As we'll show in this lesson, the overlap between fertility challenges and emotional challenges is incredibly common and persists across populations, cultures, genders, and more.
Globally, there’s been volumes of research that show patients with fertility challenges are far more likely to suffer from psychosocial challenges than otherwise similar groups.
As an example, when Dutch investigators compared the emotional state of women beginning fertility treatment compared to a similarly matched control group, they noted the group starting treatment were far more likely to suffer with depressive symptoms.
While not all fertility patients exhibit depressive symptoms, a large percentage consider the fertility challenge to be deeply unnerving. One study of 200 heterosexual couples conducted at the University of Pennsylvania in the United States revealed half of surveyed women considered infertility “the most upsetting experience of their lives”.
One study out of India surveying 300 heterosexual couples undergoing fertility treatment found the vast majority of both partners dealt with inordinate levels of stress.
Investigators noted that a person was more likely to feel distress if the infertility diagnosis resided more squarely with them (e.g. azoospermia for men) or if the period of infertility spanned multiple years or longer.
Amongst female patients the single greatest associated factor with distress was if a woman perceived a low level of support from her partner. This was followed (distantly) by factors like having an "overinvolved or intrusive family", sociocultural pressures to have a child, and financial pressures levied by treatment.
In many ways, investigators noticed the same factors tend to coincide with stress amongst men, just with a lower degree of correlation. The exceptions being a stronger correlation with one's family's attitudes and the financial pressures of treatment.
Hearteningly, academics who study the subject note that couples who endure this period emerge stronger than those who never had to face it. However, in the moment, the pressures can feel unbearable. At a time when patients and couples want companionship, many avoid social interaction altogether. This is true amongst patients globally and has been noted by more than a few researchers in India specifically.
Ultimately, investigators noted patients with better skills and abilities to cope fared better emotionally in the process. As you'll see in the forthcoming video portion of this course, there are a variety of coping strategies and interventions and which will be productive for you or a partner is highly individualistic.
A separate but closely related matter in terms of distress is that of sexual "dysfunction". Studies emanating from South Asia tend to be more robust for forms of male sexual dysfunction (e.g. erectile dysfunction, Dhat syndrome) than female sexual dysfunction (e.g. vaginismus, dyspareunia and lack of sexual desire).
Amongst South Asian women, studies of varying quality peg the rate of sexual dysfunction or difficulty at 17%—26% or significantly higher.
As for South Asian men, there are remarkably few studies that catalogue the prevalence of sexual dysfunction in the general population. One study looking at men presenting (not necessarily for sexual dysfunction) at a general health clinic in Vellore, India reported over 40% suffered from some form of sexual or erectile dysfunction.
It's common for investigators to note a large overlap between sexual dysfunction, anxiety, and depression. As most experts will attest, it can be difficult for those suffering with sexual dysfunction to surface the issue and receive help. This is true for the population at large and South Asian populations as well.
As you'll see in our videos, it's all-too-common for fertility patients, and those with a sexual difficulty, of South Asian heritage to see themselves as alone in their struggles. Those feelings can abet a sense of isolation, grief, and anxiety. The reality is these challenges are common amongst people of all races and heritages. Those feelings of sadness, grief, frustration, and shame extend to many of us, and you're not alone in the struggle to navigate the emotional challenges and heartache endemic to the journey.