Infertility and Emotional Wellbeing: Why Mental Health Must Be Part of the Conversation
Infertility isn’t just a medical condition. It’s an emotional journey. For many individuals and couples, the process of trying to conceive is marked by loss, uncertainty, and invisible pain. These real stories highlight just how deeply fertility challenges can impact mental health.
Real Stories from the Fertility Journey
Sarah: Sarah’s path to parenthood has been filled with heartbreak. After a year of trying to conceive, Sarah finally became pregnant, only to learn halfway through the pregnancy that her baby had a rare chromosomal condition and would not survive long after birth. Heartbroken, she and her husband are overwhelmed with grief. Their doctor recommends they seek support from a therapist to help them process the loss.
Gretchen: After three years of trying to conceive, Gretchen and her partner, Hal, turned to a reproductive endocrinologist and have since undergone four unsuccessful IVF cycles. Just as they were preparing for one last try, Gretchen learned that her cycle was being canceled because she is not responding to the ovulation stimulation medications. She broke down in the clinic’s waiting room. Her nurse gently suggested that therapy could help her cope with the emotional toll of treatment.
Holly & Frances: Married for four years, Holly and Frances—a same-sex couple—have always dreamed of having children. Holly plans to carry, and they hope to each create embryos using an anonymous sperm donor so their future children are genetically connected to both parents. As they begin IVF and donor selection, their doctor requires a consultation with a mental health professional to support them through the process.
Susan: After several egg retrievals and IVF cycles, Susan has only two viable embryos left. She and her husband have decided to pursue surrogacy, but they’re overwhelmed by the process. Their provider encourages them to speak with a therapist who understands the emotional and logistical complexities of third-party reproduction.
Now What?
Who should these women speak with? What type of therapist should they seek out to deal with their unique situations?
Each of these patients is facing a different kind of decision or heartbreak, but they all need the same kind of support: a reproductive mental health professional. These clinicians are specially trained to navigate the emotional complexities of family building, infertility, pregnancy loss, and more.
If you’re a fertility provider or OB/GYN, incorporating mental health referrals into your care model is no longer optional, it’s essential.
The Psychological Toll of Fertility Challenges
Starting a family is often imagined as a joyful time. But for those who face infertility, that vision can quickly shift into a clinical, emotionally exhausting experience. Relationships can suffer and patients often feel isolated and alone. Research consistently shows elevated rates of depression and anxiety among fertility patients.
In 1980, psychologist Patricia Mahlstedt published a landmark paper describing the emotional roller coaster of infertility, highlighting common experiences of loss, grief, and diminished self-worth that still resonate with patients today.
One landmark study by Dr. Alice Domar found that women undergoing fertility treatment experience depression at nearly twice the rate of those not in treatment.
More recent data shows that 56.5% of women and 32.1% of men in fertility care scored in the clinical range for depression, while 75.9% of women and 60.6% of men scored in the clinical range for anxiety.
Despite these high rates, the majority of patients are not referred to mental health support.
Clinicians: Your role isn’t just to treat the body, it’s to acknowledge the mind. Patients who receive emotional support are more likely to stay in treatment and less likely to suffer in silence.
Common Emotional Struggles in Fertility Treatment
There have been many studies that have documented the emotional challenges that fertility patients and their partners face. Patients navigating infertility often experience:
Guilt and shame for waiting “too long,” for struggling emotionally, or for feeling broken.
Grief and loss after failed cycles, pregnancy loss, or unmet expectations.
Low self-esteem tied to a disrupted sense of identity and control.
Anger and jealousy toward others who get pregnant effortlessly or with less effort.
Stress and fear about outcomes, finances, relationships, or the future.
Relationship strain due to miscommunication or different ways of coping.
These are not isolated reactions. They are the norm. And, when left unaddressed, they can derail both emotional and medical progress.
How Providers Can Support the Whole Patient
Infertility care must go beyond the physical. Here’s how clinicians can take action:
Normalize Emotional Reactions. Talk openly with patients about the emotional impact of treatment. Let them know their feelings are expected and valid.
Integrate Mental Health Support Early. Build relationships with reproductive mental health professionals and make referrals a regular part of the care plan.
Empower Patients with Knowledge. Help patients understand their treatment path so they feel less overwhelmed and more in control.
Support Couples Through the Process. Encourage open communication between partners and refer to couples counseling when needed.
Anticipate Emotional Highs and Lows. Prepare patients for moments that may be emotionally challenging, like retrievals, transfers, and the two-week wait.
Patients Need a Team, Not Just a Doctor
Infertility can feel incredibly isolating. That’s why emotional support should be part of every patient’s care plan.
Providers: Don’t stop at physical treatment. Offer referrals to reproductive mental health professionals, especially if your clinic doesn’t have one on staff.
Patients: Advocate for your emotional wellbeing just as you do your physical health. Look for therapists trained in reproductive mental health and don’t hesitate to ask your provider for a referral.
For Clinicians: The Time to Act Is Now
At the Seleni Institute, we believe whole-person care starts with integrating emotional support into every fertility journey. That’s why we’re creating a fertility-focused training, a new multi-course training designed to help mental health professionals, OB/GYNs, nurses, therapists, and other professionals provide more compassionate, inclusive, and effective care.
Ready to move from awareness to action?
