Infertility is estimated to affect more than one in seven couples in the UK. The physical demands on your body during fertility treatment are well documented, but the crippling effect it can have on your mental health is not often talked about.
The psychological toll
A recent survey by Fertility Network UK found 90% of people who had fertility problems reported feeling depressed. While 50% said they felt out of control, frustrated, helpless, sad, fearful and worried nearly all of the time. 42% said they experienced suicidal thoughts.
Kelly Da Silva, 35, from Derby, knows only too well the psychological ordeal that fertility treatment can be. She began her eight-year fertility treatment journey at the age of 24, when she tried to start a family. After being diagnosed with unexplained infertility, Kelly initially took the drug Clomid®, which boosts ovulation.
"I fell pregnant with my sixth cycle, but sadly I had a miscarriage at 11 weeks, which was obviously quite traumatic," says Kelly. "As time went on, we had three unsuccessful cycles of artificial insemination. At the time, I was a full-time geography teacher and the impact it had on my mental health, as well as work, was significant and I started to struggle with anxiety. When we went on to have IVF, I was head of year at a secondary school and had even more responsibilities. We had a failed cycle straightaway. I became pregnant on my second cycle, but again miscarried at six weeks and went on to have two further unsuccessful cycles."
After years of trying to conceive, Kelly decided enough was enough.
"I think we thought that we could just get on with our lives, but the reality was very different," she says. "I did suffer mentally and I went through three months of really dark times. I had to have time off work because you're consumed by the sadness, grief and loss that you're experiencing. It isn't only the physical loss of miscarriages, but for me I'd always imagined being a mum, so it was a loss of a life that I thought I was going to have - and it took quite a while to get my head around."
How to protect your mental health
Of course, trying to have a baby is a big life event. And when undertaking fertility treatment it's natural to experience a range of emotions, especially if you're taking medication which can affect your hormones, says Stephen Buckley, head of information at mental health charity Mind.
"Many people feel pressured to conceive and there are many considerations and concerns that may leave you feeling overwhelmed and anxious. Failing to prioritise our mental health can potentially affect all areas of our lives, including work, relationships and physical well-being," he says.
If you are going through fertility treatment, here are six ways that you can protect your mental health:
Expand your support network with people who understand
It's really important to connect to others who are going through the process, says Kelly. "For me, whether it's been since my childlessness or through the fertility treatment, knowing others are going through it at the same time is really important."
If you are looking to reach out, check out the details of Fertility Network UK's support groups in your area.
Accept stress is normal
Accept that when you are going through IVF, stress is a normal part of the process.
"If you are experiencing infertility and trying to conceive with assistance, you're in a situation where you have no control or ability to influence the outcome," says fertility counsellor Tracey Sainsbury, an advisory panel member for Fertility Network UK.
"If there was a way to promote successful treatment, your clinic would have told you. A lack of control can drive many of us nuts, in many situations, but we can feel added frustrations more when we're told we should feel relaxed."
Create a coping strategy tool box
"If counselling, acupuncture, reflexology, mindfulness, walking, exercising, talking, meeting friends - or even avoiding them - worked to manage stress consistently, that would be amazing. But, sadly, we are routinely all over the place whilst experiencing infertility," says Sainsbury.
She recommends trying different things. "If something works, do more of it. If it's not so effective, make a note of it and try it again in the future. If it was really unhelpful, then choose to avoid it."
Managing your mental health isn’t all about medication and therapy - looking after yourself is vital too.
"Quite often, whilst we are in the middle of fertility treatment, we forget to do all the things that keep us well. So, prioritise those things that you enjoy," says Kelly.
Don't put your life on hold
Planning things is so important. Kelly says: "It was one of the most detrimental things as we wouldn't plan anything - like move house or go on holiday - just in case I was pregnant. Try to continue to live your life around the treatment, so, whatever the result, you still have things that you're involved in and hobbies you enjoy."
Aileen Feeney, chief executive of Fertility Network UK agrees that you shouldn't put your life on hold waiting for the 'one thing that will make you happy'.
"Live your lives together and enjoy the moments of everyday happiness. Remember we cannot rely on something else to bring us happiness - happiness is within ourselves," she says.
Use relaxation techniques
Make time to relax - whether it's through yoga or with mediation. Kelly recommends using mindfulness. "Have that space to be in the present, because I think a lot of my anxiety was brought on by worrying about the future and what may happen or may not happen - take it step by step."
"This has been shown to be helpful in many situations, especially when coping with unexpected pregnancy announcements or if you're having a hyper-vigilant moment, spotting pregnant women and the 'Baby on Board' badges from a distance.
"Whoosh out. Breathe in for a count of 4. Hold for 7. And whoosh out for 8. Focus on the counting, rather than the breath itself."