How infertility treatment affect mental health

Infertility is medically defined as the failure to achieve pregnancy after 12 months of regular unprotected intercourse. In the United States, about one in eight couples face this challenge, and globally, tens of millions of people live with infertility. The overlap between infertility and mental health is large: infertility affects identity, relationships, work, and social roles, and it often produces stress, guilt, emptiness, anxiety, and depression.

This infertility how-to guide outlines why psychological effects of fertility treatmentmatter, how distress can both result from and contribute to reproductive problems, and why mental health during IVF and other assisted reproductive technologies (ART) deserves routine screening and support. Evidence shows up to 40% of women facing infertility may meet criteria for a psychiatric diagnosis, yet few receive psychiatric care—so understanding these risks is a key part of ethical, patient-centered fertility care.

Section 3 will review the emotional timeline of diagnosis and treatment, while later sections explain medication effects, ART-specific stressors, and practical coping strategies for prospective parents and surrogates. Readers will learn what to expect and when to seek professional help.

Key Takeaways

• Infertility commonly co-occurs with significant emotional distress and psychiatric symptoms.
• Psychological effects of fertility treatment can be both a consequence of and a contributor to reproductive difficulty.
• Mental health during IVF and ART is under-addressed despite high need.
• Routine screening and early support improve outcomes for patients and partners.
• This how-to guide will map stressors, medication effects, and evidence-based coping strategies.

Understanding infertility and its psychological impact

Infertility is a medical diagnosis with deep personal consequences. Clinically, it means the inability to achieve pregnancy after 12 months of regular, unprotected intercourse (six months if over age 35). This infertility definition prevalence helps frame why roughly one in eight couples in the United States seek evaluation or treatment.

Definition and prevalence of infertility

Causes span ovarian dysfunction, tubal disease, uterine factors, cervical issues, male sperm problems, and unexplained infertility. Female factors account for about 40–55% of cases. Male factors contribute 20–40%. Assisted reproductive technologies (ART) include pharmacologic therapies, surgical correction, intrauterine insemination (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), assisted hatching, gamete intrafallopian transfer (GIFT), and surrogacy.

The rise in ART use links to delayed childbearing and steady improvements in success rates. In the U.S., about 12% of married women report trouble conceiving or sustaining a pregnancy, a statistic that underlines clinical and psychosocial demand.

Primary versus secondary infertility and mental health implications

Primary infertility means no prior pregnancy. Secondary infertility means there was a prior pregnancy, regardless of outcome. The distinction shapes personal narratives and clinical care.

Primary vs secondary infertility mental health concerns differ. People facing primary infertility often confront lost expectations about becoming a parent for the first time. Those with secondary infertility may grieve the loss of a prior parenting identity or fear public scrutiny when a new pregnancy does not occur.

Both groups report anxiety, sadness, and a sense of failure. Grief reactions can mirror bereavement. Clinicians should screen for mood and anxiety disorders, offering targeted support when treatment begins.

How cultural expectations and identity shape emotional reactions in the United States

Cultural impact infertility US is profound. Family-building norms and pronatalist pressures vary across communities. Events with children, religious settings, and extended-family expectations can intensify distress.

Infertility identity shifts when parenthood is central to self-definition. People may feel diminished self-worth, shame, or isolation. For intended parents, infertility identity centers on hope mixed with loss. Surrogates face distinct role complexity; nurturing during pregnancy then relinquishing can trigger conflicting emotions.

Effective assessment and counseling must account for cultural context, stigma, and social supports. Tailoring care to identity, values, and community norms improves relevance and reduces harm.

