How Does Infertility Affect Mental Health?

Infertility is common, affecting 1 in 6 couples worldwide. Infertility and the treatments that often accompany it can be stressful and may bring feelings of grief, anxiety, and depression. Taking care of your physical health, mental health, and relationships can be especially challenging while navigating fertility treatment.

That's why Dr. Ruta and Allie sat down with Dr. Pooja Lakshmin, MD, a board-certified psychiatrist, bestselling author, and leading voice in women's mental health. Having experienced infertility herself and guided many patients through the treatment process, Dr. Lakshmin shares what she's learned about tolerating uncertainty, setting boundaries, and protecting emotional well-being during fertility treatment.

Whether you're currently undergoing fertility treatment, considering your next step, taking a break, or supporting a loved one, this episode offers practical strategies for navigating the emotional challenges of the infertility journey.

Resources:

• Read about infertility and mental health from the MGH Center for Women's Mental Health
• Join a support group through RESOLVE or Postpartum Support International
• Learn more about setting realistic boundaries in “Real Self-Care” by Dr. Pooja Lakshmin, MD
• Follow people with lived experience and professional expertise in infertility, such as Cheryl Dowling (@the.ivf.warrior) and Dr. Julie Bindeman (@drjuliebindeman)

Disclaimer: This podcast is not intended to be a substitute for professional medical care. The views, thoughts, and opinions shared today are the speakers’ own.

**Trigger Warning** Anxiety, depression, grief, suicidal ideation

 Like What You Heard?

• Subscribe so you never miss an episode
• Leave us a review to share your feedback
• Learn more at sogladyouasked.org
• Sign up for our newsletter and follow us on Instagram for show updates and bonus clips

So Glad You Asked with Dr. Ruta Nonacs is brought to you by the MGH Center for Women's Mental Health and the J. Willard and Alice S. Marriott Foundation. 

Transcript

Listener 00:00:00

I've been dealing with infertility for a long time and it's taken a bit of a toll on my mental health. How do you know when it's time to seek professional support versus trying to manage it on your own?

Dr. Ruta 00:00:11

Welcome to So Glad You Asked, the show where real moms bring us their toughest questions. I'm Dr. Ruta Nonacs, a perinatal psychiatrist at Mass General Hospital with over 30 years of experience supporting the mental health of moms and helping them navigate the emotional highs and lows and the often unexpected challenges that come with planning a family, pregnancy, and motherhood.

Allie Hales 00:00:33

And I'm Allie Hales, a mom of four. I know what it's like to scour the internet wide awake at 2 AM with a million questions, wondering if what I was experiencing was normal. That's why we created this show.

Dr. Ruta 00:00:45

And because we know the questions don't stop when an episode ends, we've created even more support beyond our podcast. Our new website, sogladyouasked.org, is now live with trusted resources, personal stories, and a place to submit your questions.

Allie Hales 00:01:03

One thing we've come to understand through these conversations is how many experiences people carry quietly, even when they're incredibly common. Infertility is one of them. So many individuals and families struggle to conceive, yet it's rarely talked about openly. And when it isn't talked about, it can start to feel isolating and personal, like something is wrong with you or your body. But infertility is not just about trying to get pregnant. It's about the emotional weight that comes with it. The waiting, the uncertainty, the repeated cycles of hope and disappointment. And for many, it's layered with the physical and financial demands of treatment.

00:01:39

What makes it even harder is how often this experience is carried in silence. While we've made progress in talking about mental health during pregnancy and postpartum, infertility is still often treated as a private struggle rather than something that deserves support, community, and care. Today we're creating space for that conversation, exploring the mental health impact of infertility, the realities of treatment, and the stigma that continues to stand in the way of better care. We're joined by Dr. Pooja Lakshmin, a board-certified psychiatrist, best-selling author, and leading voice in women's mental health.

00:02:13

Her work focuses on helping women move beyond faux self-care to address the deeper roots of burnout, perfectionism, and emotional well-being. She is dedicated to women's mental health and serves as a clinical assistant professor of psychiatry at the George Washington University School of Medicine, where she supervises in the five trimesters perinatal psychiatry clinic. She is a sought-after speaker whose work has been featured across many major media outlets. Dr. Lakshmin, we're so glad you're here.

