Infertility & Reproductive Psychology

The transition to parenthood can be a joyous time, but it can also be a source of significant stress and anxiety for all parents-to-be involved from conception to the first year of raising a newborn child. Perinatal and postpartum depression and anxiety are serious conditions that affect many individuals. At Mind Body Health, we understand the unique challenges you may be facing and offer specialized mental health services to support your well-being.

Signs and Symptoms:  If you’re experiencing any of the following symptoms, it’s important to seek help:

• Persistent sadness or low mood
• Loss of interest in activities
• Changes in appetite or sleep patterns
• Difficulty concentrating or making decisions
• Feelings of hopelessness or worthlessness  
• Excessive worry or fear
• Panic attacks
• Thoughts of harming yourself or your baby

Interventions: 

• • Navigating the uncertainty and unknowns using CBT & ACT. There can be anxiety that comes with every step of pregnancy and the transition to taking care of a newborn. We’ll focus on staying in the present moment, slowing the mind down and planning when appropriate, focusing on what’s within your control, and working on the acceptance of that which cannot be known or controlled. We’ll help you try to refocus on the joys of the present, unique moment in life rather than let anxiety take over every moment of the experience. 
  • Navigating changes in your body. During pregnancy, labor and delivery, and postpartum, there are incredible changes occurring in the body. This can be difficult for anyone who may have previously or are currently experiencing body image dissatisfaction, disordered eating, or an eating disorder. Given that we specialize in these areas outside of pregnancy, we’re well-equipped to help you with changes in your movement and diet that may need to occur. We can help you navigate and advocate for yourself around any weight-related stigma you may experience by a medical professional. We’ll also help you with insomnia and managing aches and pains, incorporating gentle movement, and addressing nutrition if desired. 

• Exploring Identity & Relationship Changes: The transition to becoming a parent can challenge identity. There can be fear of losing a part of yourself or your marriage/partnership being affected negatively as a new member of the family joins. Using ACT, we can dig deeper to understand what parts of your identity and relationships matter most to you and how you can work to preserve them in new and flexible ways. 

• • Setting Boundaries: Loved ones may be overly excited about a little baby on the way. However, to manage your own well-being, you may need to learn to assert yourself and set boundaries. 

• Managing Work/Life Balance: At some point you may need to return to work and balancing the demands of taking care of a newborn, another child and/or partner, and work responsibilities can be very taxing. We will discuss practical time management strategies, but also dig deeper to understand how you’d like to proactively change your approach to meeting the demands of all of these aspects of your life such that you’re finding time to take care of yourself as well. 

Medication: Medications can be safe and very effective during pregnancy and postpartum. We can help you navigate conversations with your doctor or a psychiatrist to ensure you’re supported during this time.

Pregnancy loss and miscarriage are deeply painful experiences that can leave individuals feeling heartbroken and alone. At Mind Body Health, we understand the profound impact of these events and offer compassionate, specialized support services to help you cope with grief and find healing. 

Interventions:

• • Acknowledging and Processing Your Grief: We will provide a nonjudgemental, validating, safe space for you to fully understand and express all the varied emotions that come with grief. In therapy you will not be told to “be strong.” It’s important to feel your emotions fully and allow yourself the space and time to do so. Of course you may need to still function and carry out day-to-day tasks. We’ll help you navigate the balance there of allowing yourself to feel while still carrying on with your life. 
  • Seeking the Right Social Support: It’s important that you and your partner (if applicable), support each other in the right ways. We have therapists that do couples counseling and can work with couples on how to best support each other through this difficult time. Support can come from friends and families as well, but it’s important to ensure that the support is helpful. We can help you determine who might be best to turn to in your life and how you might be able to educate people on what types of support you need at this time. 

• Taking Care of Yourself: Grief can take a toll on the mind and body. We’ll discuss what self-care can look like during this time to promote physical and emotional well-being. 

Finding Meaning: Using Acceptance & Commitment Therapy (ACT), we will have deeper conversations with you about ways you can honor your loss and finding meaning through it all.

Do you find yourself struggling with premenstrual syndrome (PMS) once a month, a week or two before you get your period? PMS can significantly impact physical and emotional well-being. Our therapists and dietitians can help you manage symptoms, improve your quality of life, and find relief.

