For many women, having children later in life is becoming the norm. This trend reflects real societal progress, as women are granted increased access to education, autonomy over reproductive choices, and the freedom to prioritize both personal and professional goals. However, this societal progress has not run parallel to our biological timeline of fertility, resulting in a conflicting and emotionally complex experience for women. Understanding this experience begins by holding two truths at once; Women deserve autonomy over when they become parents, and the emotional impact of infertility is real, complex, and deeply human.
It is no secret that as women age, fertility declines. Research supports that women reach peak fertility in their mid 20s, approach high risk pregnancies in their 30s and are considered infertile by their mid 40s, on average (Jensen et al., 2018). However, further research suggests that, despite biological risks, older mothers often exhibit greater emotional readiness and parenting capacities, creating nuance to an already complex topic. Not to add that many women, despite age, have natural difficulty conceiving and may be unable to conceive entirely. In the United States alone, it is estimated that 14% of women experience fertility challenges independent of age related decline.
Fortunately, medical advances have helped bridge the gap between the uncertainty of conceiving and the hope of childbearing. At the least invasive level, women can start this journey through cycle tracking, ovulation support, or intrauterine insemination (IUI), which works by helping sperm reach the egg more efficiently. Those who need more support often turn to Assisted Reproductive Technologies (ART), which is an umbrella term for medical treatments that help with conception by working with eggs, sperm, or embryos outside of the body. Interventions within ART are those such as In Vitro Fertilization (IVF), a process in which eggs are retrieved from the ovaries, fertilized, and the fertilized embryo is transferred back into the uterus. Additional options consist of egg freezing, retrieval of donor eggs or sperm, and genetic testing.
While these interventions are beneficial medical advancements, they come at a cost - both literally and figuratively. The financial burden of infertility treatment can be extremely overwhelming. While cost varies depending on individual need, less invasive interventions such as intrauterine insemination cost thousands of dollars. For those in need of in vitro fertilization, their expected cost ranges from $15,000 - $30,000 for just one cycle. With many patients requiring multiple cycles to conceive, the cost quickly rises into the tens of thousands of dollars (Shaw, 2024). This high cost paired with lack of insurance coverage for most individuals undergoing this treatment leaves many left with unmet financial burdens.
Fertility treatments can also take a significant physical toll on the body. Procedures like in vitro fertilization often involve daily hormone injections, frequent monitoring, and invasive procedures, which can cause side effects such as abdominal bloating, fatigue, mood swings, and discomfort, leaving many people feeling physically drained. These physical challenges often intertwine with emotional strain, with many studies emphasizing the elevated anxiety, depression, and stress among women undergoing fertility treatments. Research indicates that when assessing individuals undergoing these treatments, 56.5% of individuals test within the clinical ranges for depression, while 75.9% are within the clinical range for anxiety - both numbers well exceeding the general population rates (Pasch et al., 2016). Not to mention the underlying element of shame that most women experience, questioning if something is wrong with them or whether they made the right decisions. Furthermore, studies documenting the experience of those specifically receiving IVF treatment, one of the most common interventions, found the treatment strongly associated with experiences of emotional distress, loss of control, and lower quality of life measures (Moutzouroulia et al., 2025).
The results are striking: we live in a world where personal and professional goals often clash with biological realities. More than ever, support is needed to ease the emotional and physical burden of women navigating the infertility journey. This is where psychological care can play a crucial role. A recent meta-analysis confirms that psychological interventions, including CBT, mind-body practices, and stress management, can reduce infertility-related distress and improve overall well-being (Jackson et al., 2025). More specifically, data supports that Mindfulness Based Stress Reduction (MBSR) therapy specifically targets stress and anxiety within women experiencing infertility, while Mindfulness Based Cognitive Therapy (MBCT) targets depression (Kundarti et al., 2023). By being a tool to help increase awareness, acceptance, and resilience, mindfulness-based interventions can help reduce the emotional distress experienced by many women undergoing infertility treatment while simultaneously enhancing their sense of autonomy.
Self-care and social support are essential components of the journey. Taking intentional time for oneself, whether through exercise, rest, journaling, or mindfulness practices, helps manage stress, regulate emotions, and maintain a sense of personal identity outside of fertility struggles. Equally important is leaning on supportive relationships, whether with partners, friends, family, or peer support groups, as sharing experiences can reduce feelings of isolation and shame. Research consistently shows that individuals with strong social networks and consistent self-care practices report lower levels of anxiety and depression during fertility treatment, highlighting the profound impact that both personal and interpersonal care can have on emotional well-being. For many, these practices work best in tandem with professional therapeutic support, such as counseling or cognitive-behavioral therapy, which can provide additional tools for coping, emotional processing, and building resilience throughout the fertility journey.
So, whether you have experience with infertility, are actively going through treatment, or just planning for the future, know that you are not alone. Having intense and varied emotions during this process is normal, and there are systems in place to help support you through any challenges. Whether it’s through friends, family, or professional support, remember that it’s okay to ask for help and honor your feelings as you navigate this journey.
References
Jackson, P.L., Saunders, P., Mizzi, S. et al. The efficacy of psychological interventions for infertile women: a systematic review and meta-analysis. BMC Women's Health 25, 506 (2025). https://doi.org/10.1186/s12905-025-04054-x
Jensen, R. E., Martins, N., & Parks, M. M. (2018). Public Perception of Female Fertility: Initial Fertility, Peak Fertility, and Age-Related Infertility Among U.S. Adults. Archives of sexual behavior, 47(5), 1507–1516. https://doi.org/10.1007/s10508-018-1197-4
Kundarti, F. I., Titisari, I., Rahayu, D. E., Kiswati, & Jamhariyah (2023). Mindfulness improves the mental health of infertile women: A systematic review. Journal of public health research, 12(3), 22799036231196693. https://doi.org/10.1177/22799036231196693
Moutzouroulia, A., Asimakopoulou, Z., Tzavara, C., Asimakopoulos, K., Adonakis, G., & Kaponis, A. (2025). The impact of infertility on the mental health of women undergoing in vitro fertilization treatment. Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives, 43, 101072. https://doi.org/10.1016/j.srhc.2025.101072
Pasch, L. A., Holley, S. R., Bleil, M. E., Shehab, D., Katz, P. P., & Adler, N. E. (2016). Addressing the needs of fertility treatment patients and their partners: Are they informed of and do they receive mental health services? Fertility and Sterility, 105(1), 209–215.e2. https://doi.org/10.1016/j.fertnstert.2016.03.006
Shaw, M. L. (2024). Cost barriers continue to limit access to fertility care. The American Journal of Managed Care. Retrieved from https://www.ajmc.com/view/cost-barriers-continue-to-limit-access-to-fertility-care