The International Council on Infertility Information Dissemination, Inc

The Miscarriage Manual: Coping with the Emotional Aspects of Pregnancy Loss by Elizabeth Carney

Miracles and Memories Family-Building Pins

Miracles and Memories Family-Building PinsFourteen years ago I gave birth to a baby girl. Four hours later she died because of an internal malformation that was undetectable during my pregnancy. During my short hospital stay, nurses and doctors seemed to avoid me and my questions. What they did say was about the same as what my friends and family were saying. "You're young. You'll have other babies. Try to forget." 

I didn't want any other baby; I wanted that one! Forget? How could I forget? Instead I was overwhelmed with crushing, breathtaking grief. I remember how empty I felt the day I left the empty womb and empty arms. I never really knew her but I missed her and ached for her so desperately. 

Soon after I returned home, everyone acted as if they had already forgotten her, as if they expected me to also. Someone had removed all the baby items I had acquired before coming home, hoping to spare me the pain. Instead, it felt like a further denial of her existence. When I tried to talk about her everyone became very quiet, or changed the subject, or left the room. Friends were very careful not to say anything that might remind me of my experience. Baby shower invitations didn't come in the mail. Birth announcements didn't come in the mail. Many stayed away because they simply did not know what to say. My husband had three days to "get over it" before he was expected back at work. The world kept on spinning as if nothing had happened. I remember thinking that I must have lost my mind. I thought that if my baby had lived for a while, if people had gotten to know and love her, maybe then I would have been given the affirmation to grieve the way I needed to. But I was the only one with any memory of her, the only one who had the chance to love her. I had no one to share that with, not even my husband. Most of his grief was for me and for the dreams we had shared for this child. I felt all alone as I began my mourning. 

Over the years, after much healing, I have had the opportunity to speak with other parents who have had experiences which were similar to mine. As a result of that, and also as a result of my search for answers to all those unanswered questions, I have compiled a list of several "truths and non-truths" concerning the grieving process as it relates to perinatal bereavement. 

This is not intended to be the absolute word on the subject, but rather a gauge for the unexpected emotions felt by parents who have suffered this type of loss. Most of the parents I have spoken to agreed that the uncertainty of their grief was frightening and may have been alleviated had they known what to expect. 

Friends and family may also benefit from reading this over so they might understand the special kinds of pain and emotions involved in this type of loss and allow them to be expressed. 

The Truth Is...

1. The truth ISN'T that you will feel "all better" in a couple of days, or weeks, or even months. 

The truth IS that the days will be filled with an unending ache and the nights will feel one million sad years long for a while. Healing is attained only after the slow necessary progression through the stages of grief and mourning. 

2. The truth isn't that a new pregnancy will help you forget. 

The truth is that, while thoughts of a new pregnancy soon may provide hope, a lost infant deserves to be mourned just as you would have with anyone you loved. Grieving takes a lot of energy and can be both emotionally and physically draining. This could have an impact upon your health during another pregnancy. While the decision to try again is a very individualized one, being pregnant while still actively grieving is very difficult. 

3. The truth isn't that pills or alcohol will dull the pain. 

The truth is that they will merely postpone the reality you must eventually face in order to begin healing. However, if your doctor feels that medication is necessary to help maintain your health, use it intelligently and according to his/her instructions. 

4. The truth isn't that once this is over your life will be the same. 

The truth is that your upside-down world will slowly settle down, hopefully leaving you a more sensitive, compassionate person, better prepared to handle the hard times that everyone must deal with sooner or later. When you consider that you have just experienced one of the worst things that can happen to a family, as you heal you will become aware of how strong you are. 

5. The truth isn't that grieving is morbid, or a sign of weakness or mental instability. 

The truth is that grieving is work that must be done. Now is the appropriate time. Allow yourself the time. Feel it, flow with it. Try not to fight it too often. It will get easier if you expect that it is variable, that some days are better than others. Be patient with yourself. There are no short cuts to healing. The active grieving will be over when all the work is done. 

6. The truth isn't that grief is all-consuming. 

The truth is that in the midst of the most agonizing time of your life, there will be laughter. Don't feel guilty. Laugh if you want to. Just as you must allow yourself the time to grieve, you must also allow yourself the time to laugh. Viewing laughter as part of the healing process, just as overwhelming sadness is now, will make the pain more bearable. 

7. The truth isn't that one person can bear this alone. 

The truth is that while only you can make the choices necessary to return to the mainstream of life a healed person, others in your life are also grieving and are feeling very helpless. As unfair as it may seem, the burden of remaining in contact with family and friends often falls on you. They are afraid to "butt in," or they may be fearful of saying or doing the wrong thing. This makes them feel even more helpless. They need to be told honestly what they can do to help. They don't need to be told, "I'm doing fine" when you're really NOT doing fine. By allowing others to share in your pain and assist you with your needs, you will be comforted and they will feel less helpless. 


8. The truth isn't that God must be punishing you for something. 

The truth is that sometimes these things just happen. They have happened to many people before you, and they will happen to many people after you. This was not an act of any God; it was an act of Nature. It isn't fair to blame God, or yourself, or anyone else. Try to understand that it is human nature to look for a place to put the blame, especially when there are so few answers to the question, "Why?" Sometimes there are answers. Most times there are not. Believing that you are being punished will only get in the way of your healing. 

9. The truth isn't that you will be unable to make any choices or decisions during this time. 

The truth is that while major decisions, such as moving or changing jobs, are better off being postponed for now, life goes on. It will be difficult, but decisions dealing with the death of your baby (seeing and naming the baby, arranging and/or attending a religious ritual, taking care of the nursery items you have acquired) are all choices you can make for yourself. Well-meaning people will try to shelter you from the pain of this. However, many of us who have suffered similar losses agree that these first decisions are very important. They help to make the loss real. Our brains filter out much of the pain early on as a way to protect us. Very soon after that, we find ourselves reliving the events over and over, trying to remember everything. This is another way that we acknowledge the loss. Until the loss is real, grieving cannot begin. Being involved at this early time will be a painful experience, but it will help you deal with your grief better as you progress by providing comforting memories of having performed loving, caring acts for your baby. 

10. The truth isn't that you will be delighted to hear that a friend or other loved one has just given birth to a healthy baby. 

The truth is that you may find it very difficult to be around mothers with young babies. You may be hurt, or angry, or jealous. You may wonder why you couldn't have had that joy. You may be resentful, or refuse to see friends with new babies. You may even secretly wish that the same thing would happen to someone else. You want someone to understand how it feels. You may also feel very ashamed that you could wish such things on people you love or care about, or think that you must be a dreadful person. You aren't. You're human, and even the most loving people can react this way when they are actively grieving. If the situations were reversed, your friends would be feeling and thinking the same things you are. Forgive yourself. It's OK. These feelings will eventually go away. 

11. The truth isn't that all marriages survive this difficult time. 

The truth is that sometimes you might blame one another, resent one another, or dislike being with one another. If you find this happening, get help. There are self-help groups available or grief counselors who can help. Don't ignore it or tuck it away assuming it will get better. It won't. Actively grieving people cannot help one another. It is unrealistic, like having two people who were blinded at the same time teach each other Braille. Talking it out with others may help. It might even save your marriage. 


