Fertility Support

Fertility Support Fertility Support is the only psychotherapy practice focused on fertility and gynaecological issues.

Our team includes specialised psychotherapists who have ample experience working on issues such as: assessing fertility options (including IVF, surrogacy, donors or adoption), pregnancy-related issues (including high risk-pregnancies or birth trauma), exploring a “child-free” or ”child-less” lifestyle, considering a termination, coping with medical issues such as endometriosis, PCOS or adenomyosis, and dealing with erectile dysfunction, among other issues. Fertility Support offers individual therapy and couples therapy as well as group therapy and one-day retreats. Our aim is to offer individuals a space where they can find compassionate care, understanding and a new way forward.

Fertility Support is delighted to introduce Martha Doniach. Martha is a senior psychodynamic and psychoanalytic psychoth...
18/08/2026

Fertility Support is delighted to introduce Martha Doniach.

Martha is a senior psychodynamic and psychoanalytic psychotherapist with more than three decades’ experience working with individuals and couples across a wide range of psychological and relational difficulties. Her work centres on helping people make sense of complex emotional states, entrenched patterns of relating and the profound impact of life transitions. Her approach draws on psychoanalytic thinking, clinical curiosity and careful attention to both conscious and unconscious experience.

Martha has a particular interest in the psychological dimensions of infertility, reproductive loss and assisted conception. She has written on how infertility and Assisted Reproductive Technology (ART) shape identity, intimacy and the couple relationship. Her chapter “Becoming parents through ART: Infertility, loss and the dilemmas of Assisted Reproductive Technology” was published in Couples as Parents (Routledge, 2024). It offers clinicians a psychoanalytic framework for understanding the emotional complexities that arise when becoming a parent depends on medical intervention.

Martha teaches and presents on fertility-related themes within professional settings, including the impact of ART on couple communication, the ethical and relational challenges of donor conception, and the psychological consequences of prolonged fertility treatment. Her contributions encourage clinicians to think beyond medical outcomes toward the lived emotional realities of infertility and reproductive medicine.

Martha originally trained in social work, counselling and family therapy before completing advanced clinical training at WPF Therapy, Tavistock Relationships, Anna Freud Centre and the Institute of Group Analysis. She worked within the NHS for over twenty years. Further, she teaches and supervises across various training programmes, including at the Tavistock Clinic, Tavistock Relationships and the British Psychotherapy Foundation. She is also a member of the editorial board of the journal Couple and Family Psychoanalysis.

has spoken openly about living with endometriosis, polyendocrine metabolic ovarian syndrome (PMOS, formerly known as PC...
10/08/2026

has spoken openly about living with endometriosis, polyendocrine metabolic ovarian syndrome (PMOS, formerly known as PCOS), and recurrent pregnancy loss, as well as how reproductive illness has affected her life. She has talked about how these conditions can slowly change how someone relates to themselves, not just to their body.

Conditions that affect fertility, menstruation, pregnancy, or hormones often change more than just how the body works. They can shape how someone feels about their femininity, sexuality, attractiveness, competence, and hope. The body can stop feeling like home and start to feel like something we judge, watch, or feel let down by.

Reproductive illness can fundamentally change the way attention is directed towards the body. Instead of just living in their bodies, they may find themselves always watching, interpreting, and looking for signs of what could happen next.

This change usually does not happen overnight. It often builds up through repeated experiences, like ongoing symptoms, failed attempts to conceive, medical tests, treatments, or feeling like the body is not working as expected. Over time, these experiences can change a person's identity as much as they change the body.

Psychotherapy cannot change a diagnosis, but it can help make sure reproductive illness does not become the main way someone sees themselves. There is a big difference between living with an illness and letting it define who you are.

The ways we try to reduce emotional pain can unintentionally keep it alive.Finding it difficult to conceive often brings...
03/08/2026

The ways we try to reduce emotional pain can unintentionally keep it alive.

Finding it difficult to conceive often brings feelings of disappointment, uncertainty, and loss. When emotional pain becomes overwhelming, many people try to suppress it by pushing unwanted thoughts away, shutting down difficult emotions, or hiding their distress from others. These are understandable attempts to protect ourselves from pain that feels too hard to face.

However, research shows that suppressing unwanted thoughts can make them return more often. The harder we try not to think about something, the more attention we end up giving it. Rather than disappearing, the thought remains active in the background, making it easier to return.

