After months of prenatal tests, ultrasounds and medications, I thought I would be able to move forward with an in vitro fertilization (IVF) transfer cycle this month. Instead, I was diagnosed with an asymptomatic form of endometriosis, which required me to start a necessary treatment plan first. I was heartbroken by this delay and stressed about all the extra steps I had to take with my insurance provider to get the care I need. Luckily, I was able to turn to my therapist, who validated my concerns and helped me process the setback and strategize the next best steps.
Going through fertility treatment is like riding a roller coaster — for both your emotions and your body. That’s why access to proper mental health care, (for both you and your partner, if you have one) is so important.
“Undergoing fertility treatment has many emotional and financial stressors for couples and single parents,” acknowledges Amber Rukaj, LMFT, co-founder of Spark Mamas, a community supporting maternal mental health. “The often high cost, uncertain outcomes, fear of the treatment and procedures themselves, and loss or distance from friends who have entered into parenthood can be a few of the reasons that we recommend individuals seek therapy.”
Here's why mental health care during fertility treatments is important and how you can practice self-care and find professional help if you need it.
Infertility is an emotional journey
Struggling with infertility can take away your sense of control. “Fertility is sometimes one of the few things where you can do everything you're supposed to do, and you can't necessarily impact the outcome,” explains Batya Novick, LCSW, founder of The Calla Collective. This can make the conception process especially stressful. Add in the hormones and costs that come with treatments, and it's not a surprise your mental health can suffer.
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There are some strategies you can try today to help you work through these feelings.
Self-care strategies during IVF
If you’re feeling moderate stress, taking these actions could help:
Join a support group. Research has shown that social interaction — and specifically, sharing your experience with others — benefits a person’s health and well-being during fertility treatment, says Lauren Berson, founder and CEO of Conceive, who also acts as a fertility coach to members.[1]
Move your body. “As long as your doctor says it's okay, keep up with movement and exercise,” advises Novick.
Incorporate relaxation and mindfulness-based interventions. “Progressive muscle relaxation, breathing exercises, yoga, acupuncture, meditation, and self-compassion exercises are all excellent practices to incorporate into your routine,” says Rukaj.
Working with a fertility coach. Consider working one-on-one with a coach or joining a support group led by one. Providers often have a background in psychology, nutrition or nursing, explains Abbe Feder, certified life and fertility coach and founder of InCircle Fertility. If you have fertility insurance, you might get assigned one automatically, or you might find someone through your reproductive endocrinologist or check out RESOLVE: The National Infertility Association, which maintains a database of fertility coaches.
Have a fertility buddy. For me, trading notes with a coworker who had her toddler through IVF has been comforting, as she reassures me that I’m not alone in feeling stressed, frustrated, exhausted, etc. Feder agrees that connecting with a friend who has gone through or is currently going through fertility treatment can be helpful for venting, but remember that they “might be trying to navigate their own emotions or in a completely different phase of the process.”
Having personal check-ins. When you’re overwhelmed by TTC to-dos, give yourself permission to set boundaries and say "no" to certain commitments, chores or social events, Novick says. Ask yourself what you want to do, what would be helpful to do and what is realistic to do.
When to seek professional support
Many times, I’ve opened up to (well-meaning) friends about a frustrating fertility experience, only to see their eyes glaze over. I realized they were not equipped to offer the kind of support I could use at that moment. That’s when I knew it was time to start leaning on my therapist about my fertility issues.
If you’re experiencing any of the following symptoms, Batya suggests seeking professional support:
Feeling alone and socially isolating (from family and friends)
Feeling stuck in life – everything is on hold (not just fertility)
Feeling financial stress that is overwhelming
Feeling relational stress with your partner and/or support system
Ignoring signs of grief and trauma
Feeling that something is “wrong” with you, your body and/or your health
Losing a sense of self (not doing the routines you normally do or things you love and find pleasure in)
Difficulty with intimacy
Feeling elevated depression and/or anxiety
Having panic attacks
Having intrusive thoughts (that something bad that is not yet happening will occur)
Feeling unsafe, untreated and unheard with current medical care
“[A therapist’s] support and reassurance can help keep negative feelings and spiraling thoughts at bay,” says Georgia Witkin, Ph.D., a clinical psychologist who specializes in fertility.[2]
While this kind of mental health support is invaluable in and of itself, it could also support your desired endgame. Research finds psychological support that addresses the stress, anxiety and depression that can come with the process may also bolster IVF success.
How to find the right therapist for fertility treatment
Some fertility patients, including myself, already have a trusted therapist who they started seeing before beginning treatments. If that’s the case, you can continue to lean on them throughout the process, says Novick.
But if your therapist isn’t well-versed with fertility (or open to learning more about it) or you’re new to therapy, you might want to see a mental health care provider who specializes in reproductive mental health, notes Novick.
Look for someone affiliated with the American Society of Reproductive Medicine (ASRM) or RESOLVE. Both organizations offer lists of accredited, experienced clinicians who are trained in the field of reproductive health. You can also ask for a recommendation from a local support group or your fertility clinic.
There are also plenty of therapists who don't have those affiliations and will still be a good fit, notes Novick. “Remember, when you're looking for therapists, you can interview them,” she says. Ask a potential therapist questions like:
What's your experience working with individuals experiencing fertility challenges?
What treatment styles do you find most successful when working with people who are struggling with fertility?
What do you see as the goals of therapy for someone who’s facing fertility struggles?
Ensure that their answers make you feel secure that they have the experience you're looking for, Novick says.
The bottom line on therapy and fertility treatments
Infertility can test your emotional and mental well-being, and having a dedicated support system is a must. My therapist guided me through various physical, mental and emotional trials for several years before I started fertility treatment, but going through IVF has undoubtedly been one of the toughest experiences that I am lucky enough to say we’ve faced together. Having that kind of support — and prioritizing emotional health during the roller coaster of fertility treatment — will only serve to make your journey more successful.
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