12. The truth isn't that eventually you will accept the loss of your baby and forget all about this awful time. 

The truth is that acceptance is a word reserved for the understanding you come to when you've successfully grieved the loss of a parent, or a grandparent, or a beloved older relative. When you lose a child, your whole future has been affected, not your past. No one can really accept that. But there is resolution in the form of healing and learning how to cope. You will survive. Many of us who have gone through this type of grief are afraid we might forget about our babies once we begin to heal. This won't happen. You will always remember your precious baby because successful grieving carves a place in your heart where he or she will live forever.


Please visit the INCIID Memorial Gardens


Dealing with the Stress of the Holidays




The stress of the holidays is a topic that has appeared with regularity in articles and newsletters since 1979 when I began working as a psychotherapist with infertility patients.  Rightfully so.  Infertility is demanding and stressful.  The Holidays are demanding and stressful.  And in this case, one plus one equals way more than 2.

It is no longer in dispute that both the mental and physical experiences of stress land in the body.  That’s about the last thing that an infertility patient needs.  Your body is the stage upon which the treatment gets played out.  Being poked and prodded physically evolves very naturally into a mental ordeal for everyone.

This article addresses a big opportunity to turn down the level of stress that comes with the holidays.  That opportunity exists in the marital relationship.

In the best of families, tensions abound at holiday time.  The backdrop for get-togethers may have to do with who expects what, who can’t stand whom, whose house is center stage, whose traditions “win”, who’s impossible to buy presents for and who’s jealous of what.  And of course, a separate and very long thorn is who’ll be there who has babies.  The whos, whose and whats go on ad nauseum.

This does not mean that all families are looney toons.  It does mean that in the most serene of families, things can’t ever be perfect – AND – you are not likely to be in the mood for anyone’s imperfections.  It is a known fact that often, well-meaning people do not know what to say and invariably say the wrong thing, presuming that they even know about your struggle.  And if they don’t know, the secret may be the lesser of two evils, but it still creates additional stress.

The opportunity for any couple lies in the fact that it is critically important to be on the same page when it comes to making decisions about how to handle the holidays.  Infertility may be the first crisis of major proportions that has hit you in the time that you’ve been together.  Any crisis will demand that a person locate his or her coping methods.  It might even put you in a spin if you need better coping mechanisms than you have.  But it is only the rare couple whose coping mechanisms are congruent when a crisis hits.  This does not mean that you aren’t supportive of one another.  Most couples are.  But there is a difference between the support that flows out of compassion for someone you love and working to achieve a united front, which works best, at holiday time especially.

The Chinese character for crisis is a combination of the characters for danger and opportunity.  It may feel dangerous to set a limit to one or both families.  But it is very important for any couple to define their “coupleness.”  As married adults, it is your job and your right to let both families know what boundaries you need for your mutual satisfaction.   It is highly recommended that if you cannot get past the pull back to the whos and whats of your respective families, that you seek the guidance of a therapist with skills in both infertility counseling and family counseling.

Whether on your own or with professional help, if you successfully decide and declare your decisions about the holidays, you set yourselves up to minimize the impact of family/holiday stress on your bodies.  And beyond the logistics of who and what, there exists a further opportunity to nurture the marriage.  Now is the time to explore techniques of mind/body relaxation that you can enjoy together.  Besides being on the same page, feeling loved and understood is palliative and has a positive impact as a stress reducer.

As hectic as the holiday time can be, it would make a difference if you could locate a yoga class designed specifically for couples or a massage class for couples.  Or, this could be a really good time to go to a spa together for a weekend.  By focusing on gaining physical relief from tension, you can break the grip of the aspects of the infertility challenge that land in your bodies.

Furthermore, couples can learn methods of breathing, muscle relaxation, mindfulness meditation and self-hypnosis that go a long way toward breaking the grip of the infertility challenge from the inside out.  These techniques are extremely empowering, at a time when couples tend to feel powerless.

In this society most of us live in a state of red alert, tolerating high levels of stress.  The incidence of stress-induced illness and anxiety has risen dramatically.  As a culture, we need to take better tender-loving care of ourselves, but we tend not to.  So, while there are many who need to learn stress reduction techniques as much as you do, few need to learn them more than you.

Infertility is nasty.  But the silver lining in the clouds is that as a couple, you can and should put your needs front and center.  You need to keep your love alive, for each other and for yourselves.  The best way to do this is to acknowledge the enormous stress involved and take the opportunity to learn to communicate so you can land on the same page.  And then, you can pursue the myriad of techniques available these days which reduce stress on the body and the mind.








Developing the Expertise that Infertility Patients Deserve

Photo of Helen Adrienne

“The therapist that I fired claimed to be an expert but she was not. I could tell that she had looked up a few things on the internet and was pretending that she knew what I needed her to know.”

I’ve heard this or a variation of this upset from infertility patients many times. You can avoid being the therapist who “gets fired” by seeking the professional training that matches the needs of this special and under served population.

Close to 20 % of couples in their childbearing years find themselves in an unwanted quest to build their family. Therefore, any therapist in general practice is likely to find him or herself sitting across from an man, woman or couple who is living in a life that has become unrecognizable in every way and is suffering emotionally.

For starters, it’s important to familiarize yourself with Assisted Reproductive Technology (ART) approaches to pregnancy such as In Vitro Fertilization (IVF), Intrauterine Insemination (IUI), Ovum or Sperm Donation, Embryo Adoption and Surrogacy. This can be accomplished on the internet as long as you don’t presume to know what your patient is going through. There are many variations in protocol and you must recognize that no matter the approach, patients feel like they are in a science-fiction movie while their friends are conceiving the old-fashioned way. Rule of thumb: inquire, inquire, inquire. With gentleness and sensitivity you can make your way into a place where your patient feels understood.

That the medical treatment is an ordeal is one thing. But the emotional experience raises the agony exponentially. Doctors’ have the responsibility to enhance the patients’ “seeds”. Our responsibility is to inspire the patient to tend to their “soil” with mind/body self-care practices so that they can be in the most receptive place for the wonders of modern medicine to take root.

There is much to learn and a while back it occurred to me that with 35 years of experience in this field, I have much to teach. Helen is a dynamic therapist who not only understands infertility but also her clients' needs. Some of the things she addresses:

  • How to reverse the physiology of stress due to physical, emotional, social and spiritual issues – of which there are many.
  • How to work with the mind by understanding the brain.
  • How to evaluate what changes need to be made and how to break habits that prevent committing to change.
  • How to maintain hope.
  • How to sift through the confusion to gain clarity about the myriad choices.
  • How to claim and reclaim resilience.
  • How to grow from adversity.
  • Most importantly, how partners can stay on the same page with each other.

You can email her here: 

About the Author:

Helen Adrienne, LCSW general psychotherapist, clinical hypnotherapist, a practitioner of mind/body therapy with a specialty in infertility, author, speaker. New York City

Miracles and Memories Pins

Miracles and Memories Pin

Miracles and Memories PinConsider the first and ONLY family-building INCIID Miracles and Memories pin for yourself, your family and friends - or if you are a reproductive endocrinology and infertility clinic or a patients who might want to provide them to your extended family members or to friends. INCIID was the first to come out with a pin covering all aspects of family-building.

