Anxiety disorders

Having an anxiety disorder as well as difficulties getting pregnant can make life hard. Some genetic conditions such as premature menopause, endometriosis and polycystic ovary syndrome (PCOS) not only affect fertility, they can also cause higher anxiety levels. Some treatments for different illnesses cause anxiety. Chemotherapy for cancer, or surgery can make you fearful and significantly anxious about your own wellbeing and your ability to have a baby. Previous experience of anxiety and depression, past trauma, lack of support can all make anxiety levels higher.

Is this you?

LEARN Consider the different stories and pictures below, listen to a podcast or check out the video.

THINK Then, to understand more about what causes anxiety you can explore the different social, psychological and physical things that can increase anxiety. In this section you will find questions to ask yourself about each cause to see if it affects you.

DO Once you have explored the causes of anxiety then it is time to do something. Go to the ‘Toolkit’ to find a range of different tools to help yourself try and reduce anxiety.

View the causes of Anxiety Disorders for Fertility

Do you relate to these?

I am a science experiment.
Each month when I find out I am not pregnant I get panicky for days.
I am trapped in a body that doesn’t work.

I can’t get out.
I have no control.
I can’t do anything and I just want it all to stop and I can go back to just being me - who I was before – a woman who wanted to have a baby… someday…and I believed that was possible. Now I am anxious everyday about everything!

Failure is not usually a word I use about myself.  But I have failed and I can’t keep going. I can’t keep going back for more and now I am lost. I don’t know what to do.


Clomid didn’t work – waiting

FSH high – waiting

One egg failed – waiting

Transfer day – waiting

Pregnant – yes

Miscarriage – waiting

Causes of anxiety disorders for Fertility

What happens

Some personalities are more prone to anxiety. Your personality type and the way you operate can significantly increase anxieties. If you are a perfectionist or someone who focusses on goals or thinks in rigid ways with a need for control, the complexity of trying to become pregnant may very distressing. The lack of control and uncertainty that can be part of fertility difficulties increases vulnerability to anxiety for some women.

Questions to ask yourself

Am I the kind of person who is prone to high levels of anxiety?

How much do I like things to be perfect?

How much control do I like to have over my life?

How do I usually manage in difficult situations?

What happens

Distressing and faulty thinking such as

  • catastrophising - thinking the worst possible thing will happen
  • jumping to conclusions - thinking you can predict the future (and it is bad) 

create a negative cycle. Distressing thoughts cause physical symptoms such as a racing heart, feeling sick causing you to want to run away. Your self-talk remains negative - “I am hopeless” - and the whole cycle starts again. If you find it hard to challenge your thoughts or if you avoid situations that cause anxiety you don’t get the benefit of facing your fear and working through the anxiety – this can lead to anxiety disorders.

Questions to ask yourself

Think of a recent time when you felt anxiety and ask yourself – in what ways were my thoughts unhelpful or faulty?

For example, do I

  • jump to conclusions about what people think of me?
  • think something really bad is about to happen?

What is the evidence to support my thoughts?

What is the worst thing that could happen? How likely is this?

What happens

Having a constant and significant negative attitude can increase your levels of anxiety. You may have negative thoughts and feelings about your life in general, about how your life seems completely out of your control, and about your ability to ever become a mother.

Questions to ask yourself

How much does a negative attitude increase my anxiety?

What happens

Many women have a negative body image. If you have a very strong focus and reliance on your appearance and weight and then experience difficulties with fertility, your belief in your body and appearance will be challenged. You may have anxious thoughts and feelings about how your body is letting you down.

Questions to ask yourself

How anxious am I about whether my body is failing me?

How do I feel about how fertility treatments affect my body?

Am I excessively focused on my appearance and weight?

What happens

Physical, emotional, mental and sexual abuse can significantly affect your mental and emotional health. Ever having felt neglected, threatened or that you may be harmed in some way increases the risk of you experiencing an anxiety disorder. With maltreatment you learn you can’t trust that people will do the right thing by you – even sometimes those you thought loved and cared about you. With abuse you may lose the idea that everything in your world will be okay in the future and you may no longer feel safe.

Questions to ask yourself

Have I felt

  • neglected?
  • threatened?
  • that I might be harmed at any time during my life?

Has abuse put me more at risk of anxiety?

How much can I trust others?

How safe do I feel?

What happens

You can feel judged when a pregnancy is not happening even though you know you are doing everything you can. People may tell you - “You are still young”, “There is still time” ,“You are so lucky you don’t have to get up in the night”. While they may be trying to make you feel better, they can add to the anxiety you feel about whether you will become a mother. Then there is the ultimate judgment – “Maybe you are not meant to be a mother”. This may be said with good intentions but instead can cause panic and extreme distress.

