Infertility Takes Toll on Romance, Relationships

Feb. 4, 2011— -- Heather Chatfield will celebrate her fifth wedding anniversary in May, but after three tries with in vitro fertilization., she still can't get pregnant, and now doctors are suggesting she seek donor eggs...

"It's hard for me to even find words to explain how devastating this all has been," said Chatfield, 38, of Northville, Minn.

Chatfield's struggle with infertility has taken a toll on every relationship: well-meaning friends, family and even her marriage.

Her best friend has three children, and even though Chatfield works hard to keep her friendship going, she said she can't relate.

"When she started to make a whole new group of 'mommy' friends, it almost broke us," she said. "It's not her fault, and I don't begrudge her the opportunity by any means. It was just unbelievably painful for me to watch."

"Facebook is a minefield," she said. "I'm of course always excited for anyone who makes a pregnancy announcement there, but a little part of me dies inside each time I read one."

Sex with her husband has now become "complicated," according to Chatfield.

"I wish I could differentiate between sex and baby-making in my head, but it's very hard for me to do," she said. "As a result we've gone from scheduled sex to very little sex, not a healthy thing for our marriage at all, and I'm not sure how to fix that."

Chatfield's lonely experience with infertility is not uncommon. An estimated 7.3 million couples -- 1 in 8 -- are unable to conceive or carry a pregnancy to live birth, according to RESOLVE, the National Infertility Association.

Couples say they feel socially isolated and the pressure to conceive inevitably affects the marriage. One partner can blame the other, sex becomes mechanical and communication breaks down.

Chatfield said she fears life won't ever be normal again. "I think sometimes we both wonder if we'll make it, or if this struggle will break us."

Of the 62 million women of reproductive age in 2002, about 1.2 million, or 2 percent, had an infertility-related medical appointment within the previous year, and 10 percent had an infertility-related medical visit at some point in the past, according to the Centers for Disease Control and Prevention. .

Doctors say that more women face infertility than even a few decades ago, because women are postponing childbirth. After the age of 30, a woman's fertility drops exponentially, so that by 40, 85 percent of all women are infertile.

"Boy, is it a strain," said Dr. Sherman J. Silber, director of the Infertility Center of St. Louis at St. Luke's Hospital and author of "How to Get Pregnant."

At the first sign of trouble, women rush out to buy ovulation monitoring kits that are "notoriously inaccurate," setting in motion more stress.

"She tells the husband we can't have sex until I ovulate," said Silber. "The husband wants to be a kind and caring guy and knows how important a baby is. She is always the harder pusher and the husband goes along with it. It tends to become mechanical and not the expression of love and tenderness, and often results in a lower pregnancy rate."

Infertility Adds Anxiety to Relationships

Though anxiety is not the cause of most fertility issues, it can have an effect on the hypothalamus and pituitary gland, delaying ovulation or creating subtle uterine contractions that can inhibit pregnancy, according to Silber.

"Infertility completely takes over your life," said Rachel Imbar, a 41-year-old who lives in Israel and spent three years trying to get pregnant when she was in her early 20s.

"You are obsessed with having a baby and you put your entire life on hold until you get that baby," she said. "I didn't pursue a career or studies. I just wanted to have that baby. And when you are young it seems like an eternity."

Attending friends' baby showers was particularly painful. "Women touching their bellies, pregnancy announcements -- I couldn't go," said Imbar, who now runs the website, Fertility Stories. "They were too hard for me."

Infertility took a toll on her marriage, which ended in divorce. Today she has six children aged 17 to 3 -- three through IVF with her first husband and three after no intervention with her second husband.

Jessica and Barry Barkley, young professionals who have been together for 15 years, didn't pay much attention to getting pregnant – until they couldn't.

The Chester County, Pa., couple had four insemination procedures and two in vitro fertilization attempts-- all failures. They were too ashamed to talk about it with family and cut themselves off from friends who were building their own families.

"We lost a lot of friends through this," said Jessica, now 33 and a fashion designer. "I didn't want to go to baby showers and talk about it and we withdrew ourselves."

Even their marital relations suffered.

"It was brutal and very emotional," she said. "You get prescriptions for sex, which takes the fun out of it altogether. They tell you where and when to have it and there are so many drugs they put into your body."

One of the hardest moments came in Christmas of 2009, when they were told IVF had failed just as her brother's wife was giving birth to their second child, and they had to hold their pain in silence.

"It really does take a toll on you," said her husband, Barry. "Every family function there's kids running around and everyone says you'll make great parents. It hurt."

The Barkleys eventually did get pregnant on their third try and are expecting twin boys in May.

Getting Pregnant Puts Pressure to Excel

Renee Sebby, a 41-year-old nurse from Chicago, said trying to get pregnant was so "structured" it felt like a job. "There was so much pressure to perform and excel.

"You can't leave the stress behind and go home and relax," she said. "There are doctors' appointments and medications -- a real regimented life.

"It was hard because we had two brothers and we were all three married within a year of each other," she said. "They got pregnant at the same time and we didn't. The first question family would ask is, 'When are you going to have kids?' Even on our wedding night."

Sebby eventually had three children through IVF and said the journey, though painful, brought the couple closer. Sebby urges women going through infertility to seek support from others. "You are not the only one."

Fertility counselors agree that support is the key to coping during this trying time.

"A lot of women are afraid of support groups and think it's a pity party," said Linda Applegarth, director of psychological services at the The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at NewYork-Presbyterian/Weill Cornell.

"But groups are much more proactive than that. I often work with patients to explore other ways to be more socially involved – maybe with friends they hadn't seen in a long time or not had close relations with. We often get creative."

Couples should also work on communication, according to Applegarth, who said men and women often "disconnect" while trying to get pregnant.

"The wife or female partner tends to over-communicate and be over-emotional and caught up in this," she said. "That is the only thing she wants to talk about and it's always on her mind…If she is distressed, he doesn't know what to do to make her feel better and the tendency is for the husband to withdraw emotionally. That's when it breaks down. He feels helpless and she thinks he isn't trying or doesn't want the child as much as she does."

She advises putting a 10-minute time limit on discussion the topic. "You cannot talk about it all night long or through the football game he is desperate to watch," she said. "There's got to be a time limit, then he's more willing to listen."

Family members also need to "step back" and not demand to know what's going on. "It's unfair and invasive of a couple's boundaries," she said.

But most marriages, if they have a loving "basic core" can get stronger through infertility, according to Applegarth.

Meanwhile, Heather Chatfield said she is "one of the lucky ones," who has supportive family and friends.

Her brother has three children, the youngest one conceived and born in the middle of Chatfield's journey. She loves her nephews, but says, "It's painful to watch my parents be such wonderful grandparents to those boys knowing that we may never have a grandchild to hand to them."

Jessica Barkley knows exactly what she means.

"It's really about having your head on straight," she said. "This is really not for the weak of heart. It's a roller coaster."