Infertility Counseling at RSCBA
Infertility is inherently stressful – it can affect how you see yourself, your sexual relations, your marital relationship, and your relationships with other people.
Sharon Covington, Director of Psychological Support Services, Shady Grove Fertility and Reproductive Science Center, Rockville, Maryland.
The treatment of infertility brings cycles of hope and despair – and turns life into an emotional roller coaster. Infertile couples need psychological support, whether it be from family, friends, doctors, counselors, on-line support groups or each other. Many infertile couples turn to Resolve, a nonprofit organization founded in 1974 to provide support and information to infertile people and to increase awareness of infertility issues, and Open Path, the Fertility and Adoption Resource for Northern California.
Patients can choose the style of counseling that best suits their needs – whether individual counseling, couples counseling, or group counseling.
Infertility’s emotional effects
Depression, anger, anxiety, frustration, irritability, and grief are normal responses to infertility. Hormones can have profound effects on emotion, so treatments that send hormone levels shooting up and down may magnify the turmoil. As months go by without success, the stress of infertility builds. For many couples, the second year of infertility treatment is particularly trying.
Infertility can have damaging effects on a couple’s relationship if concerns are not addressed. A partner may feel guilty or angry about the cause of infertility, if it is known. Both may feel frustrated if the cause is unknown. Couples often have different attitudes towards treatment that can cause friction in the relationship. One may want to pursue all options, while the other may not want to be as aggressive. As most infertility treatments are performed on the woman, the unequal emotional and physical burden she bears can strain the relationship.
Counseling supports treatment
Good clinics build psychological support systems into their infertility treatment program. For example, clinics supply reading material in the waiting room, such as flyers on upcoming support groups and Resolve/Open Path meetings. These can help patients understand the treatment process and find out about available support services. Some clinics develop their own counseling groups, and a few clinics have on-site counselors. Your doctor may be able to recommend a therapist who specializes in infertility patients.
Professional counseling can ease the emotional problems of infertility and may even improve the odds of conceiving a child. Recent research found that couples who participated in group counseling sessions were more likely to get pregnant than couples who did not. It is not clear whether the counseling sessions caused the difference, whether the participants were more likely to try high-tech treatments because of the support, or whether it was just a coincidence.
Most people end fertility treatment because they run out of emotional energy, not money. Couples may find it difficult to make decisions about alternative treatments or to end treatment. There’s always another treatment available – something new to try. Counseling may help the couple press on – or realize when it’s time to stop treatment.
When to consider counseling
Don’t view counseling as a last ditch effort, but as a way to get a better understanding of infertility and its effects. Counseling can help patients develop coping mechanisms and avoid common problems.
Infertility counseling is particularly useful at critical decision points in treatment. For example, most patients are “running on empty” by the time they face IVF treatment. Counseling before IVF can help the patients know what to expect and can boost their emotional reserve.
Many individuals develop depression in the time period that they are experiencing difficulties conceiving. Quite often, women are reluctant to take medication for their depression because of concerns that it might harm the baby. However there are several new antidepressants that are effective in treating depression and considered safe in pregnancy. One of these medications, Prozac®, has been studied. It has not been associated with either increased miscarriages or birth defects. Frequently, the depression is alleviated by the good news of the pregnancy and the medication can be discontinued safely.
Women report symptoms of depression more often than men, although it can occur in either partner. Sometimes an individual is too depressed to identify their own depression. In those cases, the partner plays a crucial role in identifying the symptoms and getting professional help. Talk to your doctor if you think you or your partner is experiencing symptoms of depression. Your doctor can direct you to appropriate professional help.
Seek counseling when you notice:
- infertility is affecting your normal functioning and relationships with others
- persistent sadness and tearfulness
- increased levels of anxiety or worry
- isolating yourself from others
- strained relationships
- loss of interest in hobbies
- difficulty concentrating or remembering
- difficulty making decisions
- difficulty accomplishing your usual tasks
- change in appetite, weight, or sleep patterns
- increased feelings of bitterness or anger
- thoughts of death or suicide
- continuing feelings of pessimism, guilt, or worthlessness
Macy Schoenthaler, Third-Party Fertility, In-House Counselor
Macy Schoenthaler, MFT (Marriage an Family Therapist), is RSC’s in-house therapist who specializes in third-party fertility and LGBT family building, including the use of an egg donor or surrogate. She has worked in the field of reproductive health since 2003, and received her master’s degree in counseling psychology in 2012 from the California Institute of Integral Studies (CIIS) in San Francisco.
She originally started at RSC in 2012 as the Donor Program Administrative Liaison, screening egg donors and matching donors/recipients. She has since become a valuable resource for counseling patients who utilize a third party, such as an egg donor, for conception. Schoenthaler assists patients with the transition into the third-party program and for recipient, in-patient psychological consultations.