Leena and Nitin have been married for six years. Both are doing well in their respective careers, and they work for about 10 to 12 hours a day, six days a week. They are one of the many Double Income No Kids or DINK couples who live in metros and are busy building their careers. Leena is now into her late thirties and has been hearing too often. Warnings from her parents and colleagues about her biological clock ticking and how the possibility of having a child naturally, is dwindling as her age advances. She had visited a gynaecologist in her city two years ago, who had started her on a cycle of IUI treatment wherein her husband had to deliver his semen sample on the day of ovulation in the clinic premises. Nitin was never comfortable doing this, and their busy work schedules never gave them opportunities to be consistent with their treatments, as it involved visiting the clinic multiple times. Leena had also noticed her husband’s decreasing libido and non-interest in sex over the last few years. As he always blamed it on the work pressure, she would not insist and bother him over this. Both of them had lost their desire and pleasure in having sex, and it was almost like another clinical procedure to be done around ovulation time. Their doctor had informed that Nitin’s sperm count was good, while Leena had a decreasing egg count and so the time pressure to conceive soon was increasing day by day. She was now thinking of starting her IVF cycle. She was not too sure of whether she should reveal about her IVF treatment to her colleagues, her boss or her parents as she feared the judgements and opinions that would be given to her.
Causes of Infertility related stress
Late marriages: As women are pursuing higher education and couples are postponing plans of starting families because of work pressures. The total fertility rate (TFR) which is the number of children born to a woman in her lifetime — in Mumbai, dropped from 2.5 in 1993 to 1.4 in 2011, according to a study by the International Institute of Population Sciences (IIPS), Deonar. Rising rates of infertility may also be contributing to this fall in the TFR in the metro cities.
In India, pregnancy is considered to be a developmental achievement that is highly expected and glorified by our culture. So the women in urban areas are struggling to conceive in their thirties when their peak fertility levels denoted by the number of fertile eggs they have in reserve are falling rapidly.
This leads to frustration, anger, low self-esteem and feeling of failure. In the last 42 years, since the first IVF baby was born in 1978, about 8 million babies have been born worldwide. Though a lot of technological advances have taken place in the field of Assisted Reproductive techniques, emotional and psychological impacts of infertility have unfortunately been overlooked, and only the biological and medical aspects have been considered.
How does it impact your relationship?
When a couple undergoes fertility-related issues or is planning to take fertility treatment or maybe undergoing treatment, it will have a considerable impact on their relationship.
- Stress when trying to conceive as it can profoundly impact the IVF process
- Disagreements on when to seek help
- Finding it difficult to talk to others about the struggles faced in the procedure
- Disagreements on whether to tell other people about the struggle
- Fears that If It’s “Your Fault,” your partner will leave
- Misunderstandings over different ways of coping
- Financial strain
- Differences of opinion on moving forward or next steps
How to cope up with the stress of infertility related issues
There is a massive need for psychosocial counselling to cope up with this stress, as these couples land up spending a lot of their savings on expensive fertility treatments and undergo depression if the cycle fails. There needs to be increased awareness of fertility preservation technologies available.
- Awareness: Increase the awareness of falling fertility levels as the age progresses
- Fertility centre: It is essential to choose a good, trustworthy fertility centre which has not only specialised doctors but also empathetic counsellors who give you a patient listening
- Counselling: The team of the doctors, nurses and the counsellors together can help you with the coping strategies of meditation, exercise, support groups where you can meet other fellow patients undergoing treatments. Dealing with sexual issues and options about what to do in case these treatments fail should also be discussed during these counselling sessions. Financial Planning should also be done on the part of the couples.
- Opting for Social Egg Freezing: It’s essential to make working women aware of the process of social egg freezing, which is a process where women can freeze their eggs while they are younger and use them later when they are more ready to start a family
WATCH: Know when IVF can be done:
- Relaxation techniques: Given that infertility and its treatment often cause considerable stress; experts recommend various relaxation techniques like mindfulness meditation, deep breathing, guided imagery, and yoga promote stress management.
- Communicate: Talk to each other. Share fears. Don’t walk around worried your partner may leave you and never say anything.
With inputs from Dr Vaishali Chaudhary, Chief IVF Consultant, Cloudnine Group of Hospitals, Pune
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