Fertility
Fertility: The fear, grief and relief in accessing mental health support
90 per cent of those struggling to conceive are likely to experience depression symptoms of some kind
As research shows that women with infertility experience similar levels of anxiety and depression to those with cancer, heart disease and HIV, we find out how to get the balance right when trying to conceive.
The relationship between stress and infertility has been repeatedly debated. Although the impact of distress on treatment outcome is unclear, stress, depression and anxiety are common consequences of infertility.
According to NICE, one in seven heterosexual couples in the UK may have difficulty conceiving. But despite the prevalence of infertility, research has shown that couples often shy away from sharing their story and “fake good” in order to appear mentally healthier than they are, thus increasing their psychological vulnerability.
“The lack of scientific knowledge has meant that the correlation between fertility and mental health support has been largely ignored,” says Mithi Thaya, CEO of the London-based health tech company Harper.
“Women who undergo fertility treatment are highly stressed. However, in most cases, nobody looks after their mental well-being because the clinicians and nurses either don’t have the time or are not well equipped to do so.”
A Fertility Network UK survey on the impact of fertility problems found that only 44 per cent of women received counselling with 54 per cent of them funding some of the sessions themselves.
Existing solutions are often too costly for clinics to implement, says Thaya. “In order to offer counselling, a clinic has to go through both a fertility and a reproductive medicine regulator.
“On top of that, self-reporting – the current gold standard in mental health assessment – can be unreliable simply because people may not be aware of certain mental health issues they might have.”
Along with the team behind Harper, Thaya aims to make mental healthcare more objective and affordable through molecular biology and technology for earlier accurate detection.
The practice, also known as precision medicine, looks at the genetics, environment, and lifestyle of a person and offers a personalised treatment, in contrast to the traditional one-size-fits-all approach to prevention and care.
Reports have shown that giving the right treatment to the right person at the right time leads to better outcomes for patients and can additionally reduce the costs and the risk of adverse effects.
“Your behaviour, your tone of voice, your eye pattern, some of the hormones you produce in your body and the way you feel could be indicators of your state of mental health,” the CEO explains.
“So, we aggregate all of these data points in a seamless, non-invasive manner through a number of clinically validated digital assessments, we give each patient a personalised plan and then we assign them a fertility-trained coach.”
Coaches help couples learn to express their feelings, navigate their IVF cycles and feel more in control. However, a coach is not a counsellor, says Thaya.
“There’s a big difference between our coaches and having a counsellor. Counselling often helps with serious issues, including severe mental health challenges and trauma. But although therapy has its place, when it comes to fertility treatment, we realised that the last thing a patient wants is somebody to open the Pandora’s box of everything that has been going wrong in their life.
“Coaching, on the other hand, is there to help them achieve their goal. The coaches are either IVF nurses or patient administrators who have previously worked in an IVF setting and are able to deal with patients on a human level.”
Demand for mental health support has significantly increased post pandemic. Reports have found that 90 per cent of those struggling with fertility are likely to experience depression symptoms of some kind while 42 per cent are likely to report suicidal thoughts.
However, the mental health sector remains unexplored. Meta analyses have shown that mental health has received “an inadequate proportion of health funding”, in comparison with the burden it causes while stigma, human resource shortages, fragmented service delivery models and a lack of research capacity for implementation and policy change contribute to the current treatment gap.
Thaya hopes that by working with scientists companies like Harper will drive more research and investment in solutions targeting mental health.
“We are very fortunate to partner with experts from the University of Chicago, Oxford, Cambridge and Imperial College London and our goal is to do a joint study with them to analyse the data from the clinics we work with and improve patient support.”
After in April it raised US$6.5m to address AI-based mental healthcare, the start-up is planning to expand geographically and explore other health sectors, including cardiovascular disease and oncology.
“We know that people who live with different mental health conditions, such as chronic stress, clinical anxiety or depression, have a two times higher rate of cardiovascular disease,” says Thaya.
“Our ambition is to be able to identify patients’ state of mental wellbeing at the right time and deliver the right interventions.”
Entrepreneur
Kindbody unveils next-gen fertility platform
Mental health
Baby2Home app boosts new mothers’ mental health
First-time mothers using the Baby2Home app for a year after birth reported fewer symptoms of stress, depression and anxiety than those receiving usual postpartum care.