Questions to ask yourself

How anxious am I about what others think of me?

How anxious am I that I might be doing the wrong things?

Do I feel like I am a failure in people’s eyes because I am not pregnant yet?

Do I feel judged by people’s ‘helpful’ comments?

What happens

One third of women who have had an episode of depression or anxiety before can experience depression and/or high anxiety at other times of extreme stress. If you are distressed about not being able to get pregnant, you could be at risk of having a relapse of a previous depression or anxiety disorder.

Questions to ask yourself

Have I had depression and/or anxiety before?

What happens

Having roles that give you meaning are important to your mental and emotional health and right now you want the role of ‘mother’. If it is not happening it can throw all of your roles and confidence into a mess. If the role of mother is very important to you and you have put all your focus into becoming a mother - thinking you may never fulfil this role can cause high levels of fear and anxiety.

Questions to ask yourself

How anxious am I about who I will be if I cannot be a ‘mother’?

What other roles do I have that give me my identity or sense of purpose?

Social causes →
What happens

Problems with your family can include lots of things. It might be your relationship with your partner has changed with the stress of trying for a family – that all you both focus on is getting pregnant, you are unhappy and don’t feel as connected as you used to be, or you don’t feel supported. Being dissatisfied in your relationship can cause anxiety.

Other family members may be pregnant, or expect you to be pregnant by now. Parents may be putting pressure on you to make them grandparents. Everyone has their own agenda and their expectations cause you anxiety and you can be distressed you won’t be able to deliver what they or you want.

Questions to ask yourself

Are there family problems that cause me to be anxious?

Have there been changes to my family that I am anxious about?

How much has my relationship changed with my

  • partner?
  • parents?
  • other family members like sisters or brothers, cousins…?

How much do family expectations cause me distress?

What happens

When you are trying to get pregnant your relationship with your friends can change depending on what stage they are at in their lives. Some friends will understand what you are going through and be a support, and some will mean well but say all the wrong things. You can feel like you don’t know how to relate to them, or you can’t share your troubles with friends and you would just like to hide away.

Questions to ask yourself

Do I feel accepted by my friends?

Who accepts or does not accept me?

Do my friends understand my situation?

Are my friends at the same or a different stage in their lives to me?

Do my friends mean well but offer me unhelpful advice?

What happens

Fertility problems can be a lonely, often, secret time. You don’t tend to talk about your struggles to outsiders and often you and your partner are going through all this on your own. Anxious feelings can increase when you have secrets, when you feel alone and unsupported.

Questions to ask yourself

Do I have friends, family or people I trust who can be there for me?

Who can I turn to if I need support or someone to talk to?

Do I feel alone in this struggle?

What happens

You might be anxious about the changes happening in your life - will you ever have a healthy baby? - will you get to be a mother? – will this month be the one?

If you are dealing with other stressful life events at the same time, such as serious illness or the loss of someone you love, then your anxiety levels can be very high. You can have an increased sense that bad things happen because you have your own struggles and you fear something bad might happen like your partner may leave you and find someone else to have children with.

This can cause constant anxiety but it does not cause infertility.

Questions to ask yourself

How do I feel about change?

Have I experienced any stressful or difficult events recently? If so, what were they?

How anxious am I about something else bad happening?

What happens

If you need to have IVF or further assistance like pre-implantation genetic diagnosis (PGD) the costs can really mount up. This can come at a time when you have a lot of other expenses - you may be just starting out as a couple and trying to get ahead or now may not be the ideal time to be having a baby because your finances or jobs are unstable but you are running out of time. Anxiety about money and your situation can become quite overwhelming.

Questions to ask yourself

Are our expenses manageable?

How anxious am I about money?

Do we need one income or two incomes?

Will we be able to afford the costs of fertility treatment if we need it?

Community causes →
What happens

The community in which you live is important to your mental health. Feeling safe, that there are places to go, ways to get there and things to do can help you to feel connected to your community and that you belong somewhere. Not having a community that you feel safe in or that you belong to can cause distress about where you live. The health services in your community can be especially important at this time as local and easy access can help allay fear and anxiety.

Questions to ask yourself

How do I feel about the community where I live?

How safe do I feel in my community?

How connected do I feel and do I feel that I belong in my community?

What health services can I turn to in my community?

What happens

Work can provide a source of anxiety particularly when you are also trying to get pregnant and feel unsure about what the future holds.  You can be anxious about:

  • How safe and secure you feel in your job especially if you need to take time off for tests and procedures.
  • How important your job is to your finances and sense of self balanced with your desire to be a mother.
  • How demanding it is of your time and energy and whether this affects your ability to get pregnant.
Questions to ask yourself

How anxious am I about my work?

