Emotional health while trying to conceive

Trying for a baby, and going through fertility tests or treatment, can affect your feelings, your relationship and your daily life. The World Health Organization notes that infertility can bring emotional stress, anxiety, depression and low self-esteem. These feelings are common, and support is available.

Why trying to conceive can feel so hard

Infertility is common. The WHO estimates that about one in six people of reproductive age experience it at some point in their lives. Even so, many people feel alone, because fertility is rarely talked about openly.

• Monthly cycles of hope and disappointment
• Pressure or questions from family and friends
• Frequent appointments, injections and time away from work
• Worry about cost, results and the future
• Feelings of guilt, blame or low self-esteem

Your feelings are not a sign of weakness. They are a normal response to a stressful experience.

Emotions during a treatment cycle

The ESHRE patient guide explains that most people go through changing emotions during a treatment cycle. Knowing what to expect can make these feelings less frightening.

Treatment can also affect work. ESHRE reports that about 6 in 10 people miss some work during an IVF cycle. It can help to plan ahead and ask your clinic what to expect.

When it affects your relationship

Infertility can strain your relationship and your sex life, especially when sex starts to feel scheduled. ESHRE notes that men and women often experience infertility differently: women may report more stress before treatment, while men may stay quiet to support their partner but feel isolated.

Gentle ways to cope

1. Get clear informationAsk for written information about each procedure. ESHRE notes that preparation can reduce anxiety.
2. Ask questionsNo question is too small. Understanding your options helps you feel more in control.
3. Lean on your support circleShare with people you trust, and choose how much you want to tell others.
4. Look after your bodyRegular sleep, meals and gentle activity can help you manage stress day to day.
5. Ask for professional supportA counsellor or psychologist can help, before, during or after treatment.

ASRM explains that it is not clear whether stress affects the chance of conceiving. So please do not blame yourself for feeling stressed. Better coping is still worth it, because it can help you feel more in control and improve your wellbeing.

• Walking, yoga or other aerobic exercise
• Meditation, mindfulness or guided imagery
• Progressive muscle relaxation
• Journaling your thoughts and feelings
• Talking therapy, such as cognitive behavioural therapy
• Support or education groups with others going through treatment

At DBN, you are always welcome to tell your doctor how you are feeling. Your emotional wellbeing is part of your care.

How family and friends can help

Well-meant advice can hurt. ASRM notes that telling someone to relax or be less stressed can make them feel blamed, and may add to their stress. Simply being there to listen is often the most helpful thing.

When to seek counselling or mental-health help

ESHRE recommends that clinics offer people a chance to have their emotional needs checked, and refer those who need it to infertility counselling or psychotherapy. Consider asking for help if:

• Sadness or worry lasts most days and does not ease
• You find it hard to work, sleep or enjoy things
• Your relationship is under serious strain
• You are facing hard decisions, such as stopping treatment
• You are coping after a loss or an unsuccessful cycle
• You feel guilty or worthless most of the time
• You are pulling away from friends or things you used to enjoy
• Your sleep or appetite has changed, or you are drinking more

Help can come from a psychologist, psychiatrist, counsellor, social worker or family therapist, and from support groups that ease the sense of being alone. ASRM suggests asking your doctor for a referral to someone experienced in fertility issues.

Ending treatment is also a time when support matters. Whether you become pregnant or decide to stop, ESHRE suggests booking a talk with your doctor. You may have worries about the pregnancy, questions about other options, or feelings about a future without children.

If you feel unsafe or have thoughts of harming yourself, get help now. Go to the nearest hospital emergency department, or in Thailand call the Department of Mental Health hotline 1323, which is free, confidential and open 24 hours. Tell someone you trust and try not to be alone.

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