Infertility and Your Relationship: Staying Connected
Infertility puts real strain on a relationship: grief, scheduled sex, medical decisions, cost and a long wait without answers. It does not doom a couple. Research is mixed, and a meaningful share of people in treatment say the experience brought them closer. What tends to help is talking openly, sharing the load and protecting time that is not about trying to conceive.
How common is infertility, and why is it so hard on couples?
It is more common than most people realize while they are going through it. According to the Centers for Disease Control and Prevention, about 1 in 5 married women aged 15 to 49 with no prior births are unable to get pregnant after a year of trying, and about 1 in 4 in that group have difficulty getting pregnant or carrying a pregnancy to term. The CDC figures describe married women, but fertility problems involve male factors too, and they affect unmarried and same-sex couples who are building a family with medical help.
Infertility is hard on a couple because it is several kinds of stress at once:
- Repeated loss. Each cycle can bring hope and then grief, month after month.
- Loss of privacy and control. Your body, your sex life and your calendar are run by appointments and test results.
- Uncertainty. No one can tell you whether or when it will work.
- Money. Treatment can be expensive, and each new step is a financial decision as well as an emotional one.
- Other people. Pregnancy announcements, baby showers and well-meant questions arrive constantly.
Does infertility damage relationships?
Not in any simple way. The research points in more than one direction.
A systematic review of 20 studies published between 2000 and 2014 found evidence that infertility has a negative effect on couples’ psychological well-being and on their sexual relationships. For the marital relationship itself, the authors judged the evidence inconclusive.
Some couples report growing closer. In a Danish study of 2,250 people beginning fertility treatment, 25.9% of women and 21.1% of men reported high “marital benefit,” meaning they felt infertility had strengthened the marriage and brought them closer together. A related study followed Danish men and women through five years of unsuccessful treatment and found that about one-third reported high marital benefit.
There is also evidence of risk over the long run. A registry study of 47,515 Danish women evaluated for fertility problems found that after up to 12 years, nearly 27% were no longer living with the partner they had at the time of the evaluation. Women who did not have a child after the evaluation had higher odds of the relationship ending than women who did, with odds ratios of up to 3.13. This was an observational study in one country. It had no information on how happy those relationships were to begin with, so it cannot show that childlessness caused the separations, and the authors themselves called for studies with more detail on relationship quality.
The fair summary: infertility is a serious stressor, most couples stay together through it, and how you handle it together seems to matter.
Where do couples tend to get stuck?
Grieving differently
A common pattern is that one partner needs to talk about it often, while the other copes by staying busy, fixing what can be fixed or staying positive. The first feels alone. The second feels helpless, or feels that nothing they say is right. Neither is grieving wrong.
Blame and guilt
When a cause is found in one partner, that person may carry guilt, and the other may carry resentment they are ashamed of. When no cause is found, there is nowhere for the frustration to go.
Uneven load
In many treatments one partner’s body takes most of the procedures, injections and monitoring. The other can end up feeling like a spectator, or be treated like one.
Decisions with no clear answer
Whether to start treatment, how much to spend, whether to try again, whether to consider donor eggs or sperm, surrogacy or adoption, and when to stop. Partners often reach their limit at different times.
Family and privacy
One of you may want to tell your parents everything. The other may want no one to know. Add pressure for grandchildren and it becomes a boundary issue, which the guide covers in in-laws and your marriage.
What happens to sex and intimacy during fertility treatment?
Sex on a schedule stops feeling like sex. It becomes a task with a deadline and a result. Desire often drops for one or both of you, and physical affection can start to feel loaded because it might “lead somewhere” or because it is a reminder of what is not working. The systematic review above found the sexual relationship to be one of the two areas with evidence of a negative effect.
It helps to say this out loud and to separate the two: time for conceiving, and touch that has nothing to do with it. If distance has set in, the guide’s article on sexless marriage and the practice’s post on why intimacy often disappears in long-term relationships go further.
Does stress cause infertility?
You may have been told to “just relax.” The American Society for Reproductive Medicine says plainly that it is not clear how stress affects fertility, and that it is not known whether high levels of stress can prevent pregnancy. What is clear is the reverse: infertility causes stress.
