Why entering IVF can feel as sad as losing a loved one

For many people on the outside looking in, they believe that having In vitro fertilization (IVF) means entering a process with excitement around being able to have a baby, choosing the sex and the delivery date. However, this is far from the experience of most.

Millions of couples, single women and men, enter IVF under the gaze of being told it is their only option. For some, this may be due to male infertility, female infertility or a combination of both. Whilst it is different for everyone, what is the same for most is a process of thinking, “It was not suppose to be this way”.

This is what I hear many people say when they enter therapy. For many, it is the first time they have encountered a sense of failure. They were the “good guy” or “good girl” who had a very clear equation: working hard = success. Whatever way that may be. It may have been success in education, work, relationships or lifestyle. Yet, never in their wildest dreams did they think they would have to work hard at having a family. 

Disenfranchised grief

Whilst IVF can provide a sense of hope, there is also a sense of grief, a grief that not many know and that is “disenfranchised grief”. Disenfranchised grief is a term coined by Dr Kenneth J Doka (1989). The concept describes the fact that some forms of grief are not acknowledged on a personal or societal level in modern Eurocentric culture. In other words, it can be a loss that is not openly acknowledged, socially validated or publicly mourned. Resulting in those grieving not feeling able to openly speak about their loss.

When entering the journey of IVF, there can a loss of the reproductive narrative, how we thought our journey to parenthood maybe. There can be a loss in terms of identity, status, relationships, time and finances. Those often entering IVF may feel different to anyone else they know; for some, they may have to consider donor conception as an option to having a family. They may have to watch friends and loved ones start their family with perceived ease. This loss includes how they view themselves, others and the world.

Navigating the decision to have IVF

Trying to navigate the decision to engage in IVF can have an impact on one's sense of self, others and the world. Some people I have worked with have shared that being advised that they would need to consider IVF was more stressful than IVF itself. They believed their body had failed to do what it was supposed to do. They felt the unfairness, anger and jealousy of friends and family who were starting their families with ease, or even unplanned.

Disenfranchised grief due to having to enter IVF can also have a physical and emotional impact. Often there is also an impact on work and careers, as the focus on IVF may dictate what individuals can emotionally and physically tolerate. 

Some physical and emotional symptoms of disenfranchised grief due to starting the IVF journey include,

• changes to eating or sleeping patterns 
• weight gain or loss
• lethargy
• decreased confidence 
• feelings of anger, sadness, guilt, shame 
• feeling disconnected from others, resulting in changes in relationships
• feeling isolated and a deep sense of feeling alone 

This is not an exhaustive list, and many people process grief in different ways. Grief is not linear. Grief cannot be fixed or resolved, although it is acknowledged that there are many theories about managing grief. This includes the Kubler-Ross (1969) “Five stages of grief” or the “Growing around grief” theory developed by Dr Lois Tonkin (1996), who believes grief is a process of growth and adaptation. In order to manage and work through the symptoms of grief there are various things you can do and feel a sense of control. 

Five steps to cope with disenfranchised grief

Understand your grief 

Try to understand your grief. This may include talking it through with those close to you. It may involve reading about grief, listening to podcasts or speaking with a psychotherapist.

Seek support

Disenfranchised grief can lead to significant changes in your relationships with others. Some people will try to understand how you are feeling, and some will not be able to understand. Finding your support network is important, and it may be people you have never considered before. This may be within online forums, social media groups, and community groups. 

Be patient with yourself

Feelings of grief can hijack you without warning. Sometimes, this can lead to feeling overwhelming sadness, jealousy, guilt, anger or frustration with yourself or others. You may also have times of feeling extreme anger at the situation, how things should have been, yourself, your partner or just the world. This may include others who are having children. But be kind to yourself. In days when it is difficult, it’s ok to slow down your pace or use distraction if you need to. It’s ok to be tearful or angry; try not to judge yourself. Instead, ask yourself: What would you say to a friend who was in this position?

Give yourself permission to feel. The emotions of grief can ambush you out of nowhere. However, there is no ideal time to cry or scream. So just let yourself have these moments. 

Express how you are feeling

Writing a journal about how you are feeling and what you need or do not need will help make some sense of your experience. Writing about how you would like your future to look like can also provide a sense of hope and some control in a situation that feels like there is no control. This may be writing about what type of clinic and consultant you want for your IVF treatment, when you would like to start IVF treatment, and what support you will need.

If you do not like writing, you could be creative and draw, sing or dance to express how you are feeling. 

Seek moments of happiness

Often when we are grieving, we have an ambivalent feeling around any form of happiness. However, sadness and happiness can coexist. So ,seek out things that can give you joy. This may mean thinking about your needs first. Ask yourself if I make this commitment, go to the event, see the person, will I enjoy it, will it meet my needs, will it be helpful for me. 

This may mean having to distance yourself from friends with children, social events, text messages or WhatsApp groups, but this is ok. This intense feeling will not last forever.