Infertility is the inability to conceive a child after at least 1 year of trying. Turns out about 10% of US couples experience infertility, and of those, about half will eventually conceive while the other half remain permanently infertile[i]. That’s actually a pretty high number: 1 in 10 couples struggle with this issue, 1 in 20 permanently face it.

Challenges of Infertility

As anyone who is going through this themselves will know, infertility can be a hard thing to live with. I want to begin by normalizing some of the strain that infertility puts on marriages[ii]:

    1. Meaning. Many couples see having children as a natural part of marriage, and being unexpectedly unable to do so affects their sense of meaning and purpose in life.
    2. Expectations. Similarly, much of society sees having children as the norm, so being unable may lead to disapproval from family and friends, and high levels of pressure to conceive. 83% of couples feel some form of pressure to conceive, most commonly from their spouse or parents, or from friends and other family members.
    3. Blame and guilt. The spouse who is experiencing the infertility problems may feel high levels of guilt and shame at the distress they are causing to their spouse
    4. Physical. Taking treatment for infertility can be physically demanding and can also lead to sexual performance problems.
    5. Financial. Seeking help from doctors can take up a lot of time and also cost a lot.

These are real issues. But as far as your marriage goes, it is how you deal with these challenges that determines whether or not infertility will impact the quality of your marriage, and the quality of your life overall.

Research shows that infertility can negatively impact marriage, but can also bring unexpected positives. 25% of women and 21% of men reported that their marriage had become stronger and they had been drawn closer together as a result of the infertility, and over half of couples can identify at least some benefits to their marriage as a result[iii].

This is the kind of thing that really gets me excited about marriage because here’s pretty much a major life blow and yet it’s in the context of a loving marriage that it can be reframed into some positives.

We are going to talk about how to be sure that it turns out to be a positive in your marriage, despite the grief and loss associated with it. However, let’s talk about a couple of the negative consequences first just so we’re aware of some potential pitfalls.

Possible Negative Consequences of Infertility

Primarily we need to pay attention to the impact on marital and/or sexual satisfaction.

Marital Satisfaction and Infertility

Infertility sometimes has a negative impact on marital quality. This effect is strongest for women but can also impact men[iv]. Stress caused by infertility can increase marital conflict, reduce self-esteem, and reduce overall happiness and quality of life.

Why is this negative effect stronger for women? A study in 1992[v] looked into this and found that for men, the stress of infertility was no different to other forms of marital stress and conflict. But for women, infertility created a different kind of stress that was more rooted in the woman’s sense of identity and self-efficacy. Often women have a stronger desire to have children than their husbands, and hold motherhood as a strong part of their identity. So for men, infertility can be a stress that creates conflict and other burdens, but it often impacts women on a deeper level.

Researchers also note that stress and marital discord become more likely the longer the infertility problems go on[vi], which is understandable.

Staying Strong During Infertility

Once again we’ve created a bonus discussion guide for our much-appreciated supporters who are facing infertility. This guide will help you begin to talk through this challenge that you’re facing. Often it can be hard to talk about these things because it’s so sensitive. But having a discussion guide in hand gives you some direction for starting that conversation and continuing it as you navigate through this issue. You can get this by becoming a patron of The Marriage Podcast for Smart People.

 

Infertility Can Also Impact Your Sex Life

Research is very mixed on whether infertility impacts sex and sexual satisfaction in married couples. Different studies find that it has negative effects, no effect or even positive effects[vii].

Depending on the cause of infertility, some men can experience reduced sex drive, or sexual performance issues. This can then negatively affect sex for both husband and wife as the man feels pressure to “perform” rather than being able to enjoy sex.

Some couples end up having sex that is purely “mechanical” and focused entirely on trying to conceive and lacking any enjoyment or intimacy[viii]. This is not sexy sex anymore, it’s just trying to get a job done.

That’s a tricky place to be in because you get recommendations about certain positions and tilting hips and lying there for a while afterward… that’s pretty mechanical and so naturally it is going to be a challenge to keep your heart in it along with those mechanical components.

Other studies[ix] found no effect of infertility on sexual satisfaction, while others report that increases in sexual frequency due to trying to conceive can actually increase satisfaction. Overall this suggests that while there may be some practical issues caused by infertility, by far the most important factor is the couple’s attitude to sex and how they approach it.

How to Turn Infertility Into a Positive For Your Marriage

Think About How You Approach the Subject of Infertility

The way couples talk to each other about the issue has a big impact on marital intimacy and satisfaction.

