The secrecy of . . . infertility

Infertility affects both men and women equally, however women can experience a disproportionate social and self-stigma which can significantly threaten their self-esteem and psychological and social wellbeing.

A woman’s infertility is heavily aligned with the stigma of not giving birth to children. The associated feelings of shame and secrecy, isolation, guilt, embarrassment, and blame can be considerably damaging.

Without doubt, women encounter more curious questions about their family status than men, with perceived judgment when the answers are not as forthcoming as the inquisitor would like.

There still remains a stereotyped prerequisite for women to bear children which does not take into account the changing fertility rates worldwide or the stresses and environmental factors that affect an individual’s fertility. This verbal stigma can be offensive and obtrusive as women are asked when they will start a family or if they have a problem. These insensitive questions, while often quite simple and unintentionally harmful, can create a social stigma with negative views and labelling with social expectations.

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“From a social point of view, expectations and pregnancy comments can often cause upset,” says Karen Ferguson, group director of nursing and clinical services at Sims IVF.

“For someone who is trying to conceive, a well-intentioned comment at the wrong time can be very difficult to manage. Socially, if you are not drinking alcohol, people often assume you must be pregnant, therefore during fertility treatment many will avoid social situations which involve alcohol.

“Hearing pregnancy announcements can also be triggering for some. Physical symptoms associated with treatment can have an impact on day-to-day life and work.

“We encourage couples and individuals to maintain [a] strong support system of close family or friends. Counselling is also a great option, especially if people do not feel comfortable opening up to family or friends.”

Low self-esteem, devaluing, and inferiority can create a level of self-blame for women who are already under psychological distress with sadness, anger, and anxiety creating intense negative feelings.

“Self-blame is extremely common,” says Ferguson. “However, it’s important to realise nobody is at fault. There can be a fear of building hope and making plans around having a family which can be quite isolating at times. These feelings are normal and can be extremely upsetting.”

Always be kind and conscious that you never know what struggles someone is going through

Fertility issues can often be othering in society due to that apparent need for secrecy or to silently navigate infertility, especially for women who may internalise infertility as a personal failure. However, as Ferguson says, how a person navigates their fertility journey depends on an individual’s circumstances.

“I have seen positive change in Irish society surrounding the fertility conversation in the last few years,” Ferguson says. “With this being said, many decide to remain silent and keep fertility treatment a secret. This is often more prominent in rural areas of Ireland where fertility issues remain a taboo subject.”

Education about infertility plays a key role in diminishing any and all social- and self-stigma. With women in their 30s often shocked by the fact that infertility may be a possibility for them, educating both women and men on the possible challenges a couple may face is needed in light of infertility rates rapidly rising.

Knowledge is certainly power. Assuming that pregnancy will be achieved because periods are regular can be misleading as fertility can be impacted by a multiple of concerns. Hormone disrupting chemicals are considered to be a cause for increasing incidences of miscarriage, declining sperm counts, and the increasing need for gestational surrogacy. Adverse factors such as environmental pollution, work pressures, and lifestyle stresses can affect a person’s fertility without them knowing or understanding why.

[ Breaking the taboo of discussing fertility issues ]

The pervasive social stigma and personal shame that is heavily aligned with infertility can encourage women to keep their infertility a secret instead of talking to family or friends. But balancing infertility stigma and the silent conversations is necessary to break the taboo and has led to many people actively voicing their concerns and sharing their experiences with others.

In fact, research indicates that in order to balance the psychological damage caused by the varying stigmatised narratives in female infertility, empowered women who dictate their narratives by avoiding negative thoughts or assumptions, or refocus their energies towards what they can control, can eliminate the pressures they experience as a result of stigma.

Women sharing their stories is empowering and will provide comfort for those who need it

“Infertility is a challenging road for sure,” says Ferguson. “However, we are seeing a lot more women coming forward and sharing their journey on social media.

“This contrasts completely to 10 years ago when it was very much stigmatised. The stigma is shifting as many people feel the benefits of sharing their journey with others.

“We see a supportive online community emerging. We believe this is a positive step forward as support from friends and family is key during fertility treatment.”

In supporting women to discuss their concerns about infertility, and supporting them throughout their experience, Ferguson suggests that friends and family focus on being a listening ear. “Try not to impart unfounded advice,” she says. “Sometimes an offer of a cup of tea and a chat can be the best medicine. Avoid using phrases like ‘Just relax and it will happen’ and ‘Why don’t you just adopt?’. Always be kind and conscious that you never know what struggles someone is going through.”

Infertility is a complex scenario to navigate, affecting not only the physical health of a person but also their mental health. As such, while social support is essential, counselling is also encouraged as it can help navigate the difficult times and create coping mechanisms.

[ IVF in Ireland: ‘Time is just so precious for these people, they can’t afford to wait’ ]

“Sharing stories can be extremely daunting,” says Ferguson. “However, opening up the conversation will enable others to do the same.

“There is great strength to be found in the ‘Trying to Conceive’ community. Women sharing their stories is empowering and will provide comfort for those who need it.”

The secrecy of …

• Periods
• PND
• Contraception
• Menopause