Providing these particularly during "parenting" holidays (Christmas, Mother's Day, Father's Day etc.) can be supportive and helpful to those struggling to build their family. For thousands of reproductively challenged couples, the holidays can be a difficult time, as their only wish is to have a family of their own. If you are a doctor caring for patients,  INCIID is asking you to give out “Miracles and Memories” family-building pin to show patients and staff in a small but caring way that you support efforts to build a family. The idea is to build awareness and support for INCIID, a non-profit organization, providing scholarships for couples with infertility diagnoses as well as support and information on family building options. If you are a patient, or the family of a patient struggling with fertility, pregnancy loss or making the decision to adopt - Miracles and Memories Pins can provide added support.

Because INCIID is a non-profit organization, it relies solely on donations and contributions to maintain the success of the “From INCIID the Heart” scholarship program.  The INCIID team has created “Memories and Miracles” pins. INCIID is asking  couples, doctors, family members to donate just $25 to increase infertility awareness while at the same time providing a tax deductible donation to increase awareness and in support of creating a family.

The pins are packaged in a small clear plastic baggy attached to a white card that explains representation of each color on the pin and that pins support INCIID’s work and the IVF Scholarship.

The MAM (Miracles & Memories) Family-Building Pin :

Download the Bulk order form (for bulk orders of 100 or more pins) including a photo of the Miracles and Memories (MAM) pins



2015 Online Angel Award

2015 Heather Bruce Thiermann Online Angel Award

We live in a truly digital age. It's nearly impossible to do anything or go anywhere without a smartphone or computerized or generated something.  The early nineties was a time when for all practical purposes – the Internet as we know it today was in its infancy.  Today there are all kinds of digital scams, hackers lurking around every cyber corner and a lot of cyber bullying. But there are also many acts of kindness, paying it forward and lots of interactive success stories. We think the time has come to make once again that the community of people who use the Internet for the benefit of others. These are the people (including corporations within the reproductive and adoption industry) that go above and beyond to help others. They pay it forward with selfless determination to help others.

In 2015, INCIID will present INCIID's Online Angel Award in several categories to an individual, a professional and/or a corporation. These are the people that use the Internet to give back to the community.  Do you know someone that deserves an award for being an ONLINE Angel?

  • Details about how to nominate – coming soon!


The History of the Online Angel Award

Heather's story is a triumphant example of how going on-line can not only change lives, but enhance them. Her story shows that friendships made via computers can be as rewarding as any, even if participants never meet face-to-face. But most of all, it demonstrates how experiences in Cyberspace can be exhilarating and sorrowful, and just as in "real life," love, support, encouragement and shoulders to lean on can be found.

Heather was a popular participant on the Infertility Bulletin Boards started through AOL at the beginning of the 1990’s. She and her husband, Steven, were in the IVF program at The New York Hospital-Cornell Medical Center in New York City. Heather struggled with massive uterine fibroids that prevented her from conceiving, but she was positive and hopeful despite eight years of infertility. After five surgeries, she finally became pregnant following her second in vitro fertilization attempt.

At this time, Heather moved on to the "Pregnant After Infertility" bulletin board on AOL, a subject created by INCIID cofounder, Nancy Hemenway. She shared all the fear and excitement of finally being pregnant with others on the board. As time neared for her planned C-section (previous surgeries made this necessary), her posts on the bulletin board became increasingly excited, and nervous. Then, just hours before the long-awaited time on January 8, Heather's C-section was canceled because of intense snow storms on the East Coast. Her doctor couldn't get to the hospital.

Two days later, on Wednesday, January 10, Heather and Steven became the proud parents of a beautiful and healthy baby girl they named Tara. Steven said he had never seen such a beautiful look of complete happiness in those brief moments when Heather laid eyes on daughter. Heather saw Steven holding Tara than fell into a coma. She never regained consciousness, and thirteen days later, Heather died.

This terrible loss has been retold throughout Cyberspace and people on all the on-line services and the Internet reacted with shock and sorrow. You didn't have to know Heather to love her for all that she did to support others on-line.

INCIID established an award to recognize the contributions of an individual or group whose participation on-line has served to support, encourage and educate others about infertility. It is named the "Heather Bruce Thiermann Online Angel Award," and Heather was the first recipient, posthumously honored. Steven accepted the award in March, 1996 at INCIID’s conference.

At INCIID, we continue the mission to educate and support infertility consumers through online education and the “From INCIID the Heart IVF Scholarship Program”. INCIID works very hard to educate others, especially about their options regarding IVF. helps individuals and couples explore their family-building options. INCIID provides current information and immediate support regarding the diagnosis, treatment, and prevention of infertility and pregnancy loss, and offers guidance to those considering adoption.

Please contact INCIID if you are interested in serving on or helping on a committee to select the INCIID Online Angel Award



If Only It Were September

 by MareFL on 20:27 6/25/2004:

You would be here if it were September
Then I would not have sadness to remember
You would be lighting up our lives in so many ways
Just like you did for only six days

I think of the things you and I did not have the chance to do
Such as changing your diaper or giving a coo
Oh, what life would be like if you were still here
There would be no more tears and definitely no fear

I would be singing you a silly song or two
Watching your face and loving you
Your big brother would be giving you a hug and a kiss
To see him with you would have been bliss

All we can do is sit here looking at pictures of you
Struggling to stay here on earth for us two
Leo, you will always be on my mind and in my heart
Constantly questioning why we had to part

You are our precious little baby boy
And will always be bringing us joy
Every month, every day, every hour, every minute
Life would have been great just to have you in it

Happy Together Again: Reframing Infertility in Your Marriage by Susan G. Mikesell, Ph.D.

The sun is getting low in the sky on this ideal spring Saturday.  Planting and pruning have created a hum of activity all day in Jane and Tom’s new neighborhood.  The family across the street who they do not know well invites them to a gathering of several new neighbors.  The successful gardening on this glorious day taps Jane’s creative energy.  She is feeling up so she encourages Tom to accept the invitation.

 Even though Jane and Tom have always thought of themselves as social they have felt a little reluctant to venture out into an unknown crowd.  Their three-bedroom “dream” house is still waiting to be filled with baby sounds despite two years of  “trying to get pregnant”.  Repeated cycles of hope and disappointment have laid a foundation for a painful reaction to the question:  “Do you have children?” 

Not long ago Jane would spend most of the time at parties in the bathroom with cold water on her swollen eyes.  Tom would feel exasperated because none of his efforts would make her feel better.  He would even deny that the children question upset him thinking he needed to stay positive to help Jane.  Their communication with each other at these times was reactive and defensive.  They had a hard time communicating a sense of togetherness, a sense of loving and being loved.  Their interaction at this time might have gone like this.

They are walking out of the house heading home after one of these events.

Jane:  I just don’t understand why people have to be so insensitive.  Why is she so stupid? Doesn’t Pat know that it isn’t helpful to tell me that I always can adopt.

Tom:  Pat didn’t mean to offend you. You know she was just trying to get out of an awkward situation.

