There is a particular kind of exhaustion that comes from IVF — and it's not just physical, though the physical demands are real. It's the exhaustion of holding hope and grief simultaneously, cycle after cycle, in a process that asks everything of you and offers no guarantees.
The injections. The monitoring appointments. The retrieval. The agonizing wait for fertilization reports. The transfer. The two-week wait that somehow manages to be the longest two weeks of your life every single time. And then — for too many Missouri patients — the call that it didn't work, followed by the question of whether you can summon the courage to try again.
IVF is one of the most psychologically demanding experiences a person can go through. And yet the emotional support available to most patients going through it is strikingly inadequate — a brief referral to a counselor, maybe, tucked into a folder of medical paperwork. The message, however unintentional, is that the emotional piece is secondary.
It isn't. And at AND Psychology, Dr. Kylie Pottenger — who has lived the experience of infertility herself — provides specialized therapy for Missouri and New Jersey patients navigating IVF and the full emotional landscape it creates.
The Psychological Toll of IVF, Phase by Phase
IVF is not a single event. It's a process — one that unfolds over weeks and months and, for many patients, years — with distinct psychological challenges at each stage. Understanding what's normal at each phase can help Missouri patients feel less alone in what they're experiencing.
Stimulation and Retrieval
The stimulation phase asks you to be a medical patient in the middle of your ordinary life. Injections morning and evening. Side effects that range from bloating and mood swings to significant pain. Monitoring appointments that require early morning clinic visits, sometimes daily. All of this while working, parenting other children if you have them, maintaining relationships, and trying to function.
The emotional experience during stimulation is often characterized by hypervigilance — tracking every symptom, scrutinizing every monitoring result, interpreting every number as a sign of what's to come. The anxiety of not knowing how many follicles will develop, whether they'll mature, whether retrieval will go as hoped — it's a sustained stress response that the body holds for weeks.
Retrieval day brings its own emotional complexity. For many patients, it's a moment of real hope — the eggs are here, the embryos are possible. It's also a moment of vulnerability — anesthesia, a procedure, the body being asked to do something extraordinary. And then the waiting begins again.
The Fertilization Report
Few moments in IVF are as psychologically charged as the fertilization report. The number of eggs retrieved becomes the number fertilized, which becomes the number that develop to blast, which becomes the number that survive biopsy and freezing, which becomes the number that are euploid — each step a narrowing that can feel like loss even when the overall outcome is good.
For Missouri patients who have experienced the arithmetic of attrition firsthand — starting with fifteen eggs and ending with one euploid embryo, or two, or none — the fertilization report is a lesson in a kind of grief that has no conventional name. You are grieving potential, possibility, the futures that existed for a moment and then didn't.
The Transfer and the Two-Week Wait
The transfer is often experienced as a moment of pure hope. The embryo is placed. You leave the clinic carrying something precious and invisible. And then you wait.
The two-week wait is its own psychological category. The hypervigilance that characterized stimulation returns, now directed inward — scrutinizing every symptom, every twinge, every absence of symptom as potential evidence of what's happening at a cellular level. Many Missouri patients describe the two-week wait as a kind of suspended reality — unable to fully engage with life while also unable to know anything that would resolve the uncertainty.
For patients who have been through failed transfers before, the two-week wait carries an additional layer: the knowledge of what the call sounds like when it's bad news, the anticipatory grief that runs alongside the hope.
The Failed Transfer
A failed transfer is a loss. It is worth naming it that clearly, because the medical framing — "the transfer was unsuccessful," "the embryo did not implant" — can make it feel like a clinical outcome rather than what it actually is for the people who live it: the end of a possibility they had been carrying with extraordinary care.
For Missouri patients who have experienced failed transfers, the grief is real and it deserves real acknowledgment. The fact that it happens to many people going through IVF does not make it less significant for the individual who is living it. The fact that you have remaining embryos, or that your doctor is optimistic, does not require you to feel optimistic right now.
Starting Over
Perhaps the most underestimated psychological challenge of IVF is the decision to try again after a failed cycle. Starting over requires finding, somewhere, the resources to hope again — after hope has already been disappointed. It requires tolerating the full emotional arc of another cycle, knowing now exactly what that arc feels like.
