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Beyond the Acronyms: A Trauma-Informed Approach to ART and Infertility

  • Writer: Mindy Wara
    Mindy Wara
  • 6 days ago
  • 5 min read
Two people sitting close together holding hands across a lap; a quiet moment of support.
“Infertility treatment is full of acronyms - You need a Guidebook to understand what clients are talking about.” - Julie Bindeman, PsyD

Many perinatal clinicians are drawn to this work because of personal connections. That closeness fuels compassion we bring to each session - and sometimes leaves us feeling underprepared when a client’s journey differs from our own. For clients navigating assisted reproductive technology (ART), a therapist who already understands the medical language makes all the difference.



Gloved lab technician using forceps to handle a sample in a petri dish beneath a microscope in a fertility lab.

What is ART?


Assisted reproductive technology (ART) is an umbrella term for medical interventions used to help people build families when conception is difficult or impossible by other means.


Common elements clinicians will hear about in session include intrauterine insemination (IUI), in vitro fertilization (IVF), donor gametes (eggs or sperm), gestational carriers, and genetic testing options.




Why ART Literacy Matters Now


Person sitting across from a clinician, head in hand, appearing distressed during a consultation.

Infertility is not rare. The WHO’s 2023 reporting estimates that 1 in 6 people worldwide experience infertility in their lifetime. In the US, the most recent CDC data shows a substantial 12% of women have used infertility services. For mental health professionals, these numbers indicate that ART and family-building is likely to come up in session - often accompanied by dense medical language, legal concerns, financial stress, and relational strain.


But when a client’s heartbreak arrives wrapped in medical shorthand, it’s hard to be an effective therapist if you don’t understand the jargon.


The landscape is shifting: ASRM guidance clarifies evolving definitions and outlines qualifications for fertility counselors - guidance that affects clinicians who are asked to write readiness letters, perform third-party consults, or provide ongoing therapy during ART.


Clinicians who can quickly orient to the medical and psychosocial terrain reduce the invisible labor clients carry when they must “teach” their therapist.


What matters for clinicians is not that you become a medical expert, but that you can:

  • Recognize the kinds of decisions clients face (timelines, cycles, donor choices),

  • Ask informed questions to understand immediate plans, and

  • Know when to coordinate with clinic staff, patient-advocates, or legal counsel (ASRM, 2023).


This practical literacy lets therapy stay therapeutic rather than turning sessions into medical tutorials, you create space to explore meaning, grief, and decision-making.


This practical literacy keeps therapy focused on meaning, grief, and decision-making rather than medical education sessions.



Cultural Considerations


Three women in conversation outdoors; an intergenerational moment of family or community support.

As reproductive psychologist and instructor, Julie Bindeman, PsyD, has found, family-building choices are often shaped by faith, community expectations, and identity. These cultural layers determine what feels acceptable, possible, or shameful (Bindeman, 2022).


When supporting clients:

  • Ask about faith, family expectations, and community norms early; these often frame how clients imagine parenthood and disclosure.

  • Notice power dynamics and access issues: financial costs and insurance coverage, or lack thereof, shape choices and can intensify shame or isolation (ASRM, 2021).

  • Use gender-affirming, non-assumptive language; practice with inclusive definitions of family and infertility (ASRM, 2023).


Naming cultural influences early reduces implicit judgment and opens space for value-based decisions.



Addressing the Traumas of ART


Silhouette of a roller coaster track against sky, suggesting emotional ups and downs.

A roller coaster of highs and lows, with long emotionally-charged waiting periods in between, the ART journey can be psychologically traumatic for many clients (Bindeman, Abbasi, & Sacks, 2025; Fisher & Hammarberg, 2020).


Common patterns to watch for and respond to include:

  • Repeated loss and cumulative grief. Recurrent unsuccessful cycles, missed due dates, or pregnancy loss can create layered, complicated grief (Bindeman et al., 2025).

  • Medicalized uncertainty and anticipatory anxiety. The clinic calendar produces predictable emotional hotspots. Helping clients anticipate and prepare for these moments can reduce distress (Fisher & Hammarberg, 2020).

  • Identity disruption and relational strain. Infertility can unsettle personal and couple identities, trigger blame or withdrawal, and change family narratives about lineage and parenthood (Brigance et al., 2020; Bindeman, 2022).

