Infertility

Infertility Fact: A man and a woman become a family on the day they are united in marriage. “Wherefore a man shall leave father and mother, and shall cleave to his wife: and they shall be two in one flesh” (Genesis 2:24 DRA). Moreover, the Catholic Church recognizes a family, with or without children, as the domestic church. Infertility is hard in so many ways, but it is not the end of marriage, a barren desert, or a place where joy and peace can never reign.

Infertility Awareness: Some people, even in the Church, believe that only couples with children form a family. This adds to the social isolation of many families without children. For example, a question like “When are you going to start a family?” is hurtful because it implies that the married couple struggling with infertility is not a “family” without children.

Action: Show by your words that you recognize your married friends without children as a family. Take the lead from them and what they may wish to share about their struggle with infertility, rather than asking questions about when they will “start a family.” Listen to them with sensitivity, and when describing your own family, avoid suggesting that you and your spouse “started a family” when you had children. God has given all Christians a mission to “be fruitful and multiply” (Genesis 1:28), whether in our marriage, our work, how we serve the community, and so on. Acknowledge how your married friends without children fulfill their unique mission to fruitfulness.

Infertility Fact: Approximately 1 in 5 couples have trouble getting pregnant or sustaining a pregnancy (CDC). Infertility includes primary infertility, secondary infertility, male factor infertility, diagnoses (can lead to hysterectomy), miscarriage/recurrent miscarriage, and menopause.

Infertility Awareness: The Church rightly celebrates the gift of a child and holds large families as a sign of God’s blessing and the parents’ generosity (CCC §2373; §2378).  What many people may not realize is that conception does not occur automatically or even easily for every couple.  Sometimes well-meaning people in the Church may assume that couples with small families, or no children, are not open to life. Such assumptions can be very hurtful to couples struggling with infertility, who are often dealing with a variety of factors outside of their control (such as age, medical conditions, etc.) in combination with a desire to follow the teachings of the Church regarding licit fertility treatments. When someone offers “helpful” advice or instruction on NFP or the Church’s teaching on contraception, the couple struggling with infertility or who experiences miscarriage may feel isolated and alone, even in the Church.

Action: Challenge assumptions you may make when you observe another family’s size. Perhaps the couple in the pew without children is suffering because of infertility; or the couple with one or two children wishes they could have more. Remember that while large families are beautiful signs of a living faith in God, small families—in a more hidden way—bear witness to trust in God’s providence through their acceptance of their crosses, and His unique plan of fruitfulness for their marriage. 

Infertility Fact: Women experiencing infertility have emotional stress and depression levels “equivalent to . . . cancer, cardiac rehabilitation and hypertension patients” (Domar AD et al., “The psychological impact of infertility,”  J Psychosom Obstet Gynaecol, 1993).

Infertility Awareness: Infertility is experienced as a deep suffering marked by longing and isolation. Some couples feel they cannot open up to close friends or family members about their struggles because these encounters are sometimes marked with unintentionally invalidating or insensitive remarks. Sensitivity to the suffering of infertility is not yet widely accepted in today’s culture, and so couples experiencing infertility can easily become isolated from others.

Action: If you know someone struggling with infertility, pray for them and tell them that you love them. Make an effort to listen intentionally when they choose to share their struggle, and refrain from offering advice unless they ask for your opinion. Ask the family member or friend to share what they need to feel supported. You could always invite them over for a meal that meets their specific dietary needs, offer to go along with them to a difficult doctor’s appointment, or simply give them a hug and let them know you are there for them. 

Infertility Fact: “Infertility affects men and women equally,” writes the Society of Reproductive Surgeons, continuing, “In approximately 40 percent of infertile couples, the male partner is either the sole cause or a contributing cause of infertility” (SRS, “FAQ Quick Facts About Infertility”). According to the NIH, about “one-third of infertility cases are caused by male reproductive issues, one-third by female reproductive issues, and one-third by both male and female reproductive issues or by unknown factors” (NIH.gov, “How common is male infertility, and what are its causes?”, citing the CDC).

Infertility Awareness: Male infertility often involves issues with sperm production, such as low or absent sperm count, problems with sperm motility, or abnormally-shaped sperm. Structural issues such as blockages may also occur within the man’s reproductive tract. Male infertility has many causes, ranging from varicoceles (large veins), medical conditions such as cystic fibrosis, hormonal disorders, genetic disorders, infections, and environmental factors. Sometimes no cause can be determined and, as with female fertility issues, the cause of infertility may simply be unexplained.

Action: We all carry crosses, so it’s important to resist making assumptions, or to ask intrusive questions that imply guilt or blame, such as: “Which one of you is the problem?” Regardless of the cause, infertility is always a shared experience within a couple’s marriage, and unity and a sense of purpose are essential. Affirm the goodness and beauty of the couple’s marriage as it exists right now and pray for the strengthening of their bond. If a couple shares with you that they struggle with infertility, encourage them to draw strength from the Lord, who brought them together according to His perfect plan.

Infertility Fact: Infertility comes with its own particular grief, which is an appropriate emotional response to losses in general (not just death). More specifically, infertility often involves the losses of dreams, plans, goals, life experiences, community, and a sense of belonging. 

Infertility Awareness: Couples suffering from infertility are dealing with an often-invisible grief that is largely kept private. The invisibility of this grief, however, doesn’t make it any less painful or significant.

Action: Treat couples with the compassion you would extend toward someone who just lost a loved one. Be present, and assure that person of your love, prayers, and willingness to listen. Don’t claim to understand what they are going through, as everyone has unique experiences. Avoid “at least” statements that invalidate the couple’s suffering, such as: “At least you’re married,” “At least you can have a great career,” or “At least you have one child.” Instead, try saying: “I’m so sorry to hear you are going through this struggle. I’m here to listen, and I understand if you don’t want to talk. I don’t claim to understand what you are going through, and I care about you. Would it be alright for me to include you in my daily prayers/check in periodically/drop off a meal?” Click here for more helpful words to try when you don’t know what to say.

