EMDR Therapy for Infertility, IVF Stress, and Pregnancy Loss

Fertility treatment demands a lot of people. There are the appointments, the medications, the waiting, and the results that don't always come back the way you hoped. For many of my patients, there is also loss: a miscarriage, a failed transfer, or a cycle that was canceled before it began.

I want to say this plainly, because I don't think it gets said enough: fertility treatment can be traumatic. Not for everyone, and not always. But often enough that it deserves to be treated with the same seriousness as any other source of trauma.

October is Pregnancy and Infant Loss Awareness Month. It's a time when many people in our community are remembering what they've lost, as well as what they still hope for. Support and solidarity matter. So do practical tools for healing. One of the tools I'm most excited about is a therapy called EMDR, and it seems to be getting a lot of mainstream attention at the moment.

What Is EMDR Therapy and How Does It Work?

EMDR stands for Eye Movement Desensitization and Reprocessing; it is an evidence-based therapy that has been used for more than 30 years. The Veterans Administration (VA) lists it as one of its recommended treatments for PTSD in veterans. To me, that is a strong vote of confidence in the research behind it.

When people first hear about EMDR, they sometimes think it sounds like hypnosis. I understand why, but in reality EMDR is quite different. In EMDR, you intentionally keep one foot in the present while you process a difficult memory or feeling. You stay aware and grounded the whole time. And you are in control. It is your own mind doing the healing; the therapist is there to guide and facilitate, not to push you in a certain direction.

The processing phase of EMDR includes something called bilateral stimulation: a gentle, alternating left-right rhythm that you engage in while you focus on what you're working through. That rhythm can take many forms:

• Visual: following a light bar, your therapist’s fingers, or a ball moving across a computer screen

• Auditory: hearing tones that alternate between your left and right ears, through headphones

• Tactile: handheld tappers, or simply tapping on your own shoulders

I know that bilateral stimulation can sound a little unusual, but it does something real that helps the brain process experiences and beliefs that have gotten ‘stuck’.

EMDR does not require  in-person office visits. During the pandemic, many therapists moved EMDR to telehealth, and studies have found EMDR to be effective virtually. That means more people can access it, wherever they are.

How EMDR Therapy Helps With Fertility-Related Trauma, Stress, Negative Beliefs, and Loss

EMDR is best known as a treatment for PTSD. Some fertility patients do meet the criteria for PTSD. Many more don't, but have still been through things that feel traumatic, whether that be the repeated experience of hope followed by disappointment, a pregnancy loss, or a cycle failure. We also now know that EMDR can help ease depression and anxiety, which are common companions on this path. EMDR can also address painful beliefs we hold about ourselves—perhaps around responsibility, trust, or a sense of failure—that can become activated when in the throes of fertility treatment.

What makes EMDR especially meaningful for fertility patients is that it looks beneath the surface and incorporates the way that the body reacts to and holds on to difficult experiences. Distress rarely starts with what is happening in the present. A loss, the uncertainty of treatment, or the existential questions that come with infertility can press on an old button: an earlier experience, or a core belief about yourself that formed long ago. EMDR helps identify those roots and work through them, from the bottom up.

Signs EMDR May Help After Pregnancy Loss or Fertility Treatment Challenges 

If any of these sound familiar, I'd encourage you to ask your therapist whether EMDR could help:

• You feel intense overwhelm every time you walk into the fertility clinic.

• You feel a deep mistrust of medical providers that makes care harder.

• You have nightmares about a miscarriage or another loss.

• Unwanted memories or intrusive thoughts pop up again and again, without warning.

• These experiences are getting in the way of work, relationships, or daily life.

These can be signs of a trauma response, or of high stress, depression, or anxiety. These are not signs of a personal failing, and these reactions can be made easier with support.