The study found women randomised to the app reported better overall health than first-time mothers who received usual care alone.
Baby2Home is a digital tool to help new families with newborn care and staying healthy.
It offers tailored educational content, infant care trackers and mental health self-management tools, plus access to a care manager for on-demand mental health and problem-solving support.
Emily S. Miller is principal investigator and division director of maternal-fetal medicine at Women & Infants Hospital of Rhode Island.
She said: “Evidence-based digital tools like Baby2Home are opening the door to a new era of postpartum care.
“We can now extend high-quality support beyond hospital walls and into families’ everyday lives. The mental health improvements we saw underscore just how transformational that support can be.”
Researchers from Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Northwestern University’s Feinberg School of Medicine and Lurie Children’s Hospital of Chicago ran a multi-site randomised controlled trial between November 2022 and July 2025.
The trial enrolled 642 postpartum patients, all first-time parents. For 12 months after birth, all participants received usual postpartum care; half also used the Baby2Home smartphone app.
Participants reported progress electronically at five time points over the first year. Compared with the control group, those assigned to Baby2Home reported significantly fewer symptoms of stress, depression and anxiety.
They also reported better overall health, higher relationship satisfaction with partners and family members, and greater confidence in their parenting than the control group.
Miller said: “The first year after birth is a critical period for parental mental health. Baby2Home helped new parents feel more confident, more supported and more connected.
“That translated into better health outcomes for them and their families.”
Fertility
Most NHS regions in England limit IVF to single cycle, research finds
Nearly 70 per cent of NHS regions in England fund only one IVF cycle for women under 40, breaking national guidelines, new research has found.
Twenty-nine of the 42 integrated care boards, which control local NHS budgets, now offer only one round of treatment, after four reduced access in the past year.
National Institute for Health and Care Excellence (Nice) guidelines recommend three full cycles for women under 40 who have been unable to conceive for two years.
Only two of England’s 42 integrated care boards have policies consistent with these guidelines, which they are not legally obliged to follow.
The research was conducted by the Progress Educational Trust, a fertility charity.
Sarah Norcross, the director of PET, said the impact was “devastating” for couples struggling with infertility.
She said: “Infertility is already incredibly stressful for people, and it puts them under even more pressure, because there is so much riding on whether that one NHS-funded cycle is going to work.
“And for some people, that will be their only chance, because private fertility treatment is so expensive.”
The data showed regional variations, with the whole of the north-west offering just one cycle.
“It’s a postcode lottery, and we’re seeing a race to the bottom,” said Norcross.
Of the 29 integrated care boards that offer a single cycle, 19 provide only a partial cycle, where not all viable embryos created are transferred.
There was just one recent example of improved services, from NHS South East London, which in July 2024 went from one partial to two full cycles.
The NHS estimates that about one in seven couples may have difficulty achieving a pregnancy. One cycle of IVF can cost from £5,000 at a private clinic.
Fertility rates in England and Wales have fallen since 2010 to 1.41 children per woman in 2024, the lowest on record and below the replacement level of 2.1 at which a population is stable without immigration.
Health minister Karin Smyth said in a written parliamentary answer last month that it was “unacceptable” that access to NHS-funded fertility services varied across the country.
Revised Nice fertility guidelines are due this spring, but Norcross said changing them seemed pointless.
She said: “Fertility treatment has always been a Cinderella service. It’s always been the one they’ve chosen to cut or to ignore.
“Nice has recommended three full NHS-funded cycles, for women under 40, for more than 20 years. This has never been implemented across England, unlike in Scotland.”
Norcross advocated centralised commissioning and replicating Scotland’s approach, which included financial modelling and a phased implementation starting with two cycles to avoid long waits, moving up to three once capacity was achieved.
“It is a tried and tested plan that England could follow,” Norcross added.
A Department of Health and Social Care spokesperson said: “We recognise access to fertility treatment varies across the country and we are working with the NHS to improve consistency.
“Nice provides clear clinical guidelines, and we expect integrated care boards to commission treatment in line with these.
“Updated Nice fertility guidelines are expected this spring and we will continue to support NHS England to make sure the guidance is fully considered in local commissioning decisions.”
An NHS England spokesperson said: “These clinical services are commissioned by integrated care boards for their area based on the needs of the local population and prioritisation of resources available.
“All ICBs have a responsibility to ensure services are provided fairly and are accessible by different population groups.”
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