Emotional suppression also does not selectively dampen emotions. Research shows that people who habitually suppress difficult emotions also experience lower levels of positive emotions, including joy, enthusiasm, interest, and contentment. Because many of the psychological and physiological processes involved in regulating emotions overlap, dampening one emotional response can also reduce others.

When we hide our distress, others may not recognise we need support. Research shows that people who suppress their emotions often receive less support. This is not because others are unwilling to help, but because they cannot respond to needs they cannot see. By trying to protect others from our distress, we can unintentionally make it harder for them to support us.

These ways of coping aren’t “bad.” They often develop because they once served an important protective function. The real question is whether they still help us or have begun to keep us stuck. In psychotherapy, the goal is to understand the role these strategies have played, decide whether they still serve us, and, where appropriate, help people replace them with more flexible ways of responding to emotional pain.

Which of these strategies do you recognise most in yourself? How has it protected you, and what might it now be costing you?

When people struggle to conceive, blaming themselves often serves an important psychological function: it creates a sens...
31/07/2026

When people struggle to conceive, blaming themselves often serves an important psychological function: it creates a sense of control where life feels painfully out of control.

People are faced with a hard truth when it comes to infertility: some of the most important things that happen in life cannot be completely explained, predicted, or controlled.

When an explanation is missing, our minds rarely leave the space empty. Instead, they often choose an explanation, even if it hurts, rather than having no explanation at all. Thinking "It must be something I did" can feel easier than admitting "I don't know why this is happening."

Self-blame also preserves hope. If our actions contributed to the problem, perhaps different actions could change what happens next. That possibility can feel easier to bear than accepting that some outcomes remain outside our control.

This is why people may keep blaming themselves even when doctors say the cause is something else. Self-blame gives shape to an experience that might otherwise feel random, confusing, and scary.

In psychotherapy, the goal is not just to convince someone to stop blaming themselves. Simply understanding why we blame ourselves is rarely enough to stop doing it. Instead, therapy helps people understand what makes self-blame feel necessary and supports them as they learn to face uncertainty, grief, and helplessness without turning those feelings against themselves.

The aim is not only to ease suffering, but to prevent infertility from becoming the lens through which someone understands themselves.

For psychotherapists looking to deepen their understanding of couple dynamics through a psychoanalytic lens, Tavistock R...
15/07/2026

For psychotherapists looking to deepen their understanding of couple dynamics through a psychoanalytic lens, Tavistock Relationships offers a Summer School exploring contemporary themes in couple psychotherapy.

As part of this year’s programme, Amita Sehgal, a couple psychoanalytic psychotherapist and member of the Fertility Support team, will explore the impact of infertility and Assisted Reproductive Technology (ART) on couple relationships.

Drawing on almost 30 years’ experience in adult mental health, she will examine what happens when the deeply held hope of having a child encounters the realities of fertility treatment.

Through a psychoanalytic lens, Amita will examine the interplay between internal psychic realities and external reproductive interventions. The training will consider how unconscious wishes, narcissistic investments, loss, longing and the imagined child may be brought into sharp focus when conception does not occur naturally.

Drawing on clinical material and contemporary examples, she will explore how ART can challenge and reshape couple dynamics, transforming experiences of intimacy, dependency, difference and shared hope. She will also reflect on questions of disclosure and identity: what does it mean for a child, and for a family, to know they were conceived through assisted reproduction?

For more information about the Tavistock Relationships Couple Therapy Summer School, visit TR Together.





A recent survey by the British Association for Counselling and Psychotherapy BACP found that 3 in 4 people who have had ...
10/07/2026

A recent survey by the British Association for Counselling and Psychotherapy BACP found that 3 in 4 people who have had therapy found it helpful, and a similar number would recommend it to someone else.

When struggling to conceive, many wait until they feel they are no longer coping before seeking help. But the longer difficult experiences remain unprocessed, the more likely they are to influence how people see themselves, their relationships, and the possibilities they imagine for their future. Support is often most valuable while someone is still trying to make sense of what they are living through.

Psychotherapy can help in many different ways. One is that putting experiences into words, particularly in the context of a supportive relationship, helps the brain organise and integrate them. Research shows that when we translate emotional experiences into language, they become less emotionally overwhelming and easier to reflect upon. Experiences that feel confusing, or isolating can become easier to understand, remember, and respond to when explored in psychotherapy.

