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Fertility & Family Planning
Fertility Decisions
Decisions about fertility and family planning are rarely just medical.
Many people seek therapy while weighing timing, partnership, career demands, or whether to preserve future options through egg freezing—often without clarity, certainty, or agreement between partners.
Fertility Counseling & Family Planning in New York City
Are you trying to make sense of fertility or family planning decisions and finding that the weight of them is heavier than you expected? You may be questioning timing, partnership, or whether options like egg freezing belong in the picture—without feeling certain about what’s right.
For others, this uncertainty includes difficulty getting pregnant, pregnancy loss, or navigating fertility treatment, assisted reproduction, or third-party options. The emotional, physical, and financial demands can be consuming. Even with sustained effort, it can be hard to quiet the sense of urgency around time and the future.
Fertility Problems
You may have been trying to get pregnant for months—or longer—without success, and your attention has narrowed around why it isn’t happening. Tracking cycles, researching supplements, and planning intimacy around ovulation can begin to take over, crowding out parts of life and relationships that once felt easier or more spontaneous.
The uncertainty can be isolating. Questions from friends and family often land as pressure or pity, and it’s hard not to compare yourself to others for whom pregnancy seems to come effortlessly. Wanting something deeply while having no clear timeline—or guarantee—can leave you feeling stuck, resentful, or quietly hopeless about what the future holds.
Loneliness in Infertility
Fertility treatment can feel isolating even when others around you seem to be finding success. You may worry about whether it will work for you, what it might demand of your body, or how the logistics and emotional toll could affect your relationship or work life.
It can also become harder to stay connected to friends or acquaintances who announce pregnancies with ease. Feeling envy, grief, or distance in those moments is common—and often layered with guilt or shame for having those reactions at all.
Many people find themselves caught between wanting to move toward parenthood and wanting to feel present, grounded, and capable of joy in their lives as they are now.
Fertility Issues Are Common
If you’re struggling to get pregnant or to carry a pregnancy, you are far from alone. Difficulty conceiving or sustaining a pregnancy affects many people, even though it’s often experienced in silence.
Roughly one in eight couples encounters fertility challenges, and pregnancy loss is also common—both in recognized pregnancies and in those that end before they are detected. These experiences often bring uncertainty, fear, and grief, particularly when they collide with expectations about how family-building was “supposed” to unfold.
Relationship Impacts of Fertility Problems
Fertility challenges often strain relationships in ways that are difficult to anticipate. Guilt, anger, resentment, or self-criticism can surface, sometimes turning inward and sometimes toward a partner. Even when people understand that infertility is not anyone’s fault—and that causes are widely distributed between partners—it can still feel personal and isolating.
Many couples find it hard to talk openly about fertility struggles. Shame, pressure from others, or a sense of failure can lead to withdrawal, both from each other and from friends or family. Over time, this isolation can make decisions about treatment feel heavier, more exhausting, or even impossible to continue.
When the demands of fertility protocols begin to feel overwhelming, it can be tempting to step away simply to escape the emotional toll. Fertility counseling offers a space to slow this process down—helping individuals and couples think more clearly about next steps, cope with uncertainty, and make decisions that are grounded rather than driven by fear or depletion.
LGBTQIA2S+ Parents and Family Planning in New York City
The Keely Group works with LGBTQIA2S+ individuals and families navigating family planning, including queer, trans and gender-expansive, and non-monogamous partnerships. We offer an affirming space to explore the emotional, relational, and practical complexities that can arise in paths such as IVF, surrogacy, and third-party reproduction.
Our therapists recognize that these experiences often involve distinct medical, legal, social, and interpersonal stressors—and deserve care that is thoughtful, informed, and grounded in respect.
How Can Fertility Counseling Support Family-Building Decisions?
Fertility counseling isn’t about offering reassurance or promises. It provides a structured, neutral space to think clearly, speak honestly, and tolerate uncertainty without pressure to feel hopeful, grateful, or resilient on demand.
In therapy, the focus is not on pushing you toward or away from treatment, but on helping you understand your own limits, values, and priorities—separate from the expectations of family, partners, workplaces, or medical systems. This can be especially important when decisions feel urgent, emotionally loaded, or hard to revisit once made.
