Last month, we discussed common fertility challenges and available treatments. This month, we’ll look at fertility from the client’s perspective. Many people are surprised to discover the many emotional ramifications of the fertility treatment experience. Below we will discuss some of the most commonly reported concerns and obstacles clients wish they could have anticipated.
Fertility testing and treatment can be a major source of stress, both individually and in the context of a relationship. One of the best things you can do before starting fertility treatments is find a skilled therapist. Although this may initially seem excessive or unnecessary, it is important to establish support early on and proactively address what can often become an overwhelming and draining experience.
Rachel Horne, a registered nurse, shares, “My wife and I started seeing a therapist once our fertility journey was complicated by recurrent miscarriage. Once we started, we wished we had been seeing her the entire time. It was nice to be able to talk about things in a different space and it helped us to stay connected through the journey.”
Jessie Strick, Horne’s partner, adds, “Therapy has also been very important for me as the non-carrying partner. My wife had to carry much of the burden of our losses and the pregnancy in ways that I could not begin to imagine, all the while [I was] suffering the losses on my own as well. I really can’t suggest therapy enough. It was paramount to our success.”
The path to parenthood can also serve as a reminder of one’s childhood and personal history, which may bring up feelings around identity, roles, loss, gender, and parenting ideals. Additionally, there may be unforeseen outcomes such significant medication side effects, recurrent pregnancy loss, or many months (or even years) of unsuccessful treatments. Lastly, existing relationships may feel burdened by a constant stream of fertility-related conversations and focus. Regardless of how long the eventual journey takes, having a trusted therapist who knows your story from the beginning can provide some much needed support and solace during these difficult moments.
Another common frustration among clients is the loss of bodily control and the perception of fertility challenges as a personal failure. “The lack of control over the outcome can be quite frustrating,” says Dr. Preston Sacks, a reproductive endocrinologist at Columbia Fertility Associates in Washington, DC. “In school, if you work harder, you get a better grade. In the workforce, if you work harder, you get a promotion. With fertility treatment, the outcome is not tied to how hard you work. It’s just unfair.”
One way to mitigate issues is to have thorough discussions with your fertility provider in order to establish realistic expectations about the time frame and possible outcomes. When individuals begin treatment without a clear understanding of the process, it can result in disappointment if expectations are don’t align with the limitations of medical intervention. Because fertility care is both an art and a science, the approach should be uniquely tailored to the individual’s physical and emotional needs. “It is just as important to know when not to intervene as it is to know when to intervene,” Dr. Sacks says.
The unfortunate reality is that access to fertility treatment may be hindered by inadequate or absent insurance coverage. The best thing to do is call your insurance company directly prior to making an appointment to determine whether they cover any fertility testing or treatment. If you make an appointment with a clinic, they can also check this for you after you’ve discussed options. After meeting with your fertility provider and determining what type of treatment might be best for you, it’s then helpful to sit down and figure out what is realistically in your budget. While few things related to fertility can be planned ahead, understanding your strategy for what you plan to do if you don’t achieve pregnancy in the first few months is something to consider.
Going through fertility treatment, as a patient or as a partner can greatly impact your feeling of sexuality and desire for intimacy. People often report that the process can feel like an all-consuming priority much to the detriment of the relationship.
Strick shares, “This was a challenge for us. I think the biggest part as a supportive partner is to ask what is needed or wanted, and to ask regularly. The need for touch can change day to day. Her body was going through so much, so it was important to have the ability to quickly adapt. It’s also important not to take these changes personally.”
Having ongoing and open dialogues with your partner(s) is essential for maintaining healthy communication during a emotionally-charged time.
Partners who are not genetically involved in fertility treatments also have unique emotional needs and perspectives that require acknowledgment and support. These non-carrying partners may express feeling disconnected from the process, especially if providers place the focus on the conceiving partner. Finding an LGBTQ-knowledgeable fertility provider who will honor and include the needs of the non-carrying partner can help reduce feelings of isolation.
Because the fertility and pregnancy process can be physically demanding, it can also be frustrating for partners to be unable to share any of the physical burden. However, non-carrying partners can still find many ways to provide emotional and logistical support that can be essential for the carrying partner’s well-being. It is important though, for non-carrying partners to also seek support and share their feelings with their partner, a therapist, or other trusted loved one.
Wherever you may be on the fertility journey, there are many wonderful resources available to support you and your partner(s). Here are a few listed below!
Signey Olson is a DC-based nurse practitioner and nurse-midwife whose work focuses on providing inclusive care to her queer community. She works primarily in GYN, fertility, and trans-affirming care at Columbia Fertility Associates in Washington, DC.
Did you miss part one? Check out Queer Fertility 101 for even more information on starting families.