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Fertility

Heidi Cox

What is Fertility?

Fertility is a term that refers to the ability to conceive children. Issues around fertility can feel highly distressing and shameful, even though they are not anyone’s fault and can be experienced by anyone. There are many reasons why one may have issues with fertility, including biological abnormalities, genetic conditions, hormones, and factors like age, smoking, and even some medical conditions. Fertility can be a reason that brings individuals and couples to seek therapy, especially as it pertains to decisions about whether or not to try to conceive, trouble conceiving, and whether or not one wants to conceive.

How Can Fertility Affect Your Mental Health?

Concerns with fertility often arise pertaining to age, in part because fertility does not begin until puberty, and begins to decline at a certain point for both sexes, although typically earlier for females. Concerns may also arise when one person’s fertility is at odds with their desire to conceive, and/or when there are differences with the desire to conceive within a couple.

Infertility, on the other hand, is defined as the failure to establish a pregnancy after 12 months of regular and unprotected sexual intercourse. According to the CDC, infertility affects 1 in 5 couples in the U.S. Again, infertility can feel embarrassing or shameful, even though it is nobody’s fault and there are many treatments and options to consider if you are experiencing infertility.

Fertility is affected by anxiety and stress in both males and females. Anxiety and depression have been found to be linked to infertility and can interfere with how long it takes to become pregnant. Therefore, mental health issues are linked to fertility and the interplay between mental health and fertility is an important area to reflect on, to see whether or not you might be in need of mental health support around any concerns in this area.

Additionally, the very awareness of fertility, infertility and the related stress of discussing difficulties that may arise can lead to intense anxiety and depression. Although there is no proven link that anxiety causes infertility, we see that the opposite is very true: infertility and difficulty with fertility are likely to cause anxiety, depression, and stress. Therefore, there is a great need to have awareness of these relationships and that there are treatments that can help adjust to the stress and manage anxiety and depression.

Coping with Fertility Issues

Therapy is available if you would like to talk about issues dealing with fertility and infertility. You should seek out a therapist who is trained in reproductive issues so that they are aware of the research and information that will help you be able to help you explore, understand, and change.

A reproductive therapist will likely start off by helping you process your current and past experiences with fertility. Understanding your past experiences may help you and your therapist understand what meaning you may have made from these past experiences. Then, your treatment will focus on helping you with negative thoughts you might have about yourself, or how to cope with a challenging situation, or perhaps bring hope or acceptance to you, in a way that feels supportive.

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About the Author

Dr. Heidi Cox is a licensed clinical psychologist and the founder of The Centered Space Psychology. She uses a warm, collaborative approach to therapy which holistically integrates evidence-based practices into dynamic work. She helps people be inspired to change, to grow in understanding, and heal from emotional suffering.


Dr. Cox specializes in working with women’s mental health issues, including postpartum anxiety and depression, reproductive issues, and loss. In addition, she works with anxiety, mood disorders, life transitions and relationship issues. She is HAES and LGBTQ+ allied. If you'd like to work with Dr. Cox, you can visit her MyWellbeing profile or contact her directly through her website.