Jane:  I feel all alone.  Nobody understands. Don’t you get how painful her insensitivity is to me?

Tom:  Sure I do. But getting so upset doesn’t make it better.

Jane:  Well what do you want me to do just swallow it all like you do!

Tom:  I cannot ever get it right for you.


They walk the rest of the way home side by side but feeling miles apart, misunderstood and disconnected.

Infertility challenges the best relationships. Jane feels hurt when Tom appears to be defending Pat.  Tom feels powerless when his attempts to sooth Jane prove ineffective.  Both partners find themselves reacting defensively and not attending to the impact their words are having on each other. Warmth, fun and happiness will diminish between them with repeated disappointing exchanges.  They will feel farther and farther apart.   In the early stages of their relationship they were so in tune that they “got” each other without much work.  Now they feel like they are living on two different islands without a bridge between them.   How do they reconnect? 

Happiness is usually linked to family building or resolution for the infertile couple.  Jane and Tom can regain access to the connection and joy in their relationship by moving their focus from this outcome to what is happening between them.  Creating an atmosphere between them that feels safe is where they would start.  This can happen even in the midst of all the distress that the infertility experience evokes.  Safety in a relationship is enhanced by being respectfully heard and understood while addressing frustrations, upsets and hurts.  Tom will need to learn to hear Jane’s upsets as just that, her upsets, and not interpret them as indirect communications or criticisms of his sensitivity or caring.  Jane can learn to state her frustration in terms of herself not others.  Both partners can learn to consciously communicate in a respectful, nondefensive way. 


Here is how Jane’s and Tom’s conversation might go with these changes.

Jane:  I really felt so upset after Pat told me I could just adopt when I told her we had been trying for two years to get pregnant. I get very irritated with people who don’t think about the impact of their words.

Tom: So you were upset after talking with Pat and feel irritated with her because it didn’t seem to you like she was thinking about the impact of what she said.  Am I understanding you?

Jane: Yes. It made me feel alone, invisible, like nobody understands how painful this is.

Tom:  So when that happened you felt alone and invisible like nobody gets how painful this whole experience is.

Jane:  You do.  I just want our baby.  I don’t want to think about adoption now.

Tom:  You want our baby.  So it makes so much sense that you would feel hurt when Pat made it sound like we could easily substitute an adopted child for our baby. (He puts his arm around her shoulder)  I guess it makes you feel sad that so many people don’t understand how painful it is for us to want a child and not be able to have one. 

Jane: (Nodding her head) Yes, really sad. (Looking at Tom) Tell me how it was for you tonight with the talk about kids.

Tom:  Okay.  I just don’t let it in.  I change the subject if I can..  It was hard when Bill started talking about the t-ball game and asked me when we were going to contribute a team member. 

Jane:  When Bill talked about t-ball and wanted to know when you were going to give them a new team member you just don’t let the upset get in and try to change the subject.  Did I get you?

Tom:  Yes you did sweetie and now I would just like to look at the beautiful moon and enjoy walking home with you.  I love you.

Jane:   I love you too.


They kiss and walk the rest of the way home arm in arm.


How do Tom and Jane make these changes? They learn to be more conscious in their relationship, to build an uncluttered bridge between the islands of their unique, individual perceptions of infertility.  As they prepare to listen to each other they imagine themselves standing on their own island at the base of the bridge.  Proceeding over the bridge Tom leaves behind any of the trappings from his island that would interfere with his reception of Jane’s words or create a reaction in him.  In other words he brings his unencumbered curiosity to Jane’s island in order to truly “get” her experience.  Jane does the same preparation to listen to Tom.   Jane prepares herself to speak by framing her message in “I” statements, rather than “you” statements or global third-person statements.

The communication tool they have learned is The Intentional Dialogue, developed by Harville Hendrix, and taught by Imago Relationship Therapists.   Through this more validating communication pattern they learn how to support their individual experiences while restoring the connection between them.  Three distinct processes for the listener are involved in the dialogue, Mirroring, Validating, and Empathizing.


Mirroring is repeating back nondefensively and without judgment what the partner has said.  The listener continues the mirroring or holds the partner’s experience, without comment, until the partner indicates s/he is finished.

Validating is giving feedback to the partner that what s/he is experiencing makes sense from his/her point of view. The listener that is fully present on his/her partner’s island can see things through the speaker’s eyes.  The listener expresses nondefensively that the speaker has a valid point of view even if it differs from that of the listener’s view.

Empathizing is the ability to imagine, from the speaker’s point of view, what s/he might feel about what has been said.  These feelings might be different from what the listener might feel in the same situation. 


 Through this type of communication Jane and Tom become more assured that they can ride the emotional roller coaster and master the decision-making maze of infertility together.  The closeness that inevitably comes from these exchanges increases their intimacy and reminds them of how glad they are to be with each other. Happiness returns as the delight and sense of good fortune they have with their relationship.


Susan G. Mikesell, Ph.D. is a psychologist in private practice and a certified Imago Therapist inWashington, DC.  Her specialties include: Infertility, Stress, Career/Life Work,  Hypnosis, Depression, Women's Issues and Wheelchair Access


Phone: (202) 363-9600



Enhancing Your Relationship During Infertility By Sharon Covington, MSW, LCSW-C

Most couples enter the path towards parenthood expecting that it will occur without too much problem.  After all, they spend most of their lives trying not to get pregnant and assume that when they consciously start trying, pregnancy will soon be achieved. As the months or even years go by without a baby, and efforts to achieve pregnancy are increased—from intrusive testing to high technology treatments—the path turns into the emotional rollercoaster of infertility.

 Infertility can be a real test of a couple’s relationship and shake the foundation of a marriage.  It can make a solid relationship stronger and weaken the core of a troubled one.  Because infertility is a crisis, it is out of the realm of experience of most couples and thus challenges them to develop new strategies and coping mechanisms to deal with this life crisis.  The good news is research has shown that, for most infertile couples, the experience strengthens their marriage by teaching them life-long skills to deal with problems.  Since infertility is one of many challenges couples may face in their life together, the skills learned can be adapted to use at other difficult times. 

Relationships, like anything you want to grow and thrive, have to be tended to flourish. They are like a garden that must be carefully planted and then receive adequate amounts of nutrients such as sun, water, fertilizer, and cultivation to blossom.  If the garden is neglected too long or receives too much of these nutrients, the plants will wither and die.  Relationships are also like a bank account—you can’t continue to make withdrawals without depositing something back or you will end up overdrawn.  Infertility can be like a “withdrawal,” draining intimacy from your marriage and depleting your emotional resources. It can cause you to neglect your relationship, focusing all energy on the baby quest.  In effect, infertility can create a life of its own in a marriage, causing you to lose sight of what brought you together in the first place and what is necessary for a healthy family to grow in the future.

For a marriage to survive the crisis of infertility, couples have to learn to continue to make “deposits” and “tend the garden.” Understanding the ways in which the stress of infertility can strain a relationship, couples must make special efforts to put positive energy into a marriage during this time.  If you are an infertile couple, there are steps you can take to enhance your relationship so that it grows and thrives.  The following are some suggestions to help you along the way:


Work as a team.  No matter who is identified as “the patient,” infertility is a couple problem. Always approach the issues as a team, working together and finding ways to share responsibility regarding treatment. Avoid finger-pointing as nobody ever wins the blame game.


