Navigating the Impact of Infertility on Relationships

Having kids is a big decision, but once you finally make that choice with confidence there's nothing worse than feeling like you can't bring that dream to fruition—or feel like your body isn't doing what it was built to do.

Infertility, which is defined as an inability to get pregnant after 12 months of actively trying, is more common than you might realize, affecting about 1 in 8 couples. Anyone who’s experienced it will tell you that infertility is so much more than a medical issue. It has profound impacts on a person’s mental health and identity. Living with infertility can lead to strong feelings of loss, grief, shame, and depression.

But infertility doesn’t just affect folks on an individual level. It touches both members of the couple. Many couples feel isolated from other couples and experience collective feelings of shame and stigma about their inability to conceive. This can lead to considerable strain within the relationships and can impact communication, trust, resilience, and more.

It's bad enough that infertility itself can be so painful, but when your relationship becomes strained as well, it can be extremely distressing. We get it and are here to help. We reached out to two mental health professionals who work with expectant parents to discuss the impacts of infertility on couples and how to cope.

Emotional and Psychological Effects

Before we look at the profound impacts infertility can have on relationships, it’s important to consider how infertility affects each member of the couple. These mental health impacts tend to spill over into the relationship itself.

“The emotional and psychological effects of infertility are deep and often misunderstood by anyone who has not experienced navigating infertility,” says Rachel Goldberg, LMFT, a therapist who specializes in infertility and founder of Rachel Goldberg Therapy. “There is a range of emotions that individuals may experience, including grief, sadness, anger, guilt, shame, and anxiety.”

Besides these challenging and charged emotions, people who are experiencing infertility may be especially prone to mental health issues. For example, research has found that about 40% of women experiencing infertility have clinical depression or anxiety. There are fewer studies out there about how infertility affects men’s mental health but a study from 2023 found that 14% to 23% of infertile men experience depression.

What is the Link Between Infertility and Relationship Stress?

While not every couple experiences significant strain while dealing with infertility—and sometimes infertility can actually bring couples together—it’s quite common for infertility to strain relationships.

The link between infertility and relationship stress is noteworthy, says Becca Reed, LCSW, PMH-C, perinatal mental health and trauma therapist. “Infertility often ushers in a profound emotional journey that is marked by feelings of loss, inadequacy, and isolation,” she says. “These experiences can strain even the strongest relationships, affecting communication and emotional intimacy.”

One reason for this is that couples may cope quite differently with their feelings about the fertility issues they are experiencing, says Goldberg. “For instance, one partner may have the attitude of whatever it takes, even if that means very costly IVF cycles over and over, while the other partner may feel that putting their life on pause for possibly years for an unknown outcome isn’t worth it,” she describes.

These types of differences can lead to misaligned expectations and immense pressure between the two members of the couple, Goldberg says. In addition, the member of the couple who is found to be the source of the infertility may experience fears of abandonment and concerns about feeling less desired.

“Overall, the emotional toll of infertility can lead to increased conflict, decreased intimacy, and feelings of isolation within the relationship,” says Goldberg.

What the Stress of Infertility Looks Like

There are several ways that infertility can strain relationships. Here’s what our experts said:

Communication Becomes Tense

Often, when a couple is experiencing infertility, communication becomes strained. At times, communication may even shut down altogether as the couple moves through difficult feelings. There’s also often a sense that the other partner doesn’t understand your feelings, says Goldberg.

Sometimes, there’s truth to the idea that a partner simply can’t empathize with what you are going through, Goldberg notes. “For example, if the female partner is undergoing all the very invasive treatments (which is the case in the majority of instances), then even with a partner who genuinely desires to understand, they likely cannot fully empathize as they are not the one on the table with their legs open repeatedly, getting pricked and prodded,” she describes.

Misunderstandings

Misunderstandings are common as couples navigate fertility issues. “Misunderstandings can result from one partner feeling blamed or perceived as less invested,” Goldberg says.

The person undergoing more fertility testing and treatment might feel like their partner is less invested in the outcome than they are, or vice versa. The person who is diagnosed with a fertility problem may feel like their partner is blaming them for what they are going through together as a couple.

