IVF: Surviving the Emotional Rollercoaster, after a Failed Cycle
Published on: April 18, 2019
A journey through IVF or any treatment for fertility is hard, both physically and emotionally. Dr. Patsama describes the cycle of emotions which patients go through in case of a failed attempt and possible ways of dealing with grief.
By Dr. Patsama Vichinsartvichai
About 17% of couples living in Bangkok have infertility problems. Research indicates that most cases of infertility can be attributed to physiological causes either in a man or woman. About one-third of the time a physiological problem is identified in the woman, one-third of the time in the man, and about one-third of the time in both partners. In another 10 to 20 percent of cases (estimates vary), the basis of infertility cannot be determined.
While the causes of infertility are physiological, the resulting heartache — often exacerbated by the physical and emotional rigors of infertility treatment — may exert a huge psychological toll. As patients ‘gear-up’ toward their embryo transfer date, the anxiety is palpable, because they feel that they have gotten as close as they possibly have ever been to getting pregnant. Which is why it is so incredibly devastating for a patient if a transfer results in a negative pregnancy.
Regardless of the etiology, parents often mourn a negative embryo transfer the same way that they would mourn a miscarriage, since it is still a loss.
While the causes of infertility are physiological, the resulting heartache … may exert a huge psychological toll.
Though grief for every individual is unique when they experience loss, the devastation from a miscarriage or failed IVF cycle share in the commonality of emotional pain from the missed family both individuals had dreamed of. While the grieving process may differ, the cycle of hope and disappointment for the failure of a dream is very real and raw.
Less research has been done on men’s reactions to infertility, but they tend to experience less distress than women. However, one study found that men’s reactions may depend on whether they or their partner are diagnosed with infertility. When the problem is diagnosed in their wives or partners, men do not report being as distressed as the women do. But when men learn that they are the ones who are infertile, they experience the same levels of low self-esteem, stigma, and depression as infertile women do.
The solutions to infertility come from a variety of treatments from fertility awareness methods, super-ovulation and intrauterine insemination, and up to IVF/ICSI with PGT-A (in vitro fertilization and intracytoplasmic sperm injection with preimplantation genetic test for aneuploidy) with the success rate ranging from 8-50 percent. It’s amazing how excited a couple gets about a 40 percent chance of getting pregnant — when in reality, there’s more chance of it not working.
Stress of infertility and interventions
Infertile patients often experience the normal but distressing emotions similar to those who are grieving any significant loss. Typical reactions include shock, grief, depression, frustration and anger as well as lowered self-esteem, self-confidence, and a sense of control.
Relationships may be severed — not only the primary relationship with a spouse, but also those with friends and family members who may inadvertently cause pain by offering well-meaning but misguided opinions. Couples dealing with infertility may avoid social interaction with friends who are pregnant and families who have children. They may struggle with anxiety-related sexual dysfunction and other marital conflicts.
Side effects of medications
Medications used to treat infertility may affect the couple’s moods. For example, clomiphene citrate (a selective estrogen receptor modulator) frequently prescribed to induce ovulation and increase sperm production, may cause anxiety, sleep interruptions, mood swings, and irritability in women. Other medications may cause depression, mania, irritability, and thinking problems. Patients and clinicians may find it hard to figure out which reactions are psychological and which are caused by medications — yet identifying causes is essential for determining next steps.
Choices and outcomes
Treatment failure may trigger a renewed cycle of grieving and distress. The distress may especially be severe for patients living in Western cultures, where the cultural assumption is that anyone who works hard and is persistent, will succeed in achieving a goal.
It’s also difficult to know when to stop seeking treatment. Frequently one partner wants to end treatment before another, which can strain the relationship. Most patients need to gradually make the transition from wanting biological children to accepting that they will have to pursue donor gametes, adoption or come to terms with being childless.
Additional mental health problems
Even though rates of anxiety, depression, and other mental health disorders are not greater in infertility couples than in the general population, patients may experience transient but serious mental health problems, as they deal with the emotional and physical rollercoaster typical of infertility treatment.
Infertility treatment can also exacerbate existing mental illness. Infertile women with a history of depression, for example, are more likely than other infertile women to become depressed during treatment.
Survival guide for a failed IVF cycle
Time heals everything
Some patients feel intense distress for weeks or months, while others can experience pain for years. Make sure to allow yourself the time YOU need to grieve. Don’t listen to others in terms of how you “should” be feeling. However, don’t forget to look at your fertility clock as the time which has also been ticking off and your chance, decreasing day by day.
It’s OKAY to cry
Embrace your emotion. It’s absolutely normal to feel sad, grieve and loss. The faster you acknowledge it, the quicker you heal.
Call for help
If you feel your emotions keep falling down, the right support such as psychologist counselor might help in coaching you through it.
Ask more questions, push for more testing, change the clinic
There are many tests that should be done and some causes of your infertility are easily corrected. I encourage you to ask them and if you’re not satisfied, it’s totally ok to change the clinic to the place where it can give you a proper answer.
Your relationship is the first priority
Find some activity together. Having a good laugh. Your relationship is the starting point of your journey.
Therapies that may help
There are many relaxation techniques that might help such as mindfulness meditation, deep breathing and yoga. Try out any of these or more and see what helps you soothe or makes you deal better with your situation.
About the Author
Dr. Pat is a certified Fertility Specialist. He works as a Medical Director at INSPIRE IVF in Bangkok. He also runs a Facebook page “Chit Chat with Dr. Pat” aiming to educate people regarding reproductive health and challenges.
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