Your ADHD Brain Isn’t Giving Up on IVF. It’s Running Out of Fuel

Why stepping back from fertility treatment isn’t a willpower problem — and what actually helps.

By Liz Bancroft, Clinical & Counselling Psychologist | Bancroft Psychology

Have you started an IVF cycle full of hope, only to find yourself quietly fading from treatment a few cycles in — not because of a crisis, but because you just couldn’t keep going?

Maybe you’ve told yourself you weren’t strong enough. That other people push through. That you gave up.

If you have ADHD, here’s what I want you to know: you didn’t give up. Your brain ran out of the neurological fuel it needs to keep going toward something that keeps not arriving.

This is one of the most misunderstood patterns I see in my work supporting Autistic and ADHD people through fertility treatment. And the science gives us a really clear explanation for why it happens.

First: stepping back from IVF is more common than you think

A major 2025 review of over 330,000 fertility patients across 20 countries found that more than 1 in 3 people stop treatment before completing their planned course (Shen et al., 2025).

That’s not a niche statistic. That’s a widespread human experience. And yet when it happens to us, most of us assume it’s a personal failure.

For people with ADHD specifically, the reasons behind stepping back are often neurobiological — not emotional, not motivational, and definitely not about how much you want a baby.

What’s actually happening in your brain

Three well-established bodies of research help explain the ADHD experience of IVF. I’ll keep this simple.

Your brain runs on ‘Now’ and ‘Not Now’

Researcher Russell Barkley has spent decades showing that ADHD isn’t really an attention disorder — it’s a time disorder (Barkley, 1997; Barkley & Benton, 2024).

The ADHD brain divides time into two categories: NOW and NOT NOW. The future doesn’t feel real until it’s right in front of you. This makes it genuinely hard to keep motivating yourself toward something that is uncertain, far away, and keeps resetting.

IVF is the ultimate test of this. Every failed cycle feels like the future disappears again. And the brain has to somehow find the fuel to start all over.

This isn’t a character flaw. Barkley describes ADHD as “not a disorder of knowing what to do — but of doing what you know.” You know you want this. Your brain’s wiring makes sustaining the effort harder than it is for someone without ADHD.

Restarting is harder than starting

Researcher Thomas Brown identified that one of the core challenges of ADHD is activation — the ability to organise yourself and begin. It’s not laziness. It’s a genuine difficulty firing up the brain’s management system.

Every new IVF cycle isn’t just emotionally hard. It requires executive re-activation: new appointments, new injections, new protocols, a whole new round of hope and dread. For someone without ADHD, this re-starts more automatically. For someone with ADHD, it’s a major cognitive lift — every single time.

Your reward system needs a different kind of signal

Researcher Nora Volkow used brain imaging to show that people with ADHD have reduced dopamine activity in the brain’s reward and motivation pathways (Volkow et al., as cited in Brookhaven National Laboratory, 2009).

Dopamine is the chemical that keeps you going toward a goal. It fires when you anticipate a reward. But IVF is a reward that may never come — and even when it does, you don’t know when. For the ADHD brain, which already has a quieter dopamine signal, this kind of prolonged uncertainty is especially depleting.

This is also why hyperfocus exists: the ADHD brain can sustain enormous effort when the reward is immediate and guaranteed. The problem isn’t effort. The problem is the type of reward signal that effort requires.

So what does this mean for you?

It means stepping back from IVF — especially without a crisis or obvious breaking point — may not be about your distress level at all. It may be about your brain’s capacity to keep re-mobilising toward something that keeps not arriving.

It means the question isn’t “why couldn’t I keep going?”

The real question is: “was my care designed to work with my brain — or despite it?”

What actually helps: practical strategies for ADHD and IVF

This is the part that matters most. Understanding the neuroscience is validating. But what can you actually do differently?

These strategies are drawn from what the research tells us about supporting ADHD brains through sustained, uncertain effort — applied to the specific context of fertility treatment.

Create smaller reward loops

IVF’s ‘reward’ (a baby) is too far away for the ADHD brain to use as daily fuel.

Break the journey into short-term markers that feel meaningful: completing your injections this week, turning up to the scan, getting through the two-week wait.

Celebrate those wins explicitly — not as a workaround, but as neurobiologically necessary scaffolding.

Try: a visible cycle tracker on your wall, a small reward ritual after each milestone, or a weekly reflection on what you actually did (not just what happened).

Externalise everything

The ADHD brain struggles to hold future plans internally. So stop trying to hold them internally.

Put your entire treatment calendar somewhere visual and physical — not just in your phone.

Set alarms not just for appointments, but for the day before and the morning of.

Ask your clinic to send proactive reminders rather than expecting you to initiate contact between cycles.

Tell your partner or support person: “I may need you to remind me to re-engage, not because I don’t care but because my brain loses its grip on things that feel far away.”

Plan your re-entry before you need it

The hardest moment is the one right after a failed cycle — when you have to decide whether to try again.

Don’t make that decision in the immediate aftermath. Pre-decide before the cycle what your process will be.

