For some patients, trying to get pregnant can be a stressful and emotionally difficult process. Feeling overwhelmed can be a common reaction to the stress of fertility testing and treatment.

Is stress causing my difficulty getting pregnant?

In studies looking at the relationship between stress and fertility, it is difficult to know which comes first – is the stress affecting fertility, or is fertility causing stress, or both? There is not enough research at this time to definitively say that stress causes infertility or pregnancy loss, and the data do not suggest that you need to be stressed about being stressed!

Are my psychiatric medications okay to continue?

If you are already on psychiatric medications such as antidepressants or anti-anxiety medications, it is important to let your mental health provider know that you are trying to get pregnant. In general, it is recommended that you stay on your medications while trying to get pregnant and throughout pregnancy if those medications are helpful for you. Some specific medications may be stopped when planning for pregnancy due to increases risk of birth defects or pregnancy complications, but it is important to remember that stopping psychiatric medications may lead to other complications such as recurrence or worsening of the mental health condition. The benefits of continuing common medications such as selective serotonin reuptake inhibitors (SSRIs) are thought to outweigh the risks in most cases, but an individualized decision should be made by you and your mental health and fertility providers.

How do I know if I could benefit from counseling?

If you experience any of the following symptoms for several weeks or more, you may benefit from psychological counseling:

  • Feeling down
  • Feeling anxious
  • Changes in appetite (eating more or less)
  • Changes in sleep (for example, insomnia or needing more sleep than usual)
  • Increase in alcohol or drug use
  • Feelings of guilt or worthlessness
  • Difficulty concentrating or focusing
  • Strain in interpersonal relationships

How should I ask for help if I need mental health assistance during this process?

We have two psychologists, Dr. Boxer and Dr. Sortor, who work specifically with infertility patients in our practice. They can be helpful resources to start the conversation about your mental health throughout this process and may refer you to therapists or psychiatrists they feel would be helpful for you. If you think you would benefit from mental health services, please do not hesitate to let your doctor know – we are always happy to facilitate appointments with our psychologists or other mental health providers.

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