Today it’s common knowledge that infertility is the inability of a couple to conceive. Infertility can be in a male, female, or both. It is equally devastating, for both the genders to know that they are being termed infertile. It has various psychological as well as social effects on the couple. Bringing an offspring into the world is a goal of every couple, to know that there are few obstacles to be faced, does lighten the heart of them. Around 10%-15% of the couples are currently infertile, all around the globe. Medical science has grown a lot of treatments for infertility or assisted reproductive technology to ensure that almost every infertile couple can have a biological child. In recent years, doctors are researching and focusing on the psychiatric treatments for these couples as well.

The stress of the inability to have a child can be associated with emotional issues such as anger, depression, anxiety, marital problems, and feelings of worthlessness among the parents. Current studies show that women have higher levels of distress than in their male partners. Various research studies support the theory that women find it as their responsibility to bear a child, and when they come to know that they can’t self doubt arises as their self-respect gets affected. The pathogenesis of infertility proves that there are psychological factors that play a key role in this disease. Exploration of this issue will prove to be an important task in managing this disease, and maybe even eliminating negative cultural and social impact.

The magnitude of this issue in India

As we have mentioned that infertility is a growing problem. We aren’t alien to how Indian society finds topics like menstrual and infertility as taboos. Today one to two in every ten couples might have infertility, but do we have any awareness program regarding them? Can a couple talk about infertility openly in our country? The development of medical science has found the required treatments, but we need to understand why only a handful of Indian couples appear from treatment. For low-income classes there are many affordable infertility clinics, still, they are the ones who visit them the least.

Fertility doctors have concluded that this social and psychological barrier is not letting the maximum of the couples to visit/complete the treatment. Couples even fear the unknown but accepted public embarrassment, after the news of their infertility gets spread. Government and doctors have considered the association between psychiatric illness and infertility. Researchers have also noted that infertility treatments are very necessary for increasing mood and feeling of well being in the affected population. Still, the information regarding effective psychiatric treatments along with infertility treatments isn’t common knowledge.

Gender-specific reactions to infertility and ART

Medical researchers have proved that men and women react differently to infertility, as their approach is different so should be the management tactics. For women, the inability to conceive is one of the most upsetting events. They are the ones whose emotional reactions are more visible. This perception might get even stronger as with differences in cultures the emphasis on children and motherhood increases. Even today many cultures take it has a primary role of women to give birth to children (heir).

Some authors suggest that men and women find infertility equally distressing, it’s just their ways of expression are different. While some argue that women are more affected by men, due to the traditional concept of gender roles. This is a long debate between medical researchers and till now it is only theoretically accepted that women get more affected. Furthermore, it has been observed that certain current study designs are less responsive and inaccurate towards typical male emotional expressions. They may not capture the entire range of a male’s reaction towards infertility.

Another aspect is that male infertility is considered a taboo, and it’s a matter of one’s pride. In such situations, where females are sad and sometimes loud about it, compared to them, males are stressed and reserved. This happens to hide or accept the fact. As far as management strategies are concerned, males tend to benefit from the knowledge as they maintain a pragmatic and aim-oriented approach while women find it helpful to have someone to share their emotional reactions with. Furthermore, it’s the primary vision of living a life without children that haunts them. Even after discussing multiple treatments and ART (Assisted reproductive technology) it is hard for them to cope up.

In social life, males follow a breadwinner’s role, this happens in many societies and cultures. While the majority of women are homemakers, the ones who are not, most of them look at domestic duties too. This is common most of the cultures, so society questions their family’s future, where man is taunted by the money he has made and the same happens for the home and warm woman ensure. Thus, societal awareness regarding this natural disease/condition is equally important as psychological help. Another aspect for the couple is they think about the successful and smooth pregnancies their friends and relatives have had. This often impacts their relationships with them. Infertile women ten to lose contact or isolate themselves from their friends and relatives.

As a result, up to 60% of all infertile couples suffer from a loss of libido or erectile dysfunction during infertility treatment, because of all this stress. Menstrual cycles of some women also get affected by this intense stress. Now in the case of couples where only one person is affected by this coitus gets affected, which further decreases the chances of conception. The person loses the libido, male experience erectile issues while female get too emotional during coitus. Many couples have stated that due to these pressures and stress, often the coitus activity seems to be like a task-oriented exercise and not a pleasurable and intimate moment.

Need for Psychological Counselling for Infertility

Psychological counseling for infertility is not different from increasing the awareness of individuals and/or couples by spreading information and skills at the time diagnosis, treatment, and post-treatment stages of infertility procedure. The only difference here is that counseling is offered by a professional through specialized skills of psychology. The patients feel assisted in their decisions for the treatment and develop coping strategies in advance against the possible negative emotions. The number of studies has supported the need for counseling interventions for patients undergoing infertility treatment.

Psychological counselors for infertility can offer services by consulting to theoretical approaches such as psychodynamic, individual-centred, cognitive-behaviourist, or solution-focused interventions. Although the methods employed will be different from one another, yet all of the psychological counselors for infertility adopt the common objective of taking care of the emotional well-being of the patient and work on to boost their psychological integrity.

In psychological counseling for infertility, there is a combination of various counseling options from informative decision-making, supportive counseling, and therapeutic counseling. This involves thorough explanations on the causes of infertility, recommended treatment options, possible results from the treatment, and the ways in which the treatment process can affect everyday life. To ensure a satisfactory session, professionals practice active listening, empathetic approach, using a respectful language toward the viewpoints of every patient, identifying the interest or importance of the problem for the client, and making the targets achievable within the control of the client. It is also aimed to help the patients in understanding that most of their infertility reactions are normal and predictable.

Among the central objectives of infertility psychological counseling is instilling and developing the coping strategies with the couples. It also gives a chance to infertile individuals for seeking ways for enhancing, exploring, and clarifying their quality and satisfaction of life. This shows them the necessity of expressing infertility-related emotions such as deep misery, guilt feeling, and anxiety.

Conclusions

It can be stated that infertility is a serious crisis that can bring several psychological problems. Taking preventive measures for the discovered psychological issues can be effective for the treatment. When a couple undergoes an infertility treatment, and they are aware of the psychological problems they may experience, they adapt the infertility diagnosis and treatment procedure faster. Apart from this, there’s a developing need in the individual or couple to explore their feelings and the human story behind their condition (infertility), also the presence of an individual therapist provides space and time for a mature and positive reaction & interaction between the couple. So for sure, today it is one of the major challenges of medical treatment for infertility, to include psychosocial counseling. The thought that counseling isn’t necessary unless the couple suffers severely, needs to broaden and every infertile couple/person shall be given counseling services. Our society needs to broaden their mindset, for this awareness regarding infertility needs to be spread in every section of the society.