Write down: “After a negative result, I will wait [X] days before making any decisions. I will talk to [person]. I will do [one small thing that helps].”

This removes the activation burden from the most depleted moment.

Ask your clinic for proactive check-ins

Standard fertility clinic care assumes patients will self-initiate between cycles. For ADHD brains, this is a structural barrier.

You are entitled to ask for: a scheduled check-in call between cycles, a named contact person rather than a general line, and written summaries of your treatment plan after appointments.

If your clinic offers psychological support, flag your ADHD at the start — not because you need more help, but so your support can be structured in a way that works with your brain.

Name it with your treatment team

You don’t have to explain the neuroscience. You can simply say:

“I have ADHD and I find it hard to re-engage after setbacks. I do better with proactive contact and clear structure.”

That’s enough. A good clinic will adapt. And if they don’t, that’s information too.

Get support that understands neurodivergence

Generic fertility counselling may not address what’s actually happening for you.

Look for a psychologist who is neurodivergent-affirming and understands both ADHD and the specific demands of fertility treatment.

The Hope Affirm Thrive program at Bancroft Psychology was designed exactly for this intersection — supporting neurodivergent people through IVF with strategies that fit how your brain actually works.

A note for fertility clinicians and counsellors

If you work in fertility care, you have almost certainly seen patients quietly disengage without an obvious crisis or high distress score. This blog is for you too.

Research on ADHD and motivational persistence consistently shows that deficits in intrinsic motivation and reward sensitivity specifically limit sustained effort on tasks with delayed, uncertain outcomes (Afshadi et al., 2023; Gabrieli-Seri et al., 2022). IVF is the definition of a delayed, uncertain outcome.

Pilot data from the Hope Affirm Thrive program found that 87.5–90% of self-identified neurotypical IVF patients showed elevated neurodivergent traits on screening. This is not a niche population. Neurodivergent-aware care is simply better fertility care.

Small structural adjustments — proactive contact between cycles, written summaries, named contact people, shorter feedback loops — make a meaningful difference. Not just for ADHD patients. For everyone.

You’re not weak. You’re not a quitter.

People with ADHD are among the most resilient people I work with. You have spent years navigating a world that wasn’t designed for your brain.

IVF wasn’t designed for your brain either. But with the right structure and support, it can be made to work with it.

If any of this resonates and you’d like support that actually fits how you’re wired, I’d love to hear from you.

Want support that works with your ADHD brain?

Bancroft Psychology offers neurodivergent-affirming fertility psychology in Perth, Western Australia. The Hope Affirm Thrive program was created specifically for neurodivergent people navigating IVF.

Visit hopeaffirmthrive.com.au to find out more or make an enquiry.

About the author:Dr. Liz Bancroft is a Clinical & Counselling Psychologist, EMDR-Accredited Practitioner, and founder of Bancroft Psychology in Perth, WA. She is a late-identified autistic woman with lived experience of a 13-year fertility journey and the creator of Hope Affirm Thrive — Australia’s first neurodivergent-affirming psychological support program for IVF patients.

References

Afshadi, M. M. S., Amiri, S., & Talebi, H. (2023). Examining the structural equation modeling between intrinsic motivation, emotion regulation and ADHD: The mediating role of inhibition. Cited in Gunchai et al. (2025), Journal of Assessment and Research in Applied Counselling, 7(3), 1–9.

Barkley, R. A. (1997). ADHD, self-regulation, and time: Toward a more comprehensive theory. Journal of Developmental and Behavioral Pediatrics, 18(4), 271–279.

Barkley, R. A., & Benton, C. M. (2024). Focus on executive functions. Part 3: Emotion regulation, self-motivation, and planning/problem-solving. The ADHD Resource Hub, 2(6).

Brookhaven National Laboratory. (2009). Deficits in brain’s reward system observed in ADHD patients. BNL Newsroom. https://www.bnl.gov/newsroom/news.php?a=110998

Brown, T. E. (2005). Attention deficit disorder: The unfocused mind in children and adults. Yale University Press.

Gabrieli-Seri, O., Pollak, Y., Hirschberger, G., & Aran, A. (2022). Delay discounting in ADHD: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 134, 104514.

Parlatini, V., Bellato, A., & Cortese, S. (2024). From neurons to brain networks: Pharmacodynamics of stimulant medication for ADHD. Neuroscience & Biobehavioral Reviews, 163, 105779.

Shen, Q., Wang, B., He, T., Li, S., Peng, E., & Lei, J. (2025). Worldwide prevalence of discontinuation in fertility treatment: A systematic review and meta-analysis. International Journal of Gynaecology & Obstetrics. https://doi.org/10.1002/ijgo.70440

Volkow, N. D., Wang, G. J., Newcorn, J., Fowler, J. S., Telang, F., Solanto, M. V., … Swanson, J. M. (2007). Brain dopamine transporter levels in treatment and drug naive adults with ADHD. NeuroImage, 34(3), 1182–1190.