So Many Unknowns! Uncertainty Compounds an Already Stressful Journey: Mental Health Resources for Fertility Patients during the COVID-19 Pandemic

(updated Sept 12, 2020)

Not surprisingly, many fertility patients report that the uncertainty surrounding starting or continuing fertility treatment is a significant stressor during the COVID-19 pandemic. Learning to cope with uncertainty has always been a central challenge for fertility patients. Now, the uncertainty of treatment success is compounded by all of the uncertainties created by the pandemic. Specifically, patients worry about the impact of stress on cycle success and about the wisdom of becoming pregnant given the risk of exposure to the virus. 

Many fertility patients are goal-oriented planners who like a roadmap and a timeline. Attempts to plan for the future which are thwarted by uncertainty may create feelings such as helplessness, anxiety, and anger. Our mental health colleagues suggest that SART member practices can use two strategies to assist patients in managing the uncertainty of the current treatment hiatus.

First, we can give patients good data. We can share the research demonstrating that stress does not worsen outcomes for fertility patients.  Essentially, infertility and its medical treatment cause stress, but stress does not cause infertility.  If women had to be serene and happy in order to become pregnant, fertility centers would have very low success rates!  We also can give accurate data about risk of COVID-19 exposure for pregnant women and babies and educate about how our center provides early pregnancy follow-up care.  Being well-informed about the science can help alleviate anxiety.

Second, we can highlight the importance of focusing on the present rather than the future. We can help develop a plan for the next treatment step. We can help patients notice when they get caught up in attempts to control the future and shift focus back to the present moment. One metaphor that resonates with many fertility patients is “The What If Tree”. Focusing on the present moment is like being on the trunk of the tree, where circumstances feel more manageable and grounded. Imagining multiple future scenarios which divide endlessly is like climbing out onto the spindly branches of the tree. Not only is their more “wind”, more opportunity to feel anxious when high up in the tree, but as soon as life moves in one direction (and not the other), all of time spent detailing that portion of the tree becomes wasted. Centering oneself in the present is a learned skill that improves with practice. Making the present moment as reassuring and comfortable as possible takes some thought. If patients are out of ideas or low in motivation, encourage them to reach out to mental health professionals with fertility expertise for support. Teletherapy has made accessing expert support easier than ever.

During this pandemic, many SART member clinics have strengthened their ties to qualified local mental health professionals who are skilled at helping care for patients’ emotional and psychological needs. The increased collaboration between fertility centers and mental health providers will benefit fertility patients not only now, but also long after the COVID-19 pandemic is over.
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National statistics from SART member clinics that reported their data through SART.