The process of IVF, while often exciting and hopeful, can take a serious toll on an individual’s mental health — a fact that is often left out of conversations about fertility treatments.
When Joma Cook and her partner first began trying to conceive, she never imagined how long and arduous the process would be.
But after much time attempting to conceive naturally and one miscarriage, it soon became clear they would need the assistance of in vitro fertilization (IVF).
“You don't realize the huge weight fertility issues and trying to conceive can have on your mental health,” Cook tells Healthnews. “Trying to conceive over a number of years really impacts your emotions.”
A phobia of needles, a roller coaster of both hope and disappointment, and feeling triggered by other people’s pregnancy announcements all contributed to the psychological distress Cook experienced. She sought support from cognitive behavioral therapy (CBT), acupuncture, and hypnotherapy to get through it.
“I am big on advocating for talking about fertility struggles more — with friends, in schools, with anyone who will listen,” Cook says. “The more people talk and share their stories, the easier it will be for others to not feel alone and to seek support.”
“This severely impacted my already frazzled heart and brain,” she tells Healthnews. “Previous to our trying, I was always a very happy well-rounded individual.”
Financial worries made the process even more stressful. And then, just before her egg retrieval on their second attempt, Deakin was told she had a hydrosalpinx — a condition in which fluid accumulates in the fallopian tubes which can make pregnancy difficult.
“I was completely devastated as she said this fluid would kill embryos and we would have to wait after our egg retrieval,” she says. “I walked back to my car over Battersea bridge and for the first time in my life, I just felt I wanted to jump. I have never felt so low in my life and even tried to persuade my husband to leave me, as I was broken.”
Fortunately, Deakin had a circle of supportive friends and family who were there for her and encouraged her to open up about her depressive symptoms, helping her to overcome these challenges.
“I have now been there for friends that are going through similar experiences as I feel women need to have a safe space to be able to say whatever they are feeling,” she says.
Mental health challenges with IVF
Both Cook and Deakin’s experiences are not unique despite how little they may be discussed, mental health professionals say.
Struggling with fertility, having to turn to treatments such as IVF, and undergoing the intensive processes they entail are almost guaranteed to take a toll on an individual’s stress levels and cause emotional distress. And yet, infertility is still often seen as a taboo or private subject — forcing many to suffer in silence.
IVF, and infertility treatments more broadly, nearly always involve a measure of grief, says Lauren Canonico, LCSW, a psychotherapist clinical director and adjunct professor specializing in IVF trauma at Affirmative Therapy Collective.
“No one wants to need fertility treatment, including queer couples with limited options,” she says. “Many people romanticize the process of building a family and trying to get pregnant, and don’t envision a sterile doctor’s office and medical intervention as part of the process.”
By this nature, it is nearly always a mentally and emotionally taxing experience.
Given that infertility treatments often involve a number of unknowns, such as waiting on testing, proper timing, and treating other conditions that might impair fertility, she says anxiety is also a common effect.
Particularly given how much women are socialized to fear aging related to fertility, waiting for desired treatments and having your family building journey delayed can feel positively intolerable and downright dangerous,.
Canonico
IVF is also expensive and lacks guaranteed insurance coverage in most places, which Canonico says can be a tremendous stressor. Having to base a deeply emotional decision on finances can be extraordinarily difficult.
The American Society for Reproductive Medicine states that the average cost of one IVF cycle in the United States is $12,400, while other studies estimate that the cost per cycle is approximately $20,000-$25,000. In some of the most expensive parts of the country, the cost per live birth can even exceed $60,000.
“More existentially speaking, particularly when IVF isn’t going well or someone is a long hauler and a treatment veteran, there’s a tremendous amount of grief related to the loss of potential,” Canonico says.
She says she’s worked with many patients who show post-traumatic stress disorder (PTSD)-like symptoms after infertility treatments, experiencing changes to their body image and self esteem, even if treatments are successful.
IVF can also be very isolating, she says, as it’s a unique process that’s difficult to explain to others given how much jargon and medical background is often needed to detail the process or your prognosis.
“[IVF] creates an emotional rollercoaster of intense highs and lows, characterized by optimism and hope as well as anxiety, helplessness, stress, and depression,” adds Rachel Goldberg, LMFT, PMH-C, a therapist specializing in infertility.
Goldberg says research has shown that infertility treatments like IVF have been shown to cause emotional effects like anxiety and depression at levels comparable to serious health conditions such as cancer and heart disease.
The physical strain of IVF
The physical process of the IVF treatment itself can feel overwhelming due to invasive testing procedures, hormonal injections, uncomfortable appointments with probes, blood draws, and surgery, Goldberg explains.
Plus, medications required for treatment impact hormone levels, which can also have a major impact on mood, anxiety, and quality of life.
“Many women will often feel isolated as they struggle with the emotional and physical demands of the process,” Goldberg says. “The disruption to their daily lives — both socially and professionally — further exacerbates feelings of despair.”
Yet another physical challenge, according to Canonico, is that many people cope with mental health challenges through movement or exercise, but exercise and exertion are often off limits during portions of the IVF process, stripping individuals of a healthy and necessary coping mechanism.
How to navigate the challenges of IVF
To alleviate psychological stress, Goldberg recommends maintaining some sense of normalcy outside the intensity of treatment — whether that involves seeing friends, light exercise, or taking up a new hobby for some distraction.
“One common issue is withdrawal from activities that once brought joy, and while understandable, this can increase feelings of depression,” she says.
Asking for support from friends or family, such as having someone accompany you to appointments or arranging for a meal drop-off, can also serve as a helpful reminder that while your loved ones may not fully understand the mental health issues you’re experiencing, they still care and want to support you.
Goldberg also highly recommends finding a therapist for counseling sessions who specializes in fertility issues or joining a support group where you can share your experiences and find comfort in knowing you’re not alone.
Having support is a huge help, whether this comes in the form of support groups, via your fertility clinic, or a therapist that's knowledgeable in the process.
Canonico
And while some exercise can be off-limits during treatments, she suggests discussing the details of your typical workout routine with your doctor ahead of time so you can find ways to modify activity without losing a major means of caring for yourself when you need it most. They’ll likely recommend safe alternatives such as walking, gentle hiking, gentle yoga, stretching, breath and somatic work.
Knowing the process will be difficult, Canonico recommends planning ahead and setting aside extra time to process your experience and increase your self-care.
Part of taking care of yourself during this process is also knowing when it’s time to step back from it, she adds.
“It’s okay to choose your body, your mental health or your health, and pause or stop treatments if or when you need it,” Canonico says. “You have agency in this process, even when it might not feel like it.”
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