Common Symptoms Include: 

• Mood swings
• Irritability
• Fatigue
• Bloating
• Breast tenderness
• Headaches
• Food cravings
• Difficulty concentrating

Interventions: 

• • Symptom Tracking: It can be really helpful to track your symptoms and cycles as a way to increase mindfulness around when you’ll need to take extra measures to take good care of yourself. We can also begin to identify if there are any particular triggers that worsen or improve your symptoms over time. 
  • Lifestyle & Nutrition Counseling: With our nutritionists, you can explore dietary changes that may help alleviate PMS symptom. And with any of our team members, you can begin to examine the role of exercise and sleep in how those two areas of your life can be used to help improve your symptoms. 

• Stress Management: If you struggle with mental health disorders and/or stress, your symptoms may be exacerbated during PMS. In an ongoing way, we’ll help you learn techniques through Cognitive Behavioral Therapy (CBT), Acceptance & Commitment Therapy (ACT), and Dialectical Behavior Therapy (DBT), to manage distressing thoughts, feelings, and emotions. We’ll work on diving deeper to understand where stress can be reduced in your life as a whole to create more room for self-care. Mindfulness meditation and yoga can be strategies we explore as well to help improve your well-being. 

Medication: We can help you navigate having discussions with a medical provider about medications that can really help you manage PMS symptoms.

Premenstrual dysphoric disorder (PMDD) is a more severe form of premenstrual syndrome (PMS) that can significantly impact your daily life.

Common symptoms of PMDD that differ from PMS: 

• More intense mood swings
• Severe irritability
• Feelings of hopelessness or despair
• Social withdrawal
• Strain and discord occurring in relationships
• Extreme Fatigue
• More debilitating physical symptoms: aches and pains that make it difficult to function and get out of bed 

Interventions for PMDD are similar to PMS, but focused a bit more intensely on how to function during these episodes to promote good mental and physical well-being. We’ll discuss medication options as well to discuss with your medical team.

Polycystic ovary syndrome (PCOS) is a complex hormonal disorder that affects many women of reproductive age. While its physical symptoms are well-known, the impact of PCOS on mental health is often overlooked.

The PCOS-Mental Health Connection

Those with PCOS are at a higher risk of experiencing various mental health challenges, including:

• Depression
• Anxiety disorders
• Mood swings
• Low self-esteem
• Body image issues
• Eating disorders

These mental health concerns can stem from hormonal imbalances associated with PCOS, as well as the emotional toll of managing chronic health conditions.

 

Interventions

 

Treating Mental Health Symptoms: Aspects of Cognitive-Behavioral Therapy (CBT) and Acceptance & Commitment Therapy (ACT) can be used effectively in managing the psychological impact PCOS can have on a person. 

Stress management: Mindfulness meditation, yoga, setting boundaries, and self-care will be discussed to manage psychological distress. 

Nutrition: A balanced diet tailored to managing PCOS symptoms can positively impact both physical and mental health symptoms. 

Regular movement: Physical activity can be an important part of mental health and managing hormonal imbalances. 

Medications: In some cases, medication may significantly help the psychological aspects of enduring PCOS and we will guide you through the conversation you might have with a psychiatrist. We can also make referrals for endocrinologists we like to work with who can help you address underlying hormonal imbalances that may contribute to mental health issues.

Infertility can be a deeply challenging experience, affecting not just physical health but also mental and emotional well-being. 

Individuals and couples facing infertility often experience a range of emotions, including:

• Depression
• Anxiety
• Stress
• Grief and loss
• Feelings of inadequacy
• Relationship strain

These feelings are normal responses to the challenges of infertility, but they can significantly impact quality of life and require professional support.

Interventions: 

• • Psychoeducation: Our psychologists who specializes in infertility are well-educated on all of the new interventions that are available to help couples conceive. They’ll understand what stage of the process you’re in and will understand what options are available to you if you’re still hoping to get pregnant. Infertility can be expensive and a difficult process for families to go through emotionally, physically, and financially. We will help discuss all of these factors when determining how to move about this part of your life while also checking in on how you’re doing with other aspects of your life. 

• Treating mental health symptoms using Acceptance & Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), and Dialectical Behavior Therapy (DBT): With infertility can come a great deal of anxiety, depression, insomnia, grief, and stress. Using evidence-based treatments, we’ll help you manage internal distressing thoughts, feelings, and emotions to have a better quality of life while dealing with infertility. 

