For some, family-building involves fertility treatment, which can be overwhelming, disruptive, and very stressful. It makes perfect sense that many of those who are undergoing fertility treatment need a higher level of support while they make life-altering decisions, deal with complicated grief, and have every facet of their lives – financial, relationships, professional, and physical health – affected. Most people who need fertility treatments to create or expand their family are otherwise very healthy and thus have never had to navigate the ins and outs of the healthcare system and their insurance coverage. It’s a lot. And it’s ok if you need help. Your clinic may also require a visit with a behavioral health specialist if your plan includes a donor or gestational carrier.
I’m the SVP of Provider and Member Services at Progyny, overseeing the Patient Care Advocates (PCAs) who provide ongoing and dedicated emotional support to our members and I’m also a licensed clinical social worker. I’ve facilitated support groups for fertility patients and offered one-on-one support for patients at a fertility clinic in New York. I do have a bit of experience and have a lot of conversations with friends and family and friends of friends about their fertility journey and I always recommend finding a really good support network outside of your normal support network. Why? Because, again, it’s a lot. And while you may feel comfortable talking to loved ones about your struggles, and while infertility is common, it’s sometimes challenging to find someone who understands, and it can be difficult to share intimate parts of your life, even with loved ones. Also, once you disclose you can’t undisclose, and that can sometimes mean well-intended but unsolicited and unhelpful advice. My colleague, friend, fellow fertility therapist, and stress expert, Dr. Georgia Witkin calls this the, “Aunt Fanny effect.” Aunt Fanny may be trying to be helpful when she tells you to ‘just relax’ or when she constantly asks how your treatment is going, but for many, that only adds to the struggle.
So, we’ve established that most if not all may seek additional support, let’s talk about how.
Here are 3 tips on how to start this process:
- Check your resources – If you have Progyny, you have access to a PCA who can provide emotional and logistical support, connect you with a Clinical Education Advocate, and can help you navigate behavioral health resources through your insurance. Most employers cover behavioral health for several sessions. Check your carrier’s network and see which therapists on the list identify themselves as a fertility/infertility specialist. You can also use directories, like Psychology Today, which allows you to choose a therapist by specialty, location, and participation in insurance. Even if insurance isn’t accepted, you can often get reimbursed out of network for your sessions.
- Talk to your clinic and support network – Most clinics will have a list of referrals for individuals or couples counseling as well as support groups. This is helpful because these lists are already curated to include fertility experts. Many LGBTQ Community Centers, like The Center in NYC have programs and resources designed to meet the unique needs of those in the LGBTQ community who are on a family building journey.
- Explore the fertility community – The good news about fertility is that there is a wonderful community out there with so many lovely resources to help people find their way to support. Resolve is a large non-profit that focuses on support for those building their family through fertility or adoption. They have a list of behavioral health specialists and also offer support groups based on location. Support groups are a great way to build a network of others going through a similar journey. The American Society for Reproductive Medicine (ASRM), the governing body of fertility specialists, has a practice group for Mental Health Professionals and has a directory to find therapists who specialize in fertility. Social media has made it easier to connect as well. There are some great Facebook groups, and many fertility clinics and therapists have a social media presence.
Here are 3 questions to consider when finding the right person:
- Does this person have a specialty in fertility/infertility? – Make sure their expertise matches your presenting issue. My friend told me once how she was struggling with acute post-partum anxiety and got matched with a therapist who was an expert in gambling addiction. Not super helpful, and certainly not someone who may have been best suited to help her. If you’re sitting down to discuss your journey, it doesn’t make sense that you’d need to provide education to your therapist on the difference between IVF and IUI or a known or anonymous sperm donor.
- Do you feel comfortable with the therapist? – Speaking as a therapist, I can say that most if not all therapists are able to speak to anyone, no matter their lived experience. However, it’s also true that most patients feel most comfortable speaking to someone who is of their culture or religion, shares their primary language, or has similar lived experiences. For instance, a Black woman may feel most comfortable seeking out a Black female therapist and that’s ok. Similarly, a same-sex male couple who is discussing choosing an egg donor and feeling overwhelmed, may feel most comfortable speaking with a therapist who also identifies as gay. Don’t be afraid to search and even ‘interview’ a few therapists to find the right fit. Be patient and be persistent in finding someone who meets your needs. It’s your time, it’s your journey, and you should feel affirmed, welcomed, and understood. If the therapist doesn’t meet your needs, it can be a dealbreaker.
- What is the therapist’s accreditation? – Make sure that your therapist is a licensed mental health professional. There are a few different options – PhD, PsyD, LCSW/LMSW, or LMFT – but be sure they’re licensed and have experience. You can find accredited centers like, Ackerman Institute for the Family in NY or similar centers in your town.
Many people are reticent to see a therapist and of course there is a stigma around accessing mental health care. However, fertility is one of the more stressful experiences that many of us will endure and that’s only amplified by the stigma that surrounds fertility. So many don’t talk about their experience because of that stigma, and that leads to isolation, which only increases your levels of stress. Don’t feel ashamed about needing to speak to someone – asking for help is brave and means you’re strong and tuned in to what you need. A therapist is a trained and unbiased person who can help you manage this complex journey and that’s always a good idea.
Don’t hesitate to reach out to your PCA to ask questions. We also have a PCA who is an LMSW and can assist with your search. If you are currently in crisis and in need of emergency assistance, please dial 911. If you need help right now you can also text HOME to 741741 to reach the Crisis Text Line.