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Fertility Counseling: A Missing Piece of Your Treatment?

According to the American Society for Reproductive Medicine (ASRM) and the European Society for Human Reproduction and Endocrinology (ESHRE), fertility counseling should be included in fertility treatment options and recommended by doctors and fertility clinics for individuals and couples considering assisted reproductive technology (ART), third-party reproduction, and other kinds of fertility treatment options. Unfortunately, few clinics offer this service due to a lack of:

  • integrative and holistic interventions, that have been proven effective, within the medical model

  • trained and qualified fertility counselors

  • awareness and education of the patients on the emotional and psychological effects of  fertility treatment and diagnosis

  • continued cultural views of reproduction being a medical problem alone, instead of an event that impacts all aspects of an individual’s/couple’s life.

The ASRM and ESHRE have made this recommendation, along with “Guidelines for Counseling in Infertility” and “Qualification Guidelines for Infertility Counseling,” for many reasons.
To start, fertility counseling can assist individuals through the emotional and psychological stress associated with being diagnosed with, and treated for, infertility. Patients often feel less like a subject in an experiment and more as though they are being seen as a whole person.

Counseling sessions are a time when concerns or questions about treatment, or success of fertility treatment, are validated instead of being seen as ‘irrational’. Often patients do not voice their concerns to doctors, friends, or family, for fear of being seen as too emotional or unrealistic. In counseling, addressing fears, emotions, thoughts, hopes, and processing past experiences is the goal so that you can feel less isolated and more fulfilled.
Additionally, while undergoing medically assisted reproductive treatments (e.g., IVF, IUI, ICSI) counselors can monitor patients psychological reactions to diagnosis, medications, and treatment outcomes. ART and third-party reproduction such as using gestational carriers or egg/sperm donors via medical technology, did not exist 50 years ago. With the advent of new fertility treatment options and technologies, came an unprecedented expectation for humans; that we can have children by other means than a man and woman having sex. Our psyche is trying to come up with new ways to understand this, however we are fighting against thousands of generations that tell us otherwise.

These technologies can allow people who are single, LGBTQIA+ and older individuals and couples, and people experiencing medical complications to fertility, to conceive and build their desired family. However, the amount of stress and strain the medicalization of fertility places on a patient’s life needs to be recognized and addressed. This process creates unique personal experiences as well as a novel social phenomenon. Questions patients should be asking themselves include:

  1. How has the shift toward reproductive technology and the medicalization of building a family impacted my views of myself, my family, and my society?

  2. How is my identity impacted by my beliefs and assumptions about reproduction?

  3. Do I feel supported in all of the ways I can be during this process? If not what is missing, what fertility treatment options have I not considered?

Adding to Your Fertility Treatment:

Studies have shown that individuals and couples who utilize counseling before, during, and/or after treatment have a better quality of life and feel more equipped to handle the stress accompanied by trying to build their family. Fertility counseling can look different for each individual/couple. Everyone has different needs during this time, and having a counselor who tailors treatment is important. Some of the supports you can gain are: emotional/psychological, education on a variety of topics, assistance in the decision-making process around treatments, and relationship counseling.
Fertility counseling could be a missing part of your treatment; a piece that would help you move closer to your goals while maintaining a sense of connection to yourself and loved ones. Luckily, there is growing recognition for the need of fertility counseling, and more professionals gain training each year in order to passionately serve the infertility community.

Virginia Schwager, MEd, PsyD (candidate)
Virginia Schwager, MEd, PsyD (candidate)
My goal as a counselor is to help guide clients towards a better quality of life. I believe everyone has the internal tools to identify, cope, and overcome life obstacles, while maintaining a sense of purpose and hope.

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