Dear Tzippora,

After five years of marriage, we have just begun fertility treatments. The problem is that these treatments are putting a real strain on our marriage. While I am not yet ready to give up my dream of having a family, I can't stand how stressed out we have become. Sometimes it seems easier these days to be alone than to spend time together. What can I do to protect my marriage during this difficult and challenging time?

Stressed Out

Dear Stressed Out,

Infertility treatments are often invasive, time-consuming, and expensive. In addition, many of the hormone regulating medications often prescribed can make you moody and depressed. The requirement to discuss aspects of your intimate life with outsiders, even medical professionals, is embarrassing and sometimes degrading. So the stress load placed on your marriage at this time is indeed considerable.

Yet now that you have identified the problem, you can take steps to protect your marriage.

Explain to your husband that you believe that this process is putting strain on your marriage and you would like to work together to protect your relationship. Here are a number of steps you can take:

Give yourselves safe-time in which to reconnect as a couple. During these times, relax and enjoy each other's company, and make discussion of treatment protocol off-limits. This will give you a chance to focus on the positive and fulfilling parts of your relationship, because fertility treatments can cause an intense focus on what is lacking.

Make a decision to actively fight stress by taking care of your health through exercise, proper nutrition, good sleep habits, and an occasional luxury such as a massage, an expensive dinner out, or even a weekend getaway. It is also important to surround yourself with positive, supportive friends.

Share with your husband the challenges and pressures you experience as a result of your treatment. Encourage him to share his feelings and his thoughts about this issue as well. Yet be prepared that he may choose not to open up to you. Many men prefer not to reveal their inner world in this manner. If that is your husband's choice, it is necessary to respect his decision and appreciate his willingness to listen.

Discuss how you and your husband can support each other during the inevitable rollercoaster and disappointments that are part of this process, and what steps you will take to keep each others spirits up.

Remember that you are in this together, and the strength of your future family rests on the foundation of a strong marital relationship.

Good Luck!