By Alice D. Domar, Ph.D.
My parents experienced both primary and secondary infertility, so I grew up hearing horror stories from my mom about how miserable she had been trying to conceive both my sister and me. She felt isolated, surrounded by pregnant friends and neighbors, and was offended by people who kept on telling her to “just adopt and you’ll get pregnant.” I have always been acutely sensitive to the emotional consequences of infertility but continue to be stunned by those who aren’t.
The attitudes of most people about infertility are shocking. A prime example is the fact that the vast majority of individuals living in the United States do not have insurance coverage for fertility treatment. It is considered by most people to be an elective medical situation, and those who pursue treatment are almost considered to be selfish for not adopting instead. Yet procreation is the strongest instinct in the animal kingdom. Males of most species will die for the chance to mate, and females of most species will die protecting their young. Thus, wanting to have a baby is not something selfish; it is the most basic of instincts. Is it any surprise that individuals experiencing infertility report high levels of depression and anxiety?
The severity of these symptoms surprises many people in the non-fertility world. I published a paper a number of years ago in which we compared the level of psychological distress in women with infertility, cancer (most had metastatic cancer), HIV+ status, or heart disease. The infertile women were equivalent in their level of psychological distress to the other women. In other words, experiencing infertility has the same psychological impact as the diagnosis of a potentially terminal illness. There have been several subsequent studies which have shown the same thing, and one of these studies actually showed that infertile women expressed more distress than cancer patients.