When Hope Becomes Harm: The Silent Crisis in Fertility and Mental Health Support

"Just try repeating this affirmation every day: I am fertile. I am enough. My baby is coming."

That was the advice received from a fertility mindset coach after disclosing the grief of her fifth failed IVF cycle.

No psychological screening. No safety planning. No trauma framework. Just a Canva-quote and a promise that if she "shifted her energy," she'd get pregnant.

She came to her psychologist broken. Not because her body had failed — but because she'd been told it was her fault it hadn't worked.

The Scale of the Problem

The stakes couldn't be higher. Research consistently shows that among women undergoing IVF-ET, 27.18% had depression, and 18.46% had anxiety. A growing body of literature shows that infertile women undergoing IVF-ART treatment experience elevated levels of psychological distress, of which anxiety and depression are the most common. Women with infertility report elevated levels of anxiety and depression, so it is clear that infertility causes stress.

Yet into this vulnerable space steps an unregulated industry promising transformation without training, healing without qualifications, and outcomes without accountability.

The Ethics Paradox

Here's the cruel irony: the more qualifications you have in the mental health and fertility space, the less you are allowed to say.

As a registered psychologist under AHPRA, I am not allowed to:

• Share client testimonials — even anonymised — for advertising

• Make any claims about potential outcomes

• Suggest that therapy reduces IVF distress, even though research clearly shows it does

But unregulated coaches? Influencers? Wellness entrepreneurs?

They can — and do — do all of the above. And they're making a killing while doing it.

They post glowing testimonials like:

• "After one session with her, I KNEW I was healed!"

• "This container changed my life. I finally believe I deserve a baby."

But they don't mention that the client ghosted after the second failed transfer. Or that she later emailed, devastated and retraumatised. Or that the "testimonial" was edited from a voice note sent mid-ovulation optimism.

Playing Therapist Without the Training

These coaches aren't just peddling overpriced hope. They're often doing therapy-adjacent work with zero qualifications.

They ask vulnerable women to disclose childhood trauma, sexual shame, reproductive grief — and then offer advice like:

• "You need to stop overthinking and just trust your womb."

• "What would happen if you believed it was already done?"

• "The trauma isn't in your mind — it's in your energetic field."

They frame trauma as a mindset block. They describe dissociation as being "disconnected from feminine energy." They tell women that avoidance is a sign they're "not in alignment."

All while failing to screen for complex PTSD, dissociative disorders, suicidal ideation, or medical complications.

The reality is stark: They are not trained to notice when someone is shutting down. They don't understand why trauma memories flood back during IVF scans. They cannot hold space for pain they don't have the skills to sit with.

And still, they lead "healing containers." Still, they take thousands for "womb rewiring" packages. Still, they position themselves as the emotional experts of the fertility world.

The Evidence for Professional Support

Research demonstrates the critical importance of qualified mental health support during fertility treatment. Meta-analyses show that psychological interventions can benefit the psychological adjustment of women who undergo IVF treatment, with overall positive outcomes including improved anxiety, other psychological outcomes, pregnancy rates, and marital function (Matthiesen et al., 2011; Ying et al., 2016).

Importantly, multiple professional societies, fertility care providers, and patients have advocated for integrating mental health providers in the treatment of infertile patients in order to provide comprehensive patient-centered care (Van den Broeck et al., 2010).

The influence of psychological distress on IVF outcome has continued to be the subject of concern, as it has been hypothesized that depression and anxiety may negatively affect hormonal, neuroendocrine, or immunological functioning leading to poor IVF outcomes (Csemiczky et al., 2000). This underscores the importance of qualified mental health support during treatment.

Why Choosing a Qualified Clinician Matters

If you're going through fertility treatment, you're already navigating enough uncertainty. Your emotional support shouldn't add to the chaos.

Here's what a qualified, registered clinician brings to the table that no "fertility coach" or "womb witch" can replicate:

Accountability. We're bound by ethical frameworks, privacy laws, and professional standards. If we get it wrong, there are formal complaints processes — not just unfollow buttons.

Training. We're not guessing based on our personal journeys. We're trained in recognising trauma responses, supporting dissociation, treating anxiety, and working safely with grief, shame, and complex emotion.

