The unexpected news that you have a fertility problem can create a great deal of stress and frustration. Being infertile can make you feel out of control and that the next step in your life is blocked. Faced with the loss of a natural part of life, some people feel grief, loss and guilt.

Emotional Aspects of Treatment

Many infertile couples aren’t prepared for the emotional roller coaster of grief and loss of infertility treatments. The layers of stress are multiple:

* Financial-How will we pay for treatment easily costing thousands of dollars?

* Professional-Will I miss job promotions or will my work suffer because of treatment needs?

* Emotional-How will we cope as a couple if treatment fails?

Facing friends, family members or co-workers who have children is another stressor in an infertile couple’s life.

There are a number of issues that are critical for a couple facing treatment:

Be prepared to experience a lot of unfamiliar and uncomfortable feelings and to learn how to manage them. Understand that there are psychological reactions to infertility that are very real and related to the stress of diagnosis, treatment and lack of pregnancy. Being infertile is overwhelming. So is treatment.

Understand that men and women cope with stress and infertility differently. While a woman is physically and emotionally dealing with the effects of treatment, her outlets may involve many people. She may want to talk a lot about her experiences-with her husband-or with anyone who will listen. Her partner may be perceived as being emotionally and physically distant because he is trying to remain calm, despite his deep concern for and commitment to his partner.

Know that marriages will either be strengthened or pulled apart by infertility treatment. What happens depends on the couple’s relationship prior to treatment: Can you discuss intimate feelings? Do you have a good marriage? A good sex life? Are you a cohesive unit as a couple?

Realize that infertility and its wide range of treatment options can be overwhelming. There are many complicated issues, such as preserving embryos by freezing them for future use, adoption, donor eggs, fetal reduction, in which a woman carrying multiple embryos is induced to miscarry one or more, surrogacy and a host of other related topics. Couples who educate themselves as much as possible about treatment have a better chance of not being overwhelmed by its intensity.

Understand from the outset that treatment may not be successful. It’s typical for couples at the beginning of treatment to do whatever it takes to achieve a pregnancy. Eventually, most realize that emotionally and financially there is a limit. However, before most couples decide to pursue a different course, like adoption or remaining comfortably childless, for example, they must resolve their infertility. They have to get to the point that they can grieve and put closure on the fact that one or both biological bodies are not going to give them a child. This stage of infertility has its own stages of grief and loss. Couples must be ready to say, “I’m ready to stop this.”

Treatments for Infertility

Fertility drugs are typically the first step. Up to 90 percent of infertile women are treated with these drugs. Fertility drugs are designed to correct specific hormonal imbalances. The most common fertility drugs-clomiphene citrate (Clomid) and gonadotropins-are used to stimulate the production of mature eggs. Fertility drug treatment can include the following:

* Clomiphene citrate, also known as Clomid or Serophener. This drug is inexpensive and easy to use. For women with ovulation problems, 60 percent of those taking Clomid will ovulate following treatment and, of these, approximately 40 percent will become pregnant within six months. Clomid is a fertility medication, taken in pill form, which induces ovulation. Clomid may cause swelling of the ovaries, multiple pregnancies, hot flashes, mood swings, depression and irritability. Common side effects include weight-gain and water-retention.

While Clomid treatment is generally effective in women who experience abnormal ovulation cycles, it is far less effective in leading to a pregnancy in women who do ovulate. This treatment strategy is termed controlled ovarian hyperstimulation (COH) not ovulation induction. With COH, the goal is to allow the ovary to mature and release several eggs, not just a single egg. Further, when used for COH, Clomid treatment must be coupled with artificial insemination (AI) to yield its impact. Without AI, Clomid treatment has no added value. This strategy also overcomes any negative effects of Clomid on the cervical mucus. In some cases, Clomid can thin the uterine lining. While the impact of this thinning is not completely understood, most data do not indicate that supplementing with additional hormone like estrogen and progesterone provide any benefit.

* injectable medications. These drugs include:

* Lupron (leuprolide acetate) a synthetic version of the naturally occurring gonadotropin releasing hormone (GnRH), which causes the production and release of the pituitary hormone, follicle-stimulating hormone (FSH). FSH is a hormone that the pituitary gland uses to guide ovarian egg development and, as such, it is critical to egg maturation. –Synarel (nafarelin acetate) is a non-injectable form of GnRH, that is administered via a nasal spray.