Fertility Counseling

For many people, building a family is one of the most deeply held hopes of their lives. But the path to parenthood is not always straightforward, and when it is not, the emotional weight can be enormous. The uncertainty of fertility treatments, the grief of pregnancy loss, the complexity of third-party reproduction, and the strain that all of it can place on a relationship deserve the same quality of care as any other significant mental health challenge. 

At Old Town Psychology, we provide compassionate, specialized fertility counseling for individuals and couples in Alexandria, VA, supporting you through every stage of the family-building journey. And you don’t need to wait. We have immediate openings.

What Is Fertility Counseling?

Fertility counseling is a specialized form of therapy designed to support the emotional and psychological dimensions of the family-building process. It is distinct from fertility evaluations or medical assessments. It is not about testing or diagnostics. It is about providing a skilled, confidential space where individuals and couples can process what they are going through, develop meaningful coping strategies, and find their footing during one of life’s most emotionally demanding experiences.

The road to parenthood can involve infertility diagnoses, repeated treatment cycles, pregnancy loss, decisions about donor eggs, donor sperm, surrogacy, adoption, and the profound uncertainty of not knowing whether the outcome you are working toward will come. Each of these experiences carries its own emotional complexity, and none of them should have to be navigated without support.

At Old Town Psychology, our fertility counseling is grounded in evidence-based therapeutic approaches and delivered by therapists with extensive experience in this specialized area. We have worked closely with leading fertility clinics and agencies in the region, including Dominion Fertility, Shady Grove Fertility, CCRM, and American Surrogacy, and we are experienced in supporting straight couples, LGBTQ couples, and single parents through every aspect of the family-building process.

Signs That You May Need Fertility Counseling

The emotional toll of fertility challenges is real, significant, and frequently underestimated, both by the people experiencing it and by those around them. Society often focuses on the medical side of infertility while the psychological side goes unacknowledged. If you are experiencing any of the following, fertility counseling may offer meaningful support:

• Persistent anxiety, worry, or dread around fertility treatments, upcoming cycles, or test results
• Feelings of grief, loss, or profound sadness following a negative result, miscarriage, or failed treatment cycle
• A sense of isolation, as though no one around you truly understands what you are going through
• Strain or tension in your relationship with your partner as the stress of fertility treatments takes a toll
• Difficulty coping with the uncertainty and loss of control that infertility can create
• Feeling overwhelmed by the decisions involved in third-party reproduction, including choosing a donor, working with a surrogate, or navigating legal and ethical questions
• Struggling to manage the demands of fertility treatment alongside work, family, and everyday life
• Feelings of shame, inadequacy, or failure connected to infertility or pregnancy loss
• Difficulty processing a diagnosis of infertility and what it means for your future
• Relationship conflict around differing levels of investment in treatment, disagreements about next steps, or difficulty supporting one another effectively

You do not need to be in crisis to seek fertility counseling. Many people find that having professional support from the beginning of their fertility journey, rather than waiting until they are overwhelmed, makes the entire process more manageable and less isolating.

What Does Fertility Counseling Help With?

Fertility counseling addresses the full emotional landscape of the family-building journey. At Old Town Psychology, we provide support for:

Infertility and the grief it carries. An infertility diagnosis is a loss  of the assumed future, of the pregnancy you imagined, of the timeline you had planned. Therapy provides a space to grieve that loss honestly and work through the complex emotions it brings, including anger, sadness, guilt, and disorientation about what comes next.

IVF stress and treatment-related anxiety. The demands of assisted reproductive technology are considerable: the injections, the monitoring appointments, the waiting, the financial pressure, the physical side effects, and the emotional whiplash of hope and disappointment. Therapy equips you with practical coping strategies and a steady source of support through every stage of the treatment cycle.

Pregnancy loss. Miscarriage, stillbirth, and pregnancy termination for medical reasons are profoundly painful experiences that are too often met with minimization or silence. Fertility counseling provides the space to mourn these losses fully and work through grief that is real, valid, and deserving of care.