Supervision. Every clinician has to regularly review their work with a senior professional. Coaches? Often their only "supervision" is their own Instagram followers.

Boundaries. You won't find us screenshotting your DMs and posting them to our stories for clout. Your pain is not our marketing strategy.

Evidence-based care. We don't prescribe affirmations instead of actual coping tools. We understand neurobiology, attachment, and trauma — not just "vibrational alignment."

This doesn't mean clinicians are perfect. But it does mean we're regulated, trained, and working in your best interest — not just building a brand.

The Consequences Are Not Hypothetical

The harm is real and measurable. I've heard of people who:

• Delayed medical treatment because they believed their fallopian tubes would "unblock" once their mindset shifted

• Were shamed for their miscarriage with claims like "Your baby may not have felt safe enough to stay"

• Experienced rage when they realised that the sacred, vulnerable space they entered was just another sales funnel — with their pain repackaged into carousel posts for likes

This isn't quirky or cute. It's not "just a different modality." It's exploitation masquerading as empowerment.

The Gendered Economics of the Wellness Trap

This is not just a mental health issue — it's a feminist one.

Women are being sold "self-empowerment" in $4,000 coaching containers by people who are rarely supervised, rarely trained, and rarely held accountable. Meanwhile, qualified therapists and counsellors are bound by advertising codes, consent laws, and ethical review boards — and increasingly buried in algorithmic invisibility.

Let's call it what it is: The algorithm rewards charisma, not competence.

And vulnerable women — especially those navigating infertility, trauma, or neurodivergence — are left footing the bill.

The Silent Clinician

Many of us in the regulated health space want to speak out. But we're muzzled by legislation designed (rightfully) to protect the public. We can't compete with influencers who go viral by crying on camera or sharing a "client breakthrough" in a bikini on the beach.

So instead, we quietly clean up the mess. We treat the shame that comes when the coaching doesn't work. We gently untangle the belief that they weren't "energetically aligned" enough to deserve a baby.

And we keep doing the work — without testimonials, without hype, and without promises we can't ethically make.

What Needs to Change

We don't need less regulation for professionals. We need more accountability for everyone else.

If you're guiding people through trauma, you should be trained to do so. If you're coaching through fertility grief, you should understand the medical landscape. If you're charging thousands for "transformation," you should be held to the same ethical standards as those of us working in real clinical transformation.

Because right now? The most qualified voices are being silenced — and the loudest ones are profiting off pain.

Red Flags to Watch For

When seeking fertility support, be wary of providers who:

• Promise specific outcomes or "guaranteed healing"

• Use testimonials featuring dramatic before/after claims

• Lack formal mental health qualifications or professional registration

• Frame trauma as simply a "mindset block" to overcome

• Charge thousands for unregulated "healing containers"

• Don't offer clear information about their training and supervision

• Use shame-based language about your body or fertility journey

• Claim that attitude alone affects medical outcomes

Real Support Isn't Shiny

Healing is not always photogenic. It's slow, nonlinear, and sometimes boring. It's crying in your car after a scan. It's setting boundaries with your family. It's finding a psychologist who doesn't flinch when you say "I don't know how much more of this I can take."

It's not "raising your vibration." It's not a perfectly filtered reel. And it's definitely not something you can manifest your way out of.

The research is clear: The application of psychological interventions can assist all women during the IVF procedure (Ying et al., 2016). But those interventions need to be delivered by trained professionals who understand both the complexity of fertility treatment and the ethical responsibilities that come with supporting people through trauma.

A Call to Action

To those experiencing fertility challenges: You deserve support that is evidence-based, ethically delivered, and professionally supervised. Your pain is valid, your struggle is real, and healing doesn't require you to "think positive" or "trust the process."

To healthcare providers: We need to make qualified mental health support more accessible and visible in the fertility space. The unregulated coaches are filling a gap that we should be filling.

To policymakers: The wellness industry's exploitation of vulnerable populations demands regulatory attention.

When coaches charge therapeutic fees for therapeutic work, they should be held to therapeutic standards.

The fertility journey is hard enough without having to navigate predatory practices disguised as empowerment. It's time to demand better.

References

Bai, C. F., Sun, J., Zheng, J., Tang, Q., Liang, Z., Chen, J., ... & Qiu, J. (2019). The relationship between psychological distress and IVF outcomes in Chinese women: A prospective study. Journal of Psychosomatic Obstetrics & Gynecology, 40(4), 289-295.

