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Married couples as well as those in a longer term relationship desiring to have children and build families often view the process of conceiving, pregnancy, and delivery as a joyous time. However, for couples with problems conceiving and delivering a child this time in a couple’s relationship can be extremely frustrating, overwhelming, scary, and depressing.

For those unable to conceive the stress of trying to conceive a baby and pregnancy can affect both the woman’s mental health as well as the health and quality of the relationship. When a couple is unable to conceive or sustain a pregnancy there is often uncertainty and confusion surrounding the reasons why they cannot get pregnant or successfully deliver a child, i.e., who is to blame and or responsible for the inability to become parents.

Frequently the terms infertility and infertile are used synonymously, however, the terms are different and should be used exclusively to both describe and understand why childbirth cannot or has not occurred. Infertility describes a woman’s inability to get pregnant after one year of trying (or after trying for 6 months if a woman is 35 or older). Women that are able to successfully get pregnant but are unable to stay pregnant may also be infertile. Infertility affects approximately 10 to 15 percent of couples.

Extreme stress and the impact it has on mental health can have a significant effect on mental health, thereby affecting fertility. Couples with infertility issues not only face the challenges of getting pregnant and delivering a child but must explore and endure different treatments options to conceive and deliver. Treatment options available to those struggling to have a child are very costly and may not be covered by health insurance. Stress related to the inability to conceive and successfully deliver are child can be further exacerbated by failed attempts to conceive, multiple treatments, and expectations of when they should become pregnant or when they expect to deliver the child.

It comes as no surprise many couples who seek infertility treatment options are already overwhelmed, stressed, frustrated, and experience symptoms related to depression, escalating costs can make symptoms more pronounced. Failure to become conceive and deliver can also cause self-esteem issues for both parties. Women often feel inadequate or “less of a woman” when challenges arise pertaining to conceiving and baring children. Some women also define and measure their femininity by their ability to have children, so failure to have children can be a devastating blow to esteem and perceptions of self. Men also experience feelings of inadequacy, frustration, and low self-esteem when they are unable to successfully impregnate a woman.

Individual, couples, and fertility counseling may help those struggling with negative feelings associated with inability to conceive and deliver manage those feelings in a manner that does not compromise the existing relationship.

Tony and Nia

Tony and Nia have been married for 5 years. For the first 3 years of their marriage the couple decided to work and focus on their respective careers instead of planning and building a family. However, for the last 2 years after deciding they wanted to build upon their relationship, they decided they wanted to add a child to their relationship. Both Tony and Nia assumed they would get pregnant immediately once they stopped using birth control, but were surprised when they did not.

The couple continued to try unsuccessfully for more than a year, before they decided to seek outside help that would allow them to conceive. Although, the couple have continued to save throughout their brief marriage the costs of treatments have exhausted their savings, bringing them into debt. Mounting resentment is building between the couple, as Tony wishes to take a break from infertility treatment and Nia wishes to continue. The couple do not consider other parenting options, they both are fixed on what they think they should do for the relationship, both unwilling to compromise.

Are there other options the couple can take to become parents or should they halt treatment for a while and work on their marriage?