Causes & Treatment
A personal rollercoaster – fertility treatment, mental health, and how to manage both
Jessie Day | 24 Apr 2023
IVF stress – and fertility treatment anxieties in general – can seem short-term. We’ll get past it, surely, and come out stronger? Yes, but there’s definitely more to it than that, as Marie Prince, Consultant Clinical Psychologist at TFP Fertility UK, explains.
Fertility and IVF stress – it’s pretty universal
There are two key points to keep in mind, when stressing about IVF stress.
- Emotional stress caused by fertility problems won’t compromise our chance of becoming pregnant (read the British Medical Journal’s study write-up for more)
- You are 100 per cent not alone in struggling with IVF stress, or fertility stress and treatment in general
Even if you’re not struggling, but more just feeling the heat of each milestone and your treatment plan, it would be difficult not to feel a little overwhelmed.
Full disclosure, most of us on the team here at TRB have been through the spectrum of emotions, on our own fertility journeys. From denial and, sadly, shame, to outrage, stress and free-flowing tears, we’ve been there. And yes, some of us are still. Which is ok.
Universally, we back the value and importance of treatment with a clinic who invest resources into expert counselling and clinical psychological support. It’s fast-becoming a calling card for the best fertility teams, but very few are able to really deliver on their promise of qualified emotional wellbeing support services.
Over 2.5K of you responded to our recent poll on Insta, where a huge 95 per cent said that they struggle with challenges to their mental health while TTC.
TFP Fertility UK are exceptional across the board, and in this crucial area of the IVF journey. Their UK-wide clinic network is set up to provide patients with truly tailored care, and for many, this includes psychological support, and expert counselling. We were keen to chat the topic through with experienced practitioner Dr. Marie Prince, consultant clinical psychologist with TFP Fertility UK.
Here are Dr. Prince’s answers to our top questions about IVF stress, and treatment stress in general, based on experience and responses from our amazing community. All answered with the care and support we deserve, by Dr. Marie Prince, who has over 20 years’ experience as a practising psychologist.
Could you tell us a little more about your role?
Of course! My job is to:
- optimise clients’ physical and mental health to enable them to manage their fertility journey
- support clients at all stages of the process
- provide psychological treatment to manage distress, loss and trauma, where required
All TFP Fertility UK counsellors and psychologists also offer implications counselling, for anyone considering treatment with donor gametes or a surrogate.
What are the steps to finding the right support?
Ideally, your clinic will make emotional support available at all stages of your fertility journey. It’s so important to focus on the journey as a whole, and not just at the point of embryo transfer, for example.
The most important part of finding a therapist is the quality of the relationship you can build with them. You need to feel supported, heard and respected. It can be helpful to think about what you’re looking for before you start therapy – is it a supportive, reflective conversation or do you have a specific goal in mind or a particular therapy you want to try such as EMDR (eye movement desensitisation and reprocessing), or mindfulness-based work?
You can then tell your therapist what you’re looking for and check they have the skills to provide this. Don’t be afraid to speak to a few different therapists, until you find the person that feels like the right match for you.
How can we set up a good support system, and prepare for the rollercoaster?
Navigating any fertility journey can be daunting, with emotional, social, physical and financial pressures and – in the best way – the most amazing results, for many people.
It can be helpful to consider your unique personality and natural coping style – are you someone who likes to go with the flow and deal with one step at a time, or are you a planner who’s keen on prep, prep, prep?
Here are my three top tips for setting up the right support:
- Think realistically about what you need to know, and what you can control throughout this process. Speak to your clinic about the support and resources they recommend and seek information from credible sources.
- Ask yourself – what matters to you? What makes your body feel safe and relaxed? What do you need to do to help you live your life meaningfully whilst navigating treatment? Allow yourself to do what works for you as you navigate this journey, and prioritise what you need.
- Take control of building your support network. Often we expect people to know what we need – especially those closest to us – and we feel disappointed if they don’t deliver. However, it’s important that we take responsibility for telling people what we want and need. Some of us may want space and privacy, whilst navigating a fertility journey, whilst others will need people to check in with them, ask how they are and be more involved in the process. Take some time to think about what your style is, what you need and who you can reach out to, to meet those needs. This could be in the form of your family and friends, support groups for people with a similar lived experience or professional support from a therapist.