AspectKey detailsPsychological implicationsInfertility definition prevalenceFailure to conceive after 12 months; ~12% of married women in the U.S.High demand for evaluation; common source of stress and identity disruptionPrimary infertilityNo prior pregnancy; often first-time parenting expectation unmetAcute grief, anxiety about medical procedures, fear of social judgmentSecondary infertilityPrior pregnancy; difficulty conceiving againComplex grief, threats to established parenting identity, increased shameART and optionsMedications, IUI, IVF, ICSI, assisted hatching, GIFT, surrogacyHopefulness mixed with procedural stress, financial strain, and mood changesCultural impact infertility USPronatalist norms, variable stigma across ethnic groups, social triggers presentHeightened isolation, avoidance of social events, need for culturally sensitive careInfertility identitySelf-concept tied to parenthood or reproductive roleThreats to self-worth, altered relationships, need for identity-focused counselingHow does infertility treatment affect mental health

The path from diagnosis to active fertility care often triggers a wide range of emotions. Clinics such as Mayo Clinic and Stanford report that testing, procedures, and uncertain outcomes create repeated cycles of hope and disappointment. This emotional timeline of infertility treatmentfrequently includes sharp highs around procedures and low points during waiting periods.

Emotional timeline during diagnostic workup and initial treatment

Early clinic visits can feel nerve-racking. Learning test results may provoke anger, guilt, sadness, or a drop in self-esteem. Social withdrawal is common as patients avoid questions about family-building.

Key stress points occur at ovum retrieval, embryo transfer, and the two-week wait for pregnancy testing. Repeated cycles create monthly grief rhythms that erode resilience over time.

Common psychiatric symptoms seen during treatment: anxiety, depression, grief, and stress

Anxiety and depressive disorders appear more often in people undergoing fertility care than in the general population. Studies show up to 40% of women with infertility meet criteria for a diagnosable psychiatric condition.

Grief reactions are frequent and nonlinear. Patients report panic, insomnia, irritability, and difficulty concentrating. Chronic stress can affect biological factors, including semen quality in men, and may lower chances of success.

Gender differences in psychological responses to fertility treatment

Women typically report higher distress during evaluation and treatment. Men often underreport symptoms because expressing vulnerability conflicts with social expectations.

Gender differences infertility mental health appear in how symptoms present: men may withdraw, work more, or increase alcohol use, while women report more sadness and anxiety. Clinicians should screen both partners and recommend joint counseling when coping timelines diverge.

Mood and behavioral effects of fertility medications

Fertility medications can change more than ovulation. Patients often notice shifts in sleep, appetite, energy and irritability soon after starting a drug. These changes can stem from biology, the emotional weight of infertility, or both. Clear guidance helps you and your care team track symptoms and decide when extra support is needed.

Common fertility drugs and documented psychological side effects

Clomiphene citrate (Clomid, Serophene) is prescribed to trigger ovulation. Reports link clomiphene mood changes with anxiety, sleep disruption, and irritability. Letrozole (Femara) is used for clomiphene-resistant cycles; patients may experience fatigue, headaches and other letrozole side effects that affect mood and concentration.

GnRH agonists such as leuprolide (Lupron) suppress the natural cycle for IVF. Case reports and clinical notes describe mood swings and cases of Lupron depression, along with acne and anxiety. Oral contraceptives used in protocols can cause weight shifts and potential depressive symptoms in a minority of patients.

How to distinguish medication side effects from treatment-related distress

Timing is a key clue. A sudden change in mood or sleep that starts days after a new medication suggests a pharmacologic cause. Gradual worry, persistent sadness that predates treatment, or distress tied to tests and outcomes points to treatment-related stress.

Pattern helps too. Abrupt mood lability, severe depressive episodes or hallucinations are more likely to require medication review or urgent psychiatric care. Ongoing baseline anxiety or depression that worsens during cycles often reflects an interaction between the emotional burden of infertility and drug effects.

When medication-related mood changes warrant psychiatric consultation

Seek evaluation if mood changes interfere with daily life, work, relationships, or parenting. Suicidal thoughts, psychosis, severe panic attacks or unrelenting depressive symptoms need prompt psychiatric assessment. Clinicians should coordinate when antidepressants or mood stabilizers are considered during conception attempts.

Collaboration between reproductive endocrinologists and psychiatrists helps weigh medication risks and benefits. This team can tailor choices to fertility goals while minimizing harm, addressing the fine line between medication vs distress infertility and ensuring safe, effective care.