This matters inside a relationship. If either of you believes that worry is the reason it is not working, the more anxious partner ends up blamed, or blames themselves. Managing stress is worth doing because it makes this period more bearable, not because it is the cure.
What helps couples stay connected?
In the Danish study of people beginning treatment, the predictors were clearest for men. Keeping the infertility a secret, difficult communication with their partner, and coping by avoidance, such as throwing themselves into work, predicted low marital benefit a year later. Coping by finding meaning in the experience predicted high benefit. No significant predictors were found for women, so treat this as a pointer, not a formula.
Practical steps that follow from it:
- Contain the topic. Agree on a set time to talk about treatment, perhaps twenty minutes a day, so it does not fill every conversation. Outside that window, either of you can say “not now.”
- Ask what kind of support is wanted. “Do you want me to listen, or help think it through?” saves a lot of misfires.
- Share the work. The partner who is not having the procedures can take on scheduling, insurance calls, pharmacy runs and being at appointments.
- Decide in stages. Set checkpoints, such as “after this cycle we will talk about what is next,” so you are not renegotiating your whole future every month.
- Agree on what you tell others, and prepare a shared line for intrusive questions.
- Protect something that is not about fertility. A weekly plan, a trip, a project. You were a couple before this.
- Let grief be grief. A failed cycle or a pregnancy loss is a loss. You do not have to move on at the same pace.
When is it worth getting professional help?
Consider it if you have stopped talking about it because every conversation ends badly, if you disagree about whether to continue or stop, or if one of you feels alone in this. ASRM lists psychotherapy and support groups among the ways people manage infertility stress. Couples counseling works alongside your medical care, not in place of it, and focuses on how the two of you communicate and decide. If loss is at the center of it, the practice also works with grief and bereavement.
If either of you feels hopeless or is having thoughts of self-harm, call or text 988 to reach the 988 Suicide & Crisis Lifeline.
Talk with someone who works with couples
Moshe Ratson, LMFT, offers a free phone consultation to talk about what you are facing and whether couples work would help, with sessions in Midtown Manhattan or Online by Video. To arrange a call, contact spiral2grow.
Common questions
Most do not. Studies are mixed: some find more long-term separation among couples who do not go on to have a child, while others find many people feel closer to their partner after going through treatment together. Infertility is a heavy stressor, and how a couple communicates and shares it appears to make a difference.
Ask what kind of support they want instead of guessing. Share the practical load, such as appointments, paperwork and scheduling. Let them be sad without trying to fix it, and talk about your own feelings too, so they are not carrying the emotional side alone. Keep some time together that is not about treatment.
People cope in different ways. One partner may need to talk and cry, while the other manages by staying busy or focusing on next steps. Neither approach means someone cares less. Problems start when each reads the other’s style as rejection. Naming the difference openly usually eases it.
There is no universal answer, and it is a personal and medical decision. Partners often reach their limits at different points, emotionally, physically or financially. It helps to set checkpoints in advance, talk about what each of you can sustain, and involve your medical team. A couples therapist can help you have that conversation.
Sources
- Infertility: Frequently Asked Questions, Centers for Disease Control and Prevention (CDC)
- The Impact of Infertility on the Psychological Well-Being, Marital Relationships, Sexual Relationships, and Quality of Life of Couples: A Systematic Review (Luk & Loke, 2015), Journal of Sex & Marital Therapy, via PubMed
- Does infertility cause marital benefit? An epidemiological study of 2250 women and men in fertility treatment (Schmidt, Holstein, Christensen & Boivin, 2005), Patient Education and Counseling, via PubMed
- Marital benefit and coping strategies in men and women undergoing unsuccessful fertility treatments over a 5-year period (Peterson, Pirritano, Block & Schmidt, 2011), Fertility and Sterility, via PubMed
- Divorce or end of cohabitation among Danish women evaluated for fertility problems (Kjaer et al., 2014), Acta Obstetricia et Gynecologica Scandinavica, via PubMed
- Stress and infertility, American Society for Reproductive Medicine (ReproductiveFacts.org)
This article is part of the Couples Counseling Guide. It is general information, not a substitute for care from a licensed professional who knows your situation.
This article is for general education. It is not a substitute for professional advice, diagnosis or treatment.
