Part One: Medically Unexplained Infertility, Why See A Psychotherapist?

June 2024

We have called ourselves RSF Therapy, which stands for Relationships, Sex and Fertility because these areas are fundamentally entwined in most people’s lives. This blog offers an overview of how we work with this painful and difficult issue in our practice.

What Is Medically Unexplained Infertility?

Doctors define medically unexplained infertility as infertility with no medical cause - after a year of trying to conceive. 

Naturopathic practitioners would look to understand the potential cause by exploring in depth a woman’s hormonal balance. Women are increasingly turning to acupuncture and naturopathic nutrition for support with unexplained infertility. 

Psychotherapy

Psychotherapy has been on a journey with this diagnosis. In the 1950’s and 1960’s there was a strong focus on ‘infertility being in the mind’ as a result of psychic distress – perhaps resulting from conflicts resulting from one’s own experience of being mothered. 

This approach was largely replaced by a focus on the distress caused by infertility itself, and by the impact on women of medicalised and prolonged assisted reproductive treatments.

More recently (since 2000) research from clinical writers such as Gabor Mate and Bessel van der Kolk, coupled with advances in neuroscience, have revitalised the psychotherapist’s interest in how the brain-systems are affected by the stress of childhood trauma. For example, research suggests a link between unmanageable stress in childhood and the development of the APH axis, which is responsible inter alia for the development of the female reproductive system.

When Do People Come For Help? 

In our experience, women with medically unexplained infertility are less interested in traditional psychotherapy or analysis while they are dealing with their fertility difficulty.

Some women find that the experience of infertility activates old wounds. They may therefore seek psychotherapy to help them tolerate and make sense of what feelings come up during their assisted reproduction (IVF) journey. We offer a specialist therapy group for this cohort of women.

Most women and couples, however, need to put their energies into coping in the present. Therefore support groups for IVF are often the most helpful interventions.

We find that women and couples usually seek help with medically unexplained infertility towards the end of their IVF journey. They need help to make sense of where they’ve been and how the journey has changed them; and they need space to think about what they want to do.

We have a special interest in this aspect of infertility, and in helping women and couples to take stock and look forward. We think together about alternative ways of having a family, and we reflect on how infertility has affected them.

We talk in part 2 of this blog about how we work in practical terms with women and couples with this diagnosis.