If you’re trying to get pregnant, you are probably very familiar with the agonizing Three Minute Wait: the time it takes to see if your pregnancy test gives you the final verdict.
For weeks, you have been cutting down on every “bad” substance from your diet (goodbye, double lattes), increasing the “good” stuff (do I even like eating salmon this often?), peeing on other sticks just so you can have unromantic, functional sex in the elusive twelve-hour window when you’re ovulating, and spending every waking minute thinking obsessively about your baby-to-be.
The fruits of all of that emotional, social and physical labor are revealed at the end of the Three Minute Wait.
…Three minutes are up.
Is that a second line in the display window?
Nope, the single line continues to stand alone.
You take a moment to breathe through the heartbreak, maybe let your partner know the bad news, and then try your best to muster up a shred of optimism for the next month.
What is infertility?
After twelve months of Three Minute Waits and still no pregnancy, you would be eligible for an infertility diagnosis, and you would not be alone: Among women all over the world who are 20 to 44 years of age, about 12.4% were not able to give birth to a first or second child.
Infertility can be caused by several types of issues, such as structural impediments (e.g., blocked fallopian tubes), ovulation, semen or egg quality, medical conditions, and lifestyle (e.g., waiting until you’re older to start trying).
Very often, someone can receive a diagnosis of infertility without any of these known issues, a condition called “unspecified infertility,” which seems to be medical code for “we have no idea why you can’t get pregnant.”
Women who struggle with infertility often become so focused on the goal of getting pregnant that they forget how much this diagnosis can affect their mental health.
It comes as no surprise that women with infertility are more likely to experience dysthymia, depression, anxiety disorders, and panic attacks than women without infertility. However, understanding why infertility can be so psychologically challenging and learning some coping strategies can be incredibly helpful.
How infertility impacts our mental health
There are several ways struggling with infertility can weigh on your psychological well-being:
1. Dashed Dreams
Many people don’t even realize that they had dreams of building a family until they find out those dreams might not come true. The “normal” vision of falling in love, having sex, and getting pregnant seems less likely after months of trying.
Couples with infertility have to consider options they didn’t initially plan for, such as expensive and intensive fertility treatments, egg or sperm donors, surrogacy, or adoption. Although there are many paths to building a family, losing your dream path is a huge loss to grieve.
Unfortunately, many of the burdens related to fertility fall on women. Women are often the ones who feel the responsibility of infertility, as we tend to assume that it is our fault.
Most of the tasks involved in getting pregnant fall on women, as they have to monitor their ovulation or seek infertility treatment as patients. The science of infertility is also heavily gender-biased, as the vast majority of identified fertility issues in the research are focused on causes within women. As a result, many women feel ashamed and guilty for every failed pregnancy.
3. Relationship issues
Infertility becomes a massive source of stress within a marriage or partnership. Spontaneity and romance quickly die when a couple has to have sex at scheduled times around ovulation. Feelings of frustration and lack of control after unsuccessfully for months can also drive a wedge between romantic partners.
4. Social isolation
Nothing is worse than struggling with infertility when your social media feed is filled with exciting pregnancy announcements and photos of your friends’ new babies. People with infertility can feel a distance from their fertile friends, as they can’t join their peers in the major milestones of building a family.
It becomes harder to relate to their friends becoming new parents, and it may feel like they are the “odd one out.” It can feel incredibly lonely if it’s hard to discuss infertility with friends. For those of you who do try to talk to your friends, the lay advice (e.g., “just sip a glass of wine and relax”) you’ll hear can be maddening, knowing that you’ve tried everything you can to get pregnant.
5. Practical and financial burden
When couples have to seek fertility treatment, they are faced with an overwhelming amount of costs and medical procedures. For example, the average couple spends almost $20,000 for an in vitro fertilization treatment, which involves multiple ultrasounds, blood draws, injections, and surgery.
Coordinating the finances and appointments alone can feel like a second job, adding unexpected stress to an already stressful situation. Because infertility treatments come at such a high cost, couples also feel added pressure to make it “work,” leaving them terrified of the treatment outcome.
Tips for protecting mental health during infertility
As challenging as infertility can be, there are several coping strategies that can prevent it from destroying your mental health:
1. Stop Googling
Given how confusing, isolating, and shame-inducing infertility can feel, it is only natural that individuals struggling with it will turn to the internet for further insight.
Informing yourself through blogs and forums may feel like the responsible move but remember that there is a ton of misinformation on the internet that is based more on people’s interpretation or personal experiences than actual science.
We are all for seeking social support, but beware that following a rabbit hole of “TTC” (trying to conceive) forums may make you feel worse if you encounter horror stories or compare yourself to others.
2. Get a therapist
Like with most mental health issues, working with a trained therapist or counselor can be extremely beneficial.
A review of 380 studies showed that psychological interventions effectively reduced negative emotions associated with infertility, especially group therapies that provided education and skills training.
If your relationship with your partner has been affected, consider couples therapy as it can also reduce symptoms of anxiety, depression and can even increase pregnancy rates in some cases.
3. Get support
Although you may have support from your friends and family, no one else will understand what you’re going through more than other people struggling with infertility.
Find a well-managed support group or group therapy that can connect you to other people with similar experiences and/or teach you effective coping skills. Very often, your fertility clinic or the National Infertility Association (www.resolve.org) can point you in the right direction.
4. Find other resources
Sometimes it can be helpful to seek out other media that captures your experiences or provides further education into your condition.
Mental health podcasts like “A Little Help For Our Friends” provide tips for getting support around infertility and associated psychological struggles, while the podcast “The Egg Whisperer” by Dr. Aimee Eyvazzedeh offers the perspective of a fertility doctor.
“The Impatient Woman’s Guide to Getting Pregnant” is an accessible yet well-informed book written by the renowned scientist Jean Twenge. Those are just a few suggestions, but plenty of other books, articles, and movies might resonate.
5. Take a break
It may seem like every chance to get pregnant is precious, and you can’t even imagine not trying for a cycle but consider taking a break if you start to feel burnt out. Infertility and its treatment process can be all-consuming, so try to take some time to live your life outside of trying to get pregnant. Even a brief pause can be incredibly healing and recharge your motivation to take the next steps.
Infertility can be one of life’s most challenging stressors, bringing pain to a journey that should be filled with love and excitement. However, it is worth remembering how emotionally taxing this condition can be and to invest in your mental health as much as you invest in your fertility. Learning to take care of yourself through this process will not only make the Three Minute Wait more bearable, but it will also make you especially prepared for the challenges of motherhood.
Footnotes (italicized in the order listed below):
Mascarenhas, M. N., Flaxman, S. R., Boerma, T., Vanderpoel, S., & Stevens, G. A. (2012). National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS medicine, 9(12), e1001356.
Klemetti, R., Raitanen, J., Sihvo, S., Saarni, S., & Koponen, P. (2010). Infertility, mental disorders and well‐being–a nationwide survey. Acta obstetricia et gynecologica Scandinavica, 89(5), 677-682.
Wu, A. K., Odisho, A. Y., Washington III, S. L., Katz, P. P., & Smith, J. F. (2014). Out-of-pocket fertility patient expense: data from a multicenter prospective infertility cohort. The Journal of urology, 191(2), 427-432.
Boivin, J. (2003). A review of psychosocial interventions in infertility. Social science & medicine, 57(12), 2325-2341.
Thompson, J. (2021). The Effectiveness of Couple Therapy on Psychological and Relational Variables and Pregnancy Rates in Couples with Infertility: A Systematic Review. Australian and New Zealand Journal of Family Therapy.