Most couples who decide to have children do so with excitement and joyous expectation. For 15 – 25 percent of the population, however, the journey toward parenthood is thrown off-course by infertility issues. Some couples in this situation opt for infertility treatment, which may include IUI, IVF, or third party reproduction.

What many don’t realize, especially those not struggling with infertility, however, is that infertility treatment is often a roller-coaster of emotion. This is a major, and often under-recognized issue. The emotional impact of fertility issues is far-reaching and complex – it can take a toll physically, disrupt *partner* relationships, cause financial strain, and impact relationships with friends, family and other supports.

Additionally, the stress of fertility issues can be overwhelming and can lead to depression, anxiety, grief, and despair. It can unmask the same issues in a patient who has been treated for any of these illnesses in past. In fact, studies show that, as a group, women with fertility problems are as anxious and depressed as women with cancer, heart disease, or HIV.

In this article, I’m going to discuss navigating this often-challenging time in a woman’s (and couple’s) life. I’ll discuss some of the physical, emotional, financial, and societal issues to be aware of and then I’ll discuss some tactics to help you plan for this journey.

Finally, I’m going to discuss how I can help you.


One reason fertility treatments can be so emotionally taxing is due to the legitimate physical demands placed on women going through these treatments. Beyond the stress of scheduling and attending all of the appointments needed, there can be blood tests, pills, hormone injections, ultrasounds, egg retrievals, and even surgery. For many women, it can become exhausting and consuming.

Along with the physical demands, there is also a major time commitment. Many couples feel like they are placing their lives on hold (vacations get postponed, educational and career opportunities get put off) to be able to navigate the schedule of appointments, tests, and treatments.

Others find that the sorrow, anger, and frustration that can come with prolonged fertility problems invade every area of life, eroding self-confidence and one’s sense of self.

Couples can also feel that they’re living in a month-to-month cycles of hope and disappointment that revolve around ovulation calendars and menstruation. Building hope with every new month a treatment is attempted, only to be let down at the end of cycle when there is no pregnancy.

Most fertility treatments require couples to have intercourse at very specific times. Many couples report that sex can become a chore and a mechanical procedure. Intimacy can suffer and couples can begin to feel disconnected.

Even in the best of times, financial concerns can exert enormous pressure on relationships. Factor in the intense, frustrated desire to have a child, plus the high cost of fertility treatments, and the conflict over money can escalate quickly.

Society generally fails to recognize the grief caused by infertility, so couples tend to hide their sorrow, which only increases their feelings of shame and isolation.

This is typically many times more challenging for women — whether a woman has always envisioned herself becoming a mother, or not. For some women, motherhood is a large part of their self-image as a female. Women who are ambivalent about motherhood mothers are aware still, of social expectations to do so.

Certain gatherings or celebrations can often be emotionally taxing as well. For example, innocent invitations to baby showers or the fact that siblings and friends are having babies can be painful triggers.


Here are a few tips to help you navigate through these emotional challenges…

  • Don’t Blame Yourself
    Resist the temptation to get angry at yourself, or blame yourself, or to listen to the little voice in your head that’s saying, “I shouldn’t have waited; I’m being punished for having that abortion; I should have lost more weight or taken better care of my health; I shouldn’t have assumed that I could have children when I wanted” or whatever negative thoughts you may be having.
  • Realize That Your Emotions Are Real And Legitimate
    It’s normal to feel a sense of loss, to feel sadness, to feel stressed, angry and overwhelmed. Don’t try to downplay or brush aside your emotions. Your emotions may be overwhelming and complex, but they should be validated.
  • Work With And Support Your Partner
    You and your partner need to help each other through this time (and certainly not blame each other). That doesn’t mean you’re both going to feel the same emotions at the same time. It does mean that you need to be aware of what the other is feeling and give them the space to express those feelings.
  • Have Frank And Honest Discussions With Your Partner
    At the same time, it’s imperative to deal with your fertility issues head-on. Begin the dialogue about the next steps, and available treatment options, and ask enough questions until you are satisfied with the answers. Discuss the options with your partner and your doctors as much as you feel you need to move forward with the treatment that is right for you and your family.
  • Get Support!
    You don’t have to go it alone! Reach out to others who have gone through this process. And, please seek the help of qualified professionals to help you at each step!


As mentioned above, the roller coaster of fertility treatment is real, it’s enormous, and it can be overwhelming. Additionally, it can lead to depression, anxiety, bipolar exacerbation, grief, and despair.

Each woman has individual and specialized needs. Talking to someone who understands what you’re facing and what you’re trying to achieve can help significantly.  I highly recommend working with a specialist in Reproductive Psychiatry in concert with your Reproductive Endocrinologist.

I am one of only a handful of Psychiatrists in the United States specializing in this new and under-served field of care. If you live in the New York City area, I’m heer to help you with compassionate and professional care, as well as the most up-to-date treatment options.

Please phone me at 917-609-4990 to arrange a consultation.

For additional information about this topic, or for help finding a specialist in your particular area, please email me at

Be Well,

Dr. Amanda Itzkoff
dr. amanda.

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