Counselling and fertility support (Fertility counselling and emotional support)
Talking support from a qualified counsellor to help you cope with the emotional side of fertility problems, treatment, donor conception or pregnancy loss.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Counselling helps with the emotional side of fertility problems, treatment, donor conception and loss; it is not a medical fertility treatment.
- HFEA-licensed clinics must offer counselling, and it is strongly encouraged before donor or surrogacy arrangements.
- There is no good evidence that reducing stress improves the chance of treatment succeeding, so be wary of anyone who claims it does.
- Look for a counsellor accredited by the British Infertility Counselling Association (BICA) or an equivalent professional body.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
A safe, confidential space to talk about a stressful and often isolating experience
Counselling is not a medical treatment for infertility and will not change treatment success rates.
A confidential conversation; you set the pace and can pause or stop at any time.
An agreed plan for the number and frequency of sessions, reviewed as you go.
A confidential conversation; you set the pace and can pause or stop at any time.
You may feel relieved, tired or emotional. It can help to plan something gentle afterwards.
You may reflect on what was discussed; some counsellors suggest things to think about or try.
Many people feel more able to cope and clearer about decisions; you can review whether to continue.
What is counselling and fertility support?
Counselling and fertility support is talking support from a trained counsellor to help you cope with the emotional impact of fertility problems and treatment. This can include the stress of trying to conceive, going through IVF, using or being a donor, surrogacy, pregnancy loss, or coming to terms with not having a child.
Under the rules set by the Human Fertilisation and Embryology Authority (HFEA), every licensed fertility clinic in the UK must offer you the chance to talk to a counsellor before treatment. Counselling is also strongly encouraged before donor or surrogacy arrangements.
There are different types. 'Implications' counselling helps you think through the consequences of a particular choice, such as using donor eggs or sperm. 'Support' counselling helps you cope with the ups and downs of treatment. 'Therapeutic' counselling helps you deal with the emotional effects of fertility problems over a longer period.
Counselling is about emotional wellbeing and decision-making. It is not a medical treatment for infertility, and there is no good evidence that reducing stress improves the chance of treatment working. That does not make it any less valuable; fertility journeys are hard, and good support matters.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Implications counselling
Helps you think through the consequences of a particular decision, such as using donor eggs, sperm or embryos, surrogacy, or telling a child about their origins. Recommended...
Support counselling
Emotional support during the ups and downs of treatment, including the two-week wait, unsuccessful cycles and difficult decisions.
Therapeutic counselling
Longer-term help to cope with the emotional effects of fertility problems, such as grief, anxiety, low mood and the impact on relationships.
Couple and relationship support
Sessions with you and your partner to help you navigate decisions and the strain that fertility problems can place on a relationship.
Preparing for your appointment
- Think about what you most want help with, for example a decision, coping with treatment, or grief after loss.
- Check whether your clinic includes counselling and whether there is any extra cost.
- Look for a counsellor accredited by BICA or an equivalent body, especially for donor or surrogacy decisions.
- If you have a partner, decide whether you want to attend together, separately, or both.
- Note any past mental health support, as this can help your counsellor.
- There is nothing you need to do to your body to prepare; this is a conversation, not a procedure.
- It is fine to bring questions or things you are afraid to say out loud.
What happens
A counselling session is a private, confidential conversation with a trained counsellor, usually lasting around 50 to 60 minutes, in person or by phone or video.
The counsellor will not tell you what to do. They help you explore your feelings, think through decisions, and find ways to cope. For implications counselling, they help you consider the longer-term consequences of a choice, such as using a donor, including for any future child.
You might have a single session or several, depending on what you need. What you discuss is confidential, within normal professional limits (for example, if there is a serious safety concern). Counselling can sit alongside your medical treatment but is provided independently of decisions about whether treatment goes ahead.
Is this appointment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Counselling is not a medical treatment for infertility and will not change treatment success rates.
- It is not a substitute for urgent mental health care if you are in crisis.
- On its own, it is not the right route if you need diagnosis or treatment of a mental health condition; your GP can help arrange that.
- It cannot resolve a medical decision that needs input from your fertility team.
Delay or rearrange if…
- You are in a mental health crisis and need urgent help first.
- You are too unwell to engage and need medical support arranged through your GP.