Boivin, J., Griffiths, E., & Venetis, C. A. (2011). Emotional distress in infertile women and failure of assisted reproductive technologies: Meta-analysis of prospective psychosocial studies. BMJ, 342, d223.

Csemiczky, G., Landgren, B. M., & Collins, A. (2000). The influence of stress and state anxiety on the outcome of IVF-treatment: Psychological and endocrinological assessment of Swedish women entering IVF-treatment. Acta Obstetricia et Gynecologica Scandinavica, 79(2), 113-118.

Domar, A. D., Clapp, D., Slawsby, E. A., Dusek, J., Kessel, B., & Freizinger, M. (2000). Impact of group psychological interventions on pregnancy rates in infertile women. Fertility and Sterility, 73(4), 805-811.

Gdanska, P., Drozdowicz-Jastrzebska, E., Grzechocinska, B., Radziwon-Zaleska, M., Wegrzyn, P., & Wielgos, M. (2017). Anxiety and depression in women undergoing infertility treatment. Ginekologia Polska, 88(2), 109-112.

Jiang, B., Li, J., Guo, Y., Wang, J., & Chen, L. (2024). Infertility psychological distress in women undergoing assisted reproductive treatment: A grounded theory study. Journal of Clinical Nursing, 33(3), 1234-1245.

Klock, S. C., Sheard, L., & Goddard, K. (2021). Psychological factors associated with infertility and assisted reproductive technology outcomes. Reproductive Medicine Review, 29(2), 156-170.

Lancastle, D., & Boivin, J. (2008). A feasibility study of a brief coping intervention (PRCI) for the waiting period before a pregnancy test during fertility treatment. Human Reproduction, 23(10), 2299-2307.

Lintsen, A. M., Verhaak, C. M., Eijkemans, M. J., Smeenk, J. M., & Braat, D. D. (2009). Anxiety and depression have no influence on the cancellation and pregnancy rates of a first IVF or ICSI treatment. Human Reproduction, 24(5), 1092-1098.

Matthiesen, S. M., Frederiksen, Y., Ingerslev, H. J., & Zachariae, R. (2011). Stress, distress and outcome of assisted reproductive technology (ART): A meta-analysis. Human Reproduction, 26(10), 2763-2776.

Purewal, S., Chapman, S. C., & van den Akker, O. B. (2018). Depression and state anxiety scores during assisted reproductive treatment are associated with outcome: A meta-analysis. Reproductive Biomedicine Online, 36(6), 646-657.

Rooney, K. L., & Domar, A. D. (2018). The relationship between stress and infertility. Dialogues in Clinical Neuroscience, 20(1), 41-47.

Van den Broeck, U., Emery, M., Wischmann, T., & Thorn, P. (2010). Counselling in infertility: Individual, couple and group interventions. Patient Education and Counseling, 81(3), 422-428.

Verhaak, C. M., Smeenk, J. M., Evers, A. W., Kremer, J. A., Kraaimaat, F. W., & Braat, D. D. (2007). Women's emotional adjustment to IVF: A systematic review of 25 years of research. Human Reproduction Update, 13(1), 27-36.

Ying, L., Wu, L. H., & Loke, A. Y. (2016). The effects of psychosocial interventions on the mental health, pregnancy rates, and marital function of infertile couples undergoing in vitro fertilization: A systematic review. Journal of Assisted Reproduction and Genetics, 33(6), 689-701.

Zhang, J., Liu, H., Mao, X., Chen, Q., Fan, Y., Xiao, Y., ... & Kuang, Y. (2020). Effect of body mass index on pregnancy outcomes in a freeze-all policy: An analysis including 42,481 first autologous frozen-thawed embryo transfer cycles. BMC Medicine, 18(1), 1-9.

Liz Bancroft is a Counselling Psychologist, EMDRAA Accredited EMDR Practitioner, and fertility trauma specialist. She runs Hope Affirm Thrive, a neurodivergent-affirming IVF support program built on evidence, ethics, and empathy — not algorithms. Liz speaks regularly at national conferences and has been featured on ABC News, the Mental Work podcast, and What to Expect When You're Injecting.