Infertility
Considering Consulting a Fertility Therapist? Here's What You Need To Know
January 22, 2025
Last updated:
January 22, 2025
If you’re on your fertility journey, there may come a time when you feel like you need increased support. A fertility therapist is a mental health professional trained and specializing in reproductive mental health, and working with one can be an incredible resource. They can help you navigate the intricate web of options, feelings, and decisions that you’re facing, along with the complexities of grief, loss, anxiety, fear, and loneliness that this experience can bring up.
In the United States, about 1 in 5 women between the ages of 15 to 49 experience one or more reproductive health issues. That number jumps to about 1 in 4 women when it comes to having difficulty getting pregnant or carrying a pregnancy to term. It’s clear that fertility challenges are something many people face, yet these challenges are often seen as just a struggle connected to physical health, overlooking one of the most profound impacts of the fertility experience—the impact on mental health.
As a fertility therapist, my practice Calla Collective focuses exclusively on reproductive mental health. Almost all of the clients that come through our doors are somewhere on their journey of trying to conceive (TTC) and family building journey. Almost all of them report that they feel alone, isolated, and overwhelmed. Many state that their friends and family do not understand their experience, work, and relationships have become harder, and other parts of their lives are on hold. There are so many shared emotions and experiences among those who are trying to build their family, and many don’t know that there are therapists that specialize in this very unique experience. Most importantly, they don’t realize that what they are experiencing is significant, and they have a right to ask for support.
Studies have shown that patients with infertility have the same rates of anxiety and depression as patients experiencing cancer. Fertility struggles are significant, life-changing, and worthy of examination and processing.
It is important to know how to identify if you are struggling with your mental health and ensure you are consistent with your mental health care throughout your TTC journey and beyond. If you have been working with a mental health specialist, such as a therapist or psychiatrist, make sure you are continuing to do so throughout this time in your life. If you are taking medication, be sure to consult a reproductive psychiatrist, who is trained and specialized in medication management for women who are trying to conceive, pregnant, and postpartum.
Let’s explore the stressors that many experience on their fertility journey that may indicate it’s time to consider seeking professional support for your mental well-being.
Social isolation
Many people feel that early on during their TTC journey, friends and family stop recognizing their grief and stress levels. Aspiring parents often feel that their loved ones may not say the right thing, or dismiss their feelings altogether, suggesting that they should stop being so stressed out and trust that everything will happen in time. It can feel like a very lonely time of life.
Social support is one of the most important factors when it comes to resilience during this challenging period. This does not mean that you need a team of friends and family who are great at supporting you. Some friends are there for a good time and a laugh, while others may be better for deep conversation and advice. In this moment, you also likely need a friend or family member who is a safe space, someone who can sit with you while you cry, someone who can hear what you need and honor that for you. It might be helpful to say to this person something like, “Can you just check in and ask me how I am? You don’t need to try to fix or solve it, just let me vent and cry.”
If you are finding yourself socially isolating—no longer seeing friends and family, no longer going out in social settings, no longer talking to others about how you are feeling—then it’s time to find professional help from a licensed therapist, ideally one who focuses on reproductive mental health.
Uncertainty
Uncertainty is at the root of the TTC experience. We like certainty and predictability—it makes us feel safe and secure. So what happens when we are in a perpetual state of uncertainty? We feel a loss of control, which is often one of the hardest things to experience. This can also lead to increased feelings of anxiety and depression.
When we do not feel safe and secure, our bodies respond by trying to protect us, and our sympathetic nervous system reacts- also known as “fight or flight.” While TTC, this often translates into a feeling of extreme overwhelm or even disconnection. Those going through a complex fertility journey may stop being able to focus on other parts of life outside of trying to conceive, making life feel like it’s on hold. Small self-care tasks such as scheduling an activity or cleaning your home feel too overwhelming to handle. This is an important time to recognize that you are being impacted by a serious experience and you cannot do it alone. It is essential to ask for help from your partner, family, and friends.
Sometimes uncertainty can become too much to handle and starts to negatively impact your life. If you are not able to do everyday tasks and activities consistently, especially if you are not eating or sleeping appropriately, it is an important time to seek the support of a licensed therapist who focuses on reproductive mental health.
Another sign that it’s time to seek professional support is if you are feeling flooded with overwhelming thoughts, called “intrusive thinking,” which often looks like ‘what ifs’. These thoughts are things that are not actually happening, but are things you fear could happen, such as “What if I do not get pregnant? What if I have a miscarriage? What if we cannot figure this out?” These thoughts can be very overwhelming and are often linked to anxiety. If you are experiencing feelings of anxiety or depression, it is vital to seek support from a licensed therapist.