Fertility counseling and family planning work can support you in areas such as:
Deciding whether to pursue or pause fertility treatment
Navigating IVF cycles, transfers, or third-party reproduction
Weighing options like egg or embryo freezing
Making sense of next steps after pregnancy loss or unsuccessful treatment
Managing the emotional and relational strain that often accumulates over time
Therapy also creates room to address grief—whether for a pregnancy, a timeline, or a version of parenthood that may no longer feel possible in the way you once imagined. The goal is not to erase that loss, but to help you integrate it without letting fear or depletion drive major decisions.
Our therapists work collaboratively and adaptively, drawing on different therapeutic approaches depending on what is most useful for you. The aim is clarity, steadiness, and agency—not motivation speeches or forced optimism.
Our Approach to Fertility Counseling
Our work focuses on helping you function, think, and decide more clearly while navigating fertility and family-building uncertainty. When the process becomes consuming—as it often does—attention narrows, daily rhythms erode, and stress quietly compounds. This isn’t a personal failure; it’s a predictable response to prolonged pressure and lack of control.
Rather than prescribing “self-care,” therapy helps you notice what has fallen away and decide what, if anything, is worth reintegrating so that your life does not collapse entirely around fertility. The aim is steadiness and perspective, not optimization or forced positivity.
The Keely Group’s Founder and Clinical Director, Erin McMaugh Tierno, began her career in reproductive health policy and at the intersection of reproductive and family law. Over time, it became clear that her most meaningful work was not in advocacy or legal frameworks, but in helping people navigate the emotional and relational impact of these systems. She has practiced as a therapist since 2006.
Some therapists at The Keely Group bring personal familiarity with fertility challenges and loss. That perspective can inform sensitivity and attunement—but it does not replace careful listening or individualized care. Each person’s experience is distinct, and therapy is not guided by assumptions or comparisons.
Our clinicians pursue specialized training through the American Society for Reproductive Medicine’s Mental Health Professional Group and maintain ongoing education in reproductive mental health. This work requires both emotional fluency and clinical rigor, particularly when people are making decisions under prolonged stress and uncertainty.
Family-building can involve repeated disruption, grief, and recalibration. Fertility counseling offers support not by promising resolution, but by helping people think, feel, and function more steadily—whatever direction their path ultimately takes.
At our New York City–based practice, we work with individuals and couples for whom parenthood has been difficult or unclear. The focus is on supporting autonomy, strengthening internal trust, and tolerating uncertainty without collapsing into urgency or despair.
Common Questions About Fertility Counseling in New York City
How is therapy going to help me have a baby?
Therapy doesn’t determine medical outcomes—but it can support how you navigate the process. It can help you manage stress, reduce strain on relationships, and think more clearly while making fertility and family-building decisions. The focus is on psychological stability and decision-making capacity, not on guaranteeing results.
I’m worried that counseling will be too expensive.
Fertility treatment is costly, and adding therapy can feel like another burden. Counseling is not meant to push you to continue treatment, but to support clearer thinking about whether to proceed, pause, or stop. For some, therapy helps prevent burnout or reactive decisions; for others, it supports stepping away in a way that feels intentional rather than defeated.
I’m worried you’ll focus on my childhood instead of what’s happening now.
Therapy here is oriented toward your current situation. At times, discussing past experiences can help clarify present reactions or patterns—but this is always in service of what you’re dealing with now. The emphasis is on helping you cope, decide, and function in the present, not on excavating your history unless it’s useful to you.
Begin Fertility Counseling in New York City
The Keely Group offers psychological support for individuals and couples navigating fertility and family-building concerns. Our work focuses on helping you think more clearly, cope more steadily, and make decisions under pressure—without assuming a particular outcome or path.
All services are provided via secure online therapy for New York–based clients.
To get started:
Contact The Keely Group through our contact form
Meet with a therapist for a complimentary 20-minute consultation call
Decide whether fertility counseling feels like the right next step for you
Explore Other Services at The Keely Group
In addition to fertility counseling, our New York City–based practice offers therapy in the following areas:
Looking for More Resources and Support?
Explore our writing on fertility and family-building concerns.