Dr. Pooja Lakshmin 00:02:41

Thank you so much for having me. It's such a pleasure to be here with you both.

Dr. Ruta 00:02:45

Oh, it's great to have you. Infertility is one of these topics that keeps coming up, and I was wondering if we could start off by talking about why it still feels like it's a topic with a great deal of stigma surrounding it. It's becoming more prevalent as women are waiting to conceive. Why do we still see so much stigma?

Dr. Pooja Lakshmin 00:03:08

Yeah, you know, I think as with most issues related to reproductive health, it's always multifactorial, but one of the things that I've noticed in my private practice, where I focus on women's mental health, so many of my patients have dealt with infertility, is I think the technical nature of the infertility treatment process has a connection to the stigma, in that it's not only that you're dealing with the shame and blaming yourself and feeling like your body has failed you or has betrayed you. But it's also that the process of receiving treatment is very technical. Like unless you've been through it, you don't understand like, what is a transfer? What is a cycle?  What is a stem? You know, all these things.

00:04:06

So I find that my patients have a hard time talking about it, not only because of the emotional weight of the grief and the shame, but also like they just don't even know where to start because if the person that they're trying to share with has not been through it, doesn't have the vocabulary of knowing which phases you're going through, it just feels too hard to explain it. It really is a different language. And then on the other side of it, if you are a friend or a family member of somebody who you know is struggling with infertility, you are afraid of saying the wrong thing. And you're afraid to ask because you also are not totally familiar with what's going on. It all feels sort of like a black box.

00:04:46

And sort of similar to grief and loss, where the people that really could be your support system end up being so worried about saying the wrong thing, and so then they just stay silent and they don't ask about it. And so then we get into this cycle where the silence continues and then as the person who's going through it, you feel more and more alone.

Allie Hales 00:05:07

I feel like you unpacked so much there, which is true. I mean, I feel like I've had very close friends and family members who have experienced infertility, and then I've also, you know, been on the end of not knowing what to say, but wanting to do something. And so I'm just wondering if you can speak a little bit to, you know, whether you're someone who's experiencing this, how do you go about sharing that world? Like you said, it's a totally different vocabulary. How do you go about sharing that world with your circle? And then if you are that support system and you're worried about what to say, how do you bring that up in conversation?

Dr. Pooja Lakshmin 00:05:41

Yeah, I mean, I think that there is a spectrum, you know, because one of the things also with infertility that I see with my patients and also that I've experienced myself—I've been open about the fact that I've built my family through IVF. So I've experienced infertility myself and treatment, is I think everyone has varying degrees of comfort with self-disclosure. So I have some patients who will have maybe one or two very close people in their network that they will share with, and then I have other patients who will be very open with their social circle. And so you have to figure out where you land in that. There's no right answer.

00:06:20

But I will say having at least one or two people is important. And I think unfortunately the burden of being the educator also lies on you as the patient. So I think it is sort of like you're helping the people in your life who could support you understand that there's so many hurdles. You kind of have to be okay with doing a little bit of that work yourself. As a friend on the other side or as part of someone's support system, being open to learning. There's so much research actually looking at the postpartum period and how to show up for folks.

00:06:59

Two of the evidence-based ways actually to be an effective support is emotional support. So being that non-judgmental, supportive space for a friend, or tangible, operational support. So being that person that texts and says, “Hey, I'm at Whole Foods right now. I'm gonna pick up a ready-made dinner, and I'm gonna drop it off on the front porch for tonight,” instead of just asking, “How can I help?” Taking the initiative to decide to do something and doing it.

Dr. Ruta 00:07:29

I think giving friends and family some suggestions is a great idea because I didn't really think about it as the person going through infertility has this burden of not only dealing with the stress but also educating everybody who's around them and then having to tell them what help they need. So, you know, maybe the person who's close to you doesn't know exactly what to do, but just by saying, “I'm going to do this,” it relieves the person who's going through infertility of one of the many burdens that they carry.

