When to Seek a Specialized (In)Fertility Therapist
There are so many benefits to the world of psychotherapy becoming more specialized. Clients are more aware than ever of their ability to find a provider who is uniquely trained to address their particular concerns. A decade ago, you typically saw a generalist, no matter your concerns. Now, you can find a therapist specialized in grief therapy for single mothers ages 35-45 who have experienced a stillbirth during a second pregnancy. It truly feels that specific sometimes.
There are benefits to this level of specialization and the training that often accompanies it. However, there are sometimes drawbacks to the heightened awareness in the client population toward specificity. With social media presenting an abundance of therapeutic information on anything and everything related to your particular concerns, there are more clients seeking out specialized services that may not actually be appropriate for their needs.
I see this often in my specialization of reproductive mental health. Particularly in my work with clients experiencing (in)fertility, I’m noticing clients coming to me who don’t actually have infertility and would be better served by a generalist. You may be asking, “What’s the harm in them seeing a specialist even if they don’t have infertility but are generally concerned about their reproductive health?” Hear me out…
If you have a migraine, that’s an unfortunate event that is going to be painful. It doesn’t, however, indicate the need for a neurosurgeon. If you go to a neurosurgeon after a migraine, they may actually under empathize with your concern. They are trained to do brain surgery on people with complex neurological conditions and managing your migraine is not the best use of their skillset. Your family physician can effectively manage your migraines and may even feel more empathic toward your pain, given that they aren’t seeing people with brain tumors and neurodegenerative disorders every day.
When social media and the internet generally tells you that your condition could indicate anything from a hiccup to a major medical event, it’s hard to determine what kind of support to get. That’s confusing!
When we interpret this from an infertility standpoint, it’s helpful to know what can be supported better with your regular therapist and what needs specialized therapeutic intervention. Here are a few examples of experiences that do and don’t generally necessitate specialized therapeutic care in the population assigned female at birth:
Fertility Specific Therapy Not Generally Indicated:
2 or fewer miscarriages under the age of 35 (miscarriage, while devastating, is often a natural form of genetic screening and not always disordered)
Chemical pregnancy
An elective 1st trimester abortion
Trying to get pregnant for less than a year under the age of 35
An ectopic pregnancy that resolves with medication and no surgical intervention
PCOS that has not yet indicated problems with conception with under a year of trying
Uterine polyps or fibroids that don’t indicate surgical removal
Mild endometriosis
Irregular menstrual cycles
Hoshimoto’s
Over 35 and trying for under 6 months
Elective fertility treatments
Fertility Specific Therapy Definitely Indicated:
Experiencing a TFMR, Fetal Demise, or Stillbirth
Experiencing recurrent miscarriages (3 or more)
Having surgical intervention that disrupted your reproductive organs
Significant endometriosis or adenomyosis, even if not directly tied to infertility, can cause significant distress that needs specialized attention
Tubal or uterine abnormalities that have been diagnosed as infertility causes (Asherman’s, septate uterus, etc.)
Genetic factors causing fertility concerns, such as Fragile X, Turner Syndrome, or structural birth defects
Translocations
Fertility concerns after cancer treatment
Advanced reproductive age (35+) with 6 months of trying
Ovulatory disorders with 6-12 months of trying, depending on age
These lists are not comprehensive but rather suggestive to help you identify who is the most appropriate provider for your care. There is no reproductive concern that is invalid. They are all important and often painful, all appropriate for therapeutic care. Who you seek for that care just differs depending on the particularities of your concerns.
If you are seeking care and are unsure of what resource is most appropriate for you, I’d be happy to consult with you and provide a recommendation. You can reach me here.
Wishing you well!
Rachael Alba