Reproductive Psychology

Infertility Counseling

Infertility is not an uncommon condition. In fact, 1 in 8 have trouble getting pregnant or sustaining a pregnancy. Approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners or, is unexplained. Receiving a diagnosis of infertility can be devastating and create many negative emotions including anxiety, depression, hopelessness and anger in both partners. Although each partner may have different reactions and feelings than the other has, making it difficult to connect and support each other. Rather than joy and excitement that come with planning to have a baby, infertile couples confront intrusive and stressful medical procedures that do not guarantee success and cause financial burden. Feelings of jealousy that others can have a baby the “cheap, easy, fun way” are not uncommon. Infertility can also negatively affect a couple’s sexual intimacy. What used to be a way to express love and connection gets associated with failure to conceive. In addition, fertility relates to social standards of masculinity and femininity so infertility may lead to one feeling damaged or inadequate as a partner. Men and women process the grief and loss that comes with a diagnosis infertility differently. During the crisis of infertility, counseling can help a couple turn toward each other to develop joint coping strategies.

Pregnancy Loss

Sadly, about 15 percent to 20 percent of all women with a verified pregnancy will end up having a miscarriage, with most of them occurring in the first trimester. The loss of your baby can create intense feelings of sadness and guilt, even though it is not your fault. Often the emotion distress is greater than the physical distress. Miscarriage in our society is often brushed under the rug and not discussed. Talking to a psychologist can help you process your grief and cope with the complicated mix of feelings that occurs following miscarriage.

Postpartum and Antepartum Depression and Anxiety

Anxiety and depression are not uncommon during and after pregnancy. Some symptoms include irritation, anger, feeling disconnected, hopelessness, loss of appetite, bouts of crying, having a sense of dread, and feeling overwhelmed. Don’t wait to get help or talk to someone about your feelings. Counseling can provide emotional support, help you understand your symptoms, and provide coping skills to recover.

Egg and Sperm Donor Screenings

My pre-doctoral and post-doctoral internships both focused on psychological and neuropsychological assessment. Not all psychologists work in the field of testing and assessment, but this has been an integral part of my practice my entire career. I have received advanced training in use of the PAI, personality assessment inventory especially for the field of sperm and egg donor screening. The purpose of psychological assessment of gamete donors is to ensure he or she meets the guidelines for donation established by the American Society of Reproductive Medicine. For anonymous egg and sperm donor screenings, the client will participate in a clinical interview and complete the PAI. A report will follow to the appropriate agency or clinic. If a donor is married or has a live-in partner, that person will also be required to attend part of the meeting. Recommendations are based on emotional stability and maturity, psychological functioning and ability to provide informed consent. Screenings are done in person, in my office, no exceptions.

If the donor is a known donor (friend or acquaintance) or a family member, an additional joint meeting between recipients and donor including donor’s spouse is required. In this meeting, we will discuss disclosure to children and others, disposition of unused embryos, and decision-making authority.

Gestational Carrier Screenings

My pre-doctoral and post-doctoral internships both focused on psychological and neuropsychological assessment. Not all psychologists work in the field of testing and assessment, but this has been an integral part of my practice my entire career. I have received advanced training in use of the PAI, personality assessment inventory especially for the field of gestational carrier screening. The purpose of psychological assessment of gestational carriers is to ensure he or she meets the guidelines for donation established by the American Society of Reproductive Medicine and to ensure the psychological wellbeing of the potential carrier and intended parents. For carrier screenings, the client will participate in a clinical interview and complete the PAI. Her husband or live-in partner will also be required to attend the meeting and may also complete the PAI. If the surrogate is a friend or family member, a second joint meeting is required to make sure all participants agree with the critical issues such as number of embryos transferred, termination and type of relationship between the parties. A report will follow to the appropriate agency or clinic. Recommendations are based on emotional stability and maturity, understanding of the emotional aspects of the process, psychological functioning and ability to provide informed consent. Screenings are done in person, in my office, no exceptions.