00:08:08

As you were talking, I was also thinking about causes of infertility, and there are so many. How do you think that affects whether one shares or doesn't share or sort of the emotional impact of infertility?

Dr. Pooja Lakshmin 00:08:27

Yes. I think that is definitely a layer. The complicated dynamics of if the cause of the infertility lies with the woman versus lies with the other partner. The lucky thing or the fortunate thing is that science is amazing and there are so many different pathways for treatment. But I think that there is still a lot of stigma in terms of, you know, using an egg donor or using a sperm donor or using donated embryos or all of these different pathways that you can explore.

00:09:05

And I think everybody has different levels of comfort with sharing how their family was created. And I think that's where, you know, therapy is really helpful, having a space to talk through where you're carrying shame. Shame is such a big piece of the infertility journey because for many women, it's a surprise when this happens. You know, you're trying the quote-unquote natural way to get pregnant and it's not working. When the quote-unquote problem lies with the woman, we tend to blame ourselves even more. But even if the problem lies with the man, if you're in a heterosexual relationship, that doesn't necessarily absolve the shame either because there's still stigma and you worry about sharing that personal information.

Allie Hales 00:09:56

Yeah, I think it's just so hard because I think it does go back a lot to women internalizing infertility in this way. Like whether it's quote unquote their fault, quote unquotes not their fault, it still is something that I think we take on so much. And I'm just wondering if you can speak to, you know, women feeling like something is wrong with them or something's wrong with their body and how you help move them through that, through this infertility process.

Dr. Pooja Lakshmin 00:10:26

So, interestingly, my practice is based in Washington D.C., and most of my patients are women who are highly educated, type A, perfectionistic. Not that I would know anything about that, you know, can't relate at all. So usually when it's not working, right? You're trying to get pregnant, it's not working. What I see initially is you're just like, I need to fix this. I need to fix it. And you're kind of just like laser focused on getting that baby.

00:11:03

So, there's a level of repression that happens and even some denial about the shame because you're in operations mode. For anybody who's been through this process, going through treatment for infertility is basically a full-time job. You know, you're going to the doctor every other day, you're getting your labs drawn, you're doing the ultrasounds, you're taking these medications.

00:11:28

So usually there's not a lot of space actually for the feelings because you end up coping by staying in this sort of project manager mode, and there's plenty to keep you occupied there. So usually what we're doing in therapy and in treatment is just very gently uncovering, like, wow, this is really hard and you're exhausted. Like, this is exhausting. That is usually the main sort of surface level feeling that my patients have.

00:12:02

And we usually have to stay with that for a number of months even before we can get to the shame. Oftentimes we're not able to get to that space until there's been some relief. So whether you were finally able to make some embryos or you were finally able to– there's been some level of like, okay, we're making progress. And then your brain and your body has enough like relative safety, so to speak, to say, “Okay, let me take a breath and wow, wow, I'm I'm really sad about this and I'm holding, I'm holding grief about this.”

Allie Hales 00:12:43

No, totally. I think it makes sense. I think what you said makes a lot of sense, and I unfortunately or fortunately can relate to the Type A personality. Okay, there's a problem. I'm going to fix it. I'm going to do this, this, and this, and then it will produce this outcome. And then we're good. I have a plan. It's going. I'm wondering if you can just walk us through a little bit about what women go through when they are navigating these treatments.

Dr. Pooja Lakshmin 00:13:06

So I think I would divide it up into the logistics, the decision making, and then the uncertainty and the loss. So the first difficult piece is from a purely logistical and administrative standpoint, like life administrative standpoint, going through IVF in particular is very challenging because for many women, it's the first time you are really sort of thrown into the healthcare system.

00:13:37

With anything in healthcare, you end up needing to be your own quarterback and your own advocate. Because you're not only dealing with the work, the diagnostic workup to find out what's happening, you know, with your reproductive system, but also you are trying to figure out how you're going to pay for this. And then you're trying to figure out, okay, which medications am I going to need? 