Plan playtime.  Since dealing with infertility can feel like a full-time job, it is important to “take time off” by consciously make time for each other.  Have regular dates where you can have fun and take a break from infertility.  Vacations are also playtime, and having things to look forward that are under your control is positive. Look for ways to put nurturing energies in the relationship, making your partner a priority. 


Separate baby-making from love-making. Infertility often puts strain on a couple’s sexual relationship and what was once fun has now become a tedious job.  You may want to designate different rooms in your house for your intimate work versus play.  Remember the ways you enjoyed sex early in your relationship and find ways to recreate it.  Plan romantic encounters at non-fertile times, such as a bubble bath together or giving a massage. Understand that sexual intimacy does not have to mean intercourse and use your imagination to plan recreational sex.  


Build a support system.  Couples often have an unconscious expectation that their spouse will be able to take care of all their emotional needs.  This is a daunting task during infertility and an impossibility for any relationship. Infertility can be an isolating experience and put undue pressure on a partner for providing all emotional support. Support from others can strengthen relationships, especially during times of stress.  Encourage friendships for yourself, your spouse, and as a couple.  Work towards balance in your support network by having friends both in and out of the infertility world.


Identify individual coping styles under stress. Know your own and your partner's styles for dealing with stress.  Learning how to accept differences in the way each of you handles and deals with your feelings can lessen conflicts.  Like many things in life, men and women will feel and deal differently with infertility. However, different doesn't mean better or worse; it only means not the same. 


Allow breathing room in your relationship. Realize that marriages are fluid and in a constant state of change due to the many external and internal factors in your life, including infertility. During times of stress, try to give each other some space and distance to allow for transition. Understand that couples are seldom at the same place, at the same time, when at treatment crossroads.


Communicate the positives. Often we neglect to communicate our positive feelings to our partner, and all he or she may hear are negatives. Changes in behavior come more from positive reinforcement than from negative. Also, infertility may consume your life and engulf all your conversations. It may be necessary to put limits on the time you talk about infertility to designated periods, such as 20 minutes in the evening, so that it does not overtake all your communication.


Keep a sense of humor.  No matter how tough things get, being able to find something humorous about the situation helps to relieve the tension. Laughing together is good for the health of your relationship.


Seek help before problems get too big. Infertility can put terrible strains on relationships and couples need to consider counseling as a resource of support and information to deal with problems.  If you find that you are at an impasse or your usual coping strategies aren't working in the relationship, counseling may help.  Don't wait until things get critical. 


Sharon N. Covington, MSW, LCSW-C is theDirector of Psychological Support Services atShady Grove Fertility Reproductive Science Center inRockville, Maryland

She is the Assistant Clinical Professor, Department of Obstetrics and Gynecology

Georgetown University School of Medicine, Washington,D.C.


Phone: 1-888-IVF-0500



For more support check out the Emotional Issues Forum on the INCIID Website



Keeping Your Sex Life Alive While Coping With Infertility By Judith C. Daniluk, Ph.D.

There can be little doubt in the mind of anyone who is dealing with, or who has dealt with being unable to produce a child, that the experience of infertility and the long, arduous, invasive and costly medical investigations and fertility treatments – take a tremendous physical, emotional, financial, and sometimes even spiritual toll on infertile individuals and on their relationships.   Infertility affects a person’s feelings about themselves – their masculinity or femininity, their self worth, their self esteem, their body.  It affects their relationships with others – their fertile friends, their family members, their co-workers, and their spouse.  And inevitably, it affects their sexuality and sexual relationship with their partner – in terms of their sexual self worth, their sexual desire, and the satisfaction they get from being intimate with their partner. 

However much pleasure couples derive from their initial efforts to produce a child, infertility and the prolonged pursuit of medical fertility treatments appear to have a negative impact on couples’ sex lives – during and even after they stop pursuing treatment.   During infertility treatments 50% to 60% of couples report significant decreases in their sexual satisfaction, with levels of satisfaction deteriorating even more the longer couples are involved in treatment.  This is especially the case for couples whose levels of sexual satisfaction were not high, or who were experiencing sexual problems in their relationship prior to infertility.   Women in particular report significant negative changes in terms of decreased sexual desire, difficulties in getting aroused, problems in achieving orgasm, lack of foreplay, and painful intercourse.  Some women are plagued by intrusive thoughts and memories during lovemaking – often associated with the invasive and sometimes humiliating medical investigations and fertility treatments.  Twenty to 30% of men going through infertility treatments experience episodes of sexual dysfunction – most commonly impotence and premature ejaculation.  And in a study I conducted with 65 infertile couples after they had terminated their medical efforts to produce a child, sexual dissatisfaction continued to be reported by the majority of participants in the study.  Although many couples felt their marriages were stronger as a consequence of having “survived” infertility, sexuality was the one area in their relationships that most couples felt had never fully recovered following medical fertility treatment – in terms of returning to their pre-infertility levels of sexual spontaneity, pleasure, and overall satisfaction.

It is important therefore, for couples who are trying to have a child, to understand why and how sexuality can be negatively affected by a diagnosis of infertility and the procedures involved in the medical investigations and treatment of infertility.  Given the very negative long-term sexual toll that infertility appears to take on many couples’ sexual relationships, suggestions are provided in this article on ways couples can avoid some of the common pitfalls and keep their sexual relationships vital and satisfying during the stresses and challenges of coping with infertility.


Why Does It Happen?

Most relationships change over time in terms of sexual frequency, intensity, and levels of satisfaction.  All couples experience changes in their sex lives – with sexual frequency tending to decline over time and most couples falling into routines in terms of when and where they have sex, who initiates, and what usually happens. These are normal changes that occur in most relationships – and if they become troublesome for couples, they usually require some work and attention to put right.  Keeping sexual passion and intimacy alive in any relationship requires energy. Basically you get out of it what you put into it.

But the changes in sexual desire and frequency that are typical in the life of any couple, are different than the changes that result from infertility and medical treatment.

There are many reasons why a diagnosis of infertility and medical fertility investigations and treatments can have a negative impact on a couple’s sex life.   Perhaps the most common and obvious problem when couples are trying to get pregnant is that the purpose and goals of sex change.  Prior to trying to have a family, sex for most couples is about playfulness and the delightful exploration of each other’s bodies with the sole objective of giving and receiving pleasure.  However, when couples are trying to produce a child, the goal of sex changes from recreation to procreation.  Having sex is no longer a spontaneous act based on mutual desire, lust and passion.  Rather, something that once was a great source of pleasure and fun becomes a task that has to be done based on the calendar – on the two or three days of each menstrual cycle when the woman is ovulating and can become pregnant.  Sex becomes focused on intercourse – on egg meeting sperm – rather than on the many erotic pleasures that are part of a full and satisfying sex life.           

