The Most Difficult Issue For Couples

I once attended a seminar on working with clients who are dealing with infidelity. The speaker was a well-known expert on marriage, and the room was packed. In the midst of his teaching on infidelity, he stopped, turned to the audience and said, “You know, as hard as this is, infidelity is not the hardest issue for a couple. That would be infertility.”

I think he’s right. Don’t get me wrong – there are definitely couples who have braved the tortuous battlefield of infidelity; I see them in my practice every day, along with a myriad of other serious, real, and challenging issues. But infertility carries with it a unique and particular heartbreak, both for individuals and for couples.

Some statistics cite that marriages that have to deal with infertility have a higher than 50% chance of ending in divorce (disability-resource.com, 2011). Perhaps this is because the issue is not only around and between the couple – it is inside them. And most devastating of all, it is out of their control. A couple has no idea at the start where their journey will end, or if it will end with a child. This lack of control is one of the primary challenges of infertility.

I have seen individuals who have experienced fast and easy success in other areas of life come to a crashing stop at the brick wall of infertility. Infertility is the great equalizer – it knows no boundaries of gender, class, socioeconomic status, or simply how badly one wants a child.

According to the American Society for Reproductive Medicine (ASRM), infertility affects about 7.3 million women and their partners in the U.S. -- about 12% of the reproductive-age population (Source: National Survey of Family Growth, CDC 2002). ASRM defines infertility as “the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.”

Despite the fact that infertility affects more than 1 in 10 adults, it is still a shock when it happens. No one anticipates having a problem getting pregnant; it is expected to happen easily and quickly. True infertility is diagnosed only after 12 consecutive months of trying to conceive. This means that for at least a year, a couple is trying to get pregnant and failing – 12 times of hopeful anticipation followed by crushing disappointment. This type of disappointment adds up – its effects are cumulative, and cannot help but have an effect on the couples’ emotional and especially sexual relationship. Suddenly, what was playful, fun, and a source of comfort for a couple can quickly turn into a stressful, anxiety-producing event, one that must be undertaken on a regular schedule in order to maximize chances for conception.