- A decision you are exploring depends on medical results that are not yet available.
- You want implications counselling but the counsellor is not accredited for that role.
Alternatives to discuss
- Peer support groups and charity helplines.
- Your local NHS or HSC psychological-therapies service, or your GP, for low mood and anxiety — in England this is often called NHS Talking Therapies and may allow self-referral, but the service name, eligibility and referral route differ in Scotland, Wales and Northern Ireland.
- Relationship counselling services for couple strain.
- Condition-specific charities (for example, for miscarriage or PCOS).
- Choosing not to have counselling, which is a valid choice.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- A safe, confidential space to talk about a stressful and often isolating experience
- Help thinking through difficult decisions, such as donor conception or stopping treatment
- Support coping with the ups and downs of treatment and with pregnancy loss
- Help protecting your relationship and wellbeing under strain
- Space to consider the implications of choices for any future child
Risks & complications
- Sessions can bring up strong or painful emotions, especially at first
- It may take more than one session to feel a benefit
- Talking does not change the medical situation or treatment chances
- Finding the right counsellor can take a little time
- Difficult feelings surfacing that may need longer-term or specialist mental health support
- Disagreement between partners becoming clearer during couple sessions
- Distress severe enough to need urgent mental health care, which the counsellor should help you access
Counselling is low-risk, but it is emotional work and can feel harder before it feels better. It is not a substitute for medical treatment of infertility, and it will not change the odds of a cycle working. If you have severe depression, thoughts of self-harm, or another mental health crisis, you need urgent medical help, not only counselling.
Published figures to discuss
Counselling is a low-risk talking support, so adverse-event rates are not meaningful. The most important point is that it does not change fertility treatment outcomes, and any claim that it boosts success should be treated with caution.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Physical harm | Very low | Counselling is talking support, not a medical procedure. | Guide sourcesClinical context |
| Emotional discomfort | Common and sometimes useful | Discussing infertility, donor conception, miscarriage or treatment failure can be painful; a qualified counsellor should pace this safely. | HFEA — Getting emotional supporthfea.gov.ukSource-linked context |
| Effect on fertility-treatment success rates | No reliable evidence that counselling itself increases live birth | Its value is support, decision quality, coping and relationship/ethical clarity, not a promise of better embryo implantation. | Guide sourcesClinical context |
| Donor, surrogacy or legal-consent complexity | Clinically important | Good counselling should explore future child identity, disclosure, donor information release, grief, coercion and relationship strain. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery. 'Afterwards' is about how you feel emotionally, the decisions you reach, and any further support you arrange.
- Feeling emotionally tired after a session
- Needing more than one session before you notice a benefit
- Strong feelings coming up when discussing loss or decisions
- Wanting time to reflect between sessions
Aftercare
- Be gentle with yourself after emotional sessions.
- Agree with your counsellor how many sessions and how often feels right.
- Use peer support, helplines or charity resources alongside counselling if helpful.
- Keep your GP or fertility team informed if your mood is a concern.
- Know how to get urgent help if you feel unable to cope.
- Discuss with your partner what support each of you needs, which may differ.
- Clear idea of what you want help with
- A BICA-accredited or equivalent counsellor identified
- Decision on individual or couple sessions
- Any extra cost from your clinic checked
- Past mental health support noted for the counsellor
- Urgent-help contacts saved (GP and a crisis line; NHS 111 in England, Scotland or Wales, or GP out-of-hours/Phone First in Northern Ireland)
- Peer support or charity resources noted
⚠ Get urgent help if…
- Feeling hopeless, or having thoughts of harming yourself — get urgent help now (call 999 or go to A&E if you are in immediate danger). For urgent advice, contact your GP; you can call NHS 111 in England, Scotland or Wales, or in Northern Ireland contact GP out-of-hours or your HSC Trust's Phone First service
- Severe or worsening depression or anxiety that affects daily life
- Feeling unable to cope after pregnancy loss or an unsuccessful cycle
- A counsellor who pressures you towards a particular decision
- Any service claiming counselling will improve your chance of pregnancy
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
The 'result' of counselling is not a test value but how supported you feel and how confidently you can make decisions. Many people find it helps them cope with treatment, process loss, or feel clearer about choices such as donor conception or when to stop.
