An introduction to the fertility series by Jenny Shepherd.
‘The only thing more painful than having a baby…is not having a baby.’
This statement unfortunately epitomises the painful reality of the one in six couples in the UK facing possible childlessness as a result of infertility (1), and suffering the anguish of a long and desperate journey full of uncertainty.
The not knowing, the hanging onto strands of hope and the physical and emotional drain of successive attempts and invasive treatments can quite naturally have profoundly negative consequences in all areas of our lives. The question is always ‘Why? Why me? Why not me?’ The answer is never clear.
It is estimated that about one third of infertility issues are linked to the male, one third to the female and, most frustratingly, the rest fall into the category of ‘unexplained’. Unexplained? What exactly does that mean? If nothing else it certainly reminds us that reproduction remains a highly complex phenomenon in which Mother Nature seems to keep the upper hand.
Whilst at one level we can accept this, the social norms in our western culture seem to have created a ‘fertility illusion’. Think about it: we may have spent our early adult lives avoiding pregnancy and postponing our fertility through the use of contraception. Contraception has had an amazing influence on women’s lives; we can be sexually active without the pressure of a lifelong commitment to parenthood, yes – we can shop around for Mr. Right! Also, we can now create the space in our lives to pursue our academic or career goals.
Now, as I am writing this, I am aware that it makes life sound like a ball for women – lucky us, there are so many great conscious choices we can make! Yet realistically economic pressures and social norms are great dictators in the choices that we as women ultimately make. Let’s face it, it can often seem that women are expected to be working and achieving every bit as much as men. Social policy reinforces this, encouraging us to be working, going back to work or pursuing careers head-to-head with our male peers.
Economically too it seems we are in no position to argue this. Thank goodness for the wonders of modern contraception – we can now make sure that our fertility does not get in the way! In fact modern contraception is so reliable, easy and available we don’t even have to give ‘controlling our fertility’ any real conscious thought. The tragedy is that this has created two devastating realities for many women.
Firstly, it has created an illusion that fertility can be controlled and switched on and off at ease. I particularly wince when I am told that certain contraceptive methods are great because when you stop taking them ‘your fertility returns immediately.’ Really? How do they know? Mine certainly didn’t thank you very much. This fertility illusion sees many women on long-term contraceptive methods not just postponing having a baby but even postponing the mere thought or discussion of starting a family.
Thus when the time arrives for us to plan for a baby, we are hit by the sudden reality that our fertility cannot be necessarily be switched on, predicted and controlled in the same way that it was switched off. It cannot be project managed like the other areas of our lives. Just as we often feel totally in control of our lives, we are suddenly struck down by being unable to control our fertility.
The second reality is that, consequently, more women are starting families later in life. Many may be successful in doing so, and we may be reassured because we see them at work or know them as friends. However, this tends to obscure the well-known direct correlation between women’s age and fertility, with fertility declining after the age of 35.
It is predicted that 34 – 46% of women over the age of 35 are unable to conceive naturally (2). Unsurprisingly this has lead to a sharp increase in IVF; since the mid 1990’s IVF has doubled for those over aged 36 years, and tripled for those over 42 years, whilst remaining steady for those aged younger than 30 years (2) . In 2010 one third of IVF cycles were for women aged over 37 years (3).
Age is still the greatest predictor of success for both natural and assisted fertility, and whilst almost a quarter of IVF cycles were successful in 2010, the success rate declines rapidly for those over 37 years (3). Consequently many couples find themselves battling the painful paradox of avoiding pregnancy for years waiting for the ‘right time’, to then find that their lives are defined by desperately trying to get pregnant as the right time passes them by.
This realisation can be a devastating blow to many couples, particularly for women who are battling the biology of their body clock. Sadly for many, the decision to try for a baby comes after the many years of endeavour to create the life of security, stability and status that we desired for our future families. For many more, these issues may be faced when trying for a second child, or in a second marriage when wanting to create a new family.
As an Emotional Wellbeing Coach who supports many on their fertility journeys, I am continually struck by how extraordinary my clients are; moment by moment managing complex emotions such as anger, sadness, fear and guilt, their physical self under constant scrutiny, all whilst managing the many spinning plates of the rest of life and appearing to be ordinary to the rest of us.
Over the coming months I will be sharing with you some of the common themes that tend to present the biggest challenge to our emotional wellbeing when going through such an experience, and I will offer insight and suggestions as to ways that you, or people that you may know, may understand and manage this difficult time in more effective ways. Some of the topics that I will be exploring will include:
• Understanding me: what has changed in how I feel about myself and others? How can I cope with my feelings about others (especially those who are pregnant or have babies?)
• My relationship with my partner: what is happening emotionally and physically between us?
• Managing and nurturing other key relationships: Who do I tell? What do I say? What is happening to my friendships?
• The emotional monthly cycle: What strategies can help me to manage this effectively?
• Limiting beliefs: What are my dominant and intrusive negative thoughts and how are they affecting my experience?
• Dealing with the pain: Miscarriage, loss and failed IVF cycles.
• Moving on and life beyond ‘trying’: Deciding when to stop trying and redefining goals.
• Transitioning to parenthood: How to let go of the trauma of trying, adjusting to a new reality and evaluating our new roles as a parent.
(1) British Fertility Society (2005). Key facts on infertility, IVF and NHS provision.
(2) Szewczuk, E. (2011) ‘Age related infertility: a tale of two technologies’ Sociology of Health & Illness Vol. 34 No. 3 pp. 429–443.
(3) Human Fertilisation and Embryology Authority (HFEA) (2010) Fertility Treatment in 2010 trends and figures.