If you are going through infertility with a partner, you may have noticed that most of what is out there is written for one person. The shots, the appointments, the waiting. Much of it is very good. But infertility is almost always lived inside a relationship, and what I kept running into, first as a husband and later as a couple therapist, was a gap for couples: two people carrying the same loss in different ways, trying to stay close while everything about building a family has become uncertain.
That gap is the reason Ginny Lupka and I started Love and Infertility. (For the record, Ginny and I are both married, just not to each other.) It is also the question that has shaped all of my research.
Why a man is doing this work
People sometimes wonder why a guy focuses on infertility. The answer is personal. My wife, Marjorie, and I began our own infertility experience in 2017. Through it, we found that our marriage became more bonded. We were more in love, and we discovered a new way of being together that felt beautiful and sacred, even while we were going through a shared traumatic experience.
That left me with a question I have not been able to put down. Why do some couples turn toward each other during infertility, and why do others drift apart? Ginny and I see both in the couple therapy room. Some couples want help relating to each other emotionally. Some need help navigating conflict. Many are facing decisions most people never have to think about: what to do with leftover embryos, how to pay for treatment, and so much more.
What the research is showing
I have had the opportunity to study over a thousand couples going through infertility, looking at that one question. Here is what stands out.
About 25% of couples going through infertility come out of it with a stronger emotional bond. It does not matter whether those couples end up having a child. They go through this shared emotional, traumatic experience, and they come together. On the other side, about 30% of couples find that infertility disrupts the relationship so much that they separate.
My research points to four ways of interacting that characterize the couples who come together. I call them the Four Pillars of Connection:
Mindful emotional responding.
Navigating conflict and decisions.
Exploring disrupted dreams of parenthood.
Maintaining intimacy and passion.
That last one matters more than people expect. If you are a couple going through infertility, you know that the thing that brought you together, sex and intimacy, can suddenly become goal-oriented and mechanical. It stops being about each other and starts being about a calendar. "I'm ovulating. It doesn't matter if you're in the mood."
Mindful emotional responding starts with small bids
The first pillar rests on something I call mindful attunement. Ginny explained it through the idea of bids for connection. As she put it, all of us, from the time we are babies, reach for the attention of the people we depend on. As adults we keep doing it with our partners. A bid can be as small as "The weather's really nice today" or as big as "I'm so anxious about this upcoming transfer. Can you just sit with me?" Mindful attunement, in Ginny's words, is intentionally turning toward your partner and trying to understand their experience, whether it matches yours or not, without trying to fix their emotions.
Ginny and I are both Gottman therapists. John Gottman studied 3,000 couples over the span of 20 years and was able to predict divorce with 94% accuracy based on seven different behaviors. One of those behaviors is turning toward bids for connection.
For me, mindful attunement means holding two experiences true at the same time. I recognize the distress I am in, the heavy emotions caused by infertility or by my partner's experience of it. And I stay connected to my partner.
I often describe it as holding wet soap. The more I try to fix my partner's emotions, the more I am grabbing at the soap, and the more it slips away. If I just hold it, my partner can feel seen and validated. That is a huge connection moment: feeling like my emotions matter. I think all humans want to know that their emotional experience is real, that it is valid, and that it deserves care and space.
What I got wrong
This was hard for Marjorie and me. Ginny and I have researched the male experience of infertility, and a common theme, both in our practice and in the research, is that men sometimes feel they need to rescue their partner out of the experience. I think this is true for all humans, but I felt it strongly.
When Marjorie talked about how difficult things were, whether it was the daily shots (can we just say those shots suck? To all our medical friends out there, can we please invent a pill?) or the possibility of a future without the biological children we wanted so much, I felt anxious about needing to get her out of that pain. So I tried to stay positive. Another way to say it is that I intellectualized her pain. I would say things like, "Our fertility doctor says we can try this, this, and this. We still have so many options. Let's try to stay hopeful."
She felt unseen and unheard. It hurt. It made her feel like she was crazy. It also created a power dynamic where I was the positive one who wasn't suffering, when really I was. I was just pushing it down. That caused a big emotional rift between us.
It was not until we learned to hold two truths at the same time that things changed. I finally learned to just sit with my wife and say, "Sweetheart, I'm right here with you. I love you. I wish I could take this away from you, and I can't. But just know that what you're feeling makes sense. You're the love of my life. I'm here with you."
The picture I use for my own experience is a tiny boat in the middle of the ocean at night. There is lightning everywhere, the waves are crashing over the sides, and I feel sure the boat is going to sink. (It does not help that I have a real fear of the open ocean.) I am alone, bailing water. Then I turn to the back of the boat and see Marjorie there, bailing water too. She is in the boat with me.
That is mindful attunement from 10,000 feet up. We are going through this together, and your emotional experience does not have to cancel out mine. We can share it, and we can care for each other's experience.
Grief that nobody makes a card for
Part of why turning toward each other matters so much is that people going through infertility experience disenfranchised grief. Ginny described it well: it is the kind of loss you are never going to find a greeting card for. It is grief you have to work harder to have validated. You are grieving the loss itself, and you are also grieving the lack of support and understanding around you. You end up explaining yourself over and over, often at a time when you have no capacity to educate anyone.
I felt that. I grew up in Kentucky watching my dad raise my brother and me. I thought he was Superman, and I wanted to be like him, and part of that was being a dad. The career I first chose was built around being a present husband and father. When infertility shattered that dream, I had to grieve my identity. The version of me I had pictured at 40 died. I don't think I recognized at the time that I was grieving it, and I don't know that Marjorie recognized she was grieving her picture of how motherhood would happen for her. But we were both grieving.
When we told people we were anxious, depressed, and angry, some turned toward us. A group of friends and my brother loved on Marjorie and me. They brought food. They gave space for my grief, so my grief was not as disenfranchised anymore. Getting that from other men meant a great deal to me.
Here is the part couples often miss: grief can become disenfranchised inside the relationship too. If we are not attuned to each other's emotions and we are not honoring each other's experience, we can disenfranchise each other. Nobody wakes up thinking, "I can't wait to make my partner feel lonely today." It happens through how we communicate, how we connect, and whether we turn toward each other's bids.
Why talking about it matters
Almost everyone has a connection to this. 48% of people in America have either experienced infertility themselves or know someone who has. The CDC's rate of infertility used to be one in eight, and now it is one in five in America. Infertility is also expensive. The average cost right now is around $26,000, and couples who suddenly find the dynamic between them has changed should not have to pay a fortune on top of that just to learn how to stay together and communicate.
One of the key ingredients in making this grief less disenfranchised is to talk about it, and to be attuned to the person who is talking to you. Give them space to have their grief. In a partnership, that means giving your partner the space to have theirs.
Ginny and I are not only a sounding board, though we are glad to be that. We are active in the therapy room, using research-based approaches to help couples turn toward each other and rely on each other emotionally during infertility and miscarriage. That is what the podcast is for: practical ways to live out those four pillars, along with conversations with couples, experts, and community leaders.
Resources
My book, Couple Therapy for Reproductive Grief, is being published by the American Psychological Association and is coming early 2027. It is written for couple therapists working with couples navigating infertility, miscarriage, and the other barriers that can come with planning a family.
If you are going through infertility now, there is a free resource on my website, the Infertility and Mental Health Manual. An OB/GYN friend asked me to make a one-page handout for her patients, and I offered her 23 pages instead. It covers what you may be experiencing, how to care for yourself psychologically and emotionally, and how to stay connected with your partner. If you are a counselor, psychologist, or social worker, I also offer continuing education trainings on supporting individuals and couples through reproductive grief. You can find all of it at drclaybrigance.com.
