​1.) Look to your own mental health. Studies show that stress and other emotional experiences associated with infertility treatment does not affect the couple’s ability to get pregnant (Clayton & Nonacs, 2020). However, the jury is mixed when it comes to whether chronic anxiety, depression, or stress interferes with fertility (Clayton & Nonacs, 2020). It's also important to note that depression seems to play a role in determining whether a woman will seek infertility treatment and/ or stay in treatment (Clayton & Nonacs, 2020). If you're struggling with depression and you want to get pregnant, see your OB/GYN. Most doctors wouldn’t necessarily want you to start anti-depressants while actively trying to get pregnant or during pregnancy, but they can offer you alternatives. If you’re already taking anti-depressants, it’s vital that you talk to your doctor before discontinuing that or any medication.

If you're looking for an alternative to anti-depressants, you can ask your physician about therapy. Speaking with a therapist is a great way to help work through all sorts of issues. Talk therapy can also help you sort through your emotional experiences around infertility. It’s not uncommon for women to have feelings of betrayal, resentment, jealousy, anger, and envy of friends who are able to get pregnant. Whatever choices you make regarding your efforts to get pregnant, talking with a therapist can help you work through these feelings and create more stability through the emotional roller coaster of infertility.

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2.) Find healthy ways to cope. Each of us has our own set of coping mechanisms that we employ during times of stress. Some of these may be healthy, while others can lead to greater stress and discouragement. Implementing healthy coping strategies is a great way to stay grounded. Here are two coping strategies you might find helpful.

• A meaning-based coping strategy is when we take a difficult experience we’re going through, and we make meaning out of it. Maybe we recognize that we’ve learned something important through our struggle with infertility. Or perhaps there's a gift or lesson that’s attached to our trial that wouldn’t be available any other way. Taking stock of the good that has come from the terrible is a great way to reframe the difficulties surrounding infertility and recognizing the value that has come from what you're going through. However, meaning-based coping might not always feel right. It can be hard to consider a any important lesson or good thing in the midst of this particular suffering. If that’s the case, we can employ another coping strategy.

• Problem-solving coping. When we move into problem-solving coping, we take a look at the issue and determine the best course of action at that time. We sort out our options, determine what's best for us, and come up with a plan that can help us move toward our goal. When it comes to infertility, problem-solving coping isn’t chipped in stone. Instead, it’s written in pencil. We can always go back and readjust the steps we’re taking, dependent on what we need and our changing circumstances. 

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I also suggest that once you have a plan in place, and you’ve worked through whatever you can control, then step back and implement the plan. When it comes to infertility, there’s so much uncertainty that at some point, we have to solve what we can and leave the rest. If your plan needs an adjustment, you’ll know it. Solve what you can in the moment and then move forward.

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One thing to consider with all coping strategies is that your spouse will most likely have a different strategy. Men have a tendency to focus on problems and solutions, while women are drawn to finding meaning. Give your spouse some room to work through infertility in a way that works best for them and try to partner with them, as you both work on coping.

3.) Advocate for yourself. Give some thought to what you need and then advocate for those things. If you have friends who are also trying to get pregnant, discuss with them what you need around the news of their pregnancy, if they happen to get pregnant before you. Do you want a phone call, a text, or some face-to-face time? Do you want them to get in touch with you before making a general broadcast on social media or in a group of friends? How do you feel about shower invitations and birth announcements?

Speak to your friends and family members about the kind of support you need. Much of the time, friends and family want to help but they don’t know how, so they end up doing or saying nothing. Infertility can become the elephant in the room that can strain family relationships and friendships. If you feel emotionally safe in your relationships, don’t be afraid to approach the subject first.

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4.) Try to stick to a routine. Our brains crave routine because it’s closely related to certainty, and humans love certainty. It helps us feel safe. Sometimes, when we find ourselves stuck in a rut, it’s a good idea to shake up our routine, but infertility treatment is different. Infertility is truly a life-altering experience with its own crises and trauma. It can often feel as if everything from our temperature to our sex lives revolves around conception. This leaves us feeling unstable and depressed as our routine is thrown into disarray.