How secure do I feel in my job?

How supported do I feel by my boss and work place to take the time I need to have doctor’s appointments and tests?

Do I feel exhausted by my job?

Physical causes →
What happens

There is some debate about whether anxiety can be inherited. If you have a family member with an anxiety disorder this doesn’t mean you will automatically get anxiety, but certain genes along with things that happen in your life may mix together to increase your vulnerability to anxiety.

Questions to ask yourself

Do I have someone in my family who has been diagnosed with an anxiety disorder?

Along with other things that have happened in my life, does a family history add to my risk of anxiety?

What happens

If you are having fertility drugs they affect your hormones and hormonal ups and downs can produce mood changes making you more prone to anxiety.

Questions to ask yourself

How much could changing hormones be making me more anxious?

Have fertility treatments made my hormones and moods more unpredictable?

What happens

Your focus in an IVF cycle may be on drugs, hormones, tests and counting the days. All of this can tip from focus to obsessive thinking. Just before ovum pick-up and at embryo transfer are when you are most likely to feel anxious. The distress of failed IVF or ART can cause very high levels of anxiety.

Questions to ask yourself

What stage of IVF am I up to?

Has IVF or ART worked at all?

What happens

If you have had an illness then you know you can’t take your health for granted. This can cause you to be anxious about your health and whether your illness will affect your ability to get pregnant.

Some illnesses that affect infertility are linked to anxiety including polycystic ovary syndrome (PCOS), Fragile X and Turner’s syndrome. Cancer and chemotherapy also affect fertility and significantly raise the likelihood you will be suffering from anxiety.

Questions to ask yourself

Has an illness caused me to be anxious about my health?

Has my illness affected my fertility and also caused me to be anxious?

How anxious am I about having an illness that might be stopping me from getting pregnant?

Does the treatment I receive for my illness cause anxiety?

What happens

If you have had a lot of gynaecological problems throughout your life and this has affected your quality of life, you are more likely to have high levels of anxiety.

Questions to ask yourself

How much have past gynaecological problems caused me to be highly anxious?

What happens

If you have previously conceived but had complications or a miscarriage, then you are more likely to feel very anxious and fearful about whether you will be able to get pregnant again and/or to feel that something terrible could happen to another baby.

Questions to ask yourself

How much have previous problems in a pregnancy made me more anxious?

What happens

Women in 21st century Australian society wait longer to have babies than previous generations and other countries, yet, being older reduces your chances of getting pregnant. The combination of your expectations about the life you want, your way of life, your opportunities to date and whether you have left it too late to have a baby are often a recipe for anxious thoughts.

Questions to ask yourself

How anxious am I about my age and my ability to get pregnant?

What happens

You may drink more and take drugs to hide or numb anxious thoughts and feelings particularly if they are severe. However, heavy use of alcohol and or drugs can increase your anxiety.

Questions to ask yourself

How anxious am I about how much alcohol I drink or about any drugs I might take?

Do I use alcohol and drugs to hide or numb the anxiety I feel?

What happens

Sometimes hormonal treatments for problems with fertility interfere with your sleep cycle. And, if your bed has become a focus for conception issues rather than sleep, rest and sex, then you may well be finding it more difficult to sleep. Being tired affects your ability to think clearly making it easier to be anxious. Everything seems more awful and frightening when you have had little sleep.

Questions to ask yourself

How many hours of sleep do I get per night?

Is my ability to sleep affected by anxiety about whether I will ever be able to have a baby?

Is it hard to go to sleep or do I wake in the night and find it hard to go back to sleep?

What happens

A diet with too much fatty and sugary food combined with too little exercise can = more negative moods which can = more anxious thoughts and feelings. Being physically active helps to relieve stress and can also help you to sleep better. If you are not exercising regularly this can cause you to focus on your anxieties more.

Questions to ask yourself

Do I generally eat a range of healthy foods?

Do I have the time or energy to eat a healthy diet?

Do I exercise at least 3-4 times per week for more than 30 minutes?

Created on 18/08/2013 | Updated on 24/10/2017
References for this page

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Jean Hailes is Australia’s leading and most trusted women’s health organisation. We believe in physical and emotional health and wellbeing in all its dimensions for all women in Australia throughout their lives.

We offer a range of free resources and easy to understand information on women’s health and wellbeing. Appointments at our specialist women’s health clinics can be made in person (East Melbourne and Clayton, VIC) or across Australia via our Telehealth consultation service. www.jeanhailes.org.au

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