Why we should be talking about infertility

Published March 2025 | 7 min read
Expert contributors Dr Sarah Lensen, fertility researcher, University of Melbourne; Dr Maria-Elena Lukeides, clinical psychologist; Lisa Killian, Primary Health Care Nurse, Royal Flying Doctor Service
Words by Trudie McConnochie

If you’re among the one in six Aussies affected by infertility, getting support is crucial. Here’s how infertility impacts mental health, how to overcome the stigma and how to get help.

When university lecturer Amanda^*, then 36, was ready to start a family with her husband, she assumed it would only take a few months to get pregnant. But after six months without a positive pregnancy test, she saw a gynaecologist and was diagnosed with polycystic ovary syndrome (PCOS). What followed were three years of gruelling fertility treatments, several operations and two devastating miscarriages. 

“For the first year it didn’t bother me emotionally too much. But towards the end of the journey, I really hated going into the [IVF] clinic,” she recalls. “I know IVF works for some people, but for me it started to feel like a casino, where each round I was gambling with money we didn’t have.”

Feelings of failure, guilt, envy, helplessness and a lack of control are common in people experiencing infertility, which impacts one in six couples in Australia. But despite infertility being common, it’s rarely talked about – and the stigma can make the emotional toll even harder to manage. A 2022 review found that stigma around infertility affects the mental health and quality of life of those trying to conceive.

“I felt like I couldn’t talk to my parents as I didn't want to get their hopes up for their first grandchild each time we tried,” says Amanda. “With friends I didn’t want pity, but I also didn’t want to make them feel uncomfortable. Plus, there’s a strange sense of shame when you can’t conceive.”

What is infertility?

Infertility is the medical term for 12 months or more of regular, unprotected sex that doesn’t result in a baby (but may involve miscarriage). There are two main types:

• Primary infertility: fertility challenges for someone who has never conceived a child
• Secondary infertility: difficulty conceiving again after one or more pregnancies.
  

“There are also lots of people who pursue fertility treatments who don’t have ‘medical infertility’ in the same way a heterosexual couple can,” notes fertility researcher Dr Sarah Lensen, from the University of Melbourne. “This can include people in same-sex relationships or single women who pursue fertility treatment alone, among others.”

The biggest factor impacting fertility is maternal age, as a woman’s eggs decrease in quality and quantity over time.

“I think what many people don’t appreciate is that IVF can’t overcome the age factor,” says Dr Lensen. “Just like your age impacts your chance of getting pregnant naturally, it also impacts your chance of getting pregnant from IVF.”

Other causes of infertility include:

• female reproductive conditions: endometriosis, PCOS, fibroids, fallopian tube issues and hormonal issues
• male reproductive conditions: issues with sperm (including low sperm count), testicular problems and hormonal issues
• other medical conditions: diabetes, sexually transmitted infections and autoimmune diseases
• genetics: genetic disorders (problems with genes) passed down from either or both parents
• lifestyle factors: smoking, illegal drug use, alcohol or excessive caffeine
• environmental toxins: in particular, heavy metals like lead and mercury (found in fish and shellfish), endocrine disrupting chemicals (EDCs) found in everyday items like pesticides, lubricants and some soy products, and air pollution.
  

In around one-third of cases, fertility issues are due to the woman, another third are due to the man and the remaining third are either due to both people or fall into the “unexplained fertility” category, says Dr Lensen.

“That’s where doctors have done all the tests and everything seems to be functioning fine, so it’s sort of a diagnosis of exclusion.”

This was the frustrating situation for social media consultant Joel, 34, and his wife, who had a series of tests at a fertility clinic after 18 months of trying to conceive naturally.

“There were no red flags for us not getting pregnant,” he says. “That was the most frustrating element – that it was out of our hands. Everything’s good to go, but, for some reason, it was just not working.”

Mental health impacts of infertility

Clinical psychologist Dr Maria-Elena Lukeides says problems conceiving can have a significant impact on emotional wellbeing, causing stress and anxiety.

“Infertility can also negatively impact a person’s sense of self-worth and identity, as well as triggering feelings of loss and grief, particularly as people face repeated disappointments,” she says.

A 2022 University of Newcastle study of more than 6,500 women found the psychological burden of infertility tends to fall more on women than men, which Dr Lukeides says is likely due to the pressure some women feel to be mothers.

The desire to protect their relationship weighed heavily on Amanda and her husband. After spending $40,000 and not falling pregnant, they made the heartbreaking decision to stop fertility treatment.

“We had had friends who broke up because of the pressures of IVF,” says Amanda. “We valued our relationship too much, being a second marriage, so we decided to stop IVF to focus on us. We went through the process of understanding what our lives would be like without being parents.”

