When I first looked into fertility counselling, it quickly became clear there wasn’t a simple overview of what it involved or the options available. Google searches turned up plenty of clinics and institutes offering emotional support (reassuringly), but no clear roadmap to show what the process might look like or how different kinds of counselling fit together.
For many of us, fertility—and especially infertility—is often shrouded in vulnerability, discomfort, uncertainty, and isolation. And that may be before even starting treatment, which can itself feel deeply invasive. It’s no wonder many people feel hesitant about opening up to a fertility counsellor, especially when it’s not clear what to expect.
The Different Kinds of Fertility Counselling
Fertility counselling can be generally broken down into three main types: Therapeutic, Implications and Supportive Counselling. The Human Fertilisation and Embryology Authority (HFEA) requires clinics to offer counselling to patients, though you can also choose to seek support privately.
Therapeutic Counselling is comparable to traditional styles of counselling. Typically longer term, it provides space to fully explore and work through the challenges you’re facing. Many people access therapeutic support privately, though it can also be arranged through a clinic.
Implications Counselling is in many cases mandatory before treatments such as sperm or egg donation or surrogacy, and strongly recommended in other situations. It focuses on the social, ethical, and legal implications of treatment, ensuring you are fully informed before moving forward. Some clinics offer implications counselling as a one-off session, but the British Infertility Counselling Association advocates that it should be decided by the client and counsellor how many sessions are needed,
Supportive Counselling is available at any stage of treatment and is often offered on a per-cycle basis. These sessions are designed to help you manage immediate challenges and develop coping strategies. If needed, the counsellor may recommend additional specialist or longer-term support.
What You Can Expect in a Session
During fertility counselling, you should expect to be heard without judgement. Most importantly, you should expect counsellors to provide safety and to clarify session boundaries (for example, what can be shared and what will remain confidential).
While counsellors can’t tell you what to do, they can offer valuable insight into decision-making challenges. Of course, if you’re opting for one-off sessions, they will help identify what can realistically be achieved in a single meeting. This wouldn’t be the opportunity for deep exploration of past traumas, as there isn’t the time to work through them properly. Instead, counsellors will guide the conversation toward what is most useful right now—how they can best support you in supporting yourself. In longer term Therapeutic Counselling, there is more space to explore a wider range of topics in depth together.
Although difficult questions may arise, counsellors should approach them with gentleness and compassion. And know that you are never obliged to share more than you wish.
How to Prepare (if you want to)
To find a therapist privately, visit the British Infertility Counselling Association (BICA), which provides a catalogue of all UK-licensed fertility counsellors, as well as tips on choosing a counsellor.
Before your first session, you may want to consider what you hope to gain from your time with the counsellor. While it’s good to have an idea of the themes you want to discuss, you shouldn’t feel that this is in any way obligatory. It’s the counsellor’s role to help you explore what might be helpful to you, and the answer is entirely personal.
A Final Thought
The fertility journey is often an uncertain and disempowering one. Fertility Counselling intends to help remedy that by providing a safe and supportive space with clear boundaries—somewhere you can leave feeling better informed, more supported and crucially, with a greater sense of control. At its heart, this space should be on your time, where your wellbeing and agency are in focus