Relational stress
The family building journey can not only take a toll on your mental health but on your relationships with those closest to you.
If you’re partnered, a fertility struggle can be one of the most difficult challenges for a couple to navigate. In fact, 15% of couples report that infertility has had a negative impact on their marriage. This impact can show up in multiple ways: from a lack of communication, and decreased bids for connection, to a lack of sexual intimacy. This is an important time for you and your partner to communicate what you both need, so you can continue to support each other.
You don’t have to attempt to navigate these relational stressors alone. Seeking out a couples therapist trained in reproductive mental health can give you the space to explore these issues together, and arm you with resilience and tools to keep your relationship strong throughout the family building process.
Even if you’re not partnered, it’s so common for someone on their fertility journey to experience strained relationships with friends, family, or coworkers. If you’re feeling increasing irritability, a lack of connection, or a lack of empathy and understanding from those closest to you, speaking with a fertility therapist can help to navigate these relationships and increase overall relational satisfaction. At Calla Collective, we offer individual as well as couples therapy to support those who may be experiencing any relational hardship.
Grief
We often think of grief as the death of a loved one, but grief can also be about loss - such as the loss of hope and a dream, the loss of how we thought things would be, or the loss of trust in our bodies. This is often a more complicated form of grief, as it is unseen by society and often unnamed even by ourselves. When we do not allow grief to exist, it does not go away but festers and seeps through the cracks of life. In my work as a therapist specializing in fertility issues, I find that all of my clients have experienced profound grief in some capacity, yet most of the time they have not recognized it themselves, or given themselves the permission to grieve.
For many, fertility and family planning do not go the way they anticipated. When you do not get pregnant, when you lose a pregnancy, or when you have to explore third-party reproduction options such as in vitro fertilization (IVF) or donor conception that were not part of your initial planning, you may experience feelings of profound grief and loss. It is important to know that when experiencing this type of ambiguous grief or loss, there is no clear path or steps to take to make it go away. It does not end, healing often looks like growing around your grief and learning to cope with it in your everyday life. Your fertility journey is a major part of your life, but it’s important to remember that it is not your whole life.
Oftentimes, the inability to conceive or carry a pregnancy to term after previously giving birth to a child, referred to as secondary infertility, can bring about intense feelings of grief and confusion. Secondary infertility can bring up complicated grief and feelings of guilt because you already have a child or children, but it is just as worthy of exploration and processing as any fertility struggle- especially because it can also bring up feelings of failure and confusion as you were once able to conceive or carry a pregnancy to term, and that’s now changing. Seeking mental health support can be helpful in navigating this unique and difficult experience.
If grief develops into feelings of ongoing sadness, intense emotional pain, or avoidance and loneliness, it is an important time to seek the support of a licensed therapist. It is also an important time to name this grief for yourself and your support system, as acknowledging grief and giving yourself permission to grieve is part of the work to address it.
Finding mental health support
When looking for a therapist or other professional support in the field of reproductive mental health and fertility, it is often unclear where to look for referrals. Two good places to start are The American Society of Reproductive Medicine (ASRM) and RESOLVE, The National Infertility Association. Both have lists of health professionals throughout the United States who have specializations in reproductive mental and emotional health care. Our practice, Calla Collective, has clinicians who specialize in this field, and we currently serve clients in 10 states across the country (AZ, CO, CT, FL, ID, IL, NJ, NY, SC, and VT). We can also assist anyone outside of the states we serve with getting connected to the right mental health professional in their area.
Wherever you are on your fertility journey, remember that you are not alone, and you don’t have to go through this in isolation. Your mental wellness matters, and it’s important to seek out the support you want and need. If any of the above stressors resonate with you, we encourage you to seek professional support.
Batya Novick, LCSW
Batya Novick, LCSW and Founder of Calla Collective Batya is a Licensed Clinical Social Worker specializing in reproductive mental health. She works with individuals and couples around fertility challenges and perinatal loss to transitions into family building options, postpartum, and parental support and has dedicated her career to this specialized field of care. Batya graduated from Columbia University and trained at the Ackerman Institute for the Family. She holds professorship within the graduate program at NYU’s Silver School of Social Work. Batya is an active member of Resolve and an elected committee member within the Mental Health Professional Group of the American Society of Reproductive Medicine. Batya provides clinical support and consultation to corporations and outside industries and has authored articles and frequently speaks on the topics of fertility and postpartum supports. Batya is a clinical advisor for One Tribe and WeConcieve.
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Batya Novick, LCSW