Reproductive Loss and Infertility: Psychotherapy for Healing
Infertility and reproductive loss are among the most profound emotional challenges a person can face. When they occur together, the grief is compounded. Learn how reproductive mental health professionals use evidence-based therapies — from CBT to narrative and grief work — to help individuals heal and reclaim meaning after loss.
When Fertility Dreams Collide with Grief
A diagnosis of infertility or the experience of reproductive loss such as miscarriage, stillbirth, or failed fertility treatment can be life-altering. Both experiences shake one’s foundation, identity, and sense of purpose.
As researchers Rooney and Domar (2018) note, infertility often presents as an existential crisis, bringing profound psychological distress. Similarly, reproductive losses can feel like trauma, disrupting one’s sense of meaning, belonging, and identity (Jaffe, 2023).
For many, experiencing both infertility and reproductive loss creates what experts call compounded grief, a deep emotional pain that can lead to depression, anxiety, marital strain, and even post-traumatic stress disorder (PTSD) (Bhat & Byatt, 2016).
A 2009 study found that women who were both involuntarily childless and had experienced pregnancy loss reported the highest levels of fertility-related distress and the lowest life satisfaction (Schwerdtfeger & Schreffler, 2009).
Understanding the Emotional Toll
Healing begins with being seen and believed in the depth of your pain.
Infertility and loss are not isolated experiences. They often overlap, creating a cycle of hope, heartbreak, and recovery. Those navigating these challenges may:
Experience chronic sadness, anger, or guilt
Avoid reminders of fertility (such as baby showers or pregnant friends)
Struggle with their self-worth or body image
Feel tension within their relationship
Question their life’s meaning or purpose
In these moments, psychotherapy with a reproductive mental health professional can offer relief, validation, and a roadmap toward healing.
Infertility, Reproductive Loss, and PTSD
Reproductive trauma isn’t just about what happened — it’s about what was lost, again and again.
We often think of trauma as a single catastrophic event: an accident, assault, or natural disaster. But as Dr. Janet Jaffe (2023) explains, reproductive trauma is more often chronic and cumulative, a series of painful moments that gradually erode hope.
Dr. Jaffe broadens the definition of trauma to include “an event, but likely more than one, which overwhelmingly shatters core beliefs and assumptions.” Under this lens, infertility and reproductive loss clearly fit.
Individuals facing reproductive trauma may experience symptoms similar to post-traumatic stress disorder (PTSD):
Intrusive thoughts or reliving painful memories
Avoidance of reminders, such as medical offices or social situations
Hypervigilance, always expecting bad news
Emotional numbing or detachment
These are not signs of weakness. They’re normal responses to extraordinary distress. A reproductive mental health professional can help patients recognize these patterns and begin the process of healing.
How Psychotherapy Supports Healing
There is no one-size-fits-all approach to therapy. Each person’s path to healing is deeply personal. However, several evidence-based therapeutic models have proven especially effective for infertility and reproductive loss.
1. Cognitive Behavioral Therapy: Reframing the Inner Dialogue
Cognitive Behavioral Therapy (CBT) helps patients identify and challenge negative thought patterns, such as self-blame or hopelessness, that reinforce distress.
Dr. Linda Applegarth (2006) describes CBT as particularly effective for fertility patients coping with anxiety or depression related to medical interventions. Because it can be delivered without medication, it is often a preferred option for individuals undergoing fertility treatment or pregnancy.
“What’s wrong with me?”
”What can I do to support myself right now?”
CBT is structured, goal-oriented, and typically short-term. It often includes:
Homework between sessions
Tools for identifying cognitive distortions
Skills for managing anxiety and emotional triggers
Techniques such as behavioral activation, mindfulness, and cognitive restructuring can reduce symptoms of depression and improve overall emotional resilience (Wenzel, 2017).
2. Acceptance and Commitment Therapy: Embracing Pain to Find Peace
Pain is part of life, but suffering doesn’t have to define it.
Acceptance and Commitment Therapy (ACT) helps individuals reduce emotional suffering not by eliminating painful thoughts, but by accepting them and committing to living in alignment with their values (Harris, 2019).
ACT has shown measurable improvements for fertility patients, including better quality of life and reduced anxiety and depression (Psychology Today, 2025).
ACT therapists guide clients through six core processes, including:
Acceptance: Allowing space for all emotions, even the hard ones.
Cognitive Defusion: Seeing thoughts as separate from reality.
Contact with the Present Moment: Staying present, even in pain.
Self-as-Context: Accessing the "observing self", separate from your thoughts and feelings.
