"We Can't Have a Baby"

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The Counselor's Turn

A Medical Condition

"Katie and Bob felt helpless, hopeless and cheated by life -- emotions that are typical among the more than six million American couples who can't conceive a baby. As the American Society for Reproductive Medicine reports, infertility can trigger overwhelming feelings of loss. The decisions and expense of medical intervention can be daunting. It's no wonder, then, that marital dysfunction is both common and normal among infertile couples.

"Psychological symptoms are also typical: mild depression, persistent feelings of bitterness and anger, social isolation, feelings of pessimism and guilt.

"Shortly after they started therapy, the couple's second IVF cycle failed because Bob's sperm quality was too poor, so they tried insemination with donor sperm. After four unsuccessful attempts, Katie insisted on undergoing infertility tests herself.

"It turned out that she had endometriosis, which had caused scar tissue to block her fallopian tubes, preventing the eggs and sperm from passing through. This made it impossible for her to become pregnant through insemination, which involves assisting the fertilization in the tubes. Another IVF, using donor sperm, was their only option. But by then Katie had had enough of shots and procedures, and she wasn't sure she really wanted to bear another man's child. 'It's time for us to move on,' she said.

"Despite their ordeal, Katie and Bob remained in love and were determined to stay together. I was confident they could if they followed a multistep plan to heal and reconnect. First, I urged them to mourn openly.

The Grieving Cycle

"Infertility is like a death: Couples must go through the stages of grieving -- including anger, denial and sorrow -- before they can reach acceptance. By keeping their pain inside to avoid hurting each other, they'd become estranged emotionally.

"Katie and Bob were suffering in different ways. Katie needed to vent her anger at Bob for having had the vasectomy and at her doctor for not diagnosing her condition earlier. Bob needed to alleviate his guilt over his voluntary sterilization, his disappointment that the reversal had failed and his fear that his choices would cost him his marriage.

"I instructed them to remember each other's positive qualities and express their appreciation for those traits every day. Couples in crisis often become so focused on their problem that they forget why they fell in love. By sharing the things they enjoy about each other -- Bob's gentle nature and sense of humor; Katie's intellect and outgoing personality -- they began to distance themselves from all the negative emotions.

"I also urged them to have fun. Even though money was tight, they could still afford to rent videos, order take-out pizza, snuggle on the sofa, take long walks and ride their bikes -- activities they'd enjoyed before infertility treatments consumed their lives.

"Katie and Bob hadn't been making love very often, either because they'd had to abstain during part of the IVF cycle or because the medication and Katie's weight gain had caused her desire to ebb. Cuddling, hugging and kissing at every opportunity went a long way toward reviving their intimacy. Once Katie was off the fertility drugs and started exercising, she lost twenty pounds, and now she frequently initiates sex.

Continued on page 5:  The Counselor's Turn, continued


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