility Is Worth It

Infertility is hard enough as it is – it does not have to destroy our relationships. It can be so
powerful to simply recognize that our grief is mismatched, and that is okay. When this happens,
we can turn towards our partner in their bids for emotional support, sooth ourselves when we are
flooded, and join one another in grief. When you can do this with your partner, you might
recognize that they are in the boat with you.