In the beginning, some couples find that sex focused on trying to create a new life together – on becoming parents and taking their relationship to the next level – is very exciting and intense.  However, as the months go by without a pregnancy, sex for the purpose of trying to produce a child becomes an act associated with repeated failure – failure that plays itself out each month in the woman’s body.  Couples begin to feel that no matter how much energy or enthusiasm or effort they invest in trying to get pregnant – it likely isn’t going to happen.  They probably won’t get pregnant.  Month after month, the outcome is the same – understandably reducing the desire to keep climbing between the sheets together and have sex.  After all, who would want to keep pursuing a goal that in spite of their best efforts, they seem unable to achieve?  Who wants to feel like a failure?

This is especially true for the partner identified with the fertility problem who usually feels like a double failure since it is their body and reproductive system that isn’t functioning “properly.”   As well as feeling physically “defective,” because fertility is so closely linked with sexuality, the person with the identified problem often feels sexually deficient in being unable to do one of the most basic and most important things in life – producing a child.  Men often feel ashamed of their inability to produce motile, healthy sperm in sufficient quantities, and women blame themselves when their eggs, tubes or uterus aren’t viable.  Both men and women feel guilty for letting their partners down.  It is very difficult to feel good about sharing your body and being intimate with your partner when the feelings that have come to be associated with your body and your sexuality are shame, guilt, self blame and failure. 

Under these circumstances, sex, and the feelings of shame, guilt, and failure associated with being infertile, become something to be avoided.  Over time infertile couples often find that they rarely make love anymore, except during the woman’s fertile period.  And even then, partners often find themselves staying later at the office or stopping for a few extra drinks after work, or picking a fight just before going to bed, to avoid having to have sex…to avoid all the negative feelings that have come to be associated with sex.  While understandable, such avoidance only exacerbates the problem – as feelings of anger and resentment can begin to fester and the woman or man start to question their partner’s investment in, and commitment to having a child. And if it is difficult to want to be intimate with one’s partner when sex engenders feelings of failure and shame, or when a person feels like their body has let them down, or when sex feel like work, feelings of anger and resentment are even more toxic in dousing the flames of sexual desire. It is extremely difficult for most men and women to perform sexually, much less want to perform sexually, when they are feeling angry or resentful with their spouse.

Finally, and not surprisingly, the medical investigations and treatments that couples must endure over the course of months and even years in their efforts to produce a child, take a tremendous toll on the sex lives of most infertile couples.  The questions asked by nurses and physicians are pointed and invasive.  How many sexual partners did they have in the past?  Have they ever had an abortion or sexually transmitted disease?  How often do they have intercourse? Does the man get an erection and ejaculate while inside his partner?  How frequent are her periods and how long do they last?  What is her flow like? The majority of tests and examinations are focused on the male partner’s genitals and the female partner’s reproductive organs.  They are poked, prodded, examined, tested, x-rayed, and biopsied.  Making a baby becomes a clinical process … one that isn’t even remotely intimate. What once was private and intimate between a couple, becomes public and clinical.  It is pretty difficult for a woman or man to feel good about themselves or their bodies, much less to go home and have spontaneous, uninhibited sex with each other, after he has had to masturbate into a sterile cup or has had a biopsy on his testicles, or she has had a speculum and catheter inserted into her vagina and cervix or superovulation medication injected into her belly.  


What Can Couples Do?

In light of the very real strains and distress of being infertile and the realities of the invasive medical investigations and treatments, some sexual problems and dissatisfaction are inevitable for all the reasons discussed above. However, there are things couples can do to lessen the potential negative impact that infertility and medical intervention can take on their sex lives.  The following recommendations can go a long way towards reducing the negative impact of infertility, and can help couples maintain the sexual vitality, pleasure and intimacy that are an important and cherished part of their relationships. 


Body Love

Sex is about a lot of things.  It runs the gamut of feelings, means different things at different times, and has a multitude of purposes. But the one constant is that sex is enacted with our bodies – through touching, holding, caressing, kissing, and sharing the most intimate physical contact.  When you feel like your body has been under assault through all the fertility testing and treatment, or when you have put on weight from the medications, or when you feel your body has failed you in your efforts to produce a child, it can be very difficult to share this part of yourself with your partner. 

It is imperative, then, that you take care of, and stay connected with your body throughout the process of trying to conceive – if you are to get any enjoyment out of being sexual with your partner.  That means making self care – nutrition, sleep, and regular exercise – a priority.  On top of working and fitting medical appointments into your life – not to mention the sheer exhaustion of the process of coping with infertility – it may seem like there just is no time for anything else.  But in fact, this is one investment that is bound to net great rewards.  When you make a point of taking care of your body, you inevitably end up having more energy to cope with the strains (and disappointments) of treatment, and more energy for, and interest in being intimate with your partner.   

Also, from the outset of trying to find medical solutions to your fertility problems, you and your partner should educate yourselves about what is involved before going for tests or treatment procedures.  It is always easier to cope with something if you know what to expect (the HSG being a good example of this).  You would be well advised to ask the doctors and nurses for information on the diagnostic and treatment procedures, to read books, to watch informational treatment videos, and to go on-line to find out more about what is involved in the tests you are facing and the treatments that are being recommended.  You and your partner should also assert yourselves in terms of your needs and your rights to protect your dignity (e.g., insisting on privacy during consultations and procedures, asking that instruments be warmed before they are inserted, requesting that your partner be allowed to be present, etc.). The more you and your partner can do to maintain your dignity and sense of choice and agency, the greater the likelihood that you both will get through the treatment process with the least amount of damage to your self esteem, body image and sex life.

And when you don’t feel good about your body, it can be good to turn to your partner for help – being sure to tell them how you feel, and what you need.  Feeling the gentle touch and caress, and being in the arms of the person you love, can go a long way in helping you to feel better about yourself and your body. 


Separate Sex for Procreation from Sex for Recreation

Although a certain amount of work sex can’t be avoided when you are trying to get pregnant, it is important to limit those “goal-directed” encounters to the specific time of the month when you are likely to be ovulating.  If you are like most infertile couples, you usually know exactly where you are in your cycle at any time. In fact, one of the burdens of infertility is an almost obsessive focus on the menstrual cycle, and one of the indicators that infertility is no longer taking up as much space in your life is the fact that you no longer automatically know what day of the menstrual cycle it is.  Inevitably, when you are forced to have intercourse because you’re ovulating or taking fertility drugs – not because you feel like making love – it is likely to feel like an obligation.  But love-making doesn’t have to feel like an obligation the rest of the month.  After all, there are 365 days in the year and only 2 or 3 days during any month when you can get pregnant.  That means there are approximately 329 days of the year when fertility is not a possibility, and ideally should not be an issue.   

During those few “fertile” days, you and your partner would be well-advised to use fantasy, erotica, and any other forms of sexual stimulation that works for you, to get through and ideally even enjoy the task at hand.  It can be helpful to create rituals around “baby-making nights” – making these particular encounters different and distinct from your other intimate times together throughout the rest of the month.  It is easier if you both are able to acknowledge the purpose of having sex at that time of the month, and where possible, to add some humor and fun to these encounters.  When you’re having sex because you have to, not because you want to, it can be helpful to change the setting.  If you have a spare room in you home or apartment, you might consider having sex in that room – or maybe on the living room couch during baby-making nights – leaving you bedroom for your more erotic and intimate sexual encounters during the non-fertile times of the month.

