Psychological impact of infertility on families and relationships

SEMINAR ON STEPPING TOWARDS
FERTILITY: AN EXPLICATION
PSYCHOLOGICAL HEALTH AMONG
COUPLE AND FAMILY
Presented by
SELVARAJ.P
Professor
Department of Psychiatric Nursing
Shanmuga College of Nursing
Salem-7

FAMILIES
• Families are groups of individuals who
interact, support, and influence each
other in performing basic functions.
• They are an integral part of society,
bound together by intense and long-
lasting ties of past experience, social
roles, mutual support, and expectations.
• The family constitutes an interactive
milieu
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COUPLE
• The term couple is used to describe two
adults who have a close or intimate
relationship.
• They may be heterosexual or homosexual,
single, married, or in a same-sex union.
• The term group is used to describe at least
three individuals who gather together to
share or discuss common problems or
concerns.
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OVERVIEW OF FAMILIES
• “Family” referred to the traditional nuclear family,
that of father, mother, and children.
• Today, alternatives to this traditional nuclear family
include .
1. Single-parent households.
2. Blended families involving the remarriage of one
parent to someone who may or may not have
children.
3. Extended families that include the presence of
other relatives, and cohabitation between non-
married persons.
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FAMILY LIFE CYCLE
• The family is a developing system that must
progress in the proper manner for healthy
development.
• According to Duvall’s (1984) theory, there
are predictable, successive stages of growth
and development in the life cycle of every
family.

DESCRIPTION OF
FAMILY TASKS
DESCRIPTION OF DEVELOPMENTAL TASKS
I. Beginning
families (no
children;
commitment to
each other;
referred to as a
couple)
• Establishing a mutually
satisfying marriage by learning.
• Relating harmoniously to three
families: each respective family
and the one being created by
marriage
• Family planning: whether to
have children and when
Developing a satisfactory sexual
and marital role adjustment

II. Early
childbearing
(begins with birth
of the first child
and continues
until the infant is
30 months old)
• Developing a stable family
unit with new parent roles
• Reconciling conflicting
developmental tasks of
various family members
Jointly facilitating
developmental needs of
family members to
strengthen each other and
the family unit
• Accepting the new child’s
personality

III. Families with
preschool
children (first-
born child 2½
years old;
continues until
age 5)
• Exploring of environment by
children
• Establishing privacy, housing, and
adequate space
• Having husband–father become
more involved in household
responsibilities
• Developing of pre-schooler to a
more mature role and assuming
responsibilities for self-care
• Socializing of children such as
attending school, church, and sports
Integrating of new family members
(second or third child)
• Separating from children as they
enter school
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IV. Families with
school-aged
children (firstborn
child aged 6–13
• Promoting school
achievement of children
• Maintaining a satisfying
marital relationship, because
this is a period when it
diminishes
• Promoting open
communication in the family
• Accepting adolescence

V. Families with
teenagers
• Maintaining a satisfying marital
relationship while handling
parental responsibilities
• Maintaining open communication
between generations
• Maintaining family ethical and
moral standards by the parents
while the teenagers search for
their own beliefs and values
• Allowing children to experiment
with independence

VI. Launching-canter
families (covers the
first child through
last child leaving
home)
• Expanding the family circle to
include new members by
marriage
• Accepting the new couple’s own
lifestyle and values
• Devoting time to other
activities and relationships by
the parents
• Re-establishing the wife and
husband roles as the children
achieve independent roles
• Assisting aging and ill parents of
the husband and wife

VII. Families of
middle years
(“empty nest”
period through
retirement)
• Maintaining a sense of well-
being psychologically and
physiologically by living in a
healthy environment
• Attaining and enjoying a
career or other creative
accomplishments by
cultivating leisure-time
activities and interests
• Sustaining satisfying and
meaningful relationships with
aging parents and children
• Strengthening the marital
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VIII. Families in
retirement and old age
(begins with
retirement of one or
both spouses,
continues through loss
of one spouse, and
terminates with death
of the other spouse)
• Maintaining satisfying
living arrangements
• Maintaining marital
relationships
• Adjusting to a reduced
income
• Adjusting to the loss of
a spouse

INDIA AND ITS FAMILY STRUCTURE
• India has a rich family structure with a patrilineal
background.
• Earlier, mostly joint families were found where
family members live together under one roof.
• This also helps the family to get strong mentally,
physically and economically.
• Urbanization and westernization had its influence
on the basic structure of the Indian family structure.
• The division of the joint family into smaller units.

•What is wrong with
Indian society and
couples?

• What is wrong with Indian society and parents?

• India’s fertility rate has fallen, and couples
have begun to bear children at a later age.
• The Indian couples differ based on gender.
• Regarding infertility, women are blamed
more when compared with men.
• Infertility Rate In India Is 10 to 14% Where 1
Out Of 6 Couples Are Affected (31-12-2021)
• Couples who experience infertility often feel
isolated.

How can infertility affect a family?
• Although infertility is not a disease
• Cause disorders in physical and mental
health, Impair the quality of marriage,
and lead to separation and divorce, Loss
of self-confidence, Feelings of grief,
Threatening, Depression, Guilt and
Frustration.
• Emotional distress and bring about
marital dishormoney.