00:14:05

And I remember for me, one of the things that was really shocking, and I say this as a physician,

granted I'm a psychiatrist so it's been a long time since I've given anybody a shot or an injection, but I remember you know a box of medication in a cooler like this box of medication cost like ten thousand dollars or something and it just was sitting at my front door. And I live in Texas where it was really hot, so then I was worried, are they still cool, right? So you're basically delivered a pharmacy to your house and then you you know there'll be some videos and things to show you how to do stuff but it's a lot of it is just on you, and I say this as someone that has a clinical background but most patients you know you this is all a new world so that's the administrative burden that is really tough.

00:14:46

And then the second piece that I mentioned is the decision making. Because, like we talked about earlier, there's so many different hurdles, whether it's trying to harvest eggs, trying to collect sperm, then making the actual embryos, and then figuring out the health of your uterus to see if the embryos can even implant. At each stage, you may experience failure. It might not work. And then you might have to do additional testing. And then you might have to decide,  when do we know that we've tried every option that is reasonable? When do we move on to potential donor eggs or embryos? When do we move on to thinking about surrogacy? And nobody's going to tell you to stop.That's the other piece.

00:15:35

It's on you to know when you need to take a break. It's on you to ask your care team, “Well, what are the statistics here? What is the likelihood of success here?” So that in itself is its own really difficult piece. And then the last thing again is just with all of this, there's so much uncertainty.

00:16:03

You can look usually for with reproductive, with reproductive, endocrinology, and infertility (REI) clinics, after you've done your baseline testing, they will run all of your numbers through a computer and you'll get a nice little printout that is, very pretty, that'll tell you, kind of statistically, this is the likelihood of success after one cycle, after two cycles, after three cycles. And that is helpful, but also within that, we don't know how long it's going to take.

00:16:36

I've had patients who from the start of seeing the REI, then they have a baby within a year and a half, which is great. That's short. That's very short. And then there's other folks who are, you know, six, seven, eight, nine, ten years. And you just don't know. You don't know where you are on that continuum. So, you know, I'm making this all sound very, very dismal. And I think it's important I want to also just note that the good news is that it really does work for so many patients. And there is reason to have hope.

00:17:16

And for most folks this is a marathon, it's not a sprint. And so you have to think of it as a lot of the counseling that I'm doing with my patients who are going through this is reminding them that this is a marathon. And as you're going through it, you really need to learn how to take care of yourself, how to work on your real self-care, which is, you know, the first book that I wrote. That it's not just like going and getting a manicure or pedicure. That real self-care is about looking at realistically what are my boundaries? If I'm going through an infertility journey, then that means there's some things, because we know that this is a full-time job, there's some things that I'm going to have to take off my plate because this is such an emotionally taxing time and making honest decisions about that.

Dr. Ruta 00:18:08

I was just thinking, one of the statistics I had read was that going through infertility in terms of stress is comparable to having the diagnosis of cancer and getting treatment. And I think, you know, there's a lot of optimism in terms of the treatments, but it's both physically and emotionally draining. And I don't think people always realize that.

Allie Hales 00:18:37

Yeah, I think those are two, those are really important points that both of you made. And I was just thinking, Pooja, when you were talking, you know, no one tells you to stop the process. Like, no one tells you when to take a break. You have to, you know, another thing to add to your plate is figuring out how and when to set those boundaries. And I was thinking about your book as you were saying that, Real Self-Care, and I was a yellow light in the test where I do need to learn to set more boundaries. So I'm wondering if you can, if you can speak to that in this lens of infertility and in this process of learning to set these boundaries and what that looks like.

Dr. Pooja Lakshmin 00:19:12

Yeah, you know, I think of boundaries a little bit differently than some other folks in that I don't think of a boundary as saying no, because no always comes with a cost, whether that is financial, whether that is emotional or relational. So I think of the boundary as a pause, and then you always have three options: yes, no, or negotiate. In the context of the infertility journey and the infertility treatment journey, with every single intervention that you're coming up against or every quote-unquote failure, you're pausing. You're pausing and you're taking stock and saying, “Okay, let me take a breath here and let's look at the decision tree. Let's look at what all the different options are for the next steps. And let's give myself, you know, a day or two to really think through like where am I at right now? Am I completely depleted?

