How does mindfulness help with infertility and IVF anxiety?

Mindfulness and mind body programs reduce anxiety and depression during infertility treatment, improve resilience and self-efficacy, and some studies report higher pregnancy rates when participants complete multiple sessions.

Over the past 15 years, our clinic has had many anxious individuals, primarily women, contact us stating “I need support during my infertility treatment”. Callers usually report a variety of circumstances ranging from their first in vitro fertilization (IVF) procedure to their 11th—with a variety of complicating factors such as secondary infertility due to male factors, history of childhood sexual abuse, poor sexual health in their relationship due to “timed intercourse,” and LGBTQ couples facing complex legal and reproductive decisions. One common factor in all of these individuals is their palpable anxiety and fear.

Infertility is complex and its prevalence rates increase as both women and men age, but more significantly for women. Women under 30 years of age have infertility rates between 7-10% and until age 44, rates range from 25-30%, after which time natural conception is unlikely. After age 40–45, for men there is a slight increase in the time it takes to conceive and a higher risk of negative reproductive outcomes. Overall, male infertility contributes to approximately 30–40% of infertility cases.

While in many instances individuals are able to identify the cause of infertility, the American Society for Reproductive Medicine (ASRM) estimates that around 25-30% of infertility cases have unknown causes or go unexplained. Research has shown that unexplained infertility in women is significantly linked to anxiety and depression, and increases the risk of failed assisted reproductive technology (ART). It is important to monitor emotional distress in women of reproductive age, particularly those who have unexplained infertility.

The Impacts Anxiety and Depression in Women: Mind-Body Interactions

Generally, women undergoing infertility treatment often face negative experiences such as stress, distress, anxiety, depression, and uncertainty. The ability to tolerate distress and manage the uncertainties throughout treatment is vital for achieving successful fertility outcomes. Research has shown an interesting relationship between age and intolerance of uncertainty, with intolerance increasing as women grow older. Since infertility treatment is inherently challenging, exhausting, stressful, and unpredictable, couples, particularly women, often experience elevated levels of "uncertainty." Another factor in supporting women undergoing infertility treatment is that as women age and are unable to conceive, their intolerance toward the uncertain process worsens with each subsequent treatment attempt. Fortunately, developing tolerance can be achieved through counseling.

Anxiety and depression are significantly more common in women undergoing infertility treatment compared to women who can conceive and have a successful pregnancy. Additionally, women undergoing infertility treatment who do not achieve pregnancy experience higher levels of anxiety and depressive symptoms than those who do become pregnant. Research has shown that both women treated for infertility and those without infertility, cortisol levels, both during and after ovulation, show a positive correlation with the severity of anxiety and depression. Emotional distress negatively affects the secretion of hormones crucial for the sex cycle and healthy growth of the endometrial lining. Here we see the dynamic interaction of how one’s psychological state can impact the way the body functions. Women and couples facing reproductive difficulties benefit from psychological support and counseling, which could enhance the effectiveness of infertility treatments. Often, when a woman is aware that there are ways to support her psychological health and reduce stress, anxiety, and depression, it provides a greater sense of control and self-efficacy during a process where there is little control.

The actual incidence of 25% of women experience anxiety while 32% of women experience depression during infertility treatments. Some interesting risk factors of anxiety and depression are:

For Anxiety:

Education Level: Women with a junior college degree or higher had a 1.6 times increased odds of experiencing anxiety.
Somatic Symptoms: Severe somatic symptoms significantly increased the odds of anxiety by 15.2 times.
Sleep Quality: Poor sleep quality was associated with a 9.3 times higher odds of anxiety.

For Depression:

Age: Women over 35 years old were more prone to depression.
Somatic Symptoms: Moderate and severe somatic symptoms were independent risk factors for depression.
Sleep Quality: Poor sleep quality was also a risk factor for depression.

Infertility Counseling For Men? Most Certainly.

Research on men's experiences with infertility is limited, and even fewer studies have investigated the specific information and support men seek after a male-factor infertility diagnosis. Men have reported feeling that their information and support needs regarding male infertility went largely unmet, including:

Ultimate threat to masculinity: This highlights the profound emotional impact of the diagnosis.
Holistic care: Men expressed a desire for comprehensive support that addresses all aspects of their well-being.
The power of words: This emphasizes the importance of sensitive and empowering language from healthcare providers.

A diagnosis of male-factor infertility can be deeply impactful and challenging to navigate. To improve men's experiences during assisted reproductive technology, it is essential to provide comprehensive and holistic information, acknowledge emotional effects, proactively offer support, and use sensitive language.

Infertility Counseling: Where To Start

Infertility counseling must include both psychoeducation and providing valuable resources to navigate the journey. It also involves addressing anxiety, depression, and developing stress tolerance and resilience to improve both mental health and fertility outcomes.

Mindfulness-based interventions have been shown to effectively reduce symptoms of depression and anxiety, as well as improve health-related quality of life in women experiencing infertility. Randomized clinical trials—the gold standard in clinical research—have also indicated that mind-body interventions are effective in reducing anxiety and depression in infertile women, and may also improve pregnancy rates. The mechanisms of mindfulness approaches have been found to successfully alleviate depressive symptoms in women experiencing infertility by boosting their self-efficacy. Therefore, fostering self-efficacy in the context of infertility appears to be a crucial element of psychological interventions aimed at addressing depression.

One of the programs our clinic recommends is Circle + Bloom.This comprehensive mindfulness meditation program offers unique meditations for each stage of the IVF process that aims to release negative thoughts, feelings, and body sensations, and help individuals to accept the impact of, at times painful, medical procedures on the body.

A Special Note From Kimberly:

“It’s not often that therapists self-disclose because in my clinical experience it dilutes the power of psychotherapy. However, I’ve been open about being a single mother by choice and going through IFV treatments to have beautiful twins in 2016. I often share this experience as appropriate with women I counsel for infertility counseling, and offer resources that I found helpful in my own journey. Personally, I look at infertility treatments as a marathon, which requires tremendous psychological and emotional stamina to go the long haul. The process is inherently stressful and existential in nature—it can feel like one of the biggest threats to your existence and a source of fear about losing one of your greatest dreams of becoming a mother. Taking care of yourself, nurturing your body, and practicing self-love through kind self-talk and self-care are essential for improving coping and distress tolerance and building resilience. You can do this!”

To learn more about infertility counseling or how to support your relationship health during infertility, please contact Kimberly Keiser and Associates today.

Being In Your Body: Mindful Sexuality

Kimberly Keiser has also developed a course on her educational platform, MendEd, that covers some of the basic premises of mindfulness, and also how to apply them specifically to sexuality, sexual functioning, and sexual dysfunctions.

Explore the Mindfulness Course