I also want to be honest: the research on EMDR specifically for infertility experiences is just emerging, and as with so much in women's and reproductive health, there is more work to be done. I’d love to see more studies on EMDR and its impact on infertility related distress. EMDR does have a very strong evidence base in treating various forms of trauma, but there are only a few studies on fertility patients specifically: 

• The effect of cognitive behavioural therapy and eye movement desensitization and reprocessing techniques on infertile women: a randomized controlled trial (Qualitative study)

• Living in an unresolved trauma system: Women's experiences of infertility-related distress through an adaptive information processing lens (Study in process)

• Effectiveness of Eye Movement Desensitisation and Reprocessing (EMDR) Therapy in reducing infertility distress in women: a community-based randomised crossover trial protocol

Is EMDR Right for You, and Is It Safe During IVF and Pregnancy?

EMDR is a good fit for many people, but it is not for everyone at every moment. Before we begin, I look at a few things:

• Openness. You have to want to try it. EMDR works with your mind, not on it.

• Stability. Processing difficult memories takes some emotional footing. If you're in survival mode, just trying to get through each day, we may build coping skills first and come to EMDR later. Likewise, if you currently in an an unsafe living situation, are experiencing severe mood instability, are actively suicidal, or are experiencing psychosis, EMDR would not be appropriate for you at this time.

• Medical considerations. If you have a history of seizures or have a serious cardiovascular issue, EMDR may not be appropriate for you. 

One question I hear often from fertility patients: is EMDR safe if I'm trying to get pregnant, or if I already am? Years ago, clinicians were cautioned against EMDR during pregnancy, mostly out of a lack of experience and research on the topic and out of concern about adding stress. We now know that it is safe to participate in EMDR during pregnancy, given the results of the following studies:

• Treatment of Pregnant Women With Fear of Childbirth Using EMDR Therapy: Results of a Multi-Center Randomized Controlled Trial

• How safe is the treatment of pregnant women with fear of childbirth using eye movement desensitization and reprocessing therapy? Obstetric outcomes of a multi-center randomized controlled trial

• The effects of PTSD treatment during pregnancy: systematic review and case study

Yes, EMDR processing can feel stressful in the moment, but the goal is ultimately to lower distress and support better coping over the long term.

Even so, I'm thoughtful about timing. I may pause the active processing part of EMDR during the wait for a pregnancy test, or in the earliest weeks of a pregnancy. That's not because anything you do in therapy could affect a conception or a pregnancy. It's because I don't want you to link something you did with a disappointing outcome. Many of my patients already carry a heavy sense of responsibility for things outside of their control. At sensitive times during a pregnancy, we can lean on other kinds of support.

Mental Health Support During Fertility Treatment

The emotional burden of fertility treatment is one of the biggest reasons people stop treatment. That's why mental health support shouldn't be an afterthought or an outside referral you have to chase down. At Atlantic Fertility, reproductive psychology is part of our practice, alongside your medical team.

Whether EMDR is the right fit or another approach makes more sense for where you are, the goal is the same: helping you feel less alone, more grounded, and better able to keep going on your path to parenthood. 

Connection matters too. Leaning on a partner, friends, or a support group can make an isolating process feel more bearable.

Finding Support After Pregnancy Loss and Infertility

If you're grieving a loss this October, or any month, I want you to know that what you're feeling is real. It makes sense. And there are ways to work through it, so the hardest moments of this journey don't have to define the rest of it.

About Dr. Rachel Eshel

Rachel Eshel, PsyD, is a licensed psychologist specializing in reproductive mental health and part of the Atlantic Fertility community of providers. She offers ongoing therapy for grief and loss, anxiety, trauma, depression, parenting, and relationship challenges, as well as support with navigating difficult decisions throughout fertility treatment. In addition, she provides consultations and evaluations related to egg, sperm, and embryo donation and surrogacy arrangements. Dr. Eshel sees patients on-site at Atlantic Fertility as well as via telehealth.

This post is for general information and is not a substitute for individual medical or mental health care.