00:20:08

Am I irritable? Am I having crying spells and panic attacks? Okay, maybe I need to take a month off from this cycle?” So it's not an automatic yes or no, it's more of like giving yourself that space to take a pause. Now, there's going to be some circumstances where you say, I do really want to pause or I do really want to say no, I want to kind of step off the conveyor belt for a little bit, but maybe for financial reasons or logistical reasons or something that's going on in your family, you you don't feel like that is a realistic option.

00:20:43

Then what you can do is you can say, “Okay, what do I need to do so that three months from now, six months from now, no is more accessible or break is more accessible.” And then you can kind of reverse engineer that. That becomes more of an operational question. And the place that I see this the most actually when it comes to infertility is so we see it with like the decision making around, you know, the interventions and the healthcare, but also the place I see it is in your relationships. Usually with family and extended family and all of the expectations and the burdens that are on you and the responsibility.

00:21:19

So maybe it's something like, “Every Thanksgiving we fly across the country for Thanksgiving dinner at my in-laws, but you know what? I have this cycle coming up and this is really important to me, but I'm not sure that I want to share with my whole extended family that I'm going through IVF and we're doing a cycle because it just–” so it's kind of like unpacking that and then being able to say, “You know what, we're we're going through something right now, we're not going to be able to come this year for Thanksgiving.”And that feels, for many of my patients, that feels sometimes impossible to be able to set a boundary like that.

00:22:07

So we have to work through the guilt, we have to work through the feelings or the thoughts of, “Oh my gosh, am I being selfish? I should be able to still keep doing everything that I have been doing, you know, as if it was business as usual.” But the other piece that I also see come up often here with boundaries is especially if you are somebody who is in your 30s, 40s, maybe, and you have friends who are getting pregnant. There are going to be baby showers, there are going to be birthday party invitations, and I'm constantly telling my patients it's human to feel bad about those things. It's human to be envious. It's human to love your friend and be happy for your friend but also feel like the last thing that you want to do right now is to go to a baby shower. That doesn't make you a bad person. So that's another place to set boundaries.

00:23:00

And we were talking earlier about support systems and what you can do if you are a friend or a family member of someone who's going through infertility. That's another nice place you can check in with a friend. And you can say, ‘Hey, I know that Sally's um baby shower is coming up. How are you feeling about that? Is there anything that I can do to support you? Are you planning on going,” you know, that type of thing. So that you know other people see you and see what you're going through and why it would make sense if it would be too difficult for you to attend.

Dr. Ruta 00:23:30

As someone who's going through infertility, obviously there are all these stressors and we've been talking about them. And on one hand, I could imagine someone saying, of course I feel miserable. On the other hand, what if this person in the context of infertility develops depression or anxiety? As a clinician, I find that it's really difficult because people don't want to do anything that might disrupt fertility, like taking a medication, nor do they feel like they have the time to do psychotherapy. So, I'm wondering, how do you talk to people who are really struggling and it's not just this is hard, but they can't sleep, they're not eating, they're unable to do work? How do you help them take a step towards treatment?

Dr. Pooja Lakshmin 00:24:20

Yeah, you know, I think that it's tough. It's tough. Especially if you're in that place where everything feels very operational, and I just need to go go go go go and it'll be better once I have a baby. I try to remind folks that their mental health is an important piece of the fertility journey as well. Even though it very much mentally can feel like once you have a baby that will solve all these problems, that in fact, dealing with depression or clinical anxiety during the infertility process, puts you at higher risk for being depressed or clinically anxious during pregnancy itself. And we know we want to set you up for a healthy pregnancy and give you the best chance of an emotionally healthy postpartum period as well. So getting a handle on this now is something that sets you up better for what things will feel like when you are a mother.

00:25:26

I think it's tough. I mean, I think when therapy in particular really works is when it's really about the relationship with the therapist and building trust with the therapist. And so for me, I think it often takes a good amount of time for my patients to really say, “Okay, you know, I think I'm ready. I'm ready to try a medication. It's reached a place where I can't keep going like this.” So I usually do a lot of motivational interviewing in this clinical space. So it's sort of like, okay, well, right now doesn't feel like the right time to start. How will we know that things have gotten bad enough that something needs to change?

