Men and Women Really Are Different When it Comes to Coping with Infertility: How to Survive as a Couple

The marriage vows most couples pledge during their wedding ceremony have dramatic promises in them: to love your new spouse “in sickness or in health” and “till death do us part”. Couples who find it hard to get pregnant may wonder why they didn’t add “during the crisis of infertility.”

Most couples are blindsided by how differently each partner copes with infertility. For many couples, infertility is the first crisis they share as a couple and there is an expectation that they will weather this storm together, that they will feel the same emotions at all times, that they will easily make decisions together, and that they will effortlessly comfort and nurture each other at all stages of the diagnostic and treatment process. Right. Not going to happen.

Men and women cope with crises differently; women tend to be more emotion focused (they want to talk about their feelings and experiences) while men tend to be more problem-solving focused (they want to skip the chat and go directly to finding a solution).  So an infertile woman will report that the couple never gets a chance to really talk about their infertility while the man will report that that is all they ever do.

There are a number of other reasons why infertility poses a special emotional challenge. I have counseled thousands of couples as they navigate the infertility rollercoaster and have literally never seen a couple who are feeling the same thing at the same time. Women tend to move faster—they want to start trying sooner, worry that there is something wrong sooner, want to see a doctor sooner, and want to move on to high tech and even alternatives to genetic parenting sooner than men. Which means that women report that their husbands are holding them back, and men report that their wives are pushing them to make decisions they don’t feel ready to make.

Another argument-creator is the issue of other people getting pregnant. Because nature has programmed men to never get pregnant, they have no expectation that they will conceive, but naturally expect that other people will. Women, on the other hand, do expect to get pregnant, and can experience unbearable feelings of envy when anyone else gets pregnant (friends, family members, co-workers, neighbors, a woman on the sidewalk, and especially spoiled celebrities). Which means that a women experiencing infertility is going to want to avoid any situation that might include a pregnant woman, and becomes almost phobic about being at any social gathering where a pregnancy announcement might take place. Men simply don’t feel this way, or at least not nearly to the same degree that women do. So couples argue—she doesn’t want to attend events where there is going to be, or she suspects there might be, a pregnant women or announcement. And he wants to go. She tends to isolate herself socially and may want to only associate with others experiencing infertility, while he wants his social life to remain untouched.

Infertility can also have a negative impact on a couple’s love life. The female partner may only be interested in making love mid-cycle, they may both associate sex with failure, and he may feel that the only reason she is willing to make love with him is to extract sperm from his body. Not exactly an aphrodisiac.

Infertility might also have a negative impact on how the husband feels about himself. Why isn’t he able to make his wife happy? A “real man” should know how to support his wife and keep her happy. And he might get mad at her—isn’t he enough to make her happy? Why is a baby so all important?

Needless to say, you need to figure out how to survive as a couple during this crisis.

The first and most important thing to remember is that each of you is coping the correct way. For you. Stop believing that your way is the best way, stop trying to convince your partner that if only he or she dealt with it the way you are dealing then things would be far easier, stop blaming him or her for feeling differently than you. You need to respect your different coping styles and use them to complement how you proceed.

In addition, be aware that the person whose physical condition is causing or contributing the most to the infertility is likely to be feeling guilty, ashamed, and maybe even fearful that you are going to leave him or her for a fertile partner. Be careful what you say, be kind, be loving and supportive. Reassure him or her that you didn’t marry him or her for their gametes.

Remember that infertility is a temporary crisis. You aren’t going to be experiencing infertility for your whole life. And research shows that infertility does not have any long term impact on one’s emotional health.

It is unclear whether or not a couple’s sex life ever returns to the level it was prior to infertility. But any decrease in sex may be because many couples do indeed become parents, and parents of young children don’t tend to have hot love lives. If you are still going through infertility and want to work on your love life, try to separate making love from baby making. Have one bed (or couch or counter!) for baby-making sex, and use your own bed for true love making. Be mindful of each other in bed— focus on the sensation of being touched.

Finally, remember why you got married in the first place. Infertility is indeed a challenge, but many health care professionals have observed that couples emerge from the process with a far better relationship than many fertile couples. Perhaps surviving infertility as a couple makes any other crisis feel inconsequential in comparison.

Good luck, and good marriage.

Alice D. Domar, Ph.D is Executive Director of the Domar Center for Complementary Healthcare at Boston IVF and an assistant professor at Harvard Medical School.

She is a co-author, along with Robert Barbieri, M.D. and Kevin Loughlin, M.D, of Six Steps to Increased Fertility.

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