Understanding Stress, Self‐Blame and Fertility

If you have ever walked out of a fertility appointment thinking, “Maybe this is my fault,” you are in painfully crowded company. A tough AMH result or another negative test can land not just in your medical chart, but in the deepest parts of your identity. Your brain starts spinning stories: My body is broken. I waited too long. Nothing ever works for me.

The science is clear on two things at once: infertility is not your fault, and how you talk to yourself about it can shape how heavy this season feels.​

Psychologist Dr. Alice Domar, a longtime researcher at Harvard Medical School and author of Conquering Infertility, has compared the emotional toll of infertility to serious illnesses like cancer and heart disease. In one of her early studies, women in infertility treatment reported anxiety and depression levels comparable to patients facing other major medical conditions. Distress often peaks around the second or third year of trying to conceive, right when many people have heard several rounds of discouraging news.​

That means your reaction to “low AMH” or “another failed cycle” is not oversensitive. It is your nervous system responding to something that touches your body, your relationships, your finances, and your future all at once. When brains are under that kind of pressure, they tend to simplify complicated situations into harsh, absolute thoughts. That is where cognitive distortions come in.​

In Conquering Infertility, Dr. Domar teaches patients to notice patterns in their thinking that sound true but are not actually fair or accurate. Three of the most common are:​

Catastrophizing
One disappointing number becomes a lifelong prediction: “My AMH is low, so I will never have a baby.” A recent Psychology Today piece on “the mental maze of fertility” describes catastrophizing as expecting the worst‑case scenario and using words like “never” to try to brace for disappointment. The problem is, it slams the door on any possibility in between.​

Labeling
Instead of “this result is concerning,” your brain jumps to: “My body is defective.” Suddenly, a lab value turns into a character judgment.​

All‑or‑nothing thinking
If this cycle does not work, then nothing will: “If this IVF round fails, that proves I am not meant to be a parent.” The mind erases all nuance, other options, and the simple reality that fertility treatment often takes multiple tries.​

None of these thoughts are you being dramatic. They are what human brains tend to do when they are scared and exhausted, which is why Domar devotes entire chapters to naming and gently challenging them rather than forcing “positive thinking.”​

WebMD shares the experience of Urit Chaimovitz, a woman sitting in a Boston infertility clinic after years of failed attempts when a poster on the wall caught her eye. It advertised a mind‑body program for women struggling to conceive, based on the work later distilled in Conquering Infertility.​

By that point, infertility had taken over her life. Every month became a cycle of hope, hyper‑vigilance, and grief, mirroring what many patients describe in studies of infertility‑related distress. She describes feeling consumed by anxiety and sadness, unsure how much longer she could keep going. The poster offered something no one had really talked to her about before: a way to work with her mind, not just her body.​

Urit joined the program and began learning meditation, cognitive‑behavioral skills, and other tools to manage the stress of treatment and uncertainty, the same types of practices Domar explains step‑by‑step in Conquering Infertility. Over time, she reported feeling calmer, more able to separate her worth from her lab results, and more equipped to ride the emotional roller coaster without falling apart each month.​

Her story does not claim that mindfulness or mind–body work “cured” infertility. Instead, it shows what many studies suggest and what Domar’s book emphasizes: “When patients learn ways to soothe their nervous systems and challenge self‑blaming thoughts, they suffer less and are more able to stay engaged with treatment.” Urit moved from feeling like infertility owned every corner of her life to feeling she had at least some tools and agency again.​

So does it actually help to work on your thoughts, or is that just another thing on your to‑do list? Domar’s body of work, and the data she cites in Conquering Infertility, suggests it can matter more than most of us expect.​

She describes a 10‑week mind–body group program combining relaxation, cognitive‑behavioral therapy, and support in which participants had around a 55% take‑home baby rate compared with about 20–22% in a medically‑treated control group. A follow‑up study found similarly striking differences in pregnancy rates, which Domar discusses as evidence that addressing stress and coping can support—not replace—the medical side of care.​

Those numbers do not mean “just relax and you will get pregnant,” a myth Domar explicitly pushes back against in her writing. Instead, they suggest that learning to manage stress and unhelpful thinking can reduce dropout, improve how people tolerate treatment, and create conditions that support the medical work you and your team are doing.​

Online versions of these approaches tell a similar story. An internet‑based mind/body intervention for women experiencing infertility significantly reduced distress and improved quality of life compared with standard information alone. In other words, even when nothing in the lab results changes, how you experience the journey can shift.​

If “be kind to yourself” sounds like something on a mug, not a medical strategy, it may help to know that self‑compassion has real evidence behind it.

Psychologist Kristin Neff, who has spent years studying self‑compassion, defines it as treating yourself the way you would treat a close friend: with kindness, a sense that struggle is part of being human, and enough mindfulness to notice your feelings without drowning in them.​

When researchers looked specifically at infertility, they found that in women, self‑compassion completely “mediated” the effect of shame on infertility‑related stress. In plain language, women who were able to respond to themselves with warmth and understanding, instead of criticism, felt significantly less crushed by the same diagnosis. A separate trial of a self‑compassion‑based program for infertility showed improvements in anxiety, depression, and overall well‑being.​

For men, related research found that high self‑judgment—harsh inner criticism and isolation, was a key link between shame and distress. That suggests that learning to soften that inner voice may be just as important for partners, even if they show it differently.​

Self‑compassion is not pretending everything is fine. It looks more like:

None of this removes the sting of another low number or another negative test. But it does give you a framework:

On a practical level, that might look like this when new results land in your inbox:

It is completely understandable if infertility has made you question your body, your choices, even your identity. The research is reassuring on this point, though: you are not just your lab results, your worst thoughts, or your most frightened days. You are also the person learning, reaching for support, and finding ways to keep going in a situation that would challenge anyone.