Values: Reconnecting with what matters most and what kind of person you want to be.
Committed Action: Engaging in behaviors aligned with your chosen values, even when difficult thoughts or feelings arise.
This approach helps patients build psychological flexibility: the ability to hold pain and hope at once.
3. Narrative Therapy: Rewriting the Reproductive Story
Rewriting your reproductive story is an act of courage, a reclaiming of your voice, your body, and your future.
Narrative Therapy invites individuals to tell and re-tell their stories — not as victims of circumstance, but as active authors of their lives.
As Dr. Janet Jaffe (2023) emphasizes, each person carries a deeply ingrained reproductive story; the lifelong narrative of becoming a parent. When that story is disrupted by infertility or loss, rewriting it can be profoundly healing.
Through narrative therapy, patients externalize their struggles (“infertility” or “loss” becomes a chapter, not the whole story). This helps reduce shame, increase self-compassion, and open space for new meaning.
4. Grief and Loss Counseling: Honoring the Loss
Grief work allows us to hold love and loss in the same breath, and to keep breathing.
Grief is a natural and necessary part of the healing process. Grief counseling provides space to acknowledge and process multiple forms of loss:
The loss of a pregnancy or baby
The loss of the ability to conceive naturally
The loss of a genetic tie or imagined future
A skilled reproductive therapist helps patients name these losses, explore their unique meanings, and find ways to honor them, whether through ritual, remembrance, or conversation.
Because reproductive grief can be complicated by hope (“we’ll try again”), it often involves cycling between mourning and anticipation. Therapy helps patients balance these emotions while staying grounded in self-compassion.
The Role of the Reproductive Mental Health Professional
Reproductive mental health professionals combine clinical expertise with deep empathy. They understand the unique pain of fertility-related trauma: the monthly cycle of hope and despair, the invisible grief of miscarriage, the silent strain on relationships.
Their work involves:
Assessing emotional readiness for treatment or closure
Teaching coping and communication skills for couples
Helping patients navigate medical decisions and boundaries
Supporting meaning-making and post-traumatic growth
For many patients, therapy offers not just coping strategies but connection, understanding, and the possibility of peace.
Moving Forward: Healing Through Compassion and Connection
In the hands of compassion and care, grief transforms into resilience.
Recovering from infertility and reproductive loss takes time, courage, and care. With the right support, individuals can rebuild a sense of identity, meaning, and hope, even when the outcome is not what they imagined.
If you or someone you know is struggling, know this: healing is possible. You are not alone, and your story is still unfolding.
For Mental Health Professionals
At the Seleni Institute, we offer specialized fertility coursework designed for mental health professionals who want to expand their practice and better support clients utilizing and navigating third-party reproduction.
Our evidence-based CE courses will help you:
Understand the psychosocial dimensions of fertility care.
Gain confidence in conducting evaluations and consultations.
Apply ASRM guidelines in clinical practice.
Support clients with empathy, clarity, and competence through one of the most complex experiences of their lives.
Explore our coursework and join the growing community of mental health professionals advancing reproductive care.
References
Applegarth, L. (2006). Infertility Counseling and Psychotherapy. In Covington & Hammer-Burns (Eds.), Infertility Counseling: A Comprehensive Handbook for Clinicians. Cambridge University Press.
Beck, A. & Weishaar, M. (1995). Cognitive Therapy. In Corsini & Wedding (Eds.), Current Psychotherapies (5th ed.). F. E. Peacock Publishers.
Bhat, A. & Byatt, N. (2016). Infertility and Perinatal Loss: When the Bough Breaks. Current Psychiatry Reports, 18(3), 31.
Harris, R. (2019). ACT Made Simple: An Easy-to-Read Primer on Acceptance and Commitment Therapy. New Harbinger Publications.
Jaffe, J. (2023). Reproductive Trauma and PTSD. In Covington (Ed.), Fertility Counseling: Clinical Guide and Case Studies. Cambridge University Press.
Psychology Today. (2025). Acceptance and Commitment Therapy. Retrieved October 21, 2025, from psychologytoday.com
Rooney, K. L., & Domar, A. D. (2018). The Relationship Between Stress and Infertility. Dialogues in Clinical Neuroscience, 20(1), 41–47.
Schwerdtfeger, K. L., & Schreffler, K. M. (2009). Trauma of Pregnancy Loss and Infertility for Mothers and Involuntarily Childless Women. Journal of Loss and Trauma, 14(3), 211–227.
Wenzel, A. (2017). Cognitive Behavioral Therapy for Pregnancy Loss. Psychotherapy, 54(4), 400–405.
