Struggling to build a family can be one of the most stressful life experiences that a person encounters. One historic study found that the mental health burden of women experiencing infertility was on par with that of cancer or HIV. Research has also shown that stress associated with infertility is one of the main reasons that people drop out of fertility treatments- one study found that stress was the primary reason why insured women ended treatment. While both of these studies were conducted only on women, it’s important to recognize that infertility is stressful for all people.
For this article, I interviewed Dr. Shara Brofman, a licensed clinical psychologist in Westchester County, New York, with extensive training and expertise in reproductive mental health. She was kind enough to share some words of wisdom, which I have paraphrased below. I love Dr. Brofman’s advice- it’s different from what you typically hear. It’s real, compassionate, and eye opening.
Incorporate Your Own Rituals
Dr. Brofman points out that infertility can be understood as a process of grief. Not building your family in the way you imagined, experiencing pregnancy loss or month after month of not becoming pregnant, failed IVF transfers, eggs that did not fertilize, or embryos that did not make it to transfer stage- all are losses that may cause feelings of grief.
Most cultures and faiths have rituals to structure the process of grief or loss; however, many do not have clear rituals around pregnancy loss, and certainly not infertility (for one exception, see this Buddhist ritual around pregnancy loss or abortion). Rituals help steady us. They make us get out of bed in the morning (or afternoon) so that we may connect to others in the community and find comfort, meaning, and connection, and keep going.
Creating a ritual for yourself doesn’t have to be an involved process. It can be a routine of taking a daily walk (e.g. perhaps even at the same time each day, and/or to the same area) or moving your body in another way (e.g. going to a standing weekly/daily yoga, pilates or stretching class where you might see the same people and have the same teacher). Your ritual simply needs to be something you predictably know is going to happen, and it helps organize the structure of the day. When you engage in the ritual, you’re taking action and doing something within your control, vs. constantly playing defense and responding to events and information that are thrown at you. You create some agency for yourself in what can feel like a powerless situation.
Action Step: Think about what type of small daily ritual you can incorporate. What time of day would it fit in? What type of activity would be particularly grounding for you? If daily is not doable, think about a weekly ritual- could you go to a weekly yoga class? Take a long walk with a friend every Sunday morning? Schedule a weekly phone call or time to do something you enjoy? Get specific and add it to your calendar, until it becomes automatic and you no longer need the reminder.
Intentionally Distance From the Pain, Rather Than Avoiding It
There will be time to feel the pain and fully experience it, but at other times, it can actually be very healthy to distance from the pain in an intentional and mindful way, rather than avoiding or fighting it. This idea stems from Acceptance and Commitment Therapy, and it suggests a reframing of your relationship to the pain.
What are some ways you can do this?
Dr. Brofman recommends that you don’t spend every waking moment researching treatment options, reading books or listening to fertility podcasts. Again, there will be plenty of time to do this, and some research can be helpful. But try not to engage nonstop with infertility. It’s very normal and understandable to fear that you might miss some crucial piece of information that will unlock success. But have you noticed that when you’re working on an intense project or studying, if you take a walk or do something completely unrelated for a while, you actually come back to the task refreshed and focused?
She recommends engaging LESS with the infertility information, and MORE with other interests- What did you love to do in high school? What did you enjoy doing as a child? Is there a book or podcast on a topic that you really enjoyed before your fertility journey began? Remember that you are a whole person with varied interests that deserve to be nurtured, even as you go through this all consuming process.
Action Step: Unless it truly feels like it’s useful or feeding your soul, unfollow that infertility podcast, social media account, or newsletter. Instead, brainstorm a few topics you really enjoy and follow a podcast or social media account that will help you dive deeper, or distract yourself in a healthy (or even enjoyable!) way.
What About Acupuncture?
I encourage all my patients who are having trouble conceiving to seek out care from a mental health professional or support group (see resources below)- and while most do, for a variety of reasons it’s not a fit for everyone. Acupuncture may help patients cope with the burden of infertility. A 2022 meta analysis of studies found small yet statistically significant reductions in state anxiety (transient anxiety related to a specific situation) related to IVF transfers or egg retrievals when compared with controls.
While studies looking at acupuncture’s effects are ongoing and overall levels of anxiety throughout an IVF cycle (or more broadly, throughout a person’s infertility journey) have not yet been conducted, the meta analysis shows promise that acupuncture may provide a safe, non-pharmacological method of stress reduction. We think it does this by increasing the release of the body’s own endorphins- this helps you to feel more relaxed.
In Closing
Know that you are not alone. I love to think of the Buddhist idea of tonglen, described by Pema Chodron as “seeing the sameness of what you’re feeling with what others feel and letting the pain and joy of your life connect you with all people.” In this situation, take slow, deep breaths and imagine others not only in your town or country, but the entire world who are suffering the same pain of infertility, and imagine your calming breaths comforting all of you.
Resource guide:
RESOLVE: National Infertility Organization offering information, resources and support groups
Family Equality: Resources and Advocacy for Family Building in the LGBTQ+ community
The Broken Brown Egg: Information, support and community with emphasis on the Black experience
Resources for Those Who are Childless Not By Choice:
Podcast Discussing Being Childless Not By Choice as Reproductive Identity
Dr Aurelie Athan’s work on Reproductive Identity
Guidance on connecting with the right therapist when childless not by choice