Supporting families through loss: The need for bereavement care in fertility treatment
For the millions of intended parents pursuing fertility treatment, the journey toward parenthood often involves hope and anticipation but also profound loss and grief. While fertility clinics excel at providing medical interventions to help families conceive, many fall short in addressing the emotional aftermath when treatments don't succeed or pregnancies end in loss.
Fertility clinics that recognize the inherent risk of disappointment and bereavement, and make it a priority to support their patients’ complete well-being with ongoing support, build trust with families, and optimize treatment outcomes, too.
The Reality of Loss in Fertility Treatment
The statistics surrounding pregnancy loss in fertility treatment may surprise you. Research consistently shows that pregnancy following IVF treatment has a particularly high loss rate, with several reports documenting rates well over 30% (Lynch et al., 2024). These losses represent more than medical statistics—they signify the end of carefully nurtured hopes and dreams for countless families.
Each unsuccessful cycle or pregnancy loss can trigger a complex grief response. Studies examining women's experiences during fertility treatment reveal that personal trauma includes stress, grief, inability to focus, shock, insomnia, anxiety, withdrawing from others, and profound feelings of hopelessness, guilt, and shame (Assaysh-Öberg et al., 2023). Among women experiencing infertility, 56% reported significant symptoms of depression, and 76% reported significant symptoms of anxiety, and most alarming are the 9.4% of women who are struggling with infertility reporting having suicidal thoughts or attempts (Rooney & Domar, 2018).
The grief experienced in fertility treatment differs from other forms of loss in important ways. These losses are often invisible to others, unacknowledged by society, and inadequately supported by healthcare systems. The stigmatization surrounding infertility contributes to an atmosphere of silence, leaving many women and couples to navigate their experience alone (American Counseling Association, 2018).
A Gap in Comprehensive Care
Despite the prevalence and intensity of grief in fertility treatment, current healthcare approaches often fall short of addressing patients' bereavement needs. Research examining women's experiences reveals a troubling pattern: patients consistently report feeling neglected by healthcare systems and providers, not being fully supported, and some experiencing dehumanized care (Assaysh-Öberg et al., 2023). Healthcare systems and providers frequently lack adequate support and holistic care approaches, leaving women feeling failed by the very system they turn to for help (Read et al., 2014).
This gap in bereavement care represents more than a missed opportunity for compassion—it constitutes a failure to provide comprehensive healthcare. When fertility clinics focus solely on achieving pregnancy without addressing the emotional needs of patients who experience loss, they overlook a fundamental aspect of patient well-being that can significantly impact future treatment outcomes.
The absence of dedicated bereavement support often stems from practical challenges within fertility clinics. Many reproductive centers lack staff specifically trained in grief and loss counseling. Healthcare teams, while experts in reproductive medicine, may not have the specialized skills needed to support patients through complex bereavement processes. Additionally, the intense focus on achieving pregnancy can overshadow recognition of how maternal mental health and unresolved grief directly influence the success of future treatments.
The Connection Between Grief and Treatment Success
Emerging research demonstrates that the emotional well-being of fertility patients is not separate from their physical treatment outcomes—the two are intimately connected (Holly et al., 2021). Studies show that when the level of infertility-related stress is higher, IVF success rates are lower (Aimagambetova et al., 2020). This finding challenges the traditional separation between emotional support and medical treatment in fertility care.
The biological mechanisms underlying this connection are becoming clearer. Women who experience pregnancy loss as a result of failed treatments may trigger prolonged grief disorder (de Castro et al., 2021). More significantly, the stress associated with unresolved grief can lead to the production of stress hormones that have detrimental impacts on the reproductive system, potentially contributing to subsequent pregnancy failure or loss (de Castro et al., 2021; Valsamakis et al., 2019). These findings suggest that addressing grief and supporting emotional well-being is not just compassionate care—it's evidence-based medicine that can improve treatment outcomes.
A Practical Solution for Comprehensive Support
Recognizing these gaps in care, innovative approaches to bereavement support are emerging that can be seamlessly integrated into existing fertility clinic operations. Text-based interventions like Help Texts for Pregnancy Loss or Help Texts for Health & Well-being represent a particularly promising solution, offering several advantages for both patients and healthcare providers.