On average, women desire to have a baby more strongly than their husbands and are more actively involved in trying to overcome infertility[x]. The more a husband desires to have a baby, is involved in trying to solve the infertility issue, and is willing to talk about trying to have a baby, the more supported his wife feels. If husbands are willing to talk and act in this way, wives often report feeling like their intimacy has increased as a result of the infertility problems.

In behind this, you’ll likely be challenged with shame. The “I can’t perform” for men, or “I can’t provide” kind of shame for women. It’s OK to acknowledge that shame. That’s a delicate one because there’s some truth but then there is the need to remember that while having children is a huge thing for many, we are actually defined as persons by far more than just our reproductive capability. There are more parts to us than that: and we may need to affirm or remind ourselves or our spouse of those other parts that are so much appreciated.

Talking About Infertility

Infertility creates an issue in the couple’s lives which “forces” them to talk about important issues like their stress levels and emotional state, and their long-term desires for their life and marriage[xi]. Infertility can therefore increase a couple’s intimacy by increasing their ability to talk about important issues and become more comfortable with emotional disclosure. That’s a tangible benefit and one way this challenge can have redemptive positives linked with it.

Different communication styles around the infertility issues were linked to high and low marital satisfaction. Styles linked to low satisfaction included[xii]:

    1. Secrecy: keeping the infertility a secret from other people
    2. Avoidant: throwing yourself into work or other pursuits to avoid facing the issue
    3. Passive: hoping the issue will get better on its own, not engaging with any treatment or not talking about it

On the other hand, styles associated with increasing marital satisfaction:

    1. Active confronting: talking about the issue, the treatment process and how it makes you feel. Also engaging with others and talking/asking for help from people outside the marriage
    2. Emotional support: levels of emotions support provided by your spouse were linked to higher satisfaction, just like when dealing with any issue as a couple[xiii].
    3. Meaning-based coping: trying to see positives in the situation and talking about finding meaning in other goals in life.

We’ve been pretty real with you today because we fell into the “infertility” definition ourselves for a while, too. It took us a while to make our first baby and we’re so thankful for three girls now. I guess we are in the 50% that eventually conceived. But it was long enough coming that a lot of what we looked at today on the challenging side became pretty real for us.

While not everyone will have the change in outcomes that we did, we hope that you will find some strength and encouragement in your marriage as you put in place some of the tools we’ve shared with you today.

References

[i] Manoj Monga et al., “Impact of Infertility on Quality of Life, Marital Adjustment, and Sexual Function,” Urology 63, no. 1 (2004): 126–30.

[ii] Monga et al.

[iii] Lone Schmidt et al., “Does Infertility Cause Marital Benefit?: An Epidemiological Study of 2250 Women and Men in Fertility Treatment,” Patient Education and Counseling 59, no. 3 (2005): 244–51.

[iv] F. M. Andrews, A. Abbey, and L. J. Halman, “Is Fertility-Problem Stress Different? The Dynamics of Stress in Fertile and Infertile Couples,” Fertility and Sterility 57, no. 6 (June 1992): 1247–53.

[v] Andrews, Abbey, and Halman.

[vi] Nili Benazon, John Wright, and StÉPhane Sabourin, “Stress, Sexual Satisfaction, and Marital Adjustment in Infertile Couples,” Journal of Sex & Marital Therapy 18, no. 4 (December 1, 1992): 273–84, https://doi.org/10.1080/00926239208412852.

[vii] Monga et al., “Impact of Infertility on Quality of Life, Marital Adjustment, and Sexual Function.”

[viii] Monga et al.

[ix] N. Bahrami et al., “Relation between Infertility and Sexual Satisfaction in Couples,” Journal of Qazvin University of Medical Sciences (JQUMS) 14, no. 2 (2010): 5–11.

[x] Lauri A. Pasch, Christine Dunkel-Schetter, and Andrew Christensen, “Differences between Husbands’ and Wives’ Approach to Infertility Affect Marital Communication and Adjustment,” Fertility and Sterility 77, no. 6 (2002): 1241–47.

[xi] Schmidt et al., “Does Infertility Cause Marital Benefit?: An Epidemiological Study of 2250 Women and Men in Fertility Treatment.”

[xii] Schmidt et al.

[xiii] A. Abbey, F. M. Andrews, and L. J. Halman, “Provision and Receipt of Social Support and Disregard: What Is Their Impact on the Marital Life Quality of Infertile and Fertile Couples?,” Journal of Personality and Social Psychology 68, no. 3 (March 1995): 455–69.