FACT
• Fertility or ability to have children is the
success of reproduction and the beginning
of a rebirth for couples, and
• its opposite, infertility through making
reproductive disorders and as a
phenomenon which sometimes is curable
and sometimes incorrigible has always
brought about various unintended
consequences for the couples (Shahnooshi
& Karimi, 2010).

• Infertility is one of the most important life crises
and compared with stressful life events, after the
death of the mother, father and wife infidelity is in
the fourth place (Behiati Ardakani et al., 2010).
• Infertility is a process that lays influence on body,
occupation, personality and mentality and
adversely affects the feelings of the individual
(Tarahomi, 2011; Kormi Nouri, 2000).
• Some studies show that depression, stress, low
self-confidence and sexual dissatisfaction are
among the psychological consequences of
infertility (Kormi Nouri, 2000).

• Studies indicate that 50 to 80 million people
worldwide experience some form of infertility
during their life-time (Ramezanzadeh et al.,
2007).
• So that, one couple out of six couples in
childbearing age suffers from infertility in the
world (Faal Kalkhoran et al., 2011).

Ways Infertility Impacts Relationship
• Infertility causes emotional stress to an
individual, it also impacts relationships—most
especially, your romantic relationship.
• Trying to conceive can create conflict and
tension, but it can also bring couples closer
together.

1.Sexual Stress When Trying to
Conceive
• “Let’s make a baby” can be a turn on.
• Research has found an increase in sexual
dysfunction—both for men and women.
• sex is also a way to feel closer to your
partner, stress in your intimate life can lead
to tension in your overall relationship.

2.Disagreements on When to Seek
Help
• Trying to conceive for one year.
• Age 35 or older.
• Have any symptoms or risk factor for
infertility.
• Some couples have no arguments about
seeking help when the time comes.
• However, what happens when one of you
wants to get help now, and the other wants
to wait?

3.Disagreements on Telling Other
People
• Infertility is usually a couple’s problem.
• Talking about the struggle with other people is
a decision -need to make together.
• The partner who doesn’t want to share may
be experiencing shame or embarrassment.
• The one that wants to talk to others about
the fertility challenges may feel isolated and
lacking social support.

4. Fears Your Partner Will Leave
• I’m afraid he’ll/she’ll leave me because I’m the
infertile one.
• I’m afraid they will leave me for someone who
can give them a child.”
• Self-blame and criticism—it’s my fault, I brought
this onto myself—tend to have higher levels of
infertility stress.
• Researchers propose that some men and women
choose self-blame as a way to take away stress
from their spouse.

5.Tension and Resentment
• One who is infertile (if only one of the two),
and therefore has the emotional burden of
feeling at fault?
• Some couples, these issues lead to
resentment.
• The Pain are not unique to couples.
• This occurs between fellow fertility
challenged peers, and outside of the
infertility community.

6. Misunderstandings
• Everyone copes with stress in different ways.
Studies have also found gender differences
in the way people cope with infertility.
• Studies have also found that women are
more likely to experience marital stress than
men, regardless of the cause of infertility.
• This doesn't mean the men don't care.
• Only that their relationship stress levels from
infertility are lower.

7. Financial Strain
• Arguments over money are not unique to infertile
couples.
Possible sources of financial stress include
• Disagreements over whether to pursue treatment.
• Whether and how to borrow money.
• Whether or not to ask friends and family for
financial help.
• Whether to skip treatments and go straight to
adoption.

8. Differences of Opinion on Moving
Forward
• Some couples may disagree on whether to pursue
any treatment.
• Couples may disagree on whether to take a short
break from testing and treatment.
• They may disagree on whether to keep trying or
move on for good.
• They may disagree on whether to pursue adoption
or live a childfree life.
• Decision making becomes even more difficult and
complex.

Way to cope
• Research has found that men and women faced
with infertility may be more likely to feel
dissatisfied with themselves and their marriages.
• Other studies have found that it can bring couples
closer together.
• On the contrary, according to the research, it’s the
struggle—and their need for mutual support—
that leads to a more secure bond. Here are ways
you can lower tensions and cope better as a
couple.

Communicate
• Talk to each other. Share fears.
• Don’t walk around worried your partner
may leave you and never say anything.
• Primary coping mechanism is to avoid the
topic altogether.
• Talking about infertility all the time
• The key is finding balance. Be willing to
talk, or be willing to talk about it less.

Connect in Other Ways
• Speaking of balance.
• Infertility can shadow everything in your life.
• Make an effort to connect in other ways. -
Think back to what you did during your dating
days.
• Speaking of connection, don’t neglect your
sex life. Reclaim it back from infertility, and
make it about intimacy and love again.
5/19/2022
SELVARAJ@SCON

Allow for Differences
• Everyone copes differently.
• Example-There will always be someone in this
world that has it “worse” or “better” than
you. That person may or may not be your
partner. It doesn’t matter.
• If your partner breaks his arm, and you break
your little toe, does your toe hurt less because
his broken arm is “worse?”
• Emotional pain is emotional pain.

