Many couples say that coping with the decisions and uncertainties of infertility brings about the most stressful life crisis that they have ever encountered. It's not surprising that men and women often react differently to these stresses.

Women generally view themselves as the emotional caretakers of the relationship. Therefore, it's normal for you to try to protect your spouse from pain and feelings of failure by taking on most of the responsibility yourself. Holding yourself responsible for this entire ordeal can take an emotional toll on you—no wonder you may experience intense feelings of anger, pain, fear, and frustration. Over time, these feelings turn into anxiety and depression.

In most situations, men see themselves as the financial breadwinner and also the protector of the family. Men who usually see themselves as physically and emotionally strong may feel threatened if asked to express their feelings. It's not unusual for the man to feel overwhelmed by your emotions and not know what to do. Even if they have been trained to be decision makers and problem solvers, they often find themselves helpless to make the situation better for you, and so out of frustration, they may say that you are too emotional or acting crazy, hoping that this will calm you down. Of course, it doesn't. So they change their focus on things where they can be more successful, such as their work, sports, or hobbies.

If the reason for the infertility is because of a problem with the man, he takes on added emotional problems. Some men feel that their masculinity is now in question. They are worried that others will find out and ridicule them. Some men feel so inadequate that they don't even understand why you would stay with them. They may feel such embarrassment and shame that they turn down all offers of medical intervention or emotional support.

In addition to these stressors, it's also not unusual for you both to stop enjoying sex. What used to be spontaneous and enjoyable may have turned into a technical, well-timed, baby-making chore, and sexual intercourse can even be resented as it begins to represent failure.

You can both do some things to better deal with the emotional difficulties of infertility.

• Understand: Emotions and disagreements may become magnified during this trying time.

• Communicate: On a regular basis, discuss your emotions and fears with your partner. It won't always be easy, but having each other's support now is critical.

• Support: Know that you are both doing your best during this stressful time, no matter how you each deal with it on the outside.

• Participate: Go to doctor appointments together, and use a teamwork approach to deal with the decisions, tests, and procedures that you will both endure.

• Enjoy: Make dates to have "fun sex" during nonfertile times of your cycle, find new hobbies or activities that you can do together, and focus time and energy on your relationship.

• Get counseling: Seek professional counseling to help you get through the many challenges that you both face. Work together and provide one another with emotional support. Many couples find that it not only alleviates some of the stress but actually makes your relationship stronger and brings a new sense of closeness as you learn to lean on one another for needed reassurance and encouragement. You may come to realize that if you can get through the physical and emotional demands of fertility treatments, you can probably conquer anything that life throws your way. Being able to endure these overwhelming demands may leave you with a renewed sense of respect and confidence in your relationship.

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