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Top 6 reasons why couples don’t but should seek counseling before & during infertility treatment

By Shubha Swamy, LPC, Novo Psychotherapy, LLC

Therapists trained in reproductive mental health, have a keen understanding of your potential feelings and questions and can help you navigate this journey with compassion and kindness and a sense of knowing you are not alone.

I see couples in my therapy office who are about to begin infertility services, usually IVF (in vitro fertilization) or IUI (intra uterine insemination), and they almost all say, “I could’ve used you a year ago.”  One of my roles is to perform a consultation session, a supportive-educational meeting with couples before they begin their IVF process.  We spend most of the time talking about their history, their infertility journey, their self-care, and supports, and how they will manage during the process.  Nearly everyone speaks about how hard the earlier parts of the journey had been, and by the time I see them, they are feeling more ready, and eager to move forward with ART (assisted reproductive technology).  So, my biggest question is: why aren’t more people seeking counseling support at the beginning!?  When fertility issues first arise, or after the first miscarriage, or ectopic pregnancy, or 6 months into “trying” and no positive tests, these are all great times to seek help.  

Here’s why you likely talk yourself out of getting support, and why you need to convince yourself otherwise:

I get it, if you are struggling to conceive, then your attention becomes all about having your baby.  However, the road you are about to begin is uncharted and unfamiliar to you, and potentially has several surprise curves and bumps, and it is very helpful to have a guide alongside of you.
1 in 8 couples has trouble conceiving or sustaining a pregnancy.
Infertility crosses all socio-economic, race, cultural, and religious groups, so given the numbers affected by it, chances are you know someone or may be impacted as well.  This statistic means YOU ARE NOT ALONE!!!  Having trouble conceiving is a very real issue, and there are support groups ( (, information, trained therapists ( who can help and inform you along the way.

Most folks don’t think they deserve, need or are capable of getting help.  You are already facing more questions than answers, and the thought of trying to find support for yourself is likely daunting.  And, in spite of the shock, disappointment, anger, and betrayal you may be feeling, people tend to discount and push aside all these feelings as secondary or not important.  Here’s a good reason why you should seek support – 
Infertility diagnosis has a similar impact to receiving a cancer diagnosis.
Research from a Harvard Medical Study showed that women with infertility felt as anxious and/or depressed as those who had received a cancer diagnosis.  And in another study, 15-50% of participants said this (having infertility issues) is the most upsetting thing to have happened to them. Not having your family plan or being able to have a family is a HUGE reality adjustment.  

Hmm, maybe?  Of course, we hope time and persistence will be the answer, but that is not always the case.  People tend to adopt an “I’ll suck it up and deal with all these doctors, and answer all these very personal questions, and go through invasive exams, injections, etc. all for the baby, and I will just deal.”  
Infertility treatment is a marathon, not a sprint.
Most likely you are going to be involved in seeking professional help, such as OB-GYN and then Reproductive Endocrinologists, and then possibly Urologist.  You will undergo a lot of diagnostic testing to try and determine the cause, all the while nail-biting, wondering, speculating and doing waaay too much internet searching as to ‘what is going on.’  And ladies, if you dread seeing your OB/GYN for regular annual exams, get ready, because R.E.s need to do more exams and they can feel invasive (I’m talking about internal ultrasounds).  You need to get real comfortable, real quick with letting go of modesty and learning more about your reproductive systems than you ever cared to know.  Talking to other folks going through ART treatment or counseling professionals can be a place to share your feelings related to all the tests, treatment options, and creating a plan that is going to work for you.

True, you share a goal or a dream.  And, achieving that dream is of great importance, but not at the expense of your mental health or to the detriment of the couple.    
You have to be a strong WE before you become 3.
A strong foundation is KEY before beginning your family.  It takes effort, continued interest, respect, kindness and understanding to create and maintain a strong relationship.  And, as I mentioned earlier, this is one of the toughest things you are going through, as an individual and as a couple.  This situation is unique, and how you care for yourselves and one another is going to be very important.  Your awareness of your own needs, your partner’s needs, and how you love and support one another is of great importance and a trained counselor is a valuable consultant in this process.

You have nothing to be ashamed about.  You have done nothing wrong.  And there is nothing wrong with you!
People feel so responsible, guilty, bewildered, and can experience a sense of loss and betrayal when undergoing infertility.  A man can feel like less of a man if the issue is due to their reproductive system.  A woman feel like less of a woman if she cannot get pregnant or carry a baby to term.  We immediately heap on the blame, and go through real loss and grief. Then, there is the anxiety and worry over “if,” “how,” and “when.”  There are about 1000 questions to every answer, and then all the “helpful” advice you’re bound to get.  You are not at fault, and I want you to get through this with as much support, knowledge, skills and grace as you possibly can.  

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