MedicationTypical psychological effectsOnset patternWhen to consultClomiphene (Clomid)Anxiety, irritability, sleep disruption, headachesDays to weeks after start; fluctuating with cycleSevere mood swings or new major depressionLetrozole (Femara)Fatigue, dizziness, sleep issues; cognitive fogWithin first treatment cycle; dose-related reportsPersistent depressive symptoms or functional declineGnRH agonists (Lupron)Mood swings, anxiety, reports of Lupron depression, acneWithin days to weeks of suppressionSuicidal ideation, psychosis, or severe depressionOral contraceptives (protocol use)Weight change, low mood in susceptible individualsWeeks to months; varies by agentNew or worsening depressive disorder despite supportStressors specific to assisted reproductive technologies (IVF, IUI, ART)

The path through assisted reproductive technologies brings medical expertise and emotional labor in equal measure. Couples and individuals face a mix of physical intrusion, tight schedules, repeated uncertainty, and steep bills. Each element raises the chance of mental strain during treatment.

Procedural and scheduling stress

Daily injections, frequent blood draws, transvaginal ultrasounds and timed semen collections make the process intrusive. The routine of injections monitoring fertility stress can make bodies feel like the site of care and control at once. Clinic appointments and medication timing reduce flexibility for work and family life.

Scheduled intercourse or "sex on demand" can harm intimacy and sexual satisfaction. That loss of spontaneity feeds anxiety and a sense of diminished agency.

The emotional burden of repeated cycles and waiting

Each cycle carries a pulse of hope followed by a waiting period that magnifies uncertainty. The two-week wait after embryo transfer is a common peak for anxiety. Repeated failed attempts produce cumulative grief and raise the likelihood of depressive symptoms.

About two in ten women report notable mood disturbances after unsuccessful cycles. Deciding whether to try again involves weighing age-related decline in success against emotional reserves and support.

Financial strain and mental health

Costs in the United States for a single IVF cycle can range from several thousand to tens of thousands of dollars. The cost of IVF mental health link is strong: mounting bills increase stress, reduce access to care, and lead some to stop treatment prematurely.

Financial strain interacts with procedural demands and waiting periods to deepen the ART psychological burden. Lack of affordable counseling or clear information about financing options makes distress worse for many patients.

Practical steps that clinics and counselors recommend include setting treatment limits, planning finances in advance, and building a support team (medical, emotional, legal). These measures reduce avoidable pressure and protect well-being during a demanding journey.

Consequences of treatment failure and long-term mental health risks

Treatment failure can leave lasting emotional work for patients and partners. Distress after unsuccessful cycles often includes sadness, loss of identity, and worry about the future. Clinical teams should expect a range of reactions and plan follow-up care that matches individual needs.

Rates of depressive and anxiety disorders after unsuccessful cycles

Research shows higher rates of mood disorders among those who undergo repeated unsuccessful attempts. Historically, psychiatric symptoms in infertile couples have ranged widely, with many studies noting that about two in ten women report depressive symptoms after failed IVF cycles. Anxiety often co-occurs and can persist beyond the immediate treatment window.

Risk behaviors and relationship outcomes following long-term infertility

Long-term infertility mental health effects include changes in behavior that raise clinical concern. Some patients increase alcohol or tobacco use, and clinicians have documented higher rates of benzodiazepine use among those who remain childless after years of treatment.

Substance use infertility links appear in follow-up studies five years after failed cycles, where childless patients report more substance use than peers who parent via adoption or spontaneous conception. Couples may also face marital strain. Men and women can grieve differently, which can widen conflict and reduce relationship satisfaction.

Mental health needs after successful treatment and after discontinuation

Pregnancy after infertility brings unique concerns. Many who conceive after treatment report perinatal anxiety after infertility, marked by fear of miscarriage, hypervigilance, and increased monitoring needs during prenatal care. This anxiety can affect sleep, appetite, and bonding.

When couples stop treatment without achieving parenthood, grief-focused care becomes essential. Long-term infertility mental health follow-up may include psychotherapy, peer support, and assistance with alternative family-building options such as adoption or donor gametes. Tailored plans reduce isolation and guide patients toward realistic coping strategies.