Treating infertility in regional Australia

For regional Australians, the mental toll of infertility is compounded by how far they live from fertility treatments and services, says Primary Health Care Nurse Lisa Killian from Royal Flying Doctor Service (RFDS).

Some of the Western Australian cattle stations she attends are so remote she can only visit around four times a year due to the seasonal weather, and her patients sometimes find it incredibly challenging to travel for treatments.

“During the wet season, some women might need a small plane or a helicopter to have their blood tested, or cycle tracked, and they might need their partner to do a sample,” she says. “So it's about access, timing and logistics, as well as money.”

And for any major surgery or IVF treatment, regional women usually have to fly to a major city, which can be up to 2000km from their home.

For most of the Indigenous communities Lisa visits in Western Australia’s Fitzroy Valley, the expense of this travel and the IVF treatment itself, even with the small assistance the Government sometimes provides, isn’t really an option.

“We visit four small Indigenous communities where there is no nurse, no one with medical training at all. For emergencies, they need to call us at the RFDS,” she explains. “Three out of the four communities don’t even have a little medical chest, so they've got no support from anyone.”

The lack of access to services and an ongoing social stigma surrounding infertility, which Lisa says seems to also exist within Indigenous communities, can affect her patients’ mental health.   

“In general, women talk and bond with each other and, being so remote, it can be very isolating for women going through infertility,” she explains.

The mental impact of this isolation as well as not falling pregnant can be overwhelming, she adds, especially if you can’t afford treatment or the time off. For patients needing support, Lisa recommends reaching out through national helplines and online communities. She also helps as much as she can (“they know they can text me anytime”).

Talking about infertility

Joel and his wife chose to share their fertility journey with only a select few people.

“My wife took a step back in some relationships, especially with people with kids. She kind of went into her shell a lot. For me, there were some friends I held at arm’s length,” he recalls.

Even when the couple became pregnant on their third round of IVF, they were reluctant to reveal they’d had fertility treatment until they announced their son’s arrival.

While talking about infertility can be difficult, sharing your experiences with trusted friends, family members and support groups can help you feel less alone, says Dr Lukeides.

“This can help normalise any feelings of grief, frustration or inadequacy, reducing the shame and stigma that often accompany infertility,” she points out. “There is also research showing that getting help during this period assists in managing stress and depression, which can actually improve the success of fertility programs.”

Supporting someone experiencing infertility

Dr Lukeides says people experiencing infertility need patience and sensitivity from the people around them. It’s important to be mindful of their feelings around baby-related events or when discussing your own kids – and resist the urge to try to make them feel positive.

“The key is to be there for them without trying to fix everything. Listen with an open heart, and don’t be afraid to ask how you can help,” she says.

Amanda agrees, saying her best support came from people who simply listened with compassion.

“Don't send Instagram stories of fertility tricks; don't minimise it or talk about ‘how hard kids are anyway’ or say your ‘childless’ aunt has a wonderful life you envy,” Amanda advises. “None of that is helpful. Just say ‘this sucks’ and give them a hug.”

According to the Centre for Perinatal Excellence (COPE) some tips for supporting a friend who is experiencing infertility include:

• Be mindful of your questions: Having conversations about treatments, growing a family or future plans for a family can be a triggering topic. Instead make space for your friend to feel supported and comfortable so they can bring up the topic if they’d like to. Say things like, “I’m always here if you need to talk”. Make sure your friend knows they can come to you for support, not judgement.
• Avoid giving advice: Everyone’s situation is different, and we rarely know the full story of someone’s fertility journey. Avoid saying things like “at least you can try again”, “just be more positive” or “at least you know you can get pregnant” after a miscarriage.
• Just be present: Even though your instinct might be to fix the situation in some way, sometimes just saying “I’m sorry this is happening to you” can be really helpful. You can also make sure you plan fun catch-ups that won’t be to places with a lot of families or watching movies with related themes.
• Be respectful if you become pregnant: While your friend will no doubt be happy for you, be respectful of their feelings, too. Tell them in private, if you can, and don’t take their reaction personally. They may be going through internal turmoil and having to put on a brave face.

If you’re experiencing infertility and it’s affecting your mental health, support is always available.

• For infertility specialists and advice, search your local area on the Centre for Perinatal Excellence (COPE) website. 
• For relationship help, contact Relationships Australia on 1300 364 277.
• For mental health support, contact Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636.
• For miscarriage or still birth support and advice, visit Pink Elephants and their peer support LiveChat, or contact SANDS on 1300 072 637.
• For counselling for men, contact MensLine Australia on 1300 78 99 78.

Looking for some extra support?

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