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 (http://www.resolve.org/site/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.

Costs

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.