Text-based bereavement and mental health support can provide continuous, accessible care that doesn't require additional clinic visits or strain already busy schedules. These interventions can deliver personalized, clinically-informed support messages that address grief, provide coping strategies, and help patients process their experiences with loss or fertility stress. The format allows patients to receive support in private, comfortable settings without the barriers that might prevent them from accessing traditional counseling services.
For fertility clinics, text-based bereavement programs offer a way to extend comprehensive care without requiring additional specialized staff or extensive training programs. These systems can provide professional-grade support while allowing medical teams to focus on their areas of expertise. This approach also enables clinics to maintain a connection with patients during difficult periods, demonstrating ongoing care and support.
Such programs can be designed to recognize the unique aspects of fertility-related grief, providing targeted support for the specific challenges patients face. Unlike generic grief support, fertility-focused interventions can address the cyclical nature of hope and disappointment, the complex feelings surrounding pregnancy loss after assisted reproduction, and the difficult decisions about continuing or discontinuing treatment.
Moving Forward with Compassionate Care
Grief and bereavement are not unfortunate side effects of fertility treatment—they are predictable aspects of the journey that require intentional, professional support. Fertility clinics have an opportunity to expand their definition of comprehensive care to include bereavement support that can improve both patient well-being and treatment outcomes.
Implementing bereavement care doesn't require clinics to fundamentally restructure their operations or hire new clinical staff. Text-based support programs can be easily integrated into existing patient care protocols, providing evidence-based bereavement support that complements medical treatment.
For the countless individuals and couples who experience loss during their fertility journeys, comprehensive bereavement support represents hope for healing and renewed possibilities. By acknowledging grief as a legitimate healthcare need and implementing practical solutions to address it, fertility clinics can truly support families through every aspect of their journey toward parenthood.
References
Aimagambetova, G., Issanov, A., Terzic, S., Bapayeva, G., Ukybassova, T., Baikoshkarova, S., Aldiyarova, A., Shauyen, F., & Terzic, M. (2020). The effect of psychological distress on IVF outcomes: Reality or speculations? PLoS ONE, 15(12), e0242024. https://doi.org/10.1371/journal.pone.0242024
American Counseling Association. (2018). The invisibility of infertility grief. Counseling Today Magazine.
Assaysh-Öberg, S., Borneskog, C., & Ternström, E. (2023). Women's experience of infertility & treatment – A silent grief and failed care and support. Sexual & Reproductive Healthcare, 37, 100879. https://doi.org/10.1016/j.srhc.2023.100879
de Castro, M. H. M., Mendonça, C. R., Noll, M., de Abreu Tacon, F. S., & do Amaral, W. N. (2021). Psychosocial Aspects of Gestational Grief in Women Undergoing Infertility Treatment: A Systematic Review of Qualitative and Quantitative Evidence. International journal of environmental research and public health, 18(24), 13143. https://doi.org/10.3390/ijerph182413143
Holley, S. R., Pasch, L. A., & Domar, A. D. (2021). Dealing with the emotional distress following failed IVF. Assisted Reproduction Techniques: Challenges and Management Options, 678-683.
Read, S. C., Carrier, M. E., Boucher, M. E., Whitley, R., Bond, S., & Zelkowitz, P. (2014). Psychosocial services for couples in infertility treatment: what do couples really want?. Patient education and counseling, 94(3), 390-395.
Rooney, K. L., & Domar, A. D. (2018). The relationship between stress and infertility. Dialogues in Clinical Neuroscience, 20(1), 41. https://doi.org/10.31887/DCNS.2018.20.1/klrooney
Salame, A. A., Zhaffal, M. J., & Peramo, B. (2024). Early pregnancy loss in IVF: a literature review. Middle East Fertility Society Journal, 29(1), 30.
Valsamakis, G., Chrousos, G., & Mastorakos, G. (2019). Stress, female reproduction and pregnancy. Psychoneuroendocrinology, 100, 48-57. https://doi.org/10.1016/j.psyneuen.2018.09.031