Many patients in Missouri and New Jersey describe this as the hardest part. Not any single moment of the process, but the cumulative weight of doing it again and again — and the uncertainty of not knowing when, or whether, it will end.
Why Infertility Grief Is Cyclical Rather Than Linear
One of the most disorienting aspects of IVF for Missouri patients is that the grief it produces doesn't follow the arc that grief is supposed to follow. The cultural narrative of grief suggests a progression — shock, sadness, acceptance, moving forward. Infertility grief doesn't work that way.
Infertility grief is cyclical. It returns with each new cycle. It can feel processed and integrated and then arrive again, as fresh and acute as the first time, when a monitoring appointment goes poorly or a transfer fails or a pregnancy announcement lands in your inbox on the wrong day. It doesn't mean you haven't made progress. It means you're navigating a kind of grief that is genuinely different from conventional loss.
This cyclical quality also means that the healing process looks different. Linear models of grief — the five stages, the idea of "closure" — don't map cleanly onto the infertility experience. Healing during IVF isn't about reaching a place where the grief is behind you. It's about developing the capacity to carry grief and hope simultaneously, to return to the process again with eyes open to both the possibility and the risk.
Dr. Pottenger understands this not only clinically but personally. Her own experience with infertility has given her an intimate understanding of what it means to cycle through hope and loss repeatedly — and to find a way to keep going. That lived understanding shapes the therapy she provides in ways that purely academic training cannot replicate.
The Isolation Problem
One of the most consistent experiences among Missouri patients going through IVF is profound isolation. IVF is often a secret — kept from colleagues, sometimes from extended family, sometimes even from close friends. The reasons are understandable: the fear of having to explain a failure, the desire to protect privacy, the exhaustion of managing other people's reactions and expectations on top of everything else.
But the secrecy comes at a cost. The people around you don't know what you're going through. The support that might naturally arise in a community of people who understood your situation isn't available. You're managing one of the most demanding experiences of your life largely alone.
Well-meaning people say things that hurt. They suggest relaxing, as if stress is the barrier between you and pregnancy. They share accounts of people who conceived naturally after stopping IVF. They ask when you're going to have children, not knowing you're spending your savings and your emotional reserves trying. Each of these interactions adds a small weight to what is already very heavy.
Therapy provides something that's hard to find elsewhere during IVF: a space where you don't have to manage anyone else's feelings. Where you can say exactly what you're experiencing — including the things that feel unsayable — without worrying about the impact on the person you're telling. For Missouri patients who have been holding all of this largely in private, that space can be genuinely transformative.
How Telehealth Makes Support Accessible During IVF
The practical demands of IVF make accessing in-person therapy genuinely difficult. Monitoring appointments at early hours. Retrieval procedures and their recovery. Transfer days and the days following. The fatigue that comes with stimulation medications. The emotional unpredictability that makes committing to scheduled appointments feel uncertain.
Telehealth therapy removes the logistical barrier. A session can happen from home, from a parked car between appointments, from wherever you are when you have an hour and a phone or laptop. For Missouri and New Jersey patients in the middle of a demanding treatment cycle, this matters — not as a lesser option, but as the option that actually makes consistent support possible during the weeks when it's most needed.
AND Psychology serves patients via telehealth throughout Missouri and New Jersey. For patients in other PSYPACT states, expanded telehealth licensure may make services accessible — contact the practice to discuss your specific situation.
You Don't Have to Navigate This Alone
IVF asks more of you than most people around you will ever understand. The hope you keep finding, cycle after cycle, is not naivety — it's one of the most courageous things a person can do. And the grief you carry alongside it deserves real support, not just endurance.
Dr. Kylie Pottenger is accepting new patients via telehealth in Missouri and New Jersey. If you're in the middle of an IVF cycle, between cycles, or trying to decide whether you have another one in you — this is exactly the kind of support AND Psychology is here to provide.
Book a free consultation: andpsych.com Email: info@andpsych.com Phone: (417) 429-4580
AND Psychology — Dr. Kylie Pottenger Telehealth serving Missouri and New Jersey info@andpsych.com (417) 429-4580 andpsych.com
If you are in crisis or need immediate support:
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