00:26:04

What are the signs, whether it's, you know, you're having more arguments with your partner, you're going to bed at night after crying, you know, or you're you're going to bed and having thoughts that maybe it would be better if you didn't wake up, right? So kind of going down a list of like, if this starts to happen, that's a sign that I need to make a change. I think, you know, we talk a lot about how things like technology and social media can be harmful, which we know a lot of the ways in which social media can be harmful, and I do think that some of these online spaces, in particular for folks who are dealing with infertility, can be helpful in terms of steering people to therapy or treatment. Because if you're in one of those Facebook groups or you're following an influencer or somebody who has been open about their infertility and talks about how they've taken an SSRI during infertility or during their pregnancy, that type of thing I find helps. You know, it helps people see like this is not just me. And even though these relationships are parasocial, that is something that can make people feel a little bit more open to seeking help.

Allie Hales 00:27:23

So now we're going to shift from understanding the bigger picture of infertility and mental health to answering some of your questions and getting into what this actually looks like in real life. So the first one is, I have been dealing with infertility for a long time and it has taken a toll on my mental health. How do you know when it is time to seek professional support versus trying to manage it on your own?

Dr. Pooja Lakshmin 

So there's the standard sort of clinical pieces. Are you having trouble sleeping? Is your sleep disrupted? Has your appetite changed? Are you no longer interested in the things that used to bring you joy? Are you having any thoughts of hurting yourself or thoughts like life isn't worth living? Those are all signs that seeking out professional help would be appropriate and good. In day-to-day layman's terms, some of the things that I think about or that I hear from my patients, you're just always exhausted. You're always exhausted. Everything feels like a chore. This is sort of similar to like nothing brings you joy anymore. Like no matter what you're doing, you're not really fully there. I would also say if you're finding yourself spending a lot of time going down these Reddit rabbit holes, Instagram rabbit holes, like you're spending, you know, significant amounts of time during the day ruminating on what is happening related to your treatment, right? Like it feels like you're compulsively checking and you're compulsively reading, but none of it relieves your anxiety or improves your mood or gives you a sense of like, “Okay, I'm I have a plan and I feel confident in that.” And then also, if you're finding yourself really isolating yourself from the people in your life who could be there as a support for you. You're turning away from your family or friends, you're feeling really lonely, and that you don't have anyone else in your life to really talk to about this. Those would be some signs, yeah.

Dr. Ruta 

I think those are all great points. I think one of the challenges I've had is, you know, sometimes depression affects the way you think and it can be hard to imagine that things will ever get better. The other thing that happens, especially with anxiety, is that there's so much worry about how the medications, if that's where you go, might affect one's ability to get pregnant and you know, people get really stuck on those ideas. And sometimes when it comes to medication, I suggest that they take a break for a month and see how they do on medication and see if the decision making becomes easier in terms of continuing on the medication or saying, no, this isn't isn't for me because I feel like we can get really stuck when we make decisions about about medication, and it it's very frustrating to everybody involved.

Allie Hales

So, I was wondering if you do have some examples of resources for women who are experiencing infertility, whether that's, you know, a social media site or a website, but a place where women can find that sense of community because I do know it does feel isolating sometimes. And like you said, an online presence is sometimes really helpful in feeling community or learning to take that first step to seek help.

Dr. Pooja Lakshmin 

Yes, yes. Well, there's a national organization called Resolve that is focused on infertility and has a number of different resources. So that's a great place to start. In terms of social media, there is actually an influencer community that comes to mind. It's called IVF Warrior, and she is somebody who’s not a clinician, but she's gone through infertility herself and her whole Instagram page is focused on supporting and educating women that are going through infertility. Dr. Julie Bindeman is somebody who I've worked with clinically. She is a reproductive psychologist and focuses on infertility and loss as well. 

So I think that those are some places to start and it's okay to just lurk around. I think lurking in these spaces is totally fine and great because you're reading other people's experiences and you're seeing that you're not alone and also you can kind of click through and there's sometimes those online support groups can be a nice way, you know, we were saying it can be hard to get yourself to an individual therapy appointment or actually go to in person somewhere, but sometimes these online support groups can feel more accessible because they're virtual and also because sometimes they can just be anonymous, too.

