Psychological aspects of infertility

Infertility is the inability to naturally conceive a child or the inability to carry a pregnancy to term. There are many reasons why a couple may not be infertile or may not be able to conceive without medical assistance but, regardless of the cause, the physical, emotional, and interpersonal impact of infertility can be crushing.

Regardless of the cause, infertility frequently results in a range of psychological and social problems for the woman, the man, and their relationship. The infertile couple may experience social isolation and marital discord. The woman and man may decide to go through the numerous medical infertility options, each of which is accompanied by its own set of physical and psychological as well as financial demands. Invasive medical techniques raise moral, ethical and religious concerns and their invasive and impersonal requirements can rob the reproductive process of its sense of intimacy. The result is that infertility and the infertility process often results in anger, frustration, anxiety and stress, and depression.

If you and your spouse have been having difficulty conceiving, some of these thoughts and statements may be familiar to you:

  • I can't believe this is happening to me;
  • I feel as though we are the only couple in the world with this problem;
  • It seems as if I'm being punished;
  • I often daydream about being pregnant;
  • I am afraid that my spouse resents me for this problem;
  • I wonder if my spouse still finds me sexually attractive;
  • I feel pressured by relatives who keep asking us about starting a family;
  • I feel angry toward the doctors;
  • I feel cheated;
  • I feel jealous and uncomfortable when people my age talk about their babies;
  • It's difficult to feel excited when friends become pregnant.


If any of the above thoughts and statements are all too familiar to you, you are not alone. Over the past two decades the incidence of infertility has increased by nearly 50%, and today approximately one of every six couples who have tried to conceive have been unable to do so.

Treating only the physical causes of infertility often is not enough, however. Attending to the emotional needs of the infertile couple is an integral part of infertility treatment because the couple's relationship can suffer at the very time when each partner most needs the support and understanding of the other. The stress, frustration, and embarrassment of infertility can be painful and destructive to the emotional well being of the individual partners as well as to the couple's relationship.

Aspects of the individual and/or couple's functioning, which can be affected by infertility, include:

Sexuality - Lovemaking may lose its spontaneity, affection, and pleasure as a result of the temperature charting, hormone taking, and the sometimes mechanical efforts at intercourse made in order to maximize the chances of conception. Sex can become associated with feelings of stress, failure, inadequacy, and loss. It may begin to feel like an obligation, which can lead to a decreased desire for sex, orgasmic difficulties, or other sexual dysfunctions.

Self-esteem - When an individual or couple learn that they have an infertility problem, feelings of inferiority, depression, and of being physically defective can arise. Infertility can erode an individual's sense of masculinity or femininity so that he or she no longer feels sexually attractive or complete. These feelings may interfere with an individual's daily functioning and can undermine the couple's relationship as well.

Communication - Because of the guilt, anger, embarrassment, and frustration that often accompany infertility, the couple may decrease their sharing of thoughts and feelings with each other and may lose some of their former closeness. A lack of open and honest communication between partners can result in each person feeling alone, unsupported, and misunderstood.

Withdrawal and Isolation - Although approximately 15% of couples experience infertility problems, the infertile couple often feels isolated, alone, and unique. They tend not to share their problem with others and remain unaware of the many other couples who share the same experience. Consequently, they miss out on receiving the support and understanding of other couples with the same problem.

Coping With Infertility

Although there is no universal symptom pattern that characterizes infertile couples, they all are similar in that they are unable to reproduce by choice and the outcome of their medical treatment is uncertain and beyond their control. Feelings of anger, frustration, guilt, and helplessness often are present. It is important that these feelings are identified and their effects on both the individual and couple be recognized and dealt with. Support, discussion, and insight can help people reduce their emotional distress and regain a sense of control over their lives.


Infertility counseling can be helpful in the following ways:

  • It can help couples recognize and work through feelings of disappointment, deprivation, and loss
  • It can foster the development of self-esteem and a sense of control over one's life
  • It can help to facilitate communication between partners
  • It can help to identify strengths and weaknesses in both the individual and couple and build on the strengths
  • It can serve as a source of information about the various aspects of infertility
  • It can help the couple examine their options and aid in their decision-making.

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