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According to a study published in the European Journal of Reproductive Medicine, wishing and hoping for a child is strongly associated with a woman’s long-term mental health.

Approximately a third of women going through fertility treatment do not achieve parenthood [through treatment]. This recent study associates less favorable mental health in women who continue to long for a child but who remain without children.

A survey was given to the women in the study. Over 16,000 women from 12 IVF facilities (from 1995-2000) in the Netherlands were invited to participate in the study. Just over 7,000 women provided psychological data. The average age of these women was 47. The average age upon entering into fertility treatment was 30.  Fifty-one percent of the women did IUI and 85% IVF/ICSI. Ninety per cent were married or living with a partner. 20.9% remained childless and 5.9% continued to wish for a child.

Male factor infertility and/or infertility of unknown origin or cause were associated with better mental health outcomes. This may be because the thinking of these women is that they did not cause the infertility. Beginning treatment at an older age was also associated with better mental health. Wishing for a child was associated with worse mental health but the worst mental health associations were with women who wished for a child but had no children.

A large portion (15.9%) of the participants considered the questionnaire to be too confrontational or it elicited painful memories. This may lead one to wonder if the numbers associated with worse mental health might be larger than reflected.

It is not clear from the study whether remaining without children is the cause or if other factors also play a role in this association of less favorable mental health. Other factors to consider are:

• Diagnosis
• Treatment related factors (cause of infertility, age related problems, length and number of treatments and type of treatment) and
• The ability to resolve to live child-free

INCIID Insights

Clinic staff can play an important role beyond just medical treatment. Clinics need to provide a nurturing supportive environment. Training staff in all aspects of grief, loss and trauma would be helpful. So when selecting a clinic – ask about support and pay attention to the environment when shopping for a clinic.

Couples undergoing treatment should have long and short term goals and a plan that includes how much treatment they will undergo before stopping. They should think about how far they should go; IUI’s (how many), IVF’s (how many cycles), will they use donor processes or surrogacy?  At what point do we stop treatment? How much will we spend? How will we finance the treatment? Do we want to live child-free if treatment is not successful? Do we want to adopt? Should we consider putting some money away in case we adopt? These considerations should be discussed and figured out BEFORE setting foot into a clinic to start treatment.

Couples undergoing fertility are often caught up in the excitement and anxiety of treatment and need to be prepared for the fact that more than 20% will not succeed meaning a live birth.

Support while in treatment is important. There are support groups and  therapy groups as well as individual therapy. There are many virtual support groups and forums online.

Fertility treatment can be traumatic. Others in the “fertile world” often don’t understand this trauma and as a result it is “not validated” – making women doubt their self-worth,  and left feeling shamed. It is important to take care of yourself while going through treatment. Success can be yours if you figure out what “success” means for you and your partner. Coming out on the other end of fertility treatment with a healthy mental attitude should be considered a success whether or not you have a child from treatment or resolve your infertility with a child-free lifestyle. Meeting your goals is success – even if you have to adjust those goals. 

And look for a clinic that treats the whole patient – body-mind-and spirit.

Some suggestions for taking care of yourself:

• Consider individual or group therapy
• Yoga
• Exercise; swimming, tennis, running, outdoor activities
• Find friends who understand and who you can confide in
• Acupuncture
• Avoid alcohol and drugs
• Get plenty of sleep
• Stay hydrated
• Get in touch with nature
• If you like animals – use them as therapy animals
• Spend time with positive people
• Practice visual imagery and relaxation