During the other 329 days of the year when making a baby isn’t possible, you need to avoid the tendency to say, “to heck with it, why bother having sex, we can’t get

pregnant anyway.”  Instead, you need to make a point of enjoying each other and enjoying sex for all the varied purposes it serves in you lives and in you relationship – for pleasure, validation, intimacy, fun, connection, excitement, and as a way of expressing caring and love.  This may require that you step outside of the box of what is “normal” and “typical” in your sex life.  It may mean giving yourselves permission to step out of you comfort zone and incorporating new and exciting activities into you sexual play such as body massage or erotic movies.  It may mean changing old patterns by having sex at different times of the day and in settings other than the bedroom at night when the lights are out – or changing who initiates the encounter.  As noted earlier, in any long-term relationship, sex can become routine and it can be difficult to keep things exciting and vital.  Add infertility to the mix, and that becomes even more the case.  So whatever you can do together to bring back the romance, fun and excitement to your intimate encounters – will be well worth the effort – while you are dealing with infertility, and long after when you no longer are hoping to get pregnant. 


Beyond Intercourse

In most cultures of the world whether someone is considered to be “sexually active” is directly connected to whether they are having intercourse.  In fact, intercourse is considered thesexual act – with virtually all other erotic, sensual, and sexual interchanges and activities being categorized as foreplay – things that lead up to the main event of intercourse.  Intercourse can, under conditions of personal choice and agency, be a wonderfully exciting and fulfilling aspect of sexuality.  However, as noted above, when trying to produce a child and coping with infertility and medical treatments, intercourse frequently becomes associated with work, obligation, and failure.  And when it is the expected and inevitable outcome of all sexual encounters, it can become oppressive, unsatisfying, and something to be avoided.

That being the case, it is very helpful if you and your partner can move beyond the mind-set that intercourse is sex, and that all other erotic and intimate activities must inevitably lead to intercourse.  There is an enormous range of pleasurable, intimate, sensual and erotic activities that you can enjoy other than intercourse – activities such as kissing, caressing, massaging, fondling, holding, licking, sucking, tasting, watching, reading, etc. – activities that often are as satisfying and enjoyable whether or not they end in one or both partners having an orgasm. These activities are not part of the traditional sexual script and when disconnected from the expectation that they will lead to intercourse and orgasm, they do not have the same associations with obligation, expectation, and failure that characterizes intercourse when you are trying to have a baby.

Consequently, one very effective way to maintain passion, desire and sexual intimacy in your relationship while dealing with infertility, is to clearly designate certain times during the month – when ovulation is not occurring – as times for exploring and engaging in intimate activities together that are NOT expected to lead to, or end in intercourse.  Because the social link between sex and intercourse is so firmly embedded in our cultural beliefs about what constitutes normal and fulfilling sex, this disconnect can, in the beginning, be difficult to achieve.  That being the case, it is sometimes easiest at first to designate one particular night of the week as your “intimacy without intercourse (IWI)” night – a night when the only goals of your interactions are intimacy, exploration, pleasure, and connection.  You can get some great ideas and suggestions on the many ways couples can pleasure each other in Lonnie Barbach’s book “For Each Other.”  Some of the basic books on Tantric Sex can also be a good source of idea on non-intercourse ways of enhancing the erotic and intimate parts of your relationship.



The relationship is the context or container for sex and intimacy within any marriage or committed partnership.  Dealing with the inability to have children can place tremendous strain on the healthiest of relationships.  Although surviving infertility often results in bringing couples closer together, the process of coping with the ongoing stresses of infertility and medical treatment can test the metal of even the best of relationships.  Misunderstandings are common, and social isolation from the rest of the fertile world, while adaptive in some respects, can place even more pressure on each partner to be there for, and to understand, the needs, feelings and desires of the other. 

The pain of treatment failure and the distress of being unable to have a child will at times make it difficult to even speak to your partner, much less wanting to have sex.  If you are angry or frustrated with your partner, it is unlikely that you are going to want to make love or have sex.  If you feel he or she doesn’t understand how you feel, or doesn’t appreciate what you need – having just given a sperm sample or received the results of a negative sperm analysis, or having recently been through a particularly uncomfortable or unpleasant test or treatment, or having found out that treatment has been unsuccessful – you may find it difficult to be in the same room together. 

If you are to get through the experience of infertility and medical treatment with your sex life in tact, it is going to require that you pay serious attention to your relationship.  Through the stresses and incredible strains and disappointments of trying to have a child together, you’ll need to nurture and take care of each other and your relationship.  You’ll need to remember that the reason you are upset is because you care enough about your partner to want to become parents and raise a child together.  You’ll need to remember that part of your distress is because you want to share the experience of creating a life with your partner and seeing the things you love about him or her reflected in your child, and you’re afraid you’re not going to have that experience. And you’ll need to remember that although you may handle the stresses differently, and although at times you may not express yourselves in the same ways, or seem equally invested in the process of trying to have a child – you are in this together. 

That being said, it is imperative that you communicate with each other – about your needs, desires, wants and fears – about your relationship, about infertility, and about your sex life.  It is important that you not expect your partner to know how you are feeling or what you need. When you want to be held or caressed but not make love – you need to say so and not assume that your partner knows that – or why you feel that way.  It is important that you not expect your partner to share or express the same feelings, at the same time, and in the same way as you – or to assume that she or he should feel the same way as you do.  For your partner, the sexual release of orgasm might be important, while for you the physical contact and intimacy of holding each other might be what you need.  Or one or both of you might need some physical space from each other. And it is important to recognize that sex may well have very different meanings to the two of you, at different times. For one of you sex on a particular evening or day may be about intimacy and connection, while for the other it may be about the release of stress and tension – different purposes and meanings, but both are equally valid. 

The key to communicating effectively about your emotional and sexual needs is not to assume that you know what your partner wants, or is thinking or feeling.  Don’t make assumptions – and don’t assume she or he can or should be able to read your mind.  Infertility places unbelievable stress on most relationships, and touches at the core of what it means to be a man or woman and what it means to be a couple.  Negotiating the waters of infertility is uncharted territory for you both, and you are both doing your best, within your personal and collective resources, to find a way to cope with infertility while trying to keep your relationship in tact and your sex life alive.  So be kind to yourself and to your partner – talk, listen, don’t assume, don’t expect, and give each other the benefit of the doubt.   



Early Intervention

Not surprisingly, if your sex life was satisfying and vital prior to dealing with infertility, you’re likely to fair better throughout the medical treatment process.  You may still struggle with the lack of intimacy and burden of work sex.  But when your sex life starts to falter, you and your partner will be able to fall back on and incorporate the sexual and erotic activities that used to give you pleasure, and comfort, and joy – prior to the intrusion of infertility in your lives and in your relationship.  It may take a conscious effort on your part and on the part of your partner, but at least you have a vital sexual history to be able to build on during the more difficult times of dealing with infertility.

