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Primary Infertility
         You probably never imagined that you would have problems with infertility.  While you were dating your significant other, you may have imagined your life together.  Getting married, choosing a place to live and starting a family.   Then, you and your spouse decide to start trying to have a baby.  A couple of months pass and there is no pregnancy.  Then more months pass.  You start to worry a little and decide to talk to your doctor.  Your doctor is reassuring and will often say to give it more time, and so you do.  
         More months pass and no pregnancy. Then your doctor decides to order some tests.  In the meantime, your friends are starting to have babies.  Your well-intentioned friends and family have been asking about when you and your spouse are planning to have children.  It can be painful to see siblings starting their families, especially if they are younger and got married after you did.  
         Baby showers can be particularly difficult.  Friends are chatting about cribs, nursery colors, cute clothing stores.  You feel a lump in your throat and wonder why things aren't happening the way you planned.  It takes all your strength not to leave the shower in tears.  Instead of feeling joyful, holiday parties may feel dreadful, especially those where babies and children are present, serving as a reminder that you are missing something in your life for which you have been yearning. 
         Then the test results come back.  Sometimes you're given a definitive explanation (s) as to the reason for the lack of a pregnancy and a plan for how to proceed.  At other times, the tests come back negative, and infertility is considered unexplained.  Your doctor may provide a relatively straightforward treatment plan or one that involves significant time, money and energy.  You will probably start to hear a whole new alphabet of letters and vocabulary – FSH, LH, HSG, ICSI, semen analysis, ovarian reserve, endometriosis, clomid, and many others.  In any situation, the news can be overwhelming and stressful. 

The Impact of Infertility 

       Infertility is a medical condition of the reproductive system that affects approximately 10% of the population.   It is diagnosed if a couple, with a woman under the age of 35, has had one year of unprotected intercourse with no pregnancy, or 6 months if the woman is over the age of 35.   It is also diagnosed if there have been multiple miscarriages.  Approximately 30% of infertility is due to a female factor, 30% is due to a male factor and in the remaining cases, infertility is attributed to both partners or is unexplained. Infertility can be one of the most stressful events in a person’s life.  Studies show that the psychological impact of infertility can be as significant as a severe illness.  Infertility can effect all aspects of a woman’s life, including her identity, career, relationships, and emotional well-being.  This is not unique to women, as men may also experience significant stress during this time.  Dealing with infertility may feel like being on an emotional roller coaster.  

When to Seek Therapy

Many women coping with infertility treatment report symptoms of depression and anxiety.  The following symptoms may warrant consultation with a mental health professional:
-Ongoing feelings of sadness and guilt
-Feelings of helplessness, hopelessness and worthlessness
-Loss of interest in usual activities
-Changes in appetite or sleep
-Social isolation or avoidance
-Marital problems
-Feeling excessively irritable or moody
-Increased consumption of alcohol or use of drugs
-Persistent worry
-Constant preoccupation with infertility and getting pregnant

How Therapy Can Be Helpful

Therapy offers a supportive environment for you to explore your feelings and concerns, as well as to learn new coping skills.  Having emotional support can help reduce stress and anxiety, which may improve your response to fertility treatment.  During the infertility diagnostic and treatment process, you may also have to confront difficult issues and decisions.  A therapist can help guide you through these challenges.  Some issues may include:

-What should I tell my family, friends and co-workers about my infertility?
-How do I respond to intrusive questions from others about my plans to have a baby?
-How long should I continue fertility treatments?  What feels right for my situation?
-How do I deal with indecisiveness about a treatment plan?
-Should I consider third-party reproduction treatment options (egg, sperm, embryo donation or surrogacy) and what are the psychological implications?
-How do I deal with the financial stressors of this process? 

Psychological Evaluation
In addition to working with individuals and couples dealing with issues of infertility,  I conduct psychological evaluations for egg donors, embryo donors and gestational carriers.  The evaluation involves completing a history form and questionnaire, and a meeting with all relevant parties.  As a member of the American Society of Reproductive Medicine, I  stay current on research and treatment issues dealing with infertility.  I am also a member of Resolve, the Texas Psychological Association and the Houston Psychological Association.  


American Society of Reproductive Medicine


Society for Assisted Reproductive Technologies


Conquering Infertility (2002).  Alice Domar

Wanting Another Child:  Coping With Secondary Infertility (1998).  Harriet Fishman Simons

Waiting for Daisy: A Tale of Two Continents, Three Religions, Five Infertility Doctors, an Oscar, an Atomic Bomb, a Romantic Night, and One Woman's Quest to Become a Mother  (2007).  Peggy Orenstein

Healing Mind, Healthy Woman (1996).  Alice Domar and Henry Dreher

The Long Awaited Stork (1998).  Ellen Glazer.

Empty Cradle, Broken Heart:  Surviving the Death of Your Baby (1996).  Deborah L. Davis