Reach Out for Support
• Don’t try to cope with infertility alone. Shame
does keep many individuals and couples from
reach out for support.
• Research has found that couples that receive
social support have improved relationships.
• Don’t have to “tell the world,” so to speak.

Sit Down and Make a Plan
• Research has found that putting together a
practical plan of action helps improve marital
satisfaction,
• In some ways, infertility is not plan-friendly.
make short-term plans.
• You can also make flexible plans.
• Putting together financial plans—especially a
savings plan—is a smart choice.

Compromise
• Avoid black-and-white thinking.
• Decide together on a select group of people
who can be social supports.
• Compromise by taking a temporary break
instead, with plans to discuss moving forward
when that break is over.
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SELVARAJ@SCON

Consider Counselling
• Sometimes, you’re not going to be able to reach
compromises alone.
• A counselor can help you communicate and reach
mutual agreements.
• You may assume that counseling is only for those
considering divorce, or situations of clinical
depression or anxiety . This is a myth.
• Counseling is for everyone who can use some extra
help with stress or a difficult situation.

Remember Infertility Is Not Forever
• Research has found that feelings of depression
and anxiety peak around three years post-
infertility diagnosis. However, six years post-
diagnosis, couples are feeling stronger, and
depression and anxiety symptoms lessen.
• Your relationship can survive this tough—but
temporary—challenge.
• Either have a child or stop trying to conceive. But
there is life after infertility. Hold onto that hope.

FAMILY THERAPY
• Psychotherapy that helps family members gain
insight into problems,
• Improve communication,
• Resolve conflicts, and
• Improve functioning of individual members as well
as the family as a whole.
• Issues such as dysfunction or the acting out of a
child, marital conflict, work stress, financial
problems, or intergenerational relationship
problems.

The Nurse–Therapist’s Role in Family
Therapy
• The clinical nurse specialist or nurse practitioner
with a graduate degree in psychiatric–mental health
nursing can function in many highly skilled roles,
one of which is serving as a family therapist.
• During the initial assessment,, nurses obtain
information about the client’s family members,
including grandparents, aunts, and uncles.
• One assessment tool that nurses can use in
determining the family’s constellation of members
is a genogram, a diagram of family-member
relationships, usually over three generations.

Couples therapy
• Couples therapy, an intervention involving two
individuals sharing a common, is a way of resolving
tension or conflict in a relationship.
• When two people enter into a relationship, they
each bring a set of beliefs about love, intimacy,
gender roles, sexuality, and marriage.
• Problems may arise at any time during the
development of a couple’s relationship, as each
person attempts to maintain independence while
attempting to experience mutual growth and
fulfilment as part of a couple.

Types of Couple Therapy
1 .Marital-relations therapy
• Negative interactions.
• Conflicts in problem solving.
• Inability to communicate.
• Sexual dysfunction.

2. Contextual therapy
• Power struggles
3. Object-relations therapy
• Poor self-esteem
• Recurrent dissatisfaction with partner
or spouse
• Escalating interactions and emotional
patterns

•What are some
simple but useful
psychological fact.

• 80% of people would write their name if asked to
write something with a new pen.
• If a person laughs at a low quality joke then he is
suffering from loneliness.
• Psychology is the first 6 seconds of meeting with
someone, the first impression about him is
formed.
• In 90% of cases, those whose handwriting is bad
are more creative than usual.
• 8 positive statements disable a negative
statement.

• You will rarely die in your dreams, if you die in
your dreams then you have started something
new in life.
• Every 10 years you become a new person, our
desires, needs Changes every 10 years.
• Listening to sad songs actually creates positive
emotions.
• 91% of people are not friends with people they
once called their best friends.

• Trouble sleeping at night for no reason it because
you are actually alive someone else's dream.
• People who hide their feelings, cares the most.
• If a girl likes you, she will play with her hair while
talking to you.

CONCLUSION
• Families may consist of married or non married,
homosexual or heterosexual couples with or without
children. They are an integral part of society in which
members learn how to relate to and communicate with
others.
• Duvall’s theory of the family life cycle describes the
family as a system.
• Family therapy is a method of treatment in which
family members gain insight into problems, improve
communication, and improve functioning of individual
members and the family as a whole.
• The family nurse–therapist obtains a detailed family
history of at least three generations to provide
information regarding the family’s current and past
levels of functioning.

Reference
1.Mohammad Amiri, Ahmad Khosravi, Reza Chaman,
Zakieh Sadeghi , Mehdi Raei, Mohammad Ali Jahanitiji
, Fardin Mehrabian
Glob J Health Sci. 2016 May; 8(5): 89–95. Published
online 2015 Aug 31. doi: 10.5539/gjhs.v8n5p89
2.https://www.verywellfamily.com/how-infertility-
impact-your-marriage-and-relationship-4121098
3.https://www.verywellfamily.com/symptoms-of-
infertility-1960282
4. https://www.apa.org/ed/graduate/specialize/family

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Psychological impact of infertility on families and relationships

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