• Couples Counseling: Infertility can put great strain on a couples’ relationship. Addressing the impact of infertility together can strengthen your bond and improve communication. 

• Stress Reduction, Sleep, Nutrition, and Movement: As you struggle with mental health and infertility concerns, it’s best to try to take care of your body and mind in the best ways possible. We know that the mind can affect the body and vice versa, so we’ll check in with you about how to tend to these parts of your life so that you’re feeling the best you can while facing a very difficult time. 

Remember, seeking help is a sign of strength, not weakness. Mental health professionals can provide the support and tools you need to navigate the emotional challenges of infertility.

While the journey through infertility can be difficult, many individuals and couples find that with proper support, they can develop resilience and maintain hope. Whether your path leads to successful conception, adoption, or choosing to live child-free, prioritizing your mental health is crucial for your overall well-being and future happiness.

Are you contemplating egg freezing as a way to preserve your fertility? This decision can bring up a range of emotions and concerns. Fortunately, there are mental health services available to support you through this journey.

The choice to freeze your eggs is deeply personal and can affect your mental well-being. Common emotions include:

• Anxiety about the procedure
• Stress over financial considerations
• Uncertainty about future family planning
• Pressure from societal expectations

Types of Mental Health Services for Egg Freezing Patients

1. Fertility Counseling:

• Coping strategies for procedure-related stress
• Decision-making support

2. Cognitive Behavioral Therapy (CBT) & Acceptance & Commitment Therapy (ACT): 

• Managing anxiety and negative thought patterns related to body image concerns during hormone treatments
• Managing fear of medical procedures
• Managing worries about future outcomes
• Using mindfulness based approaches, staying in the present moment to reduce stress and anxiety. 

• Provide tools for long-term emotional resilience

Remember, seeking mental health support is a sign of strength. It’s an essential component of self-care during your egg freezing journey. By prioritizing your mental health, you’re taking a holistic approach to fertility preservation and investing in your overall well-being.

When one is unable to conceive, but would like to, third party reproduction often comes into the picture as an option, including egg donation, sperm donation, and surrogacy. While these options can instill hope, it can have it’s own unique emotional and psychological challenges. 

Individuals including those who identify as wanting to be a Single Mother by Choice (SMBC) or Single Father by Choice (SFC) and couples considering or undergoing third-party reproduction may experience a range of emotions, including:

• Grief over the loss of genetic connection
• Anxiety about the process and outcomes
• Fear of societal judgment
• Concerns about disclosure to the child
• Stress related to legal and ethical considerations
• Mixed feelings of hope and uncertainty

Specific mental health considerations for different third-party reproduction methods  can include the following: 

Egg Donation

• Coping with the use of another woman’s genetic material
• Managing feelings about physical resemblance
• Addressing concerns about bonding with the child

Sperm Donation

• Dealing with male factor infertility emotions
• Navigating feelings about genetic lineage
• Addressing societal perceptions of masculinity

Surrogacy

• Managing complex relationships with the surrogate
• Coping with lack of control over the pregnancy
• Addressing fears about bonding with the baby

Interventions: 

We have some highly specialized psychologists on our team who can provide support when navigating third-party reproduction. 

• • General Psychotherapy: When navigating big life decisions like this, you may experience an exacerbation of underlying or existing psychological disorders. We’ll make sure we’re addressing that using Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT) to ensure you’re feeling your best as you go into making a decision around third party reproduction. 
  • Fertility Counseling: Our specialists can help you make informed decisions and process the complex emotions, questions, and anxiety you might have as you consider third party reproduction. 
  • Couples Counseling: For those in relationships, addressing the impact together and strengthen your bond and help ensure good, supportive communication throughout the process. 
  • Family Therapy: This can be particularly helpful when addressing disclosure issues with existing children or extended family members. 

• Addressing Ethical & Legal Consideration:During this process you may need to consult and/or meet with several other professionals including a lawyer who specializes in third party reproduction and a bioethicist or counselor to discuss ethical concerns. We’ll help you go into these meetings prepared by reviewing important questions and considerations to be discussing with them. We’ll also review in this process creating a clear plan for future disclosure to the child and establishing boundaries/expectations with donors or surrogates. 