Decision Fatigue

Another factor that can put a huge strain on relationships is decision fatigue. There are just so many decisions to make when it comes to fertility treatments and couples may argue about them. They may also just feel exhausted and burned out from making so many difficult decisions.

“Decision-making regarding fertility treatments, especially given the very hefty price tag that insurance rarely covers, is an added stress that can seep into relationship difficulties,” Goldberg remarks.

No Room For Other Experiences

Dealing with infertility can become completely all-encompassing, says Goldberg. It can leave “little room for other aspects of the relationship, creating disconnection,” she describes.

Other aspects of your relationship you used to enjoy, such as sex or spending time out socially, may be impacted, or may diminish altogether.

Too Much Focus on Fertility

It’s not just what you do together as a couple that can change, even the types of conversations you have can change too. “The challenges related to infertility can feel like a wall between partners,” Reed says. “You might find all your talks circling back to fertility treatments leaving little room for the laughs and shared moments that used to lighten your days.”

Strategies and Coping Mechanisms

Dealing with infertility as a couple is hard, period. But there is hope. Simply recognizing how you are feeling, individually and as a couple, is a great first step.

“Couples can work through and cope with infertility challenges by acknowledging that infertility can be extremely disheartening, it’s normal for conflicts to arise, and committing to open communication or even scheduling time to discuss their feelings,” says Goldberg. “It's important for each partner to validate each other's feelings and experiences even if they disagree or don’t fully understand.”

Tips For Nurturing Your Relationships During Infertility

Goldberg shared her top practical tips for nurturing your relationship as you navigate infertility:

• Try to schedule regular “feelings” check-ins related to fertility concerns and goals
• Make an effect to find ways to connect privately, that don’t involve baby making (e.g., doing a challenging puzzle together, cooking an intricate meal together)
• Practice active listening together
• Practice learning to empathize with your spouse’s perspective
• Plan joyful activities on days you are expecting news about your journey (e.g., a special breakfast after a scheduled ultrasound to see follicle growth; a weekend getaway after an IVF treatment is over)
  

Resources and Help for Couples Facing Infertility

Here’s maybe the most important advice: You don’t have to do this alone. There is support out there for both individuals and couples dealing with the stress of infertility.

Support Groups

Joining an infertility support group for couples can be hugely helpful. You may be able to find one through your local fertility clinic, or through a therapist who specializes in infertility and holds support groups for couples.

“One of the most helpful resources for showing grace to oneself is joining a support group of others experiencing infertility,” says Goldberg. It can also be helpful to find a friend or two who has struggled similarly and connect with them, she adds.

“Having someone who can truly understand the emotions and challenges involved can really help an individual to feel less like something is wrong with them and less isolated,” Goldberg describes. “It’s also helpful to allow oneself to grieve the losses associated with infertility while also feeling emboldened by the courage and strength to put themselves through all the appointments, treatments and angst that come with that.”

Therapy

Therapy is one of the most helpful ways to manage the strain that infertility can place on couples, Reed says. “It offers a neutral and welcoming space to unload some of those heavy feelings and fears,” she explains. “It’s a place to learn new ways to communicate and support each other while also finding strategies to cope with the ups and downs of fertility treatments.”

There are several different individual therapy types that can help the emotional upheaval that comes from dealing with infertility. Reed recommends Eye Movement Desensitization and Reprocessing (EMDR) therapy and Brainspotting, both of which can help you work through the traumas sometimes experienced during infertility. Research has found that Cognitive Behavioral Therapy (CBT) is effective at managing the psychological effects of infertility.

Partners may find it helpful to enter couples therapy to work on communication and manage the ways that infertility has affected their relationship. “A therapist specializing in infertility can help normalize all the feelings each of them is experiencing and help educate them on things they may not know yet,” Goldberg describes. “It is a place where couples can process grief, resentments, and find constructive ways to support each other.”

The Bottom Line

Without a doubt, infertility is challenging—not just on each person, but on the couple who is going through it together. You can’t underestimate the impact it might have on your relationships. If you are experiencing some heavy impacts as a couple, you are far from alone. This stuff is hard!

You can get through this—we promise. But you don’t have to go through this on your own. Please reach out for support—from your physician, therapist, or a trusted friend—to help you navigate the chopping waters of infertility as a couple.