Consultation for Heterosexual Couples

Many reproductive endocrinologists require gamete recipients and intended parents to meet with a mental health professional skilled in reproductive psychology prior to their IVF cycle. You may be asking yourself, “Why did my doctor send me to a psychologist? I am not crazy. I just want to have a baby!” There are many important reasons. First know this is not an evaluation. It is not the same as the home visit with adoption. The purpose of the meeting is educational. Topics covered in this one to two-hour session include decisions about disclosure to the future child:  if, how, and when do you disclose about third party reproduction. We will also address some the critical decision points along the way to ensure you and your partner agree with the family building plan. Additional topics include donor/surrogate selection, future contact with the donor and/or surrogate, decisions about remaining embryos and avoidance of common pitfalls in the process. Please feel free to bring any and all questions you have to this meeting. If you are using a known donor or carrier, an additional joint meeting with all parties is required to ensure everyone agrees with the plan, and to address any potential differences.

Consultation for Same Sex Couples

Research has long shown that children raised by same sex couple do just as well as those raised by heterosexual couples. I wholeheartedly support gay and lesbian family building. You may be asking yourself, “Why did my doctor send me to a psychologist? I am not crazy. I just want to have a baby!” There are many reasons. First know this is not an evaluation. It is not the same as the home visit with adoption. The purpose of the meeting is educational. Topics covered in this one to two-hour session include decisions about disclosure to the future child:  if, how, and when do you disclose about third party reproduction. We will also address some the critical decision points along the way to ensure you and your partner agree with the family building plan. Additional topics include donor/surrogate selection, future contact with the donor and/or surrogate, embryo disposition and avoidance of common pitfall in the process. Please feel free to bring any and all questions you have to this meeting. If you are using a known donor or carrier, an additional joint meeting with all parties is required to ensure everyone agrees with the plan and to address any potential differences.

Consultation for Single Men and Women

If you are a single woman and are choosing to build your family with a sperm donor or you are a single man opting for a surrogate and egg donor, I support your choice to have a family. You may be asking yourself, “Why did my doctor send me to a psychologist? I am not crazy. I just want to have a baby!” There are many reasons. First know this is not an evaluation. It is not the same as the home visit with adoption. The purpose of the meeting is educational. Topics covered in this one to two-hour session include decisions about disclosure to the future child:  if, how and when do you disclose about third party reproduction. We will also address some the critical decision points you may face along the way. Additional topics include donor/surrogate selection, future contact with the donor and/or surrogate, embryo disposition and avoidance of common pitfall in the process. Please feel free to bring any and all questions you have to this meeting. If you are using a known donor or carrier, an additional joint meeting with all parties is required to ensure everyone agrees with the plan and to address any potential differences.

Fertility Consultations in Other Languages

I work closely with a certified medical interpreter who grew up in Bilbao, Spain. If you need a Spanish interpreter during your fertility consultation, please let me know and we can arrange for her to join us.

If you are from China, I also have worked with a Chinese interpreter so this may also be possible. Please contact me directly.

Egg Freezing

Egg freezing, or oocyte cryopreservation, is a process in which a woman’s eggs (oocytes) are extracted, frozen and stored as a method to preserve reproductive potential in women of reproductive age. Choosing to freeze your eggs is an important decision and there are emotional implications to this decision. Talking to a psychologist can help you sort out your feelings and provide you with the critical psychological information you need in making your decision.

Oncofertility

With 10% of cancer patients being younger than age 40, infertility resulting from cancer treatment affects more than 135,000 people in the United States each year. As cancer survivorship increases, the preservation of fertility in women, men, and children becomes a critically important topic to patients and their families. The ability to preserve fertility prior to cancer treatment can provide hope at the time of diagnosis for families later in life. However, receiving a cancer diagnosis and the news of potential infertility can be overwhelming. Often there is little time to decide about fertility preservation because of the need to start cancer treatment as soon as possible. Talking with a psychologist about your fertility preservation choices and the emotional impact of a cancer diagnosis can provide support and coping skills.