Infertility Fact: Infertility and all that it encompasses (e.g. uncertainty, treatment decisions, treatment management, social triggers, social isolation, etc.) places great stress on a couple’s marriage.

Infertility Awareness: When a couple experiences infertility, husband and wife will each cope differently with the stress caused by the situation. Typically, a woman confronts the stress of infertility directly and seeks social support from others, while a man seeks distance and a solution to the “problem” of not being able to conceive. This often leads to tension and misunderstanding, which can multiply the stress on a marriage (see Roccas, Under the Laurel Tree, 130). 

Action: Pray for God’s blessing and protection of all marriages, and especially those experiencing the cross of infertility. Help couples remember the Lord’s love for them and their marriage. If a couple expresses feeling overwhelmed by the weight of infertility, consider reminding them that there is no weakness in seeking help from a trusted pastor and/or a licensed counselor. Be available to listen, pray for them, and let them know you are there for them.

Infertility Fact: According to the American College of Obstetricians and Gynecologists, the decline in female fertility begins at age 32 and accelerates from age 37 on (Committee opinion #589). As a woman ages, hormonal changes may also negatively affect fertility. 

Infertility Awareness: Couples experiencing infertility, especially those who married later in life, feel particularly pressured in their pursuit of having children. They are keenly aware of the calendar and the clock, as well as the scrutiny of family, friends, and even strangers. Often people want to be helpful, but their intrusive questions and unsolicited advice can instead be hurtful.

Action: Friends and family can be most helpful by taking their cue from the married couple. Be available to listen when the couple is ready to share, and don’t offer advice unless asked. If you don’t know a couple well, refrain from continuing to ask questions if they haven’t offered further details about their family size. If a struggling couple married later in life, resist assuming that they put off marriage for selfish reasons. Sometimes we have to wait until God brings us together! Be patient, and don’t assume the couple doesn’t want children, or that they don’t know about or haven’t tried medical interventions (like NaPro Technology), charting cycles, and making lifestyle changes. Love them, listen to them, be there for them, and give them space to share their struggle with infertility when they are ready.

Infertility Fact: According to the Society of Reproductive Surgeons, “Twenty-five percent of infertile couples have more than one factor that contributes to their infertility” (SRS, “FAQ Quick Facts About Infertility”). Even if a couple is seeking medical interventions, finding healing can be a long, complex process that may or may not end in pregnancy.  

Infertility Awareness: To some dealing with infertility, phrases like, “It will happen in God’s timing!” or, “Just relax, you’ll get pregnant when it’s meant to be!” can feel like a dismissal of the pain they’re dealing with here and now. While God does have a plan for their lives, it doesn’t mean they won’t struggle with or question the hardships they experience. Couples dealing with infertility need to be reminded that God’s presence is always with them, and that they are not alone. 

Action: Instead of offering spiritual advice or a catch-all phrase, listen first. Simply asking a person struggling with infertility how you can pray for them will go a long way. They may need prayers for an increase in trust for God’s plan, for the gift of discernment, and the grace to process anger, grief, fear, or any other emotion or situation on the roller coaster of infertility. Pray for the intercession of the Holy Family for whatever God has in mind for them. Most importantly, asking how you can specifically pray for someone struggling with infertility lets them know that they are not alone.

Infertility Fact: According to the March of Dimes, “Miscarriage is very common. Some research suggests that more than 30 percent of pregnancies end in miscarriage, and many end before a person even knows they’re pregnant” (March of Dimes, “Miscarriage”).

Infertility Awareness: Infertility and miscarriage are often intertwined. For some couples, factors related to their infertility may allow them to conceive, but the pregnancy then ends in miscarriage. Sperm abnormalities, endometriosis, endometritis, polyps, and low progesterone, among other conditions, can all contribute to the loss of a child in a miscarriage. Couples who experience both infertility and child loss may grieve their fertility differently than couples who have never conceived.

Action: Couples who have lost a child or children in miscarriage may not feel “counted” as parents in their communities, but they deserve recognition of both their parenthood and their grief. Make a point of letting others know that you recognize the parenthood of couples who have lost children, and that you recognize the spiritual parenthood of those who long for children. Particularly on occasions like Mother’s Day and Father’s Day, this recognition can bring great comfort and validation to couples who have lost children in pregnancy or who experience infertility.

Infertility Fact: “PCOS is one of the most common causes of female infertility, affecting 6% to 12% (as many as 5 million) of US women of reproductive age” (CDC, “PCOS (Polycystic Ovary Syndrome) and Diabetes”).

Infertility Awareness: Because of its prevalence, there is a very good chance you know someone with PCOS, an endocrine disorder where, among other health issues, the woman’s eggs fail to mature and release from the ovary, thereby making fertilization difficult or impossible. Women with PCOS often feel that their bodies are broken, unfeminine, or that they did something wrong to cause the disease, which can affect their mental health and the health of their relationship with their husband.

Action: PCOS is a condition affecting many aspects of a woman’s health, even though she may appear perfectly healthy. The same holds true for many cases of infertility, regardless of the cause. It is easy to assume that there is nothing wrong, even though a couple may be struggling physically and emotionally. It is important to be delicate with words when interacting with any couple who seem like they “should” be growing their families. Do ask a couple how they are enjoying their marriage. Don’t ask if they are “working on having a baby.” Do keep them in your prayers for a strong, spiritually fruitful marriage, children or not. Don’t assume a large family is the pinnacle of a successful or holy marriage. And most of all, love the couple for who they are. Be supportive, even if that support means remaining silent.