• Establishing social support: Part of our intervention will be working to ensure you are building a strong support network of friends, family, and professionals. We’ll also discuss how to connect with other families formed through third-party reproduction.  

Addressing long-term considerations: As you raise a child from third party reproduction, we may continue to discuss in therapy feelings that may arise as a child grows and develops, desires to contact donors or surrogates in the future, navigating disclosures to the child and others, and managing your child’s potential questions or emotions about their origins.

Gamete (egg and sperm) and embryo donation are increasingly common paths people take to help individuals and couples facing fertility challenges. Donation can present unique psychological and emotional considerations. 

Mental Health Considerations for Donors

• Coping with the emotional impact of hormonal treatments
• Processing feelings about genetic offspring
• Addressing concerns about future fertility

• Managing emotions about biological children they may never know
• Dealing with societal perceptions of donation
• Considering potential future contact with offspring

• Navigating complex emotions about unused embryos
• Decision-making process for embryo disposition
• Coping with the idea of genetic children being raised by others

• Navigating disclosure to their own future children or partners

Interventions: 

1. Fertility Counseling: Specialized counselors can help both donors and recipients navigate the emotional journey. Therapists can also provide psychoeducation around the ethical and legal considerations that come along with this journey. 
2. Cognitive Behavioral Therapy (CBT): Useful for managing anxiety, depression, and negative thought patterns associated with the donation process.
3. Mindfulness and Stress Reduction Techniques: Can help manage the emotional stress of the donation process.

Seeking social support and connecting with supportive communities. Social support can be incredibly powerful to not feel so alone. Choosing the right groups or people is critical to feeling best supported.

Surrogacy offers a path to parenthood for individuals and couples who cannot carry a pregnancy themselves. While it brings hope and joy, it also presents unique psychological challenges. 

Surrogacy is when an individual carries a child genetically unrelated to her (gestational surrogacy) or uses her own egg and is genetically related to the child (less common). Arrangements can be made such that the surrogate is not compensated beyond medical expenses (altruistic surrogacy) or receives payment for carrying the pregnancy (commercial surrogacy). 

Mental Health Considerations for Intended Parents

• Coping with infertility grief and loss
• Managing anxiety about the surrogacy process
• Navigating complex emotions about another woman carrying their child
• Addressing fears about bonding and attachment
• Dealing with societal attitudes and potential stigma
• Preparing for parenthood in a unique context

Mental Health Considerations for Surrogates

• Processing the emotional impact of carrying a child for someone else
• Managing relationships with intended parents
• Coping with physical and hormonal changes during pregnancy
• Addressing potential attachment issues and preparing for separation after birth
• Navigating relationships with their own family during the process
• Dealing with societal perceptions of surrogacy

Interventions

1. 1. Fertility Counseling: Specialized counselors can help all parties navigate the emotional journey of surrogacy. Topics may include
      • Establishing clear boundaries and expectations
      • Maintaining open and honest communication
      • Navigating complex legal and ethical considerations
      • Considerations around future contact between surrogate and child 
      • Developing strategies for explaining surrogacy to the child
      • Addressing fears and insecurities about the unique path to parenthood
      • Preparing for potential questions from family, friends, and strangers
      • For surrogates, processing emotions around the child they carried
   2. Cognitive Behavioral Therapy (CBT): Useful for managing anxiety, depression, and stress related to the surrogacy process.
   3. Family Therapy: Helpful for addressing family dynamics and preparing for the arrival of the child.
   4. Mindfulness and Stress Reduction Techniques: Can help manage the emotional stress throughout the surrogacy journey.
   5. Postpartum Counseling: Important for both surrogates and intended parents to navigate the transition after birth.

• Social Support: Creating a support network of professionals and peers will be instrumental in the psychological well-being of intended parents and surrogates alike. 

Surrogacy is a complex and emotionally charged journey that requires careful attention to the mental health of all involved. With proper support, education, and resources, intended parents, surrogates, and children born through surrogacy can navigate these challenges successfully.

Oncofertility is a field that bridges oncology and reproductive medicine, focusing on preserving fertility options for cancer patients. This intersection of cancer treatment and fertility preservation presents unique emotional and psychological challenges.