Counselling cannot change the medical outcome of fertility treatment, and a difficult emotional response does not mean it has failed. The benefit usually builds over time, and the right number of sessions varies from person to person.
Support needs change as your situation changes; you might use counselling at one stage, pause, and return at another, such as before a donor cycle, after a loss, or when deciding to stop treatment. There is no fixed course, and it is fine to revisit support whenever you need it.
Related tests, treatments or support
Counselling often sits alongside fertility investigations and treatment, recurrent miscarriage care, and decisions about donor conception or surrogacy. It also pairs well with peer support groups and charity helplines. It does not replace medical assessment, and important medical decisions remain with your fertility team.
Follow-up & long-term care
You and your counsellor agree how many sessions you have and how often, and you can review this as you go. If deeper or longer-term needs emerge, you may be signposted to your GP or to specialist mental health services. There is no medical 'result' to chase, but a good service makes sure you know how to get further or urgent help.
- Return to counselling at key decision points or after setbacks if it helps.
- Keep using peer support and charity resources between sessions.
- Tell your GP if your mood is a concern, so support can be coordinated.
Repeat, follow-on and what comes next
- The number and type of sessions can be adjusted as your needs change.
- You can pause and return to counselling at different stages of your journey.
- If needs are deeper than expected, you may be signposted to specialist mental health care.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- An agreed plan for the number and frequency of sessions, reviewed as you go.
- Clear information on confidentiality and its limits.
- Signposting to peer support and charity resources.
- A route to your GP or specialist mental health services if needed.
- Clear advice on how to get urgent help in a crisis.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether your clinic includes counselling or charges separately
- Number and length of sessions
- Individual versus couple sessions
- In-person versus phone or video sessions
- The counsellor's accreditation and experience
- Whether specialist input (for example, donor or surrogacy implications) is needed
- Whether counselling is included in any treatment package or charged separately
- The cost per session and the likely number of sessions
- Whether couple sessions cost the same as individual sessions
- The counsellor's accreditation (for example, BICA)
- Whether phone or video sessions are available
- How to access further or urgent support if needed
On the NHS? Some NHS and charity counselling is available, and HFEA-licensed clinics must offer counselling (sometimes at extra cost); private counselling is also widely available, ideally from a BICA-accredited counsellor. Whether the NHS or HSC funds fertility counselling or wider fertility treatment — and any limit on the number of funded IVF cycles — is decided separately in England, Scotland, Wales and Northern Ireland and can change, so confirm current eligibility with the relevant NHS/HSC fertility commissioner, service or clinic rather than assuming a UK-wide entitlement.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Claiming counselling will improve your chance of pregnancy.
- Not explaining the limits of confidentiality.
- Pressuring you towards a particular decision rather than supporting your own.
- Offering implications counselling without appropriate accreditation.
- Hidden charges for sessions within a treatment package.
Marketing red flags
- 'Stress-busting' programmes that promise higher IVF success.
- Bundling expensive 'mind-body' packages with treatment as if they improve outcomes.
- Counsellors without recognised accreditation offering implications counselling.
- Pressure to commit to long, costly courses of sessions upfront.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What type of counselling do I need: implications, support or therapeutic?
- Are you accredited by BICA or an equivalent body?
- Is counselling included by my clinic, or is there an extra cost?
- Can my partner and I be seen together, separately, or both?
- How many sessions might help, and how do we review this?
- How do I get urgent help if I feel unable to cope between sessions?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my appointment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this appointment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will counselling improve my chance of getting pregnant?
Do I have to have counselling before treatment?
What is implications counselling?
Is fertility counselling free?
How do I find a good fertility counsellor?
Is what I say confidential?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: HFEA — Getting emotional support HFEA — In vitro fertilisation (IVF) BICA — Find a Counsellor Tommy's — Mental wellbeing nidirect — Urgent and emergency care services (NI) nidirect — GP out-of-hours service (NI) NHS — NHS Talking Therapies (England) NHS inform — Psychological therapies (Scotland) NHS 111 Wales — Counselling nidirect — Mental health care professionals (NI) NICE NG257 — Fertility problems NHS inform — Infertility and fertility access (Scotland) NHS Wales — Specialist fertility services commissioning policy (CP38) Belfast Trust — Regional Fertility Centre (NI)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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