Studies have shown that someone diagnosed with a disease like cancer and someone dealing with infertility have the same level of stress.
This information comes from Tanja Faessler-Moro, a certified fertility counsellor at Virtus Fertility Centre, who elaborates: “If you have something like cancer, you can explain it to people, they will ask about it and support you, but if you tell people that you’re going through fertility treatments, people often don’t know what to say.”
This high level of stress also comes from the fact that the process is often a long, arduous one and, each time a fertility treatment doesn’t work, it further adds to the possibility that it might end in failure.
“Women work very hard to get to where they are in their career and they perform well to get there,” Tanja explains.
“Then, when they’re on this fertility journey, they look at it as a performance as well, from the check-ups at the clinic through to the medications and injections, and the scans and procedures. And going through this ‘performance’ is related to stress.”
But it’s not just about the stress levels – there seems to be a stigma concerning infertility.
“In Asia, many people, especially the older generation, think that a marriage is not complete until you have children,” says Dr Adrian Wang, a psychiatrist at Gleneagles Hospital. “So, if you suffer from infertility, there’s a sense that you’ve failed in some way to fulfil your obligation to your spouse, to your family, to reproduce.”
When it comes to dealing with infertility, women face some big challenges, the biggest of which is not having any control as to what’s going to happen next.
“These days, you can get everything you want through a mouse click,” says Tanja. “And then, at some point, women realise that the one thing they really want to have the most – a baby – they cannot get through a mouse click. This is the realisation that it’s out of their control and this ultimately leads to stress.”
One of the best ways to deal with the stress is to talk about it, to let off steam or to have a shoulder to cry on.
But who you talk to is very important, as you could be opening yourself up to a minefield of judgemental and insensitive comments.
Says Dr Wang: “You should only talk to people who you know well enough or you trust, who are not judgemental towards you. It’s not something you’re going to put on the office bulletin board or on Facebook.”
When you do decide to share your story with friends, be frank so that it reduces the chances of getting hurtful or insensitive comments in return.
“Tell them that there’s something that you’re going to share with them and that you don’t expect them to know what you’re going through as a couple,” Tanja shares.
“You can say: ‘You might not know how to respond and that’s totally fine with me but what I need right now is someone who listens to me and to give me a warm hug at the end’.”
Coming up childless
Sonia*, 43, did more than 10 IVF cycles over three years and found that people couldn’t, or didn’t want to, understand what she was going through.
“I think the ‘answer’ to infertility is often simplified,” she shares. “Everyone says, ‘Oh, it will work out, don’t worry’. I understand that they’re trying to be supportive but it makes the whole process even more heartbreaking knowing that ‘so-and-so’s friend/sister/cousin/colleague’ went through fertility treatments and had a baby in a few months.
“Nobody seems to want to talk about the women who went through years of treatments and ended up with nothing.”
The amount of stress that your body is put through during fertility treatments is also a factor that many women don’t know about. So it comes as no surprise that some give up quickly.
“When I went through IVF, I did it as best as I could,” says Kalpana*, 42, who went through one IVF cycle. “I tried to stay calm and went for the whole works, including acupuncture. The whole month was nothing but needles for me.
“I just felt like the effort – the cost and on your body – was tremendous and when it didn’t work out, it just felt like all for nothing. So much effort and all decimated by one simple blood test and a phone call.
“I did only one round of IVF and it was enough for me. Post-IVF, I had a long period of recovery. The weight gain, the hair loss, the acne breakout and, most importantly, the emotions and sadness – once was enough.”
The support that a woman gets while going through fertility treatments is very important but this is often hard to come by, as others often struggle to understand the process.
“Over the three-plus years that we went through IVF, I felt the support from friends dwindle,” says Sonia. “Initially, they were positive and wanted to know what was going on but after a year, most stopped asking.”
Kate*, 44, went through nine fertility procedures and had five miscarriages, over four years. She admits that she didn’t feel a stigma for undergoing IVF but she does feel a stigma “for coming out of the process childless”.
“Infertility is like grief,” she shares. “It’s an incredibly painful, heart-wrenching process but sooner or later you come out on the other side. It was the loneliest time in my life. I had this constant ache in my heart.
“To those women who have children and who don’t support their friends or family members struggling with infertility, try showing some sensitivity, kindness and understanding.”
Liz, 43, went through six rounds of intrauterine insemination (IUI) treatment and feels that infertility is “still predominantly seen as a woman’s defect”.
“Dealing with infertility hits your self-esteem big time, and I always believe that we have to be our own best friend and to manage our feelings. Find a support group, tune out the negative voices and know that our worth is much more that bringing our own child into the world.”
Sonia adds: “Women who deal with infertility go through a lot of pain, physically, emotionally and mentally, especially if they’ve been doing it for years.
“It’s difficult enough to go through it, without others undermining your problems or thinking that they are better off just because they managed to have kids and you didn’t.”
When faced with ignorant or judgemental comments, turn the other cheek and don’t let it get to you.
“First of all, you have to tell yourself that they aren’t intentionally being mean towards you,” Dr Wang advises. “Sometimes, they are saying these things out of concern, it’s just that they’re phrasing it badly, so don’t jump to conclusions that people are judging you or are critical of you.
“Secondly, you just have to ignore it. Just explain to them that you’ve either chosen not to have children at this point or that you’re going through the process.”
When should you stop?
Dr Yeong Cheng Toh, consultant gynaecologist and reproductive endocrinologist at Virtus Fertility Centre Singapore, says: “When a couple decides to stop IVF or any fertility treatments, there’s more than just the medical side; there’s the emotional aspect, the family and social structure, which are equally, if not more, important.
“From a medical perspective, and purely based on statistics, for a couple that’s less than 40 years old, there’s a 70 to 75 per cent chance that they will have a baby within three cycles. So, if you do not get pregnant after three cycles and you’re under 40, you really have to look deeper into possible causes.
“If you’re above 40, we know that the success rate drops by half, and if you’re above 43, the chances of you conceiving within three cycles is less than 10 per cent.”
But Dr Yeong cautions couples against making a decision based on the number of failed cycles. Instead, look at the reasons for the treatments not succeeding.
“You have to look at the couple themselves. If they exhibit signs that they are really very fatigued from the emotional, physical and financial part of the whole process, then maybe it’s time to take a break.
“If they do nothing but think, eat and sleep fertility, if it’s consuming their lives, then that’s when you try to enlist the expertise of a counsellor.”
However, it can be very hard to have gone through countless fertility treatments and come out of the process childless.
On top of accepting this reality, women also have to deal with being surrounded by women with children and being asked questions such as, “So when are you going to have kids?”
“There’s no easy answer for that one,” says Dr Wang. “You have to tell yourself to focus on the positives in your life. Your life is still complete even though you’re not able to have children. You have to get over this mindset that there’s this vacuum or that there’s something missing.”
When you’ve reached the point where you know you’re never going to have children, it’s important to deal with the situation and get some closure as a couple.
“If a couple decides to stop undergoing fertility treatments, it can feel like a loss to them, so they have to get closure on this unfulfilled desire,” advises Tanja. “We focus on loss when we mean it physically but we can also experience loss in a more abstract way, like a desire that remains unfulfilled.
“You have to allow yourself some time. It’s also important to know that there is a world of resources out there, such as counsellors and support groups.”
*Names have been changed.
A version of this article appeared in Simply Her.