Infertility and emotional distress

A wedding at a community centre in Shyamoli, the plates of kacchi still steaming. Labonno, 33, has chosen a seat at the far end of the table, behind a pillar, which has never once worked. A distant phupi finds her within ten minutes. “Ki, any good news? Five years now, na? You should try the doctor in Kolkata. My neighbour’s daughter-in-law...”

Faisal, beside her, has a practised answer. “Phupi, the good news is the kacchi. Have you tried it?” The phupi laughs and moves on to someone else’s weight. Labonno does not laugh. She is counting: three rounds of treatment, two early losses no one at this table knows about, one more cycle that her savings might allow.

At home she cannot look at baby photos on Facebook. She has stopped going to aqiqahs. Faisal copes by researching clinics until two in the morning, and they have started to argue about money, about his mother, about nothing. Some nights she thinks the marriage might not survive this, and feels guilty for thinking it.

An illustration drawn from common experience. The people are invented; the pattern is not.

Understanding infertility

Infertility is a medical condition, and for many couples it is also a long, private grief: the loss of an expected future, repeated each month or each cycle, often alongside pregnancy losses that others never hear about. In Bangladesh, where parenthood is highly valued and questions are public, women in particular may carry blame that is not medically theirs. Treatment itself is physically and financially demanding. The result can be depression, anxiety, sleep problems, strain in the marriage and withdrawal from family life.

How common it is

In a study of 375 women receiving fertility treatment in Dhaka, 59.7% had symptoms of depression and 55.0% of anxiety on a screening questionnaire. A 2026 study of 658 people with infertility at two tertiary hospitals in Bangladesh found depression symptoms in 67.2% of women and 31.9% of men; among women, a longer duration of treatment was linked with more distress. A 2025 meta-analysis of 17 studies with 3,528 women in low-resource settings, mostly in Africa, gave a pooled figure of about 49%, and found that good support from a husband was linked with lower odds of depression. These are screening scores, not diagnoses, but they show how common distress is.

Signs worth noticing

• Low mood, tearfulness or hopelessness that lasts between cycles
• Avoiding weddings, aqiqahs, friends with children or social media
• Sleeplessness or constant worry about the next result
• Arguments with a partner, or blaming oneself
• Thoughts that life is not worth living

How care helps

A psychiatrist can assess mood, anxiety and sleep, check for physical contributors such as thyroid problems, and work alongside the fertility team. Talking therapy, individual or as a couple, helps with grief, with how to answer questions at family events, and with making decisions about further treatment together. Where depression is moderate or severe, medication may be discussed, with careful attention to plans for pregnancy. Faith and family can be sources of strength, and care respects them.

What getting better can look like

What helps Labonno might be a script she and Faisal agree on for phupis, a rule of no clinic research after eleven, one cousin who knows the whole story, and an aqiqah she chooses to attend, and leaves early, without guilt.

Common questions about infertility

Is depression common with infertility?

Yes. Studies of women attending fertility services in Bangladesh found more than half had symptoms of depression or anxiety on screening questionnaires. Men are affected too, though in one Bangladesh study less often than women. Distress is an understandable response, and it can be treated.

How can I cope with questions about having a baby?

It can help to prepare a short, polite answer with your partner, decide together what you will share, and have one trusted relative who can redirect the conversation. Limiting events or social media for a while is reasonable. If the questions leave you low for days, talking to a professional can help.

When to see a psychiatrist

If infertility is affecting your mood, sleep or marriage, you do not have to wait until treatment ends. If you have thoughts of harming yourself, please seek help now, or call 999.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

Sources

• Hasan et al., PLOS Global Public Health, 2023 (PMID 38079385)
• Ahsan et al., Sexual Medicine, 2026 (PMID 42434367)
• Tadesse et al., Frontiers in Medicine, 2025 (PMID 40083341)