Third-party reproduction. Donor conception, surrogacy, and embryo donation involve decisions that are medically straightforward but emotionally layered. We help individuals and couples think through these decisions thoughtfully and process the feelings they bring up.

Relationship support. Fertility challenges can place significant strain on even the strongest partnerships. Partners often cope differently, communicate differently under stress, and find themselves feeling increasingly disconnected at a time when connection matters most. We help couples stay on the same team by building communication skills and mutual support strategies that sustain the relationship through the process.

Navigating decisions about next steps. When to continue treatment, when to stop, whether to pursue adoption, how to tell family and friends, what to do with remaining embryos; these are among the most emotionally charged decisions a person can face. Therapy provides a space to work through them with clarity and intention.

Support for LGBTQ individuals and couples. Family building as an LGBTQ individual or couple often involves additional layers of complexity, including navigating third-party reproduction, legal considerations, and a healthcare system that was not always designed with your family in mind. Our therapists bring both clinical expertise and genuine familiarity with these experiences to this work.

What Does Fertility Counseling Look Like?

At Old Town Psychology, fertility counseling is a personalized, ongoing source of support tailored to where you are in your journey and what you need most at each stage. Sessions are 50 minutes and are available in person at our Alexandria, VA office or via a secure, HIPAA-compliant video portal.

We work with both individuals and couples, and our approach combines the emotional depth of traditional therapy with practical skills-based counseling. Depending on your needs, treatment may involve:

• Developing personalized coping strategies. We will help you build a toolkit of evidence-based techniques for managing anxiety, processing grief, tolerating uncertainty, and regulating difficult emotions; tools you can draw on between sessions and throughout the treatment process.
• Processing grief and loss. Whether you are grieving a pregnancy loss, a failed cycle, an infertility diagnosis, or a version of your family-building story that did not go as planned, therapy provides the space to move through grief honestly rather than pushing it aside.
• Strengthening your relationship. For couples, sessions may incorporate communication-focused work to help you support each other more effectively, navigate disagreements about treatment decisions, and maintain connection during an emotionally demanding time.
• Preparing for the road ahead. Whether you are preparing emotionally for a new treatment cycle, processing a decision about next steps, or planning how to talk to children about their origins, we help you approach the future with clarity, intention, and resilience.

Our therapists bring deep expertise in this specialized area and understand the particular landscape of fertility treatment, including the medical language, the emotional rhythms of a cycle, and the weight of the decisions involved. You will not need to explain the basics. We are already familiar with the terrain, and we are here to walk it with you.

What Our Patients Say

"We brought our daughter in for testing and the OTP team was amazing. They were so kind, caring and great with children. My daughter is shy and takes a little time to warm up when first meeting someone new. The Doctor was patient and encouraging and my daughter had a wonderful time. They also provide fast results and meet with you to explain everything in the report. I would definitely recommend them."

"Very prompt response to our inquiry. Welcoming environment and very professional, thorough communication. The staff genuinely seems to care that your needs are met."

"Excellent service, knowledgeable staff, incredible responsiveness, diligence and follow through -- we feel lucky we found such a great therapy practice. We cannot recommend them highly enough!"

“My daughter took WISC-V test there and we are very pleased with our experience. They are professional, patient and wonderful throughout the entire process. My daughter had such a great time that she hardly felt that was a test - she even asked when she could take it again. I would highly recommend them to whoever needs child IQ testing services.”

“I took my children here for TAG testing. Both of my kids actually enjoyed their assessments. I was very pleased with the time and care taken to assess my children, the thoroughness of the report, and the fact that there was a follow-up session to discuss any questions that I had relative to the assessment included. Also-- the tea selection in the waiting room is top tier :)”

“Very prompt response to our inquiry. Welcoming environment and very professional, thorough communication. The staff genuinely seems to care that your needs are met.”

Take the Next Step

You should not have to go through this alone. Whether you are just beginning to explore your options or are deep in the middle of a fertility journey, professional support can make a profound difference in how you experience the process. At Old Town Psychology, we maintain immediate availability for new fertility counseling clients. While many practices in the area have waitlists, we are ready to support you now.

To schedule a consultation or learn more about fertility counseling, contact us today.