Facing challenges when trying to expand your family is often the first major roadblock any couple, or individuals, face. The financial, emotional, and physical strain can put any relationship to the test.
Maintaining relationships throughout the family building journey can be difficult, whether it be with your partner, a family member, or a close friend.
We sat down with Dr. Alice Domar, Executive Director of the Domar Center for Mind/Body Health and the Director of Mind/Body Services at Boston IVF, to discuss the interactions between infertility and relationships. An expert in the field, Dr. Domar responds to frequently asked questions about relationships, boundaries, and strategies to check in on both yourself and your partner. For more of Dr. Domar’s advice, watch her discussion with Dr. Georgia Witkins here.
1. What tips do you have for patients when it comes to setting boundaries? What about tips for setting up the foundation for supportive communication across family and friends?
Setting boundaries is a personal decision. Some people are happy to speak freely about all aspects of their fertility journey and some don’t even share with their parents that they are trying. You need to decide what you are comfortable sharing and what you don’t want to discuss, and then think about how best to communicate this to others. I encourage my patients to think about the comments and questions which bother them, and to then memorize answers which feel comfortable. So, for example, your answers can be polite (“I am not comfortable discussing my personal life with you”), they can educate (“Infertility is in fact extremely common, and the cause is as likely to be male factor as female factor”). Or my favorite, the zinger (“I don’t understand why you feel it is ok to ask that question”).
In terms of family and friends, the positive side is that there is a decent chance they or someone they love has been through infertility or loss, and they might be able to offer more appropriate support. However, this might make them more comfortable giving unsolicited advice or making comments which might not be helpful. Many of my patients have emailed family and friends with their own preferences for communication. This might look like “when we have news to share, we will, but please don’t keep on asking if we are pregnant”.
2. How can I (the partner not struggling with infertility) help my partner through this process?
Ask your partner what he/she needs! And to be honest, if you are in a relationship and your partner is the one with the medical diagnosis, I would hope and guess that you are both struggling, but likely in different ways. One tactic I suggest is that each partner write down 10 things their partner can do for them when they are having a bad day and thus when that bad day comes, the ok partner is not floundering to think of what to do. They can look at the list and try #7 (bring me flowers) or #3 (let me veg out in front of the tv and bring me my favorite snack).
3. What are some good strategies I can use to check in on myself? Both as the person struggling and the person supporting the person going through treatment?
Pretty much everyone who is experiencing infertility is going to have bad days. It is a roller coaster ride. So if you have 2-3 days in a row where you just feel down and sad, that is a normal reaction to this process. But if a week or two go by and it is a struggle to get out of bed, to concentrate, to sleep, or any real deviation in who you are, this could be a sign that you need more support than you are getting now. There are so many resources available to you, whether it is a support group, talking to a friend who has been through this, using the app FertiCalm Pro, looking at ASRM.org for a reproductive mental health professional in your area, or talking to your doctor for ideas.
While this is a life crisis for sure, it is good to remind yourself it is temporary, and you are not alone. Most people facing family-building barriers feel anxious and/or sad as a result.
4. What are some common tips other infertility patients have found helpful in maintaining their relationships during this process?
Talk! There is no question about it: most couples experience infertility in different ways and at different times. The best advice I give to my patients is to not try to force your partner to feel the same as you do. The way you are feeling, and coping is the right way for you: the same goes for your partner. Setting aside some time each day to communicate how you are both doing can help keep communication and support open but try not to make infertility seep into all aspects of your life together.
5. I’m suffering from secondary infertility, and it’s hard for me to join a support group when I see others struggling to have their first. What would you suggest?
The research shows that secondary infertility causes as much distress as primary, for some different reasons. I would try to find a group for secondary patients, or make sure that any group you join has more than one secondary participant.
6. What should you do if you’re scared to tell someone about what you’re going through?
Telling anyone about your infertility diagnosis can be uncomfortable. Fear can often creep in when telling one’s boss or supervisor. Otherwise, why tell? It is your private medical information, and no one is entitled to know anything you do not feel comfortable sharing. In terms of a work situation, infertility is classified as a disease by the World Health Organization so you can always frame the discussion as looking for support and treatment for a medical condition.
7. What are some suggestions for concrete ways I can incorporate this advice into my relationship?
There are so many ways to make this easier on one’s relationship. Ideas include not expecting your partner to feel the same as you, limiting the time you spend talking about it by having dedicated time (maybe 5-10 minutes each), not pressuring your partner to attend social events which might make them uncomfortable, and suggesting they read up on the experiences of others, so they understand that you are having a normal reaction to infertility.
8. If therapy is not an option for me, what are some other ways I can learn about communicating my needs and boundaries?
There are numerous resources on how to manage the stress of infertility. Some include:
- Check out Resolve.org
- Join an online support group, which you can find through your fertility clinic or Resolve’s website.
- Talk to a friend or relative who has been through it
- “Conquering Infertility” – which I wrote a few years ago
- Try having one session with a reproductive mental health professional for coping suggestions, not therapy.
9. How can I manage my expectations for my relationship to return to normal after fertility treatments (regardless of fertility treatment outcome)?
There is no guarantee things will go back to normal after facing infertility, regardless of how it is resolved. In fact, divorce rates in couples who went through this are lower than in couples who easily had children, so there is clearly an advantage in getting through hard times together. So even though nothing is guaranteed, it is clear that for most couples, facing infertility can bring couples closer together and make a relationship even stronger.
All in all, how you choose to manage your relationships and the dynamic you have with each loved one will be different and that’s ok. If you have any additional questions or looking for more resources on this topic, check out Progyny’s Education page or reach out to your dedicated Patient Care Advocate.