"I always wanted children, even more than I wanted to get married," Jennifer Palumbo, director of patient care at New York-based fertility service Progyny laughingly tells me during an interview. "I just always wanted to be a mom." In fact, it was her own experience with infertility, ultimately led her to her job. "When I was going through treatment there were so many things, I didn't know what to ask," Palumbo recalls. Neither did her husband. Through her own journey she learned there are conversations to have with your partner if they're infertile (or if you're the one that's infertile) that will help you plan ahead.
The fertility journey can be fraught with overwhelming information and emotions, says Palumbo. And it was certainly a journey she never expected to go on as a newlywed. "When I got married at age 34, and by all accounts that's not old, we started trying to conceive and nothing was happening," Palumbo says. She became aggressive and proactive, searching for answers. Eventually medical tests revealed that she had an egg quality issue.
Infertility can be really taxing on a relationship. Palumbo says through her involvement in the infertility community, she's seen couples really suffer, especially when they disagree about their options. And sadly, she's seen plenty of divorce from it too.
One thing Palumbo recommends for couples struggling with infertility based on her own experience, is therapy. She says talking about infertility with an objective party really helped her and her husband connect and have healthy discussions. Whether a couple seeks help or not from a professional, there are nine conversations you'll want to have with your partner if you're faced with infertility.
1. How Are You Feeling About The Situation?
This is the time to be really open and honest with your partner. Whatever you are feeling, you need to let it out, even if it's anger and frustration. Studies show couples who hide their feelings are more likely to have issues with stress and infertility, according to the site Healthy Women.
2. Which Options Are You OK With?
"It's not that anyone's right or wrong," Palumbo says. "It's just if you're not on the same page, it's a hard situation to be in." She adds that it's really all about comfort level. Often the fertility treatment options presented to a couple are based off of a medical diagnosis. Some couples will need to decide if they're OK with one being the biological parent, and the other one not. Some will need to decide if not getting pregnant is OK, and surrogacy is an option.
It's also important to remember that fertility treatments and IVF aren't the only options. Adoption might be on the table. The National Association of Infertility reminded couples that adoption is a lifelong commitment, and there are choices to consider like open or closed adoption, domestic or international. But all need to explored during the decision making process.
3. What Lifestyle Changes Need To Be Made?
There are health considerations and lifestyle choices to consider. Is one person not eating as healthy as they should? Is someone drinking alcohol or smoking? During an interview, Dr. Monya De of Proactive Health in Santa Monica says, "actions that improve the couple's overall health will increase the likelihood of conception."
Beyond possible health-related lifestyle changes, De also suggests that couples examine their professional lives. For example, does one partner work crazy hours or travel a lot for work? "Will this same partner be missing during "fertile windows?" De asks hypothetically. Though she says most of the lifestyle changes will be temporary, they may be very bold in the beginning.
4. How Much Money Are We Willing To Spend?
According to the National Infertility Association, the average cost of in vitro fertilization (IVF) cycle is $12,400. Some health insurance companies pay portions of treatments, some don't at all. It's important to talk about how much your treatments options will cost and come up with a solid plan to pay for them.
5. Are We Going To Tell Other People?
The National Infertility Association notes many infertile people may feel shame or guilt. Both partners will need to decide together, who the infertility news will be shared with and how.
6. Do You Want To Join Support Groups?
Because infertility struggles can be a lonely road, many people will find solace in support groups. The National Infertility Association says these groups can inform, engage and help people feel less alone. If you're not into physically joining support groups, there are plenty online.
7. Can We Handle Hanging Out With Pregnant People?
Infertile couples are grappling with a lot emotionally. It may seem like all of your friends and family members, even celebrities are having babies except you. You might not want to be around them, as it could cause jealousy.
“It [jealousy] is a normal, natural, negative thought," Dr. Madeline Licker Feingold, PhD, a reproductive medicine psychologist and fertility counselor based in Berkeley, California told Babble. "It’s the pain and grief speaking." Find out what will work best for you and your partner as you make your way through this journey.
8. Do You Want To Go To Therapy?
Couples going through infertility will often retreat into their own coping mechanisms. Doing so, can make it so couples are turning to outside people or activities for support and not each other.
"I became entrenched in the community and he became entrenched in like video games," Palumbo says. She recalls that when her and her husband spent time together, it seemed all they would talk about was fertility. "It'd be hard to find a night where we go out to dinner and not talk about his sperm count or my cervical mucous, because it became like an obsession."
Palumbo noticed the obsession and the retreating, and suggested to her husband that they go to couple's therapy. She learned a lot, mostly about how to reconnect with her husband.
"I need to have nights where I don't talk about fertility, and actually have blocks of times scheduled where we will not talk about anything fertility related," Palumbo says. Of course, both couples have to be willing to talk in order for therapy to be effective, so don't sign up for a session unless you're both ready.
9. When Will We Stop Trying?
Everyone has a threshold. And as The National Infertility Association pointed out, childfree living is a way to deal with infertility. Though that may seem undesirable, or completely off the table at first, alas, it's still an option. And if couples want to move on from the grief of not getting pregnant, or having a biological child, deciding to live childfree is something to explore.
Having this healthy dialogue about infertility with your partner, and exploring all aspects will help you stay connected during the process. It may be a hard journey, but leaning on each other, and being on the same page will hopefully give you the comfort and support you need to get through it.