Mental Health & Fertility Treatment: Turning to Therapy & Support Groups

We recognize that for many, the impact of undergoing fertility treatments extends far beyond just the physical side effects. In honor of Mental Health Awareness month, we sat down with Spring Fertility’s in-house clinical psychologist Dr. Julia Conant to learn more about the role she plays in helping couples and individuals undergoing fertility treatment, and why mental health support can be such an important part of the family-building journey. 

While undergoing or planning for fertility treatment, why is it so important to pay attention to and take care of your mental health?

It is easy to understand why most patients report impacts to their quality of life or sense of well-being while undergoing fertility treatments — there is the physical toll of multiple medications and/or procedures, the time commitment involved, and the profound uncertainty that individuals and couples must endure about the “if,” “how” and “when” related to their goals to become parents. Managing these stressors alone can take a significant emotional toll, and in addition, so many fertility patients are grieving losses (pregnancy losses, losses of a sense of safety or security about the future, losses of feelings of freedom or agency, etc.) along the way. These stressors, traumas and losses can compound over the course of ongoing treatments and lead to mental health challenges with mood, sleep and anxiety. I always encourage individuals and couples to proactively seek mental health support in the fertility treatment process.

How are support groups a valuable way for people navigating fertility treatment or pregnancy loss to find community and feel less alone? 

The shared community space of a support group (for Pregnancy Loss or IVF Support) can offer something often absent in patients’ everyday lives, workplaces, and family and friend communities. These spaces are dedicated to helping patients process and transform the impact of infertility, losses and/or disappointments. Patients can bring the most isolating aspects of their fertility journeys to these groups, such as their feelings of anger and hopelessness, and feel understanding and compassion for those experiences in the context of a support group. We don’t shy away from painful feelings, and there’s strength in holding and putting words to them together in a group. Resilience and renewed hope are cultivated gradually, without false reassurances or pressures to “be positive” that patients often feel in other relationships. Conversations in support groups, both those facilitated by the therapist and arrived at organically through connection with other members, often lead to some perspective change that patients can bring back to their outside lives and relationships.

As a clinical psychologist, how are you able to support people on their fertility journeys?

I have a trauma-informed lens for thinking about peoples’ experiences with fertility treatment, which allows me to offer strategies for coping with acute anxieties and feelings of unsafety or lack of control in this process, as well as to track and help transform the meaning that people make of their experiences so that over time a cohesive narrative and sense of agency can (re)form. I understand the complex layers of identity and self-concept (values, goals, cultural considerations) and how a non-linear fertility journey can shake and shift our sense OF SELF,  worth or image. I can hold with patients the duality of their experiences of loss, that while profoundly painful, can also lead to unexpected growth (sometimes referred to as post-traumatic growth). In work with couples, I can help partners better communicate and support one another in a fertility process, especially when their experiences or perspectives differ greatly.

What is the most rewarding part of your job, and the work you get to do with patients?

Regardless of the outcome in treatment, it is so rewarding when patients discover (or rediscover) their strength after surviving and making it through a process, loss or disappointment that they didn’t think they would be able to weather emotionally, or accept or adapt to mentally. When patients can internalize this kind of self-experience, it leads to a resilience and a new recognition of their capacities that will be with them forever. 

What are some ways in which the loved ones of couples and individuals navigating fertility treatment can offer care and support? 

They can practice sitting with disappointment, loss and uncertainty. Often loved ones (with the best of intentions!) try to encourage optimism, positivity and reassurance about things they cannot predict or guarantee, and the experiences of those navigating fertility struggles and losses can feel diminished or misunderstood. Patients undergoing treatment or grieving losses (pregnancy loss, changes in expectations and plans, impacts on their health and quality of life, etc.) often just want to be listened to, heard, and validated in their emotional process. Loved ones can ask if advice or ideas are desired before offering. And they can try to hold feelings of profound uncertainty with their loved one, and not move away from them in discomfort.

What is donor tissue counseling, and why is it an important part of the third-party family building process? 

Third party family building refers to the process of using a gamete or tissue donor (oocyte, sperm, embryo) or gestational surrogacy to help individuals or couples (Intended Parents) conceive and build their family. The American Society for Reproductive Medicine (ASRM) has established guidelines for psychological services in third party assisted reproduction to ensure that all parties involved receive the necessary support and counseling throughout the complex process, as well as ensure adequate psychological screening of gamete donor and gestational carrier candidates. At Spring we have designed this process to provide IPs with information about various third party options and paths available, as well address any specific concerns in areas such as: grief, loss or worries related to third party family building, strategies for coping with stress or emotional challenges in the process, disclosure of gestational carrier or donor-conception to family/community as well as future child/ren, the limits of gamete donor anonymity, impact and decision-making around treatment failure or other possible medical risks, and emotional implications in general for Intended Parents and future child/ren. Overall, the goal of the Intended Parent consultation is to ensure that IPs are fully informed about the process and empowered to navigate emotional challenges that may arise along the way.