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Chapter on Infertility Grief and Loss

An infertility story always begins with hopes and dreams of having a family one day. It’s normal to assume that this will go according to plan. Generally, unless there is a known medical concern that may impact the chance of a viable pregnancy, infertility is not an issue for the majority of the population and parents don’t even think of infertility solutions until there is a reason to think of it. When things don’t go according to plan, month after month becomes a repetitive cycle of hope, heartbreak, and insufficient time to grieve before the cycle begins again. Infertility is a deep, repeated grief of failed opportunities and unfulfilled longing. Many will isolate and suffer in silence and feel disconnected from those who do not experience difficulty in starting a family.

Infertility is generally defined as a condition of the reproductive system that inhibits or prevents conception after at least one year of unprotected sexual intercourse. Infertility can affect both men and women, despite a common misconception that infertility is a woman’s condition. Infertility in men may be caused by testicular or ejaculatory dysfunction, hormonal disorders, or genetic disorders. In women, infertility may be caused by disrupted functioning of the ovaries, blocked fallopian tubes, or any uterine abnormalities such as the presence of fibroids. No matter what form of infertility experienced, infertility services are generally a “roller coaster” ride of strong emotions ranging from hope to despair.

Most of the focus in infertility is on women but men are also greatly affected by infertility solutions. Men tend to cope with infertility through distancing themselves from the problem through humor and making light of the situation. Partners will experience an onslaught of conflicting emotions and guilt in the face of grief and loss. Each partner will experience the problem differently and use different coping mechanisms. How a couple deals with infertility will directly impact the success of the family. Established bereavement therapy can assist in the struggle with this significant loss.

When we experience grief after losing someone close to us, that relationship and related memories are easily identified, talked about amongst the mourners and some comfort is associated in doing rituals to celebrate the life that passed. This type of loss is easily identified, recognized, validated and supported. In infertility, the loss comes from an absence of something that never was rather than the absence of something that used to be. The loss connected to infertility is looked at very differently by family and friends. They often can’t understand the complexities of infertility; primarily the loss of the child you imagined giving birth to; the entire process of parenting is now gone; conception, pregnancy, related milestones such as ultrasounds, baby announcements, showers, and delivery. Also lost is the passing on of family genetics, traits, traditions and rituals. These are often parts of the grief of infertility that are not discussed and they can often compound the pain. Infertility and the accompanying grief is not outwardly visible. Often a woman feels a sense of failure she may withdraw socially or struggle with their identity. This type of grief is ongoing and unacknowledged and the usual rituals for mourning are generally not available due to the nature of the loss. This means that individuals may experience a grief that is stuck and difficult to move on from. Individuals and couples that grieve the ability to have a biological child may struggle to move forward or go for IVF embryo transfer because of the unresolved desire. Infertility grief is not something that those affected can just turn it off or just get over it. Like any other major loss, it very well may be something that stays with a person forever. Working through the stages of grief and accepting the outcome is a process that can and does impact all of the relationships in a person’s life; spouses, other family members, children, friendships, coworkers and even strangers.

Woman often have difficulty reaching out for support and oftentimes, those surrounding them do not have the skills to support and comfort this type of grief. This is why getting professional support and discussing other options in embryos fertility clinics can be important. Counselors provide compassion, empathy, and good listening skills. By taking the time to listen, and support with an understanding of the client’s culture, religion, spirituality and values, they can effectively assist in the grief process. Clients who experience infertility often feel alone, unheard, misunderstood, broken, ashamed and without hope. Grief is a very personal experience and no two people grieve alike. A counselor can evaluate and assist in discussing what this loss means and to help redefine expectations of how to build a family when the client is ready to move forward with an alternative plan such as donor embryo adoption. Managing the roller coaster of emotions and working towards closure is a vital part of the healing process. The grief of infertility even after it seems to have been overcome, never fully goes away; it often resurfaces when a friend becomes pregnant or you are invited to a baby shower. Christmas, Thanksgiving, baby showers, birthday parties and other events may become painful events that only remind you of what you have lost. It’s helpful to be honest with yourself about whether it is in your own best interest to attend or participate in those events that feel too painful for you. It is also ok to find new rituals and traditions that help you to observe significant days in whichever way you see fit.

An important part of healing from the grief of infertility is self-care. The toll that infertility solutions take on the mind and body is significant. Ongoing infertility can significantly impact mental and physical health. Discussing ways to find support, develop healthy coping strategies and conflict resolution is vital. Part of taking care of oneself can include journaling, getting involved in hobbies, relaxing rituals, an exercise routine, socializing and sometimes taking a break from family planning.

In addition to infertility, some people are simply unable to carry a biological child due to other medical reasons. In this situation, the loss of not being able to biologically have a child can cause one to view this bodily inability as failure; just like in infertility. It is a loss of a potential child they hoped for and expected. The issue of pregnancy is attached to the social concepts of womanhood, sexuality, identity, family and parenthood. The grief associated with the loss of the ability to carry a biological child is often expressed through anger, frustration, hopelessness and a loss of confidence by those unable to parent. Although the issues of infertility and embryo donation adoption are separate in nature, they are intrinsically connected. Infertility is the most common life experience that leads couples and individuals to pursue adoption as a means to build their family. If one is capable of a viable pregnancy and delivery then embryos available for adoption are an alternative way to experience the full circle of conceiving, carrying and delivering a baby to term. This allows one to explore the hopes and dreams of maintaining a sense of self; changing the narrative to one of hope which gives optimism and control where there had not been control previously. IVF embryo adoption allows for the birth experience, however, the reality is this is not a genetically linked child needs to be understood and accepted. If you decide to build your family through embryo adoption, it is important to have realistic expectations. In these situations, adoption is often the journey towards parenthood.

In 1969 Elisabeth Kubler Ross came up with the Five Stages of Grief in her classic book, “On Death and Dying”. In this book, the five stages are described when suffering a loss. These stages are applicable to many types of loss. Many who are grieving move in and out of the various stages at different times during their journey through grief. These stages are: Denial, Anger, Bargaining, Depression and Acceptance. There are no right or wrong ways to grieve; it is a personal journey and even the family members who are impacted by infertility may be at different stages in grief and need to be mutually supportive and compassionate. Once one feels they are emotionally ready, an alternative plan can be created and if a viable pregnancy is possible then There are many books available that address grief and loss in infertility. This list includes some interesting topics to consider adding to your library:

*Let’s Talk About Egg Donation by Marna Gatlin and Carole LieberWilkins, MFT

*On Fertile Ground: Healing Infertility by Helen Adrienne

*Overcoming the Emotional Stigmas of Infertility by Frances Jones, MA

*The Baby Binder by Callie Micks

*A Baby at Last! by Dr. Zev Rosenwaks, Dr. Marc Goldstein, and Mark L. Fuerst

*Having Your Baby Through Egg Donation. Perspectives Press, 2005.

*Detours: Unexpected Journeys of Hope Conceived from Infertility by Sue A. Johnston

*Happy Together by Julie Marie (Author) and Ashley Lucas (Illustrator)

*Daniluk, Judith C. The Infertility Survival Guide: Everything You Need to Know to

Cope with the Challenges While Maintaining Your Sanity, Dignity, and Relationships

*Glazer, Ellen Sarasohn. The Long-Awaited Stork: A Guide to Parenting After Infertility.

*Lorbach, Caroline. Experiences of Donor Conception: Parents, Offspring, and Donors Through

The Years

*Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss by

Lora Shahine, MD, FACOG


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