We are growing in a society where having children is expected or treated as a necessity. When reproduction is not met it is like the person who experiences this situation has an added burden in his/hers shoulder that of social pressures of their environment and alongside guilt and other feelings. Even though the concepts of femininity, masculinity and sexual ability are distinct, they are usually confounded with maternity and paternity and this confusion makes the process harder to handle.

As referred by the French psychoanalyst Delaisi de Parseval, the desire of having a child might be conceptualized by people as an offer to their parents or humanity, mankind or as patriotic duty. This desire includes even unconscious attitudes and fantasies not only of the couple but of their parents’ (Chatel, 1993). When all the above are active and moved by the reproduction challenge, then women and men feel a different degree and quality of impact of this process in their lives.

The doctor, donor and other ethical and philosophical issues are impicated, addressed and make the psychological state of the people involved more complex. Feelings of shame, weakness and guilt are often still remaining long after the birth of the child. Parents also find it difficult to have a second one while carrying inside them previous losses. While infertility is usually treated as a solely medical matter, the psychological dimensions of it are frequently neglected as other issues more apparent seek medical care. Nevertheless the ways that couples use to express their sorrow qualitatively differ and when this dissimilarity is not understood or respected by both of them but a behavioral resemblance is expected, it is possible for further tensions to be caused between the couple (Peterson, Newton, Rosen & Skaggs, 2006).

For many women the reproductive challenges they face are occasionally translated into a threat to their female identity. In a parallel manner there might emerge a degraded sense of self value not only because her body does not respond but because her confidence is also disturbed (Greil, 1991). Moreover it is likely to feel guilty and encounter the reproduction challenge as a punishment for previous sexual preferences or abortions. As a counterbalance they might get so target oriented to make the conception succeed that they set this as the utter goal of their life and possible career pursuits or personal hobbies and relationships only come second (Domar & Seibel, 1997). While this was more evident in previous years it is still present in some cases. Research findings show that the infertility experience is also affecting the pregnancy with mothers to be feeling agony, mistrust and not so positive feelings of euphoria as usually expressed by pregnant women. It seems that the previous unpleasant experience affects the way that future mothers were thinking and feeling about the baby that was so hard to conceive. There are described five possible states that a woman who had come into contact with such a difficulty might feel: fear of miscarriage, fear of having an unhealthy child, difficulty in accepting the identity of a pregnant woman of that of a infertile one, confusion and fear of a high risk pregnancy (Glazer, 1993).

Men are also affected by the infertility challenges in a different way though, but their experiences are not equally represented in the bibliography. It seems like they feel a wound in their confidence regarding their perceived social role and might feel responsible for the current situation that the couple has to face. It is very common for them to increase their working hours and other activities. Nevertheless they are more optimistic and goal oriented but less likely than women to resort to social support systems (Jordan & Revenson, 1999). While trying to obey to masculinity norms, many tend to suppress their feelings believing that in this way they become more supportive to their women
(Berg & Wilson, 1991).

Every failed try is often experience from both sides as a loss of a baby and sometimes is followed by a new try with a new hope as a way to quickly erase this loss. Delaisi & Verdier names this constant and repetitive try as the ‘’at all cost’’ syndrome leaving the emotional, physical and financial burden that accompanies this try as unmet. Some couples appear obsessive ideas, decrease of sexual desire, depressive symptoms as anxiety, insomnia, anorexia/bulimia, feelings of helplessness as an aftermath of the previous pursuit. Others create space for grief and loss, deal with the process and some may even set their priorities at a different hierarchy.

A theory created by the Belgian psychoanalyst Luc Roegiers mentions that possibly a number of people trying to have a child either through adoption or IVF has experienced some injustices in their childhood like a parent loss or abandonment which they are trying unconsciously to resolve through the childhood of their descendants. Clearly the above notion is not applicable everywhere but it is useful for someone to see clearly the parts that create pressure for having a child.

The burden that this process holds might be more controllable through psychological support and a broadening and understanding of aspects that are triggered by infertility which have implications in the current psychosocial state of living. Many times alongside with the above processes there might emerge some control issues, old psychological traumas, child disappointments and other things which are affecting the emotional state of a person. Moreover in psychotherapy there can be faced the social, emotional and ethical extensions of the various medical services used like for example thoughts about the future of the cryopreserved embryos in case a pregnancy is succeed. The doctor can only discuss the medical implications of this process but her/his role is not to cover this matter from every possible aspect. It is clear that it is important in this case for the person to explore the possible consequences of a destruction of an embryo or a donation for the individual, child, family, society so that there might be an insight and the belief that there has been a responsible choice.

The emotional support is not only met though experts but also involves the support system of every person’s family, other support groups or hobbies that one can find consolation. When people are thinking to ask for a therapist’s help but avoid it usually this happens either because they believe that they themselves can deal with the problems either because they are not sure about how they can recieve that help (Boivin et al., 1999). Some researchers claim that the couples or people dealing with infertility issues are one of the most neglected and silent minorities of our time (Domar & Seibel, 1997).

Do you feel that you are getting enough support?

Nikopoulou Maria
Mental health councelor
Trained in Gestalt psychotherapy