AreaTypical findingsSuggested clinical responseDepression ratesApproximately 20% of women after failed IVF report depressive symptoms; broader studies show 25%–60% psychiatric symptom rangeScreen with PHQ-9, offer brief psychotherapy, consider psychiatric referral for moderate–severe casesAnxiety and perinatal concernsElevated perinatal anxiety after infertility in pregnancies that follow treatmentProvide prenatal mental health check-ins, CBT for anxiety, coordinate with obstetric teamSubstance use patternsIncreased alcohol, tobacco, benzodiazepine use reported among childless patients five years post-failureScreen for substance use, brief interventions, refer to addiction services when indicatedRelationship outcomesHigher rates of marital strain and relationship breakdowns documented after long, unsuccessful treatmentOffer couple therapy, communication skills training, referral to family counselingAfter discontinuation needsPersistent grief, identity loss, need for alternative family-building supportGrief-focused therapy, support groups, resources for adoption and donor optionsTherapies and interventions to reduce psychological harm during fertility care

Care during fertility treatment works best when emotional support is built into medical care. Counseling and structured therapies target stress, grief, and decision-making at key moments: before cycles, during retrieval and transfer, while waiting for results, and after pregnancy or treatment end. Clinics should offer options that fit patients' needs and timing.

Formats of counseling

Infertility counseling formats include one-on-one therapy, couple sessions, and group programs. Individual therapy helps a person process loss and mood changes. Couple sessions focus on communication, roles, and shared decisions. Group work offers peer support and normalizes feelings after failed cycles or long waits.

Psychotherapy approaches with evidence

CBT infertility interventions aim at changing unhelpful thoughts and behaviors tied to treatment stress. Trials show reduced anxiety and depressive symptoms when CBT is available alongside medical care.

ACT fertility programs teach acceptance of uncontrollable aspects of the journey and clarify values that guide choices. Patients learn practical exercises to stay present during scans, transfers, and waiting windows.

Grief-focused therapy addresses cumulative losses from repeated cycles, pregnancy losses, or the sense of lost life goals. This approach helps patients name layered sorrow and plan adaptive next steps.

Relaxation and mind-body options

Relaxation techniques IVF clinics can offer include guided breathing, progressive muscle relaxation, and short meditations timed for high-stress moments such as embryo transfer.

Yoga and guided imagery have improved quality of life in randomized studies. These practices reduce intrusive negative thoughts and increase calm during monitoring and procedures.

Self-administered CCRI PRCI tools are low-cost, user-friendly interventions patients can use during waiting periods. Trials show these tools raise positive reappraisal and lower anxiety without extra clinic visits.

How to match therapy to need

• High distress around procedures: brief CBT infertility techniques plus relaxation techniques IVF for immediate symptom relief.
• Couples facing repeated losses: grief-focused therapy with couple sessions to rebuild communication and shared goals.
• Patients wanting self-help: CCRI PRCI materials and guided meditation curricula for daily practice.

InterventionPrimary benefitFormatWhen to offerCBT infertilityReduces anxiety and depression; improves copingIndividual or short group courseBefore treatment and during high-distress phasesACT fertilityIncreases acceptance and values-based actionIndividual or couple sessionsWhen uncontrollable uncertainty fuels avoidanceGrief-focused therapyProcesses layered losses and ambiguous griefIndividual or couple therapyAfter failed cycles or pregnancy lossRelaxation techniques IVFImmediate anxiety reduction around proceduresBrief sessions, recordings, in-clinic practiceDay of retrieval, transfer, and waiting periodCCRI PRCIBuilds coping and positive reappraisal; low costSelf-administered materialsDuring waiting windows and between cycles

Therapists who collaborate with reproductive endocrinologists provide the best fit for these interventions. Referrals should be routine so you can access targeted support at predictable moments in treatment. This coordinated approach reduces harm and supports decisions that align with personal values.

Conclusion

Infertility and fertility treatments carry a clear psychological burden across diagnosis, active care, and after treatment ends. Distress often appears as anxiety, depression, grief, and stress, and these reactions can affect decision-making and reproductive outcomes. Recognizing this link helps clinicians and patients see mental health as a core part of fertility care.

To improve coping with infertility treatment, teams should screen both partners, normalize grief, and offer evidence-based options such as CBT, acceptance and commitment therapy, and grief-focused therapy. Simple self-help tools (CCRI/PRCI), relaxation training, and clear information about psychiatric medications during conception reduce uncertainty and empower informed choices.

