Dr Kopitzke described the distress felt in four psychological domains by infertility patients. Distress may be caused by a roller-coaster of emotions, which include anxiety, depression, optimism, and feelings of abandonment by the treatment, and as more treatment interventions become available for men, their reactions are beginning to follow a similar course to those of women. Constant efforts to regulate the emotions may themselves take a significant toll. There is bound to be a psychic cost for these frequently stoic 'super-copers'.
Social relationships are one such area of psychic cost.
Although perceptions of stress and mood disorder may be lower in women reporting more social support, the effects of painful social interactions are significantly related to negative mood beyond the effects of social support. Many relationships and activities may change from being positive to negative experiences for those coping with infertility. For example, some women experience distress when going shopping, because of the pain caused by seeing babies and pregnant women. In addition, interactions with the wider community may be disrupted, as, for example, friends are often made in the school yard. Finally, disruption of identity can accompany infertility, producing a loss of the link with the future and making it difficult to mobilize action in the present.