What to Expect at Your First Infertility Therapy Session
Introduction
You finally made the appointment. Maybe it took weeks of thinking about it, or maybe a particularly hard day pushed you to pick up the phone. Either way, you scheduled your first session with an infertility therapist, and now you're wondering what you've gotten yourself into.
That nervous feeling in your stomach? Completely normal. Walking into a stranger's office to talk about one of the most painful experiences of your life takes courage. You might be wondering what you'll be asked, whether you'll cry the entire time, or if the therapist will actually understand what you're going through.
Here's what I want you to know: there's no wrong way to show up to your first session. You don't need to have your thoughts organized. You don't need to know exactly what you want to work on. You just need to show up as you are, wherever you are in your fertility journey.
Before Your First Session
The Paperwork
Most therapists will send intake forms before your first appointment. These typically include:
Basic information such as your contact details, emergency contact, and how you heard about the practice.
Health history covering any mental health diagnoses, previous therapy experiences, current medications, and relevant medical history. For infertility-specific practices, this often includes questions about your fertility history, treatments you've tried, and where you are in your family-building process.
Informed consent explaining confidentiality, practice policies, session fees, and cancellation procedures. Take time to read this carefully and bring any questions to your session.
Insurance and payment details if applicable. Many clients use out-of-network benefits or HSA/FSA funds for fertility counseling. Check our FAQs page for more information about payment options.
Filling out paperwork beforehand allows your therapist to review your situation and means you can spend your actual session time talking rather than filling out forms.
What to Bring
You don't need to bring anything specific, but some clients find it helpful to:
Write down a few things they want the therapist to know, especially if you tend to forget details when nervous.
Bring a list of questions you have about therapy or the therapist's approach.
Have your calendar available to schedule future sessions.
Tissues are always provided, so you don't need to worry about that.
Setting Your Intentions
Before your appointment, spend a few minutes thinking about what brought you to therapy. You don't need a polished answer, but having a general sense helps. Are you struggling with anxiety during treatment? Feeling depressed and hopeless? Experiencing strain in your relationship? Grieving a pregnancy loss?
You might have multiple reasons, and that's okay. Your therapist will help you sort through priorities together.
What Happens During the First Session
The First Few Minutes
Your therapist will likely greet you, offer you a seat, and spend a few minutes helping you settle in. This might include small talk or simply checking how you're feeling about being there.
If you're doing a telehealth session, your therapist will confirm you're in a private space and troubleshoot any technology issues.
These first moments matter. Your therapist is paying attention to how you're doing and working to help you feel comfortable.
Your Story
The bulk of your first session will involve sharing your story. Your therapist wants to understand:
What brings you to therapy now? Something shifted that made you reach out at this particular moment. Maybe you just got difficult news, maybe you've been struggling for months and finally hit a wall, or maybe someone suggested therapy and you decided to try it.
Your fertility history. This includes how long you've been trying to conceive, any diagnoses you've received, treatments you've undergone or are considering, and losses you've experienced. A therapist who specializes in infertility won't need extensive explanations of medical procedures. They'll understand the difference between IVF and IUI, know what a two-week wait feels like, and recognize why a failed cycle can be devastating.
How infertility is affecting you. This goes beyond the medical facts. How are you sleeping? How is your relationship? Have you withdrawn from friends or family? Are you dreading social events? How are you coping day to day?
Your support system. Who knows about your fertility struggles? Who can you talk to? Who do you avoid? Understanding your support network helps your therapist know what resources you have and where the gaps are.
Your mental health history. Have you experienced anxiety or depression before? Have you been in therapy previously? What worked or didn't work? This information helps your therapist tailor their approach.
You Won't Cover Everything
One session isn't enough time to share your entire history and all the nuances of your experience. That's normal and expected. Your therapist is gathering enough information to understand your situation and start building a relationship with you. The deeper work unfolds over time.
If there's something specific you want to make sure you mention, say so. "Before we run out of time, I want to make sure I tell you about..." is a perfectly acceptable thing to say.
Questions Your Therapist Might Ask
Every therapist has their own style, but here are questions commonly asked during an infertility-focused intake:
About your fertility experience:
How long have you been trying to conceive?
What treatments have you tried or are you currently doing?
Have you experienced any pregnancy losses?
How do you and your partner communicate about fertility? (if applicable)
About your emotional state:
On a scale of 1-10, how would you rate your anxiety right now?
How has your mood been over the past few weeks?
Are you having trouble sleeping, eating, or concentrating?
Have you had any thoughts of harming yourself?
About your goals:
What would you like to get out of therapy?
How will you know therapy is helping?
What does support look like for you?
About your coping:
What helps you get through hard days?
What makes things worse?
How do you typically handle stress?
You don't have to have perfect answers. "I don't know" is a valid response. So is "I haven't thought about that before."
Questions You Can Ask Your Therapist
The first session is also your chance to learn about your therapist and decide if they're the right fit. Consider asking:
About their experience:
How long have you worked with clients experiencing infertility?
What training do you have in reproductive mental health?
Are you a member of any professional organizations like ASRM Mental Health Professional Group?
About their approach:
What does a typical session look like after the intake?
What therapeutic approaches do you use?
How do you measure progress?