  • Legal and ethical distress. Post-Dobbs legal uncertainty introduced practical client anxieties surrounding embryo storage, cross-state treatment, and subpoena risk. Clinicians should screen for legal worries, coordinate referrals, and use cautious chart language when appropriate (ASRM, 2021).

  • Stigma and secrecy. Shame silences many clients; targeted psychosocial supports reduce isolation and improve coping (Alirezaei et al., 2022).


These presentations call for trauma-informed assessment: screen early for suicidality, substance use, intimate-partner violence, and destabilizing grief. Prioritize stabilization and resourcing before trauma-processing interventions and coordinate timing with medical teams when treatment cycles are active (Bindeman et al., 2025; Fisher & Hammarberg, 2020).




Countertransference Risk


If infertility or ART is part of your own story, that experience can be an empathic asset and a countertransference risk.


Be proactive about your own self-care:


  • Limit self disclosure

  • Schedule time to reflect

  • Seek case consultation

  • Develop a plan for processing difficult outcomes

Close-up of hands writing in a notebook with a coffee mug nearby, suggesting reflection and note-taking.




Practical Next Steps for Clinicians


If you’re ready to go beyond Googling acronym meanings to support clients as they navigate ART, join Julie Bindeman, Psy-D for The ABCs of ART.


An emotional moment between two partners viewing a pregnancy test while holding hands.

The ABCs of ART

🗓 November 12-13, 2025

Gain a deeper understanding of infertility and the diverse paths to parenthood to support clients with inclusivity and insight.





This training is designed to bridge the gap between generalist skills and the specific clinical, ethical, and practical demands of ART work so you can:

  • Conduct psychosocial consults that clinics expect,

  • Write scoped, defensible documentation when needed, and

  • Apply trauma-informed interventions in ways that respect medical timing and client needs.


Watch the video below to learn more about the course.




You don’t need to become a reproductive endocrinologist to support clients through ART. You do need a few practical habits: orient quickly to the clinic plan, attend to cultural meaning, screen and stabilize when grief or trauma is present, and coordinate with medical and legal partners when ethical or documentation questions arise. Those small changes shift the work from “teaching the therapist” to making therapy a place of care, meaning, and steady clinical guidance.



References


Alirezaei, S., et al. (2022). The effect of infertility counseling interventions on marital and sexual satisfaction of infertile couples: A systematic review and meta-analysis. International Journal of Reproductive BioMedicine, 20(10). https://doi.org/10.18502/ijrm.v20i10.12264. PubMed Central


American Society for Reproductive Medicine. (2023). Definition of infertility: A committee opinion. Fertility and Sterility, 120(6), 1170. https://doi.org/10.1016/S0015-0282(23)01971-4. integration.asrm.org


American Society for Reproductive Medicine. (2021). Guidance on qualifications for fertility counselors: A committee opinion. Fertility and Sterility, 115(6), 1411–1415. https://doi.org/10.1016/j.fertnstert.2021.02.016. PubMed


Bindeman, J., Abbasi, R., & Sacks, P. C. (2025). The mental health traumas of infertility: Impact and consequences. Obstetrics and Gynecology Clinics of North America, 52(1), 133–143. https://doi.org/10.1016/j.ogc.2024.10.005


Bindeman, J. (2022). Sex, religion, and infertility: The complications of G-d in the bedroom. In K. Bergman & W. Petok (Eds.), Psychological and Medical Perspectives on Fertility Care and Sexual Health (pp. 237–261). Elsevier. https://doi.org/10.1016/B978-0-12-822288-1.00012-9


Brigance, C. A., et al. (2020). Therapeutic intervention for couples experiencing infertility: An Emotionally Focused Couples Therapy approach. The Family Journal, 29(1). https://doi.org/10.1177/1066480720973420. SAGE Journals


Centers for Disease Control and Prevention. (2024). Infertility (FastStats). National Center for Health Statistics. https://www.cdc.gov/nchs/fastats/infertility.htm.


World Health Organization. (2023, April 4). 1 in 6 people globally affected by infertility: WHO.https://www.who.int/news/item/04-04-2023-1-in-6-people-globally-affected-by-infertility.

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