12:03 20th November 2018 | Infertility
The psychological impact of infertility
He looks at his wife as the doctor explains the diagnosis - “Azoospermia”, He says, “IVF… “Surgical sperm collection”... “donor Sperm"... the words lost on him as he catches the look in his wife’s eye, it frightens him to the very core of his being - she will never see him the same way again, “Not a man, incomplete” he mutters to himself oblivious to the tears streaming down his wife’s face… trapped, alone.
Infertility can be a source of both psychological and emotional stress. The diagnosis of this condition as well as its treatment are factors that can profoundly affect the mental health of the infertile man or woman.
The experience of conceiving, nurturing and giving birth to one’s own child is a fundamental desire that is experienced by most women. The feeling of incompetence and helplessness experienced by infertile women can quickly lead down the road to mental disorders. This mindset and the focus on the woman as the responsible party of infertility ensures that mental disorders are more prevalent in women than in men.
How does infertility affect mental health?
Infertility and its emotional effects can threaten every aspect of an individual’s life—marriage, health, work and relationships which can lead to stigmatisation, reduced quality of life, reduced intimacy, fear of divorce and separation. Many also experience depression, and other psychological disorders like anxiety, somatisation and sexual disorders. Some people have been led to substance abuse (with its attendant effects) and in worse case scenarios suicidal tendencies.
At the heart of all these challenges, there are a number of times where the very people who are meant to provide support for these couples, families and friends as well as their medical professional who should understand their struggles the most, are the ones who tend to be the least understanding of these challenges.
With the immense pressure faced by infertile men and women, they readily become exposed to fraudulent practices from both the formal and informal health sectors. At times, monies are exchanged from hand to hand and expectations are not met, or patients leave with iatrogenic injuries as a result of treatments received at inexperienced and poorly trained hands.
Even in experienced hands, some side effects of treatment can be so emotionally and physically taxing which can lead to increased work absence with sufferers not being able to share the source of their pain or health problems with their colleagues; this only leads to more withdrawal and risk to their mental health.
The importance placed on childbearing can contribute to the enormous weight that infertile couples have to grapple with in their daily lives. The active rejection of adoption in some societies, as well as traditional barriers, has also put a stumbling block in the way of many couples who would hitherto have been satisfied with adoption.
Available Treatment options
Medical science seems to have some answers, and the field of infertility treatment has grown in recent years with highly specialised treatments that are able to help these couples where no solutions would have existed before. This leaves those that cannot benefit from this to wonder - why me? Is there something unique about my problem that others do not have?
Cost of treatments
With the advanced technologies and extensive research involved in the care and treatment of infertile couples, it can only be imagined that there would be enormous costs involved in infertility treatments. In order to achieve pregnancy, couples invest huge financial resources into the procedures, and the devastating effect of negative pregnancy outcomes can quickly become multiplied in the looming face of bankruptcy and extreme financial indebtedness.
The aftermath of treatments
One may erroneously believe that once a woman gets pregnant, the need for emotional support immediately ceases. While it definitely presents a breather to the couple and the treating physician, the aftermath of pregnancy, its peculiar health challenges and delivery of the baby, presents its own unique set of challenges. Take the case of a donor cycle where either one or both of the gametes involved in treatment are of donor origin, the continuing fear of rejection of the child by the affected partner is an ever-looming presence in the home where not only the mental health of the couple is at risk, but also the health of the child who has possibly come into an emotionally charged home, not of his own making.
In the treatment of infertility, it is sometimes easy to feel that the healthcare team involved do not have some emotional connection to the process - from the intense hours and labour invested by doctors, nurses, embryologists, counsellors and the rest of the team, a season of unsuccessful treatments can quickly lead to burnout and emotional wear on the medical team involved. It is important that their psychological health is not left out in this discourse.
In the management of infertility as with any other health condition, the biopsychosocial approach must be employed in managing the reproductive health needs of the patient who needs to be considered as a whole.
It is imperative that any fertility treatment program is incomplete without effective emotional management and proper ethical consideration in order to manage the psychosocial effects of infertility before, during and after treatments.
By Dr. Adelopo Esther
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