Providers are urged to integrate mental health fertility care by embedding counseling, timely referrals to fertility-competent mental health professionals, and planned follow-up after successful conception or discontinuation. This caregiver-and-sage approach balances empathy with clinical rigor, supporting intended parents and surrogates while aiming to reduce long-term harm and promote ethical, comprehensive care.

FAQHow does infertility and its treatment affect mental health?Infertility and its treatments commonly provoke anxiety, sadness, grief, and stress. Diagnosis can feel like a life crisis and challenge identity, relationships, and future plans. Repeated invasive procedures, uncertain outcomes, medication side effects, financial strain, and social triggers (family gatherings, friends’ pregnancies) all add to emotional burden. Psychological distress may persist long after treatment ends, even after successful conception, and can both result from and contribute to poorer reproductive outcomes.What is the medical definition and prevalence of infertility?Infertility is defined as the failure to achieve pregnancy after 12 months of regular, unprotected intercourse. Globally, tens of millions are affected; in the United States about one in eight couples (roughly 12% of married women) report trouble conceiving or sustaining a pregnancy. Causes include ovarian, tubal, uterine, cervical, and male factor problems, as well as unexplained infertility. Assisted reproductive technologies (IVF, ICSI, IUI) are common treatments.What's the difference between primary and secondary infertility—and do they affect mental health differently?Primary infertility refers to not having ever conceived; secondary infertility means difficulty conceiving after a prior pregnancy. Both can cause significant distress, but reactions may differ. Primary infertility often threatens self-identity and future plans, while secondary infertility can bring unexpected grief and feelings of failure despite prior parenting experience. Clinical assessment should explore past reproductive history and tailor counseling accordingly.How do cultural expectations and identity influence emotional reactions to infertility in the United States?Cultural norms and pronatalist expectations shape how people experience infertility. In many U.S. communities, family-building pressures, religious beliefs, and stigma can intensify shame, isolation, and secrecy. Intended parents and surrogates face different identity challenges (hope mixed with loss for intended parents; role complexity for surrogates). Clinicians should assess cultural context and social supports when offering counseling.What emotional stages are common during diagnostic testing and initial treatment?Early stages often include shock, anger, guilt, sadness, and withdrawal. Diagnostic testing and waiting for results provoke uncertainty. Beginning treatment introduces hope alternating with disappointment (monthly grief cycles). High-stress moments include ovum retrieval, embryo transfer, and the two-week wait for pregnancy testing—times when anxiety and intrusive thoughts typically spike.What psychiatric symptoms are frequently seen during fertility treatment?Anxiety and depressive disorders are common; grief reactions and chronic stress occur frequently. Women report higher symptom rates than men. Symptoms can include persistent worry, sleep disturbance, low mood, loss of interest, panic attacks, and impaired daily functioning. Up to 40% of women facing infertility may meet criteria for a psychiatric diagnosis, though few seek specialized care.Are there gender differences in psychological responses to fertility treatment?Yes. Women generally report greater distress, more frequent help-seeking, and higher rates of diagnosable mood and anxiety disorders. Men may underreport emotional suffering and show distress through withdrawal, irritability, or increased substance use. Couples often cope on different timelines; screening and therapies should include both partners and encourage joint communication.Which fertility medications are linked to mood and behavioral side effects?Several commonly used drugs have documented psychological effects. Clomiphene citrate (Clomid) can cause mood changes, anxiety, sleep disruption, irritability, and headaches. Letrozole may cause fatigue, dizziness, and sleep issues. GnRH agonists (for example, leuprolide/Lupron) are associated with mood swings, anxiety, and depressive symptoms. Oral contraceptives used in protocols can also affect mood. Providers should review side effects before treatment.How can patients and clinicians distinguish medication side effects from treatment-related distress?Consider timing and symptom pattern. New symptoms that begin soon after starting a drug suggest a pharmacologic cause. Abrupt severe mood lability, suicidal thoughts, or psychosis are red flags for medication-related or emergent psychiatric issues. Symptoms present before medication likely reflect underlying anxiety or depression amplified by treatment. Careful history, symptom tracking, and communication between reproductive and mental health clinicians help clarify cause.When do