Conception, infertility and assisted reproduction
The idea of having a family starts well before conception. The dreams and desires of wanting a baby can start early in life and continues to develop over time.
For many, planning a family is a time of anticipation and excitement, sometimes with the expectation that conception will occur without problems.
However, some people face emotional, physical, spiritual and ethical challenges in their efforts to conceive. Struggles with conceiving are surprisingly common – one in six Australian couples have difficulties falling pregnant. The process can be exhausting and drawn-out. The desire to have a child can be so strong that people may go to great lengths to fulfil their dreams.
Couples sometimes find these experiences bring them closer together while, for others, relationships experience a lot of strain due to invasive medical testing and difficult decision-making processes. Sex and intimacy may also change during this time, as it becomes more methodical and planned. However, in the beginning there is often much hope as well as some emotional reactions as listed below.
Common emotions and experiences include:
- Repeated cycles of hope and disappointment
- Fears about failure and anxiety about the future
- Negative thought patterns such as “what if I never become a parent?”
- Frustration, anger and depression
- Guilt and self-blame for prospective parents about their body’s perceived failure
- Grief and loss
- Resentment towards other people who conceive
- Shock and disbelief
These are common emotional responses. Practising self-compassion, reaching out to others, recognising your grief and listening to your partner’s responses may help. Attending support groups or seeing a fertility counsellor may also help.
Infertility is defined as having 12 months of regular, unprotected sex without conception in the context of regular ovulation. For women over 35 the threshold is six months instead of 12.
Doctors can provide a range of treatments to help resolve infertility. Australia has advanced reproductive medicines and techniques available. These provide options to those who were previously unable to conceive and also for sole parents and diverse couples and families, including people from LGBTQI communities.
In Australia, approximately one in 25 babies are born via assisted reproduction. It is a challenging process that can require significant financial and emotional investments. People in rural or remote Australia have additional stress when seeking treatment, including travel times, costs, and limited access to specialists.
Common experiences when undergoing assisted reproduction include:
- Uncertainty about if or when the process will work
- Fatigue and emotional exhaustion
- Physical side effects and mood fluctuations caused by fertility medication
- Cycles of grief and loss if a cycle is unsuccessful
- Loneliness and isolation
- A feeling of having to put “life on hold”
- Tension or disagreement with a partner or other family
- Financial stress
- Impacts on work and career
- Difficult decisions, for instance relating to unused embryos
Counselling is recommended when embarking on assisted reproduction. Additional support from other professionals, peers and understanding family members or friends can help people through this complex experience.
The stress of assisted reproduction is linked to higher rates of anxiety and depression in the perinatal period (pregnancy and post-birth). If new parents, their families and their friends are aware of this and watch for signs and symptoms, better mental health outcomes can be achieved. Accessing psychological support early, or prior to reproductive treatment, can also help with maintaining good mental health and recovery.