Therapy can also provide a space to make sense of uncertainty, difficult decisions, and relationship pressures. Processing emotions can help ensure that the impact of treatment, loss, or disappointing news does not continue to shape how a person understands themselves, their body, or their future.

George and Martha Washington lived consequential and meaningful lives despite never having children together. Their live...
04/07/2026

George and Martha Washington lived consequential and meaningful lives despite never having children together. Their lives challenge the belief that involuntary childlessness inevitably results in a less meaningful life.

Martha’s four children from her first marriage sadly died in childhood or early adulthood. She became a widow and, at age 27, married George Washington. Medical historian John Amory has argued that George Washington could not conceive, possibly as a consequence of tuberculosis.

Not having children would have carried practical and symbolic weight for Washington, whose public life became inseparable from questions of legacy. However, after retiring, he repeatedly shared a vision of contentment in old age, returning in his letters to the image of sitting beneath a tree, undisturbed and at peace.

Martha’s life also challenges the idea that circumstance determines fulfilment. She lived through widowhood, the deaths of all four of her children, war, and repeated disruption of private life. Yet she continued to find meaning in the life she actually had, rather than the life she might have expected.

Their story does not suggest that involuntary childlessness is painless. But it does suggest that it need not result in a life without joy, accomplishment, contentment, or fulfilment. Many people assume that later life will expose childlessness as a permanent source of regret. The Washingtons remind us that a meaningful life is shaped by friendships, work, care given and received, values lived, and communities built.

As the United States marks 250 years since its founding, the Washingtons remind us that there are many paths through which a life acquires depth, attachment, purpose, or significance. Happy 4th of July.

03/07/2026

Infertility is not a mindset problem.

The idea that infertility can be overcome by relaxing or thinking positively confuses cause and consequence. Infertility is a medical condition. Stress, grief, and anxiety are responses to infertility, not the reason it exists.

Infertility arises from identifiable biological mechanisms: ovulatory dysfunction, tubal pathology, s***m parameters, implantation failure, among other biological factors. None of these can be altered solely by positive thinking or stress reduction.

What is psychological is the impact of infertility. Repeated negative pregnancy tests, miscarriages, and prolonged uncertainty foster anticipatory anxiety grounded in prior loss, grief without social recognition, erosion of bodily trust, and a narrowing sense of future. Distress is a proportionate response to sustained biological disappointment.

Attributing difficulties in conceiving to a person’s mindset creates an additional psychological burden: the burden that comes from feeling one is not coping well enough.

Psychological support can help people navigate the emotional consequences of a difficult fertility experience. Infertility can affect relationships, identity, self-esteem, and a person’s sense of what the future might hold. Psychotherapy can provide a space to process loss, uncertainty, and difficult emotions, and to preserve a sense of self during what is often a profoundly disruptive experience. It can also reduce the isolation that frequently accompanies infertility.

The goal is not to think your way out of infertility but to find a way of living with an extraordinarily difficult reality without turning the suffering against yourself.

Rabindranath Tagore, the Indian poet and philosopher, wrote about the importance of meeting one’s own truth directly. Hi...
26/06/2026

Rabindranath Tagore, the Indian poet and philosopher, wrote about the importance of meeting one’s own truth directly. His words invite us to reflect on how easily pain can be minimised by comparison. In moments of distress, it can feel easier to say, “others have it worse” or “this is nothing compared to what some people face.” Such thoughts may appear as helpful, but they often serve as defences against contact with our own grief.

In a fertility journey, this can take many forms. You might tell yourself that your loss is not as great as someone who miscarried later, or that your sadness is disproportionate because you have not tried as long as others. These comparisons may seem to offer perspective, but they actually create distance from the emotion that most needs attention.

This impulse to compare is a way of avoiding overwhelm. It protects against the fear that your feelings might be too large to bear. Yet by turning away, you also turn away from understanding. Emotions that are dismissed cannot be integrated; they remain suspended, seeking acknowledgment.

Rabindranath’s words remind us that what is “yours to know” must be explored by you, without being minimized. When your suffering is recognised rather than ranked, it begins to make psychological sense.

What part of your pain have you been comparing away instead of allowing yourself to truly know?

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