But I would also say, I think there's different stages to this because then sometimes I will have a patient, who, for example, has just done an embryo transfer and then they're in that two-week wait before they can take a pregnancy test. And in those patients, we say, okay, let's silence all of the infertility accounts. Let's even maybe delete Instagram off of our phone, right? So I think you have to work on your awareness to know are you in a space where that external parasocial support is going to be a value add, or are you in a space where your anxiety level is very high and you're finding yourself going down all of these different rabbit holes, fearful about where you are in the journey?

Allie Hales 00:33:03

The next question is going through infertility treatment feels all-consuming. What strategies do you have for helping me find some sort of balance to keep up with other parts of my life?

Dr. Pooja Lakshmin 00:33:14

I'm glad we're touching on this. It's so important to keep the other parts of your life that are unrelated to going through treatment for infertility. So, do you have a hobby? Do you have something that you really like to do? Whether it's your book club, whether you're somebody who loves puzzles, whether it's, you know, pickleball. Trying to find– well not trying to find, scheduling in your week, in your month that you are still keeping up with those one or two things that feel very unique to you. And without a doubt, there's going to be plenty of moments where you feel like, I don't have time for this. I have too much going on. Those are the types of things that keep your identity intact during an infertility journey.

00:34:09

So you sort of have to be pretty fierce about keeping some parts of yourself, even if it's just one thing. And then the other piece too is if you're in a relationship, making a point to have connection with your partner that is not related to infertility or trying to get pregnant. So saying, okay, once a month we're going to go out to see a movie, we're going to have dinner, and we're not going to talk about what's happening with the infertility stuff during that time. Because even in a relationship, everything can end up becoming about that. And these are times you have to protect your identity, you have to protect your relationship, because if you don't do that, it will completely become eroded.

Dr. Ruta 00:34:55

One thing that I also recommend for couples is they set a time to talk about infertility issues because I feel like otherwise there's, you know, a million messages during the course of the day or all through dinner, then through a television program that there's no stop. But really, again, protecting your time, putting boundaries around those discussions so there's some infertility free zones in your life, in your days.

Allie Hales 00:35:26

I'm wondering if you could share with us what's coming for you next?

Dr. Pooja Lakshmin 00:35:30

So, my next book will be out in spring of 2027. It's called Quantum Shifts and it's all about how to deal with life's big changes where there's a very clear before and after, and in that space you really want to go back to the person that you used to be, but that person doesn't exist anymore. And you don't yet know who you are becoming or who the next version of yourself is. And I call that in-between space the quantum shift. And the book is all about how to get through that time and how to follow the breadcrumbs to the person that you're becoming. And so yeah, so I'm very excited for that to be out next year. It was such a pleasure to be here with you both and to talk about this topic, and I really appreciate you having me.

Allie Hales 00:36:14

Thank you so much for coming on.

Dr. Ruta 00:36:16

Thank you. Infertility is common, affecting about one in six couples. And the challenges surrounding infertility and its treatment can be accompanied by stress, anxiety, grief, and sometimes depression. In this episode, our guest, Dr. Pooja Lakshmin, reminds us that mental health is not separate from fertility care. Prioritizing self-care, seeking support, and finding community can make this difficult journey feel a little less isolating. 

Thanks for tuning in. As a reminder, please note that this podcast is not intended to be a substitute for professional medical care. The views, facts, and opinions shared today are the speaker's own. Your feedback and questions drive this show, so feel free to send us an email at podcast@womensmentalhealth.org or leave a voicemail at 617-643-9232.

Allie Hales 00:37:14

You can find additional resources at our resource hub at sogladyouasked.org. This show is executive produced by Dr. Lee Cohen, produced by Mike Brown and Peri Barest, and edited by Mike Brown. This is So Glad You Asked with Dr. Ruta Nonacs and Allie Hales, brought to you by the MGH Center for Women's Mental Health and the J. Willard and Alice S. Marriott Foundation. Listen and subscribe wherever you get your podcasts.