Coping With the Stress of Infertility: 5 Best Practices
March 12, 2015
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Sad Couple - infertilityPhoto Credit: Dragunsk

Infertility is a life crisis; an emotional, social, developmental, medical, ethical, and spiritual crisis. The medical definition is: “trying to conceive over a 12-month period without success.” These days, there are a higher percentage of people trying to conceive after age thirty-five. Thirty-five is when fertility starts to make a marked decline in women. Secondary infertility is defined as, “the inability to become pregnant, or to carry a pregnancy to term, following the birth of one or more biological children. The birth of the first child does not involve any assisted reproductive technologies or fertility medications.”

Psychological research shows that a diagnosis of infertility is as stressful as a diagnosis of cancer. People struggle, often quietly for years, with depression and anxiety due to their prolonged state of infertility. This leads to social isolation, which further exacerbates existing anxiety and depression. Because infertility is invisible, it can become a secret, which can lead to feelings of shame, guilt and personal failure.

The social aspect is often debilitating. Co-workers, friends, and relatives are pregnant, sending birth announcements and celebrating. Baby showers, children’s birthday parties and Facebook posts can be painful reminders of being left behind. This creates a social “in” and “out” group. These situations create a hyper-vigilant state of urgency around trying to catch up with peers and a desperate feeling that time is running out. Then there are the well-intentioned, yet typically uninformed questions, from those who want to be supportive but miss the mark.

What follows are my “best practices” in coping with the stress of infertility:

1.) Do Your Homework. Initially, you may be overwhelmed with fear and disbelief. Try to stay calm so you can gather information about your options. If you have knowledge, it is power and it can settle down the feelings of uncertainty about your future. Review websites such as www.resolve.org and www.asrm.org since they are full of resources and factual data. Avoid infertility chat rooms. They are guaranteed to make you feel miserable and confused. If you haven’t already, make an appointment with a reproductive endocrinologist at a fertility clinic.

2.) Feel Your Feelings. You will experience feelings akin to death and dying. Denial, “this isn’t happening to me!” Bargaining, “if only I’d… or, if only I hadn’t.” Grief, “I am incredibly sad, I cry all the time.” Anger, “I am so angry! Why is this happening to me?!” Acceptance, “I am accepting that this is my journey, I will get through this one way or another.” This cycle does not progress in a linear fashion. You can wake up one morning angry and be in denial the next. This is a normal response to loss and infertility is a big loss. You might not be able to have a child the way other people do. Your vision of the surprise moment when you tell your partner you’re pregnant, seems like a shattered dream. Other common emotions include envy, fear, guilt, shame, and confusion. Don’t stuff your feelings down. Talk to your partner, friends and family. Write in a journal. Seek professional help with a counselor who specializes in infertility counseling.

3.) Focus On Self Care. It is extremely important to take extra good care of yourself during this stressful time. Eating a healthy diet will optimize your conditions for getting pregnant. Stay clear of processed foods and restaurants. Say goodbye to sugar, alcohol, dairy, caffeine and white flour for now. These foods cause inflammation in the body. Inflammation is the enemy of conception. Stay hydrated and get at least seven hours of sleep per night because sleep is incredibly healing. Engage in gentle exercise such as restorative yoga, walks, easy bike riding or swimming. Practicing deep breathing, meditation or prayer calms your central nervous system. See an acupuncturist who knows about infertility. Adopt a mindset of being in the moment. Don’t focus on regrets of the past or worries about the future. Repeat a soothing mantra such as “everything is going to be okay.” Give yourself a break and decline that invitation to another baby shower or birthday party.

4.) Stay Connected To Safe & Trusted People. Share your story with friends and family who have the ability to listen, show empathy and not make judgments. Most are uninformed about infertility. Don’t take on the burden of trying to educate them. That is not your job, especially when you are struggling. Gently guide them to infertility resources so they can take on some of the responsibility of learning. It’s okay to say, “I don’t want to talk about it right now or I’ll let you know when I need an ear.”

5.) Check In With Your Partner. Infertility is a couple’s problem and it can negatively impact your relationship. Unspoken resentment, feelings of inadequacy, and sexual pressure is not uncommon. Couples report increased conflict and decreased sexual relations due to invasive treatments and the impact of added hormones on mood stability. The financial strain takes its toll as well. Fertility treatments are costly with little to no insurance coverage provided.   Seek out counseling for even a few sessions with a counselor who is knowledgeable about infertility. Attending fertility support groups or fertility weekend workshops can also be a great support.

Infertility Resources: 

Resolve – The National Infertility Association
American Society for Reproductive Medicine
National Institute of Health – Infertility Topic Page

About this Contributor: Diane Cote is a psychotherapist specializing in reproductive health and mindfulness based psychotherapy, with offices in San Mateo and San Francisco, CA. She has been in private practice for over 15 years. Her treatment orientations include psychodynamic, mindfulness based cognitive-behavioral therapy, and yoga therapy, which includes meditation and working with the breath. She received her Masters degree in Clinical Social Work from Boston University.   She has completed post graduate training through the American Society for Reproductive Medicine on areas specific to infertility counseling and numerous issues related to reproductive health including ethical issues and mind body influences on fertility. She has studied at the Domar Center for Mind-Body Health, the Esalen Institute and the EMDR (Eye Movement Desensitization and Reprocessing) Institute. She is currently pursuing yoga teacher training and will be a certified yoga teacher in June, 2015. She will offer Yoga for Fertility retreats for women and couples with an emphasis on self-care and mindfulness based practices.   Diane has a twenty-five year yoga and mediation practice. For more information, please visit Diane’s website: http://dianecotelcsw.com.


  1. Thanks Diane, I think this is an overlooked topic.

    Personally, I haven’t got to that stage in my relationship but I can imagine that infertility would be pretty hard news to hear, regardless of gender…certainly a big life adjustment with a lot of changes in dreams and expectations.

    As far as thinking about this situation and problem-solving/coping related to it, it would personally make sense for couples of all sexual orientations to talk to same-sex couples who have children or want to have children. Same-sex couples are a minority compared to hetero couples, but after reading the article, I realized that each of them who wanted children have frankly faced the issue of infertility. Some stats on this I found with a quick search:
    http://www.lifelongadoptions.com/lgbt-adoption/lgbt-adoption-statistics
    Other thoughts?

    • Hi Clark,
      Thanks for your thoughtful reply. Yes, same-sex couples have actually opened up some of the very present social taboos related to 3rd party reproduction through the use of egg/sperm donors and the use of gestational carriers. Because they have too! Everyone knows it takes a sperm and an egg to make a baby. Hetero couples can keep how they got pregnant a “secret” if they so choose. The mental health community strongly recommends openness around the use of assisted reproductive technology. All children have a right to know how they were conceived and ideally, intended parents are thinking ahead and making sure their future adult children have access to their donor if they so choose. This is another piece of my work with couples when they move to 3rd party reproduction – always reminding them to think of the needs of any potential offspring.

  2. Thank you for this compassionate guidance and the window into the experience of infertility. These suggestions for coping are all the more poignant given what a silent struggle it is. I am going to educate myself more about this topic after having read your post.

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