Health & Fitness

Few discuss the emotional toll of struggling to conceive a child

An individual, or couple, may dream of having a child their entire adult life. For many, this can be a challenging journey. The reasons that some individuals or couples struggle with conceiving may be many factors.

The CDC reports that nearly 7.3 million women in the United States between the ages of 15-44 years have used infertility services. More than 12 percent of women between these ages report difficulties carrying a pregnancy to term or becoming pregnant; that’s approximately 1 out of 8 women living in America.

There are several reasons for infertility. These can include reasons related to the man, the woman, or both.

The good news is that there are more people seeking treatment for challenges with fertility. The reasons are many and include awareness, greater access to care, and advances in medical technologies.

While fertility challenges are relatively common, the emotional toll that accompanies unsuccessful attempts to conceive, or miscarriage, is often not discussed. Research studies have shown that couples suffering from infertility may have higher rates of depression and anxiety. Research also suggests that failed in vitro fertilization (IVF) cycles may affect a woman’s self-esteem and further exacerbate depression.

Dr. Samantha Saltz is a PGY-5 (5th-year post-graduate resident) at the University of Miami Miller School of Medicine Department of Psychiatry and Behavioral Sciences.

For all these reasons, and more, a fertility center often becomes a second home to those in treatment. The center takes that emotional journey with their patients.

It is not uncommon for a woman in fertility treatment to attend an appointment at her fertility center every two to three days. Juggling work, personal lives, families, and often times other children, may make this journey feel like an endless uphill climb. It can be too much to bear; it can make the strongest of us break. This makes it important to be willing to seek mental health treatment early on.

There is sometimes a misconception that women who are trying to conceive shouldn’t see a psychiatrist out of fear of being prescribed medications that could interfere with pregnancy. But an evaluation by a mental health professional does not necessarily mean that you will be prescribed medication — medication is not always indicated. Risks and benefits need to be weighed to determine whether medication is indicated. Ultimately, this decision involves the patient, the patient’s significant other, the psychiatrist, and the fertility team.

Non-pharmacologic treatments are also available to those trying to conceive. Data has shown that many women may benefit from regular support groups and sharing their experiences with other people. Alternative treatments like acupuncture may be recommended. We also recommend techniques like mindfulness, breathing exercises and other relaxation techniques.

When a woman is unable to carry a child, adoption is an option. There is also a possibility that a couple can utilize a surrogate, or gestational host, to help carry the baby. This is a great option for gay men, as well.

According to Dr. Michael Jacobs, “A gestational host is a third party for reproduction that has no biological relationship with the egg or sperm used to carry the pregnancy.” Surrogates are sometimes family members or friends of those trying to conceive. Other times, the surrogate is a person who is paired up with a couple or individual through an agency who specializes in finding surrogates for families.

Finding the person who will be a surrogate can also be a stress-provoking experience for an individual or couple. There are many factors that need to be considered when choosing a surrogate. For example, it’s important that those trying to conceive consider the kind of relationship they want with the surrogate during and after a pregnancy, as well as their personal and religious beliefs regarding pregnancy, multiple births and abortion. Discussing this with a therapist or support group may be helpful for some couples.

While the psychological consequences of infertility can be challenging, the dream of having a child often motivates families to push forward with fertility treatments or to pursue adoption. We encourage those trying to conceive to make regular appointments with their reproductive endocrinologists, primary care physicians, therapists, psychiatrists and specialists. Families should also commit to a lifestyle involving good nutrition and healthy levels of exercise. Whether a family has a child naturally, with the assistance of reproductive technology, or through adoption, every child is a miracle. By taking a proactive approach to treating the mental and physical symptoms of infertility, the sometimes-challenging journey to reaching that miracle will be that much easier.

If you are struggling with mental health challenges secondary to infertility, call 305-243-6400 to schedule an appointment with a mental health specialist. The University of Miami Health System offers a clinic specifically dedicated to women’s health.

Dr. Samantha Saltz is a PGY-5 (5th-year postgraduate resident) at the University of Miami Miller School of Medicine Department of Psychiatry and Behavioral Sciences. For more information, visit or call 305-355-9028.