Every June, the International Infertility Awareness month serves as a chance to highlight the struggles and social stigma attached to infertility.
Women’s joy and excitement in finding out that life is growing inside them is a unique, unfathomable moment that many dream of experiencing someday.
Expectant mothers often begin wondering what to name their child, whose features they’ll inherit, or what their nursery will look like, while looking forward to the emotional moment of finally meeting their baby for the first time.
For Sophia*, 2020 was the year when she felt that emotional rush for the very first time upon finding out that she was expecting triplets following her first In Vitro Fertilisation (IVF) cycle.
Sophia had opted for IVF at the time following her first-degree infertility diagnosis due to previous surgeries, which rendered her pregnancy a miracle.
But her life shifted after facing the unexpected pregnancy loss at just 19 weeks, triggering feelings of self-defeat and crushing weight of grief.
“Managing my own mindset and the feeling that somehow I am failing as a woman, that my body isn’t able to do the one thing it was designed to do. I believe many women struggle with this part especially,” Sophia, who is based in Qatar, told Doha News.
It took two other unsuccessful cycles before eventually welcoming her miracle baby daughter, who is now one years old.
But Sophia is not alone as her case represents one of millions of other women globally who undergo IVF, an overwhelming and costly procedure that often aids in conception.
During the procedure, an egg is fertilised by sperm outside the body before it is transferred to the uterus.
Every year, more than 2.5 million IVF cycles are conducted globally, where one in six people experience infertility, as per data by the World Health Organisation (WHO).
While IVF is a common procedure that has existed for decades, it has a major emotional and mental toll on women—a side that often goes unnoticed.
“There is anxiety associated with embarking on the IVF journey, is it going to be successful? Might it fail? Will the babies be normal, will I tolerate the medications, how expensive might it be, will I get the appropriate support etc,” Dr. Zainab Imam, Acting Division Chief of Women’s Mental Health at Sidra Medicine in Qatar, told Doha News.
The decision itself to undergo IVF is not simple, particularly given the time it takes many to educate themselves on the procedure, its many complications and reckon with themselves mentally and physically on whether it’s an extra challenge they want to undergo.
Umayma Abdul, a new mother based in the United Kingdom, made the decision in 2021 after trying to conceive for four-to-five years. What helped her make the decision was all the open resources on IVF on YouTube.
Still, the process had its own set of complications.
The UK-based mother’s first round ended with an ectopic pregnancy, which occurs when a fertilised egg implants itself outside of the womb. It was not until an emergency surgery and a year later since the incident that she went for another transfer, resulting in her pregnancy.
‘Frozen time’
A major part of the IVF process is the long wait for results that do not necessarily end with a pregnancy. At least 33% of women undergoing IVF to get pregnant during the first cycle whereas more than 50% require more cycles in order to conceive.
With pregnancy not guaranteed, the crushing anxiety of the waiting period is among the most difficult parts of the IVF journey, with women juggling between hope and despair.
For both Sophia and Umayma, their biggest struggle was the wait, a period that fills their minds with multiple “what ifs?”
“I knew it was a long journey with many steps involved. Until that baby was in my arms I always felt a “what if”. My faith in God’s plan kept me going strong,” Umayma said.
Having experienced several unsuccessful cycles, Sophia could not help but remain stuck in the moment where she lost her triplets. It was not until she reached the 34th week of her pregnancy that she was able to catch her breath again.
“The 19th week I didn’t breathe, what it felt like, at all. Because they say the body remembers the first delivery date and might go into labour then. It was horrible. But we went through it and got a healthy baby girl. Thank God,” Sophia recounted, referring to the period when she had her miscarriage.
Looking back at her previous experience, Sophia said she felt as if “time froze” during the two-week results waiting period, which she said was more difficult than the physical pain of the hormonal injections.
“I froze, it was like I was afraid to take a breath too, it’s hard to explain but I just wanted to not exist for two weeks and fast forward the time. Just go to sleep and wake up […] The thoughts went in repetitive patterns – it’s not going to work, we have to go through this again,” Sophia said.
Infertility alone can result in Post Traumatic Stress Disorder (PTSD), with several cases triggered by the distressing experience of fertility treatments such as IVF, as per the findings of numerous studies.
Dr. Imam stressed the importance of seeking mental health throughout one’s IVF journey, stating that it can help women better cope with feelings of uncertainty, hopelessness and fear.
“A counselor or therapist will be able to provide structured support for mild to moderate anxiety and refer to a psychiatrist if the symptoms are severe. Severe symptoms may require treatment with medications in addition to therapy,” Dr. Imam said.
Despite having a degree in psychology, Sophia felt the need to reach out to a therapist in order to better process her emotions and listen to her voice instead of “unwanted advice” that could have contributed to her struggle.
“‘Relaxing and letting go’ won’t get a woman pregnant, this one is probably the most insensitive and most common thing people say. I know they mean well but it’s invalidating and dismissive. No one goes through IVF just for fun,” said Sophia.
Similarly Umayma advised those with loved ones who are undergoing the procedure to provide them with the support they need, whether by simply showing up or providing them with distracting activities such as watching a movie together.
The stories shared by the women in their struggles with infertility over the years, including celebrities such as Mariah Carey and Jennifer Aniston, commonly mention the pressure of the social stigma surrounding infertility.
The pressure on women to conceive often appears under the guise of questions such as “when are you going to have a baby?” Aside the overstepping of one’s boundaries, the questions also engrain in women the feeling of self-doubt and inadequacy, Dr. Imam said.
“This puts a lot of pressure on the women to conceive or become mothers. Many cultures see having children as a necessary outcome of marriage and people will look down on women who are not able to conceive,” the expert added.
For Umayma, culture pressured her to rush into her motherhood journey rather than happily wait.
“Sadly our culture has normalised harassing women about when they will conceive if they haven’t gotten pregnant in the first few years of marriage. As a couple we were happy to wait. We traveled, invested and wanted to be stable before bringing a baby into the world,” Umayma said.
The overwhelming pressure can also be felt among men, who are part of the IVF journey as they also witness their spouses undergo the painful procedures. Several studies, including one in 2021, found that concerns over fertility can take a toll on couples as opposed to only the woman in the relationship.
A 2012 study had found that 62% of the men surveyed reported an equal desire for parenthood to their spouses.
Looking at the overall image of the compounded mental and emotional toll of infertility, social stigma and procedures such as IVF, Dr. Imam advised people to not “pry” and allow women to open up at their own comfort.
“A woman who is being investigated or on treatment for infertility is already under a lot of pressure […] People need to understand that they should not pry, and allow the woman to share only the information she is comfortable sharing,” Dr. Imam advised.