In trying to create a routine, make sure you keep a calendar with your appointments, medication requirements, and other treatment necessities clearly written out, so you don’t have to guess about what’s coming next in your treatment plan. Also, try to go to bed and get up at the same time every day. Sleep is an important component to overall health, and when we can routinize our sleep, it helps the rest of the day fall into place. Keep meals at the same time, as well. This not only helps anchor us in our day but encourages healthy eating.

5.) You get to decide how you want to handle the holidays. In the church, we make a big deal out of Mother’s and Father’s Day. If you need to stay home on those days, then do so. If you have a responsibility that would require your presence, start looking for a substitute in advance. Most folks don’t want to take on an extra chore during Mother’s or Father’s Day, but if you approach them early enough, they can often make room for the job in their schedule. If the Mother's Day and Father's Day catches you by surprise and you just can’t manage it, then call as early as possible to let others know that you won’t be in attendance.

Christmas, Thanksgiving, Easter, and other holidays can also be difficult, especially if they involve big family gatherings. Talk with your family about what you’re able to do and what you can attend. If your family enjoys making big announcements such as engagements, pregnancies, and missionary calls at these gatherings, ask family members in advance to let you know if there’s going to be a baby announcement, so you can be prepared when the news is shared with the family.

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6.) Find your tribe. Every study done about every possible condition, including infertility, makes it clear that we do better when we're connected. It's no surprise, really. Our brains are wired for connection and community. If the COVID pandemic has taught us anything, it's that we need each other. But community is one of the most difficult things about infertility. It's easy to feel alone when suffering from infertility. Our lives become immersed in tests, doctor's appointments, and a language no one else really understands. Church members often ask insensitive and thoughtless questions that can further isolate us. But that doesn't mean we have to be alone. What it does mean is that you're probably the one who's going to have to reach out. There are a couple of ways to do this.

First, look for those who are also going through infertility treatment. You can begin by looking online for groups such as resolve.org or American Society for Reproductive Medicine (ASRM) at reproductivefacts.org. These organizations are designed specifically for individuals working through infertility. There are also social media pages dedicated to both infertility and Latter-day Saints who are suffering with infertility. Consider searching for what fits your specific needs.

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Second, look for individuals who share your varied interests. Do you enjoy yoga? Do you write or garden? Are you interested in nutrition, exercise, animals, technology, or the outdoors? Whatever you enjoy, look for like-minded people who can share your joy around the same things. When working through infertility treatment, it's easy for our cyclic process to become all-consuming while these other pieces of us become small. But we need other interests and people. Don't let those parts of you fade into the background. Instead, use them as a force for good to help you connect both with others and yourself. 

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Infertility is traumatic for those who are working through it, involving a wide range of feelings. It can often feel as if we're living in a recuring nightmare of tests, menstrual cycles, doctor's examinations, hope, and despair. But we do have some say in this. We can mitigate some of the difficulties that come with this diagnosis if we're willing to take control of what's ours to control by finding healthy ways to cope, treating ourselves with gentleness while advocating for what we need, and doing our best to stick to a routine.

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If you begin to feel that your journey through infertility is overwhelming, despairing, or making it hard for you to manage your day-to-day life. If you feel like hurting yourself, giving up on life, or your emotions are running the show more often than not, then please consider seeing a therapist. There are good therapists out there who are willing and able to help you through this difficult time. To find a good therapist, you can ask for a referral from your bishop, relief society president, family services, or you can ask others who've sought therapy through their infertility journey.

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If you live in Washington State, I'm available for mental health sessions through telehealth regarding infertility. You can contact me here.

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Wherever this journey takes you, taking care of yourself is extremely important. You deserve the best you can offer. Be tender and compassionate with yourself as you navigate these difficult waters.

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Clayton, E., & Nonacs, R. (2020, December 10). The intertwining effect of mood disorders and infertility. Psychiatric Times, 37(12).