Partners: Are You On the Same Page?

Infertility can really turn a relationship upside down. After the initial shock ("We can't get pregnant!") subsides, even the closest couples find that, after all, they are two individuals with their own ways of coping. Each person in a couple is responsible for their own coping. Not all coping mechanisms are productive or healthy. Control issues can quickly erupt if one partner believes the other isn't dealing with the problem in the "right" way.

One of the most important things a couple can do throughout the infertility experience is to consider the value of their shared goals. The unfortunate fact is that infertility and the travails of its treatment can bring some united couples to the point of disintegration.

It doesn't have to be that way. Gretchen Sewall, RN, LICSW, actually sees something positive coming from the struggle.

“For many couples, infertility requires a whole new level of commitment, compromise, and compassion,” says Sewall, who provides support services at Seattle Reproductive Medicine. “To me, this can be the silver lining of what could be a horrible journey. It can bring a couple to a whole new place and experience of deep love and devotion shared between two people."

Does your relationship need reviving? Find out what the experts say are red flags...

We Both Want a Baby -- Of Course, We're United!

How many couples wind up disjointed over infertility issues? At some point -- most!

Paula Acker, LCSW, who has counseled men, women, and couples for nearly two decades, says it's very common for couples to be in different places while going through infertility. The reasons are as varied as the individuals.

Acker explains, “Some couples are influenced by ethical issues, religious beliefs, spiritual beliefs, financial circumstances, and family pressures in deciding what avenues to pursue for treatment.”

For some, it seems as though gender differences present the biggest gap.

In her role as Third Party Reproduction Coordinator for Reproductive Endocrinology Associates of Charlotte (REACH) in North Carolina, Jeffress Kirkland, RN, sometimes sees a “red flag” in couples where the husband is ready to move faster into treatment than the wife is comfortable.

Kirkland explains, “Men are often into 'quick fixes' and especially when it’s a female infertility problem, as in the need for donor egg. The men sometimes just want to jump in and do it.”

Paula Acker, who sees the patients of Oregon Health & Science University Fertility Consultants, consoles, “Often husbands are overwhelmed with the emotional experience of their wives and want to get off the infertility treadmill more quickly -- it is so difficult to see their wives upset each and every month. It's a helpless feeling.”

Gretchen Sewall concurs that gender-based communication differences require thoughtful understanding on both sides. “For many women, they need to talk about their feelings and every step of the process -- a lot. Many men need to have time when they don't have to listen and be reminded of what they haven't been able to protect their wife from -- the pain of infertility. Both needs are valid and deserve to be honored.”

Take Time to Breathe – But Stay in Touch

Honest, conscious communication between partners is essential, not only toward your goal of a successful pregnancy, but to your marriage as a whole. That means that each of you must invest some time and energy in evaluating some facets of the infertility experience, then be willing to share even your most uncomfortable thoughts with each other.

Some common-sense tips to help you weather the storm include:

  • Early in your conception attempts, come to an agreement on a plan of action, whether it be aggressive treatment, no outside intervention at all, or somewhere in-between.
  • Discuss and review your plan of action at regular intervals, making changes as required to accomodate each others' changing desires.
  • Allow your partner their own limitations, and recognize yours. Openly discuss these with each other.
  • Use other relationships as an emotional sounding board. Do not rely solely on your marital partner to meet your emotional needs. (Courtesy of How to Make a Family)

A easy tip to remember, says Sewall, is the “20 minute rule,” which she credits to Barbara Eck Menning, the founder of RESOLVE. “No matter how intense treatment is -- 20 minutes a day is probably enough time to talk about it, and then move on to other aspects of your lives."

What to Do When You Lose Track of Each Other

Having a shared goal doesn't mean that partners are always completely in sync with each other. Most couples do part ways from time to time, metaphorically speaking. A relationship that's optimally prepared to bring a child into the mix will include conscious understanding about these moments of varying opinion and desire, as well as active pursuit of reunion.

Gretchen Sewall comments on the transformational impact of this life challenge. "Infertility takes what's there and grows it. If a couple has a solid foundation, mutual respect and open communication, their relationship will only get better in the face of infertility. If, on the other hand, the couple has some problematic areas that haven't been addressed, the problems can easily become malignancies that have the potential to destroy things that were once good between them."

For some couples, the pressures of infertility and its treatment can wind up revealing a partner's truest desires – and occasionally, that's not a baby.

Pat Buetow, RN, donor egg nurse at REACH in North Carolina, has seen this story before...

“One husband kept dragging his feet in a donor situation,” Buetow remembers. “He kept setting appointments with me, telling me what he wanted, things that weren't a part of our protocol. He was clearly not on the same page as his wife.”

The nurse eventually expressed her concerns to the husband, that it seemed as though he wasn't ready to go through with treatment. “In the end, the man revealed to his wife that he didn't want to share her [with a child], that he valued their relationship as it was already, and he knew that would change if they had a baby.”

Reproductive medicine specialists are not just in the business of helping couples make babies -- they have a keen interest in building strong families for those children. That's why you'll find more than just physicians in your corner. Think of it as 'collaborative reproduction.'

In reproductive medicine, even the nursing staff is specially trained to assist patients in truly following their heart, and sometimes that means referring a couple to specialized counseling.

Jeffress Kirkland has seen couples who seem to be silently working at odds against each other. “I certainly recommend that they see the psychologist and work on the decision before they proceed.”

Pat Buetow uses her intuition and experience to guide couples when she hears wide differences in the individuals' needs and plans. She says, “When they're just not in sync, it's time to refer them.”

The social and emotional needs of patients are so important to fertility specialists that the American Society for Reproductive Medicine has sponsored a specialty society, the Mental Health Professional Group, for over 20 years now. The MHPG's multi-disciplinary membership works to provide services directly to patients and to foster more research and knowledge in how patients needs can be met.

Paula Acker explains how MHPG members can provide superior assistance to individuals and couples when their journey becomes overwhelming. “[Professional members of this group] are experienced in understanding the cycles of ups and downs and have learned specific techniques to help couples cope...”

She advises that the following feelings may be relieved with professional support: isolation, loneliness, depression, hopelessness, sleep disturbances, appetite changes, moodiness, anger, lack of joy, frustration, and inability to cope with day-to-day life.

You can find professionals who are members of the ASRM's Mental Health Professional Group through this online database:

http://www.asrm. org/search/asrm_mentalhealth/index.html

Many parents who went through infertility first will tell you that their struggles were worthwhile. That sentiment can be tough to keep in mind when you're still in the middle of it all. It may help to keep in mind that just as the children who follow their parents' fertility struggles are genuinely precious, so can be the relationship between you two, before and after all.