Oncofertility addresses the impact of cancer treatments on fertility and provides options for fertility preservation. Common procedures include:

• Egg freezing
• Sperm banking
• Embryo freezing
• Ovarian tissue cryopreservation
• Testicular tissue cryopreservation

A cancer diagnosis is already emotionally overwhelming. Adding fertility concerns can create additional stress:

• Shock and grief over potential loss of fertility
• Anxiety about making quick decisions regarding fertility preservation
• Fear of delaying cancer treatment to pursue fertility options
• Concerns about the impact of cancer and its treatment on future children
• Relationship strain, especially for couples facing fertility decisions together

• Coping with dual threats to life and fertility
• Managing stress of fertility preservation procedures alongside cancer treatment
• Dealing with uncertainty about future fertility and survival
• Navigating financial stress of cancer treatment and fertility preservation

Interventions

1. Oncofertility Counseling: Specialized counselors can help patients navigate the complex decision-making process by addressing the following: 
   • Decision-making tools and frameworks
   • Allowing time for reflection while balancing urgency of treatment
   • Providing comprehensive information about fertility preservation options
   • Addressing body image and self-esteem concerns
   • Discussing alternative family-building options
   • Managing anxiety about cancer recurrence and its impact on family planning
2. Cognitive Behavioral Therapy (CBT) & Acceptance & Commitment Therapy (ACT): Useful for managing anxiety, depression, and stress related to cancer and fertility concerns.
3. Family Therapy: Helpful for addressing family dynamics and decision-making processes.
4. Mindfulness and Stress Reduction Techniques: Can help manage the emotional stress of cancer treatment and fertility preservation.

Oncofertility presents a unique set of emotional and psychological challenges, intertwining the stress of cancer diagnosis and treatment with concerns about future fertility. With proper support, education, and mental health resources, patients can navigate these complex waters more effectively. It’s crucial to prioritize mental health alongside physical health throughout the oncofertility journey, seeking professional help whenever needed. Remember, it’s normal to experience a wide range of emotions, and support is available at every step of the way. We are here to help.

Adoption is a life-changing experience that creates families through non-biological means. While it can bring immense joy, it also presents unique challenges.

Mental Health Considerations for Adoptees

• Identity formation and integration of adoption story
• Grief and loss related to birth family
• Attachment and bonding challenges
• Coping with feelings of abandonment or rejection
• Navigating cultural identity in transracial adoptions
• Managing societal misconceptions about adoption
• Addressing genetic uncertainty and medical history gaps

Mental Health Considerations for Adoptive Parents

• Processing infertility grief (if applicable)
• Managing expectations versus reality of adoption
• Addressing fears about bonding and attachment
• Navigating the complexities of open adoption relationships
• Coping with societal attitudes towards adoptive families
• Supporting adopted child’s emotional needs and identity formation
• Dealing with adoption-related anxiety and depression

Mental Health Considerations for Birth Parents

• Coping with grief and loss after placement
• Managing ongoing relationships in open adoptions
• Addressing feelings of guilt, shame, or regret
• Navigating identity as a birth parent
• Dealing with societal stigma surrounding placing a child for adoption
• Processing trauma related to circumstances leading to adoption

Interventions

1. Adoption-Competent Therapy: Specialized therapists who understand the unique dynamics of adoption including ethical considerations in adoption such as: 
   • Addressing the complexities of transracial and international adoption
   • Navigating the balance of adoptee’s right to know versus birth parent privacy
   • Understanding the impact of adoption fees and financial considerations on the process 
   • Recognizing and mitigating potential exploitation in adoption practices 
2. Attachment-Focused Therapy: Particularly beneficial for addressing bonding issues in adopted children.
3. Cognitive Behavioral Therapy (CBT): Useful for managing anxiety, depression, and negative thought patterns related to adoption.
4. Family Therapy: Helpful for addressing adoption-related family dynamics and communication along with navigating relationships and potential reunions with birth families. 
5. Identity Formation: Supporting adoptees in exploring their adoption story, facilitating connections to birth culture in transracial adoptions, helping adoptees integrate their dual identities, and addressing adoption themes in different life stages (e.g. becoming a parent). 
6. Grief and Loss Therapy

• Recognizing and validating adoption-related losses for all triad members
• Providing space and support for processing grief
• Understanding that grief in adoption can be lifelong and cyclical

Adoption is a complex and lifelong journey that presents unique mental health challenges and opportunities for growth. With proper support, education, and resources, members of the adoption process can navigate these challenges successfully.