Sofia is in her early forties. She works in the advertising sector and calls herself a ‘creative’. Mostly, colleagues at her workplace in central London are young and trendy and they often go drinking and partying together. She is in a senior position and though she has a strong bond with her work, she feels that the lifestyle it requires of her does not suit her anymore and it also makes her feel old and that she no longer fits in. 

Sofia and her partner Rob have been trying for a baby for the last seven years. She was diagnosed with what is called ‘unexplained infertility’. Three years of IVF after five years of experimenting with a series of alternative therapies and treatments have resulted in a miscarriage, which she found heart-breaking; her relationship with Rob is on the rocks. Sofia decided to try therapy as a last resort. She understands that therapy cannot make her have a baby, though she secretly hopes it may. After a year in therapy, she now wants to come to terms with the fact she will not have a baby, as she has rejected the possibility of adopting. 

Very few of her close friends and workmates are aware of what Sofia is going through. She says most of them do not have children and they live a completely different lifestyle where babies do not feature. She has had to reduce her drinking and alter her diet while trying for a baby and she knows that many of her friends find her ‘boring’, as she will not party with them anymore. 

As no possible explanation has ever been found for the infertility on either side, Sofia has been obsessing with the idea that she could have possibly got pregnant with another partner. During one of the work parties, she has let down her guard and ended up having unprotected sex with a colleague. The encounter did not result in pregnancy, but in a deep depression and an awkward situation at work. This was the determining incident that has led her to therapy. 

The focus of the therapy has been on how unbearable her life has felt for the last seven years, but what has also emerged is her difficult relationship with her mother. Her mother was very depressed after Sofia’s father died unexpectedly of a heart attack when Sofia was 11. Since then, Sofia’s mother used her as an emotional crutch throughout her adolescence. 

Through therapy, Sofia has started seeing how the battle with infertility and the dark depression that it has triggered in her has meant that she has expected Rob to support her emotionally like her mother expected her to do when she was younger. As a result, she has disregarded Rob’s feelings, assuming that her own pain should take priority. She is also gradually talking about her deep fear of becoming a carer again in her adult life through having a baby. Though the process of uncovering these feelings has been difficult and painful for Sofia, she has begun to envisage the possibility of living a life with fewer conflicts. 

If I were Sofia’s therapist, I would experience the depth of her frustration and sadness for not being able to have the baby that she wanted. I would also feel along with her the sense of her pain being invisible and how hiding it has often felt like the only valid option. I would understand how unbearable living day in and day out with the cycle of uncertainty, hope and disappointment has felt for her. I would feel concern about how her unresolved conflicts from the past have played out in her relationship with her partner. I would worry that if she continues to be unaware of her impact on Rob, the experience of infertility may result in a further loss, that of her long-term relationship, as it often does for many couples who go through it.  I would hope that through understanding how the past has affected her adult life, Sofia may find other fulfilling ways of living her life and she can begin to find her loss more bearable. 

This is only one example of how infertility affects women and couples. Though the particularities are unique to each individual and couple, the unbearable sense of loss and frustration, as well as the feeling that one’s life has been arrested are very common. Alongside such feelings comes a sense of social alienation and isolation from friends and family who either seem to enjoy an apparently easy family life or do not seem to understand what it feels like to long for a baby. Infertility can therefore easily become, like so many other forms of emotional struggle, an experience of stigma and painful aloneness. Therapy offers the possibility of a journey alongside somebody who can listen to the person’s feelings, understand her experience and guide her through suffering to freedom, choice and connection.

This case study is entirely fictional. Any similarity to a real person is completely unintended