Sometimes we don’t even know what we need, and in these cases it may be helpful to think this through with a therapist.
How do you know when you’ve found the right clinic, team or practitioner?
Whilst success rates, location and pricing are super-important when choosing a clinic, it’s also sensible to look at what’s offered, in terms of counselling support.
Again, it’s easier to break this down into a few key signs and things to consider:
- You have to feel respected and heard, your concerns have to be validated and you must trust the team you choose to work with
- You may want to look at the success rates associated with the clinic – you should be able to access this information on a clinic’s website or ask them for details
- Check the clinic provides all of the services you require, plus practical considerations like staff availability, opening hours, distance to travel and the availability of remote and face-to-face appointments. These things will make a difference to how convenient the clinic is to access
Don’t be afraid to be clear about what you’re looking for, and ask direct questions.
How can we navigate (in)fertility grief, and begin our healing process?
There is no simple, fast-track answer here, but I’ll try to be succinct!
Not many people grow up expecting to struggle to have a family. And, more societally, fertility problems go against widely-held, old-fashioned expectations about what a woman’s body is supposedly for. Consequently, the need for fertility treatment can feel like a loss or failure from the beginning. It can lead us to question the beliefs and expectations we hold about ourselves.
At the same time, many people feel grateful that they have the opportunity to engage with fertility treatment.
We don’t all experience the fertility journey as being characterised by grief or trauma. But if you do, that is ok – ask for support. You’re not finding your fertility journey difficult because you’re doing something wrong, you’re finding it difficult because it is really difficult.
At times of distress, prioritise looking after yourself, allow the full range of emotional responses and try not to judge or criticise yourself for how you feel. This will only add another layer of suffering onto an already difficult situation.
Do what it takes to look after yourself. 56 per cent of you in our Insta poll said you don’t take time off work for treatment, but do you need to skip a friend’s birthday, leave the laundry for another day or say no to that extra piece of work? You are allowed to look after you.
Research shows that people going through fertility treatment are at a higher risk of experiencing anxiety and depression than the general population. And some studies have reported that as many as 50 per cent of people undergoing fertility treatment will experience anxiety and depression.
Recent polls we’ve run with The Ribbon Box on Insta show 95 per cent of over 2,500 respondents struggle with challenges to their mental health while TTC. And 90 per cent confirmed this only increased when going through fertility treatment. Almost half struggled with panic attacks due to stress, with most people (67 per cent) agreeing that waiting, and the general uncertainty, was the most difficult aspect.
So you are absolutely not alone, whatever your feelings or response.
Some people will find parts of their fertility journey traumatic and will require psychological treatment to heal from this. I often recommend EMDR due to how quickly it can make a difference.
If you think you need professional support to manage your mental health, speak to your clinic or GP.
How can we bubble-wrap against loneliness, and find a safe space?
I think it helps to be really clear about what you want, when working out how to build your support network. If you don’t know what you want, a therapist can absolutely help with that.
Ask yourself:
- What are the barriers to me accessing support?
- Have I told people what I need?
Often, people feel a sense of shame about requiring fertility treatment. This can stifle them from talking about their experiences – sometimes we tell ourselves that other people will judge us, or feel sorry for us. In our Insta poll, 42 per cent of respondents said they don’t speak openly to friends and family about their fertility journey, the main reason (for almost half) being the pressure of it not working.
Remember, there is real power in being authentic. It gives others the opportunity to respond to how we are really feeling and validate our experiences. If people can’t give you the support you need, consider where else you can access your tribe – those people that can help you with this part of your life. Alongside this, a therapist can help you explore why you are feeling isolated and help you think about how to change this.
You are allowed to say no. You do not need to go to that baby shower, or your nephew’s first birthday party. You are allowed to look after yourself.
