News & Resources

How to Deal with Unexplained Infertility

March 04, 2013
By Dr. Sejal Dharia Patel

A negative pregnancy test again. My aunt went into the bathroom and cried for six hours. After every IVF cycle, we all grieved her loss of implantation; we grieved over her social isolation, and her depressed spirit. There was no happiness, only hopefulness after the transfer until the first spot of blood or the negative pregnancy test and then back to the bathroom for more tears.

Infertility is depleting. It represents many losses, such as, the loss of fertility and reproductive ability, the loss of an embryo, the loss of a pregnancy with miscarriage, and/or the loss of a child and biological offspring with a stillborn or neonatal death. Thus, grief is a normal reaction. However, when the loss is of a potential, not an actual loss, the couple may not realize they are allowed to grieve. However, without the ability to grieve the impact on the patient and her partner can be grave: from social isolation, marital discord and ultimately depression.

Infertility and miscarriages evoke emotional losses that are overwhelming to patients but may be classified into four main phases: the initial phase (shock, surprise, denial); the reactive phase (frustration, anger, anxiety, guilt, grief, depression, isolation); the adaptive phase (acceptance) and a resolution phase (planning for future solutions).

As a patient undergoes the four main phases, influences of the event itself, the patient's personality, cultural factors and social support from close family and friends can all influence their grieving process and their ability to cope.

Coping mechanisms will vary from patient to patient, however a few tips to keep in mind that will help as your transition through your four phases include:

1. Do not blame yourself-Negative thinking patterns can only make matters worse. Remember that infertility is not your fault. Concentrate on your future.
2. Work as a team with your partner-Do not blame one another for the difficulty encountered.
3. Educate yourself-This will eliminate the unknown and the associated speculation.
4. Set limits on how long you are willing to try and decide on what you are willing to pay. This will help you and your provider create a customized plan for you that help you reach your goals.
5. Get support from professionals and others with infertility problems to help you through your infertility journey. Programs such as the Mind-Body Program through Alice Domar, PhD have been shown to improve outcomes.
6. Feel comfortable avoiding activities which are focused on pregnancy or births (i.e. baby showers).
7. Balance optimism and realism-Realize that infertility is a journey. For most there is success, however, for some there is not and one should be prepared.
8. Take care of yourself by pursuing other interests.

As you look to the community to help and support you, look for psychologists who have experience in infertility counseling. Take the time to look for support groups where you can relay your experiences, learn from others and create a support structure with those who understand. Finally look to books to help.

One resource is Alice Domar's book on Conquering Infertility, which provides some guidance on what they need most from stress relief, support and hope. Another great resource is "I never held you: Miscarriage, Grief, Healing and Recovery by Ellen Dubois and Dr. Linda Backman.

For my aunt, in her last IVF cycle, she conceived and nine months later, a beautiful baby girl. However, the crying, the guilt and the anger my aunt and I never forgot.

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