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Psychological Effects of Infertility and In Vitro Fertilization

Forty years ago the first baby conceived using artificial reproductive technology was born, and since that time, there have been an estimated 8 million more babies born using In Vitro Fertilization (IVF) and related technologies [1].  This is hailed by many as a triumph of science and an unquestioned benefit to heterosexual couples who are unable to have children naturally. What is less commonly focused upon are the negative physical and psychological effects that occur as a result of the IVF processes themselves.  While the desire to become a parent is a natural good and the grieving process that can accompany infertility has its own suffering and pain [2], the medical interventions, physiological changes, and stress filled expectations that accompany artificial reproduction also take a costly toll on the persons involved.

The Stress of Infertility

The rate of infertility in the developed world is estimated to be approximately 5-10%, and recent studies conclude that most (upwards of 80%) of this can be attributed to a physiological cause [3] in either the man, the woman, or both.   While psychological issues do not appear to be a primary cause of infertility, they are a significant consequence for many who dream of having children of their own.  The symptoms, which vary from person to person, include depression, anxiety, and poor sense of self-worth, and the intensity is on par with the emotional distress felt by persons diagnosed with cancer or recovering from a heart attack.  Interestingly, although women are generally more likely to experience these reactions, when men are identified as suffering from the physiological cause of the couples’ infertility, they are just as likely to report experiencing such feelings at a similarly intense level.  Conceptually, such feelings are best understood as reflective of a grieving process [4], the loss of the ability to procreate.

IVF Treatment Side Effects

Many organizations and physician groups sell the idea that the best way to cope with the grief of infertility is to find a “work around,” through artificial technologies which take the conception of a child further and further from the procreative act of the man and woman who are the parents.  This is the temptation to find a “quick fix” to a difficulty for which oftentimes the underlying cause is not understood.  In doing so, a myriad of unintended though predictable psychological side effects occur.  At the basic physiological level, the drugs and hormones used to treat infertility may cause a variety of psychological problems such as anxiety, sleep interruptions, mood swings, irritability, depression, mania, irritability, and thinking problems. Studies suggest that persons undergoing this treatment are two times as likely to experience clinical levels of anxiety and depression [5]. Even if the process is successful at its initial stage, the psychological state of the couple then enters a new phase of concern about whether the pregnancy can be carried to term or end in miscarriage, initiating another grief process. Couples often discuss the stress and strain [6] of going through the treatment process, and the woman’s behavior and emotions in particular can be adversely impacted by the hormonal changes. It is not uncommon for one spouse or the other to desire to cease the efforts, causing increased relationship stress and psychological struggles [3]. In addition, those who do conceive are often left with frozen embryos, conceived children who may not be given a chance to be born.  While programs exist to allow others to adopt (e.g., Snowflakes [7]), the ethical dilemmas surrounding IVF only get more complex [8] while embryo adoption grows as couples continue to experience remorse for having placed their children in “concentration cans [9]” for an unknown fate [10].

A Real Hope

Difficulties with artificial technologies occur at multiple levels, physical, psychological, and spiritual.  At the natural level, there are dozens of ways [11] to approach difficulty conceiving children which are truly therapeutic, preserving the natural union between man and woman, and treating the body with dignity and respect.  Such processes, even if they involve surgery or hormone treatments, allow the husband and wife to continue to relate with each other in an intimate and fully cooperative manner.  Treating the underlying cause of the infertility would also seem to have the natural benefit of improving the integrity of the person’s biological state overall, preparing them physically and psychologically for the task of parenting.  Although other interventions may come with some of the same stress and worries as artificial methods, for people of faith, it will be more comforting for the couple to know they are cooperating with the natural order established by God rather than trying to circumvent it.

The suffering of those who desire children and are unable to conceive is very real. Their pain is often private, at least at first, yet when others in the community have growing families and questions arise, there is a public aspect that can add to the distress.  Discomfort with being around pregnant women or families with children can add to the feelings of isolation.  These couples need support and understanding from those in their sphere. Still, when the door is open, ensuring that the couple knows how to find [12] the right kind of help [13] can foster hope.  While there are obviously no guarantees, scientific efforts to support the fertility of couples has progressed much in recent decades and holds promise for advances in the future.