If there are times you find difficult – like Christmas or Mother’s Day – take time to think about what will help you feel better. Do you want to hike up a hill, delete social media or do something lovely for yourself?
78 per cent of people responding to our Insta poll said they find the festive season difficult to navigate, while TTC or struggling with fertility, so you really aren’t alone in the emotional rollercoaster. More specifically, 33 per cent said their key coping tactic is managing who they see, which says a lot about the loneliness part of it, and 23 per cent rely on a trusted support network, during these difficult dates in the calendar.
Perhaps, you need to allow yourself to feel distressed – again, let’s be authentic here – waiting for your time to be pregnant, or become a parent, can be incredibly hard.
Manage your expectations – don’t expect yourself to be happy and positive all of the time. You are allowed to struggle, you are allowed to be vulnerable and you are allowed to look after yourself.
What about our relationship with our body, during/after IVF or treatment?
Many of us feel pressure around how our body is supposed to look and function. When we don’t feel it is doing what it should, this often leads to distress.
It’s so easy to focus only on what our body is not doing for us, but how can you embrace a sense of gratitude for what your body is doing for you? Developing a gratitude practice is associated with improved mental health, improved relationships, physical health benefits like reduced blood pressure, improved sleep and improvements to immune system function.
A gratitude practice also helps us to shift our thinking from focusing on the stressful parts of life to noticing some of the more positive aspects. This can be hugely beneficial, as we try and improve our relationships with our bodies.
Find safe and supportive spaces where you can be honest about how you feel about your body, this could be through your friends and family, support groups or a professional therapist.
Any tips for IVF stress, or treatment and fertility stress in general?
Stress occurs when we feel the demands placed upon us outstrip the resources we have to cope.
So, you have permission to be stressed-out – you are going through a lot! Try not to criticise yourself for feeling stressed, this is just another stress you do not need.
During your fertility journey, stress will fluctuate. It helps to have a pool of resources you know you can pull on when you need to, so spend some time thinking about what helps you cope in times of stress.
Consider all of these, when developing your personal fertility or IVF stress management plan:
- Sleep, rest & relaxation – life is often busy and worry can disrupt our sleep, so consider how to maximise rest, sleep and slowing down. Consider developing a relaxation or meditation practice, have you tried yoga or Non-Sleep Deep Rest (NSDR)? Perhaps you’d benefit from time spent walking in nature or just sitting down with a book.
- Nutrition – ‘we are what we eat’, and when under pressure our ability to prepare nourishing food is often diminished. Think about what foods make you feel good and may support you on your fertility journey, and make sure you have these easily to-hand.
- Connection with people you trust and value – prioritise the relationships that make you feel good, and give you what you need.
- Move your body – stress is stored in every fibre of our body, so it tells us how we’re feeling, and when we need a break – listen to your body.
- Seek professional support – whether this is through your clinic, the team at TFP Fertility UK or separately, using my tips to find the right support (earlier in this article) and working with a qualified counsellor or therapist can be pivotal.
What about acute stress, at times like embryo transfer?
There are many different practices that help us manage the impact of acute stress, so the key is finding what works for you. How do you soothe your nervous system when it’s triggered, and feels like it’s in overdrive?
Pay attention to your body, it will tell you when you need to slow down and look after yourself. Many therapists can help you develop your own practice for managing acute stress and uncertainty, for example during key treatment milestones.
Science tells us that breathwork reduces stress, meditation improves our focus and attention and NSDR can boost our energy levels. Many practices only take 10 minutes a day, so it’s not about taking hours out of your schedule – it’s building in the tools which really help!
Remember, you are unique. And what you need to help you navigate your fertility journey will be unique to you. You are allowed to do it your own way, and you are allowed to be really stressed out at times. Building a network is helpful for so many of us, so use the support available at your clinic – at TFP Fertility UK or otherwise – support groups, social media communities and therapists, alongside your existing networks of family and friends.
You’ve got this, and we’re (all) right there with you.
Connect with TFP Fertility UK online or by phone on 0808 2234128 and get to know the support options available to you, in your nearest clinic – they’re based UK-wide – or in a virtual session.
