It has been said that few other experiences in life are as difficult to cope with and come to terms with as the inability to experience the joys of pregnancy, childbirth, and parenting of a child created by one’s own biological make-up. Disappointment and frustration are experienced again and again as a couple moves from repeated attempts to get pregnant to the involvement of medical tests and procedures which often only bring false hope. Physical and emotional exhaustion is a common outcome. The issue of infertility can take a toll on the relationship in many ways including creating tension and guilt, placing of blame, altering otherwise healthy communication, and inhibiting sexual functioning.

Eventually, infertility means facing the undeniable reality that the biological creation of a child is not possible. Most find this to bring profound feelings of sadness and grief but, there may also be a sense of relief that the repeated futility and dashing of hope for a child is over. There is often much anger and resentment toward the medical community for what seems to be an unnecessary prolonging of the agony, toward God for the perceived injustice, toward one’s partner and even toward one’s own body for letting them down. A lack of purpose or direction along with a questioning of the meaning of “family” may occur. The meaning of infertility varies among people but for many it includes a sense of shame or embarrassment or even a feeling of being only marginally a part of society. One’s own sense of femininity or masculinity may come into question. The stress of dealing with infertility can challenge the core of the strongest relationship. At some point couples must reexamine their desire to have children. Much self-reflection is necessary in deciding whether to remain childless or to pursue alternate means of building a family. It is often at this stage that adoption is seriously considered.

Before a couple can move on, one’s thoughts and feelings about infertility need to be addressed. Doing so allows for infertility to be integrated into one’s sense of self, thus freeing one to pursue other ways to build a family without reservation. This is a critical process for each person to go through whether the plan is to move on in a new direction in life without children or to build a family through an alternative route such as adoption. For those who do build their family through adoption, not coming to terms with one’s infertility can create a whole host of problems that can crop up later on. For example, some parents who have not come to terms with the issue of infertility may have a difficult time fully accepting their adopted children or feel inferior to families formed biologically.

The good news is that any work on unfinished issues with infertility has the potential to benefit the parent-child relationship and also the marital relationship, thus benefiting the entire family.

Chester Smith is a licensed professional counselor who works with adoptive children and their families. He is a CHI adoptive parent.