Supporting Employees Through Infertility and Depression: A Complex Relationship

The journey to starting a family isn’t always easy for many employees. It can be a profoundly emotional journey and, when dealing with fertility struggles, full of big ups and downs that can take a serious toll on mental health.

Many people struggling with infertility experience depression, anxiety, and stress. Individuals dealing with infertility and depression must understand they don’t have to tackle these feelings alone. So, let’s talk about it, and identify things that your organization can do to support your employees who may be navigating this journey.

What is infertility?

Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse, as defined by the WHO. When the birthing person is over 35 years old, infertility may be diagnosed after six months. Fertility struggles may be caused by health issues in one or both partners or by a mix of multiple factors that contribute to reduced chances of pregnancy.

How Infertility Can Lead to Depression

According to the World Health Organization (WHO), about 1 in 6 adults — or 17.5% of the adult population — struggle with fertility. An estimated one third of all fertility struggles are related to the birthing person, one-third to the parent providing sperm, and the remaining a combination of both. Despite this, women are most likely to undergo medical fertility treatment, which can be highly emotional, financially straining, and physically taxing.

Pregnancy is a joyous occasion that future parents share with their friends and family. Fertility struggles, on the other hand, often exist in silence. Talking about infertility is incredibly hard and the lack of representation can feel isolating.

Regardless of the cause of fertility problems, the effects are often the same:

• Physical, financial, and emotional stress
• Feelings of loneliness and isolation
• Social pressure
• Anxiety and irritability
• Not being able to concentrate or think about anything other than fertility struggles

The Emotional Toll of Trying to Get Pregnant

When an individual or couple is ready to start or expand their family, they enter a phase called “trying to conceive” (TTC) or trying to get pregnant. While the definition of TTC can differ between specialists and patients, the overall goal is the same: to get pregnant.

Trying to get pregnant and depression often go hand-in-hand due to the emotional toll of the process. While trying to get pregnant, individuals undergo a variety of stressors that can adversely affect their mental well-being.

The following factors can link this time and depression for prospective parents:

• The pressure of tracking cycles, attending appointments, and keeping up with requirements and side effects of medical interventions
• Pervasive societal expectations around getting pregnant and having children
• Managing individual expectations and personal hopes for a successful pregnancy
• Feelings of isolation and inadequacy throughout treatment

Hormonal changes and their role in mental health

Adding to the stress and anxiety of infertility, many fertility treatments can involve medications like clomiphene, gonadotropins, and leuprolide — all of which can affect the patient’s mood. Side effects may include depression, anxiety, irritability, and sleep disturbances, among other reactions.

Hormonal changes, or hormone overload, can add to mental health strain. Prescribed hormones are intended to improve the chances of getting pregnant but can also lead to mood swings or even anxiety and depression. This is a normal reaction to hormonal changes, though it can make the patient’s experience more intense.

The psychological effects of infertility on mental health

Infertility impacts all areas of a person’s life: physical, financial, social, and mental. Over time, the emotional toll can manifest as psychological effects such as depression, anxiety, and even post-traumatic stress disorder.

The Financial and Physical Stress of Fertility Treatments

For many people, infertility treatments aren’t just emotionally demanding. They’re financially and physically exhausting, too.

Financially, the high cost of assisted reproductive technology (ART) can create added stress on individuals and couples. Take in vitro fertilization (IVF) for example. Even as one of the most common forms of ART, the cost of IVF easily adds up to thousands of dollars per cycle. Considering that people often require multiple rounds of IVF, this price tag can add another layer of stress.

Physically, fertility treatments involve frequent doctor’s appointments, medication, injections, blood tests, ultrasounds, and other invasive procedures. These treatments don’t end in specialist offices, though. Individuals must also deal with side effects, including everything from nausea and vomiting, hot flashes, and headaches to bloating and mood swings.

The Impact of Infertility on Employee Identity and Self-Worth

Struggling to get pregnant can impact a person’s self-worth, making them feel broken, unfulfilled, or “less than” others. On the other hand, these individuals may feel like they are letting down their partners, families, or even themselves.

The stigma of infertility is common across cultures, adding even more societal pressures on those hoping to have children.

Examples of how fertility stigma can contribute to low self-worth include:

• Not having children is seen as the birthing person’s fault
• Infertility may lead to discrimination or prejudice
• Fertility struggles can affect marriages and other familial relationships

Those struggling with fertility challenges are often forced to deal with many outside and inside factors that can affect one’s sense of self.

Steps Your Organization Can Take

As an employer, there are several steps that your organization can take to start supporting your employees and their families who may be facing these challenges.

Provide Professional Support

People with fertility challenges must focus on prioritizing their mental well-being alongside fertility goals. Luckily, there are several coping strategies to turn to for those dealing with infertility and depression.

Therapy can offer a safe space to process grief, frustration, and anxiety. Cognitive behavioral therapy (CBT) can offer an effective structure for treating depression and anxiety. Other types of therapy provide a safe space to process the frustration, grief, and stress of this trying phase of life. Additionally, forming internal support groups can give individuals a sense of connection with people who deeply understand their situations.

Some employers have also branched coverage out to fertility counseling. Fertility specialists can provide more individualized care to address mental and physical symptoms and direct patients toward the right fertility treatments for them.

Building a Support System

Even though fertility struggles can feel isolating, individuals should remember this: You don’t have to do it alone.

Partners, close friends, and online communities can offer emotional support when you need it most. Building support systems is an essential, and impactful, coping strategy for those dealing with mental health and infertility, which is why it is important for fertility benefit messaging to reach all members of the household.

The Employer Impact

Approaching fertility coverage and topics with open communication is the first step to success. When an organization openly shares and promotes the resources available, it can make an already complex scenario much less isolating and intimidating. These benefits can include:

• Expanded fertility treatment coverage, beyond those that meet the standard definition of females facing infertility
• Support with adoption assistance and other family planning avenues
• Flex time for those needing to attend appointments
• Employers can also point employees to additional resources, such as:
• The National Infertility Association
• Mental Health Resources

Fertility benefits have become an essential part of a comprehensive employee engagement strategy. Offering fertility support from providers like Carrot acknowledges the diverse life choices employees make and shows a commitment to supporting all employees through all stages of their personal and professional journeys. By offering fertility benefits, you are fostering a more inclusive and supportive environment where employees feel seen and valued for who they are — a key component for high levels of employee engagement.

Whether your organization is looking to start offering fertility benefits, or expand existing plan coverage, reach out to your AssuredPartners team to provide individualized guidance today.