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Infertility Counseling (Therapy)

Infertility Counseling
By Ellen

Many people experience increased feelings of depression, conflict, family tension, and anxiety during infertility. An experienced and supportive infertility counselor can help individuals and couples understand and cope with the stress and confusion of infertility. This counselor might be a licensed psychiatrist, psychologist, or social worker. The academic degree itself is not important in most cases; what is important is the counselor’s understanding of and approach to infertility issues and treatments. Some clients prefer a counselor who has personally experienced infertility, but a good counselor will be able to help a client regardless of his or her background.

Compared with support groups, infertility counseling has many advantages. Some people enjoy the energy of group sessions, but others feel that group sessions are too dramatic, do not like the personalities of some members, or do not feel comfortable speaking candidly to a group. Inevitably, there will be pregnancy announcements, which can seem like “graduations” to those who are still trying to conceive. Also, some issues are too serious and pressing to be adequately addressed in a group setting, such as persistent depression, marriage problems, and conflict over the next step in treatment or ending treatment.

Finding an Infertility Counselor

Because infertility counseling is so specialized, it can take some work on your part to find a good counselor. The first place to begin your search is your reproductive endocrinologist’s office. Many fertility clinics offer individual or group counseling sessions and keep lists of recommended counselors. Also, the RESOLVE website features a list of mental health professionals and groups (/PageServer?pagename=cop_mhpart). Unfortunately, this list is very short, and many states are not included. If you can’t find a counselor in your city or state on this list, you can contact your local RESOLVE or infertility support group for recommendations. Message boards such as IVF Connections are another good resource. Don’t forget to check adoption support groups and message boards; many people who adopt after infertility have worked with a counselor to resolve their feelings about infertility. Some adoption social workers also offer infertility counseling services, but keep in mind that this type of counselor may be somewhat biased against treatments such as IVF. If you know that adoption may be in your future, though, this counselor might be a good choice. Finally, you can contact marriage and family therapists and ask them whether they have worked with other clients experiencing infertility.


Counselors usually charge per session and can be very expensive if you have to pay out of pocket, but as with anything related to infertility, triple-check your benefits plan! Many health insurance plans allow a certain number of sessions per year or may cover it as mental health services, and you only have to pay your general co-pay. Counseling sessions provided by psychiatrists and psychologists, and any travel costs to these sessions, are also deductible as medical expenses if you meet the IRS requirements (http://www.irs.gov/taxtopics/tc502.html).

What to Expect

The first counseling session usually begins with the counselor asking you to explain how long you have been trying to conceive and what led you to seek counseling at this time. This first session is mostly for the purposes of getting to know you and offering some general coping tools or new ways of thinking about infertility.

If you can afford the cost and time, schedule sessions at least twice per month. In the world of infertility, time is measured in 2-week increments, and your emotions may be vastly different from one week to the next. Regularly scheduled appointments will be helpful to you and also to your counselor, who will better understand your entire infertility experience if he or she sees you at different times in your cycle.

You might wonder whether your counselor will ask your partner/spouse to attend a session or two with you or alone. Some counselors may do so, but as a general rule, the counselor is there to help you as an individual and will refer you to another marriage counselor, if necessary, so that your partner doesn’t feel that the counselor is biased or taking your side.

Other Options

It is normal to occasionally feel antagonistic toward your counselor or question the benefits of a particular counseling session. However, if you find that the negative feelings outweigh the positive ones or you are not comfortable with your counselor after a few sessions, you should look for another counselor or consider alternatives to one-on-one counseling, such as attending a support group (in-person or online), reading about infertility’s psychological impact (the book Unsung Lullabies by Jaffe, Diamond, and Diamond is very good), blogging and journaling, or practicing the mind-body exercises described in Dr. Ali Domar’s book Conquering Infertility.


1 Foxy Popcorn { 07.05.10 at 5:05 pm }

Great summary Ellen! I am a big fan of including therapy as an essential part of my coping toolkit. I actually insisted that my dh and I start seeing a counselor together after we got our IF diagnosis. It was a great tool to help us navigate this new journey. Earlier this year, after some particularly upsetting test results, I decided that I needed to see someone alone. I had to try three different therapists before I found the ‘right’ one for me. She has helped me immensely! (in reframing my thoughts from negative to positive, and in finding the right words to talk about my fears and hopes.)

Finding a therapist who is skilled in dealing with infertility can be a real challenge. There was no one in my community who listed this as an area of speciality. My RE office couldn’t help with any recommendations. Resolve didn’t have anyone in my area on their list. I felt very alone in my search, and ended up ‘interviewing’ therapists who listed adoption as a speciality. It turns out that they have some experience with the loss and anxiety that comes with infertility.

I think that you advice to keep looking until you find the right therapist is critical. Don’t give up!

2 Rachel Hoffman { 07.09.14 at 1:37 pm }

Hi, Ellen and Foxy. Another good source of professional listings for therapists is Psychology Today. For my area (Los Angeles) it is much more comprehensive. Both Resolve and Psych Today are paid listings, which is to say, the providers are not screened by the organizations. But it’s a place to start. Once you have checked the therapist’s credentials you can usually have a phone chat with them to get a felling for whether you like them before having a first session. If possible, try to get some word of mouth feedback abut them. If your RE doesn’t know them, ask anyone in your support network; other patients, or friends from a support group. I’m a huge believer in getting some counseling to help manage the stress and anxiety of the family building process. Some REs even require patients to have a session before treatment. The most challenging parts may be the transitions – when you are facing decisions about whether to continue on one path, like fertility treatment, or shift to another, like adoption. Those decisions may be very difficult, and couples are not always on the same page about when and how to make them. A good therapist can help keep you and your relationship safe emotionally, the way a good RE keeps you safe physically.

(c) 2006 Melissa S. Ford
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