On the other hand, if you didn’t experience a lot of sexual desire or pleasure, or if you experienced problems in your sexual relationship prior to infertility, or if sex was never a particularly vital or important component of your intimacy – there is a greater likelihood that you’ll experience sexual dissatisfaction and that the difficulties in your intimate life will be exacerbated when faced with the stresses of infertility.  The obligation of having to perform sexually upon demand and the indignities of the medical treatment process may present quite a challenge for you and your partner.  You may have outstanding relationship issues that are also playing themselves out in your sexual relationship and getting in the way a more satisfying intimate relationship. 

As noted above, the longer you are involved in pursuing treatment, the greater the likelihood that your sexual relationship will suffer. And once lost, it appears to be extremely difficult for to recapture the passion and pleasure and satisfaction that may once have characterized your intimate relationship.  That being said, if you felt your sex life could have used some attention prior to dealing with infertility, it is a good idea to get some professional help before getting too far into the infertility treatment process.  The same holds if you find during treatment that infertility is destroying what once was a vital and healthy part of your relationship.  Or if you find that you’re at loggerheads with your partner and unable to communicate.  With some professional assistance from a marital and sex therapist, not only is your sex life likely to improve, but your overall relationship will likely become stronger and more satisfying as a result of counseling.



Infertility can and often does challenge relationships at their very core.  And certainly, sexual intimacy is one very important and core aspect of most relationships.  It can be destroyed by infertility, it will certainly be challenged by infertility, but with attention and nurturing and understanding, it can also be enriched – in terms of greater intimacy and deeper connection. 


Judith C. Daniluk, Ph.D. is a professor in the Department of Educational and Counselling Psychology at the University of British Columbia and clinical consultant to Genesis Fertility Centre in Vancouver, Canada,  She specializes in infertility and sexuality, and is the author of numerous articles on sexuality and infertility, including The Infertility Survival Guide:  Everything You Need to Know to Cope with the Challenges, while Maintaining Your Sanity, Dignity, and Relationship, as well as Women’s Sexuality Across the Lifespan:  Challenging Myths, Creating Meanings.


Infertility makes Father's Day forever bittersweet by Jeffrey Collins

Infertility makes Father's Day forever bittersweet 
By Jeffrey Collins  (Caution: Child Mentioned)


Like a lot of men, I'm sure, Father's Day never meant a whole lot to me. For most of my life Father's Day was only about my dad, and whether or not I'd remember to call him on "his day" or whether I'd just mow the lawn in homage to him instead. In my lifetime I've had only one friend who'd said that he'd always dreamed of being a dad. But he seems to be the exception in our crowd, not the rule. I know Father's Day certainly never meant as much to me as Mother's Day meant to my wife.

For a long time I didn't know how important all this was to her because my wife and I didn't plan on having kids right away after marriage. We weren't young exactly, having finished college and started our careers. But we just didn't see there was any need to rush things. We had our careers and years full of travel to wonderful places; hobbies, house-buying and remodeling, raising our pets, and enjoying each other without distractions. And besides, did the people with kids look all that happy, anyway? I remember how we always used to joke between ourselves that they didn't. And I'd just always felt convinced, and thought my wife did too, that there was plenty of time for things to work out.

But still nothing happened. We tried harder. For years. Basal body temperature and charting everything from drinks with dinner to the actual act itself ruled our lives. What had been a pleasure became a duty. It became less like making love and more like doing a biology lab project. A seemingly never-ending project which we were apparently failing over and over again. When we started trying artificial insemination it was really strange, and I started to wonder why we were trying at all, since it just seemed that for us, it wasn't going to be possible.

Eventually, we gave up. So for me, Father's Day seemed like something that just didn't apply to me. We'd tried for years, but if the fates held that we were going to be childless, then so be it. There were other things to devote our time to, and surely a married life filled with travel and leisure would be an acceptable substitute for having children. I could live with that.

But my wife couldn't. For her there would always be a missing place in her heart where her love for a child should be. It didn't always show, but sometimes there would be inexplicable sorrow, or anger over something that seemed small to me. Other couples, even strangers, would get pregnant, and she would be jealous and hurt. Pets would get pregnant, and she would be jealous and hurt.

I remember the day when I came home from work and found her laid-out on the living room floor, weeping. She'd opened the mail when she got home from work and had gotten two birth announcements on the same day. To me these things seemed trivial, but to her these things were a horrible reminder of what she couldn't have. And it was more painful for her than I ever understood. So, seemingly defeated, we stopped trying. And something quiet and vague in her seemed to begin to die. Although I regret having to mention that I never really noticed it, and completely misjudged how deeply affected she'd become.

After a number of years like this, we agreed to start trying again. And finally, but also quite suddenly, after ten years of marriage, we got pregnant. We got the daughter that my wife had always wanted. And I found out that a baby in the house changes everything, but in pretty wonderful ways, by-and-large. After sufficient time had passed for us to recover our strength, we optimistically decided to try again. We tried, and tried, and tried again. We sought-out fertility specialists and spent thousands of dollars. For two years we returned to the sort of sex-life infertile couples live. But as fate would have it, we would never get to have our second child.

So even though I am a Father to a wonderful little girl, I will never experience that joy again. And Father's Day, among other things, reminds me each year that I'll never get over the regret I feel about that. I have one child to cherish, but I also worry constantly that something will happen to that one, priceless, precious child. And, as "the man of the family" I wonder what sort of strength I don't feel I possess that it'll take to get me through that sort of emotional decimation. And I secretly suspect, just as it was with trying to conceive, it'll probably be my wife who'll be the driving force that sees to it that I survive that sort of unimaginable loss. And it leaves me again amazed at her strength and ability to persevere despite terrible odds and obstacles.

And now Father's Day does mean something to me after all. It means something pleasing and satisfying to me as a father, to be sure. But it also reminds me that I am a man who has tried to be a father, but who has failed over and over again. I've discovered that, much to my surprise, years of failure to reproduce really aren't erased by a single success. I understand now a little bit of what my wife felt for years when she wanted so much to have a baby, but couldn't. I'll never know how strong the depth of her yearning for a child was, and how deeply felt her hidden depression was. But I understand at least a portion of it now, or some degree of the sensation, if only just a little bit.

My message to all would-be fathers is this: Keep trying, and give your wives all of the love and support you possibly can. And, if you can manage it, then give them even more. Because even if it doesn't seem worth the time and anguish and expense, it may just be worth more than you realize, not only to your wife, but also to yourself. This is a journey no one should have to take. But at least it's not a journey we or our partners make alone, and that's a blessing.

And know, whether you're finally successful or not, that there likely will remain for you a bittersweet nature to Father's Day which, for this incredibly, unbelievably lucky man, has never gone away. I've learned over our years of marriage and years of trying that even though we were finally able to achieve our little success, we're always going to feel as if we'll remain an infertile couple. A couple whose failures so outweighed our single success that the scars of our infertility seem likely to remain in our lives forever.

The men who haven't yet been able to become fathers and the men who've stopped trying are never far from the thoughts of the men who've had even the smallest of successes. Especially, I've learned, on Father's Day.


Jeffrey D. Collins, 

Editor's Note: Jeffrey is the "dh" (husband) of one of INCIID's volunteers.