About logistics:
How often do you recommend meeting?
What's your cancellation policy?
How do you handle communication between sessions?
Do you offer telehealth as well as in-person sessions?
A good therapist welcomes these questions. They want you to feel confident in your choice.
What Your Therapist is Assessing
While you're sharing your story, your therapist is doing several things simultaneously:
Building rapport. They're working to create a safe space where you feel heard and understood. This foundation is essential for effective therapy.
Assessing your current state. Are you in crisis? Are you experiencing symptoms of depression, anxiety, or trauma? Do you need additional support or resources?
Understanding your needs. What kind of help are you looking for? Are you seeking coping strategies, a space to process emotions, help with decision-making, or something else?
Evaluating fit. Is this therapist the right match for you? Do they have the expertise to address your specific concerns? Sometimes a therapist may recommend a different provider who specializes more closely in your needs, and that's a sign of ethical practice, not rejection.
Formulating initial impressions. Based on what you share, your therapist is beginning to think about how they might help and what approaches might work best for you.
Common First Session Experiences
Crying (A Lot or A Little)
Many people cry during their first session. For some, it's the first time they've told their full story to someone who actually gets it. For others, just being asked "How are you really doing?" opens the floodgates.
Crying in therapy is not a sign of weakness. It's often a sign that you're finally in a safe enough space to let your guard down.
If you don't cry, that's equally fine. Everyone processes differently.
Feeling Relieved
Some clients leave their first session feeling lighter. Finally telling someone the truth about how hard things have been, without having to manage their reaction or reassure them you're okay, can be incredibly freeing.
Feeling Exhausted
Talking about painful experiences takes energy. Don't be surprised if you feel tired after your session. Consider scheduling your appointment at a time when you can rest afterward rather than rushing back to work or responsibilities.
Feeling Uncertain
You might leave wondering if therapy is right for you or if this particular therapist is the right fit. That's okay. It often takes a few sessions to know. Give yourself permission to try it out before deciding.
Feeling Worse Before Feeling Better
Sometimes stirring up difficult emotions leaves you feeling raw. This doesn't mean therapy isn't working. Processing pain often involves feeling it more intensely before it starts to ease.
After Your First Session
Scheduling Follow-Up Appointments
Before you leave, you'll typically schedule your next session. Most therapists recommend meeting weekly, especially at the beginning, to build momentum. As you progress, you might shift to every other week or as needed.
If you're actively in fertility treatment, weekly sessions can provide crucial support during high-stress times like the two-week wait or after difficult results.
Reflecting on the Experience
In the days after your first session, notice how you feel. Did you feel heard? Did the therapist seem to understand infertility? Could you imagine opening up more over time?
Red flags to watch for include feeling judged, dismissed, or pressured. If the therapist said things that felt insensitive about infertility (like suggesting you "just relax"), trust your instincts.
Green flags include feeling understood, sensing genuine warmth, and leaving with even a small sense of hope.
Giving It Time
The therapeutic relationship takes time to develop. Most therapists suggest giving it three to four sessions before deciding if it's working. The first session is just the beginning.
People Also Ask
How long is a first therapy session for infertility?
Initial intake sessions typically run 50 to 60 minutes, though some practices schedule 75 to 90 minutes for the first appointment to allow more time for history-gathering. At Dancing Bee Counseling, we offer extended intake sessions so you don't feel rushed while sharing your story. Subsequent sessions are usually 50 to 55 minutes.
Do I need to prepare anything for my first infertility therapy session?
No preparation is required, but some clients find it helpful to jot down a few notes about what they want to discuss or questions they have for the therapist. If you've completed intake paperwork beforehand, review any questions that came up while filling it out. Most importantly, come as you are. You don't need to have your thoughts perfectly organized.
Will my therapist tell me what to do about my fertility treatment?
A fertility therapist won't make medical decisions for you or tell you what to do. Instead, they'll help you process your emotions, clarify your values, and make decisions that feel right for you. Whether you're considering another IVF cycle, exploring donor conception, or thinking about when to stop treatment, your therapist provides support while respecting your autonomy.
Can my partner come to the first session?
This depends on what you're seeking. If you're interested in couples fertility counseling, both partners would attend together. If you want individual support, you would attend alone. Some clients start with individual therapy and later add couples sessions, or vice versa. Discuss your preferences when scheduling.
What if I don't connect with my therapist?
Not every therapist is the right fit for every client, and that's okay. If after a few sessions you don't feel comfortable or understood, it's appropriate to try someone else. A good therapist will understand and may even help you find a better match. Your healing matters more than any individual therapeutic relationship.
Taking the First Step
Scheduling your first infertility therapy session is an act of self-care during one of the hardest experiences of your life. You deserve support from someone who truly understands the unique pain of infertility, someone who won't offer empty platitudes or unsolicited advice, but will sit with you in the difficult moments and help you find your way through.
At Dancing Bee Counseling, Abby Lemke provides specialized support for individuals and couples navigating infertility, pregnancy loss, and the emotional challenges of family building. With personal experience and professional training in reproductive mental health, she creates a warm, judgment-free space where your feelings are validated and your story matters.
Ready to schedule your first session? Contact us to book an appointment, or learn more about Abby and her approach to fertility counseling.