medication-related mood changes require psychiatric consultation?Seek psychiatric evaluation for severe mood changes that impair daily functioning, suicidal ideation, self-harm, psychotic symptoms, panic attacks, or persistent major depressive or anxiety symptoms despite coping efforts. Also consult when starting or changing psychotropic medications during conception attempts or pregnancy so risks and safer alternatives can be reviewed collaboratively.What stressors are specific to assisted reproductive technologies like IVF and IUI?ART involves frequent clinic visits, daily injections, blood draws, transvaginal ultrasounds, and invasive procedures such as egg retrieval and embryo transfer. Scheduling intercourse ("sex on demand") can damage intimacy. Repeated cycles, the emotional ups and downs of waiting periods, and the financial costs of ART add to cumulative stress and can lead to treatment discontinuation or worsening mental health.How do repeated cycles, waiting periods, and failed attempts affect mental health?Repeated cycles create a pattern of hope and disappointment that compounds grief. Waiting periods are intensely anxiety-provoking. Failed cycles increase rates of depression and anxiety; two in ten women report depressive symptoms after failed IVF. Over time, prolonged unsuccessful attempts raise the risk of chronic distress, relationship conflict, and disengagement from care.How does financial strain from fertility care impact psychological well-being?High out-of-pocket costs for IVF and related services amplify stress, limit access, and contribute to feelings of hopelessness. Financial worry interacts with treatment uncertainty to increase anxiety, reduce treatment persistence, and worsen relationship strain. Discussing costs openly and connecting patients to financial counseling or insurance resources can reduce one major source of distress.What are the long-term mental health risks after unsuccessful fertility treatment?Long-term risks include persistent anxiety and depression, increased substance use in some groups, and relationship difficulties or separation. Historical studies reported elevated psychiatric problems in 25%–60% of infertile couples. People who stop treatment without achieving parenthood may require grief-focused therapy and long-term follow-up to address ongoing loss and life-plan changes.What mental health needs arise after successful conception following infertility?Many people experience heightened pregnancy anxiety, fear of pregnancy loss, and hypervigilance during prenatal care. Perinatal anxiety and mood disorders are common and should be screened and treated. Coordinated care between reproductive teams and obstetric and mental health providers helps manage these concerns and supports a healthy transition to parenthood.What forms of counseling and therapy are recommended during fertility care?Counseling can be delivered individually, for couples, or in groups and should be integrated into fertility care. Evidence-based psychotherapies include cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and grief-focused therapy. These approaches reduce anxiety and depression, improve coping, and may enhance quality of life during treatment.Which relaxation and mind–body interventions help during infertility treatment?Yoga, meditation, deep-breathing exercises, guided imagery, and progressive muscle relaxation show benefits for anxiety reduction and improved quality of life. Self-administered tools such as the Cognitive Coping and Relaxation Intervention (CCRI) and Positive Reappraisal Coping Intervention (PRCI) are low-cost options with evidence for improved coping during waiting periods and procedures.What practical communication tools help couples navigate fertility treatment?Set shared expectations about treatment goals and privacy (who to tell), express support preferences (physical comfort, space, practical help), and plan for trigger situations (family events). Use brief check-ins to share emotions, agree ahead on decision-making steps, and consider joint counseling to align coping styles and prevent misunderstandings.What self-care routines can reduce anxiety, improve sleep, and support appetite?Prioritize consistent sleep schedules and sleep hygiene. Maintain balanced nutrition and regular physical activity. Limit excessive caffeine and alcohol. Practice relaxation techniques daily (meditation, breathing exercises, yoga). Allow yourself to grieve, journal emotions, and set small, manageable routines to preserve daily functioning.Where can patients and partners find reputable support resources in the United States?RESOLVE: The National Infertility Association offers support groups, local chapters, and educational resources. Many clinics provide lists of fertility-competent mental health professionals. Moderated online forums and professional groups can reduce isolation—choose sources run by licensed clinicians or established organizations for evidence-based guidance.When should someone seek a mental health professional during fertility care?Seek professional help for persistent or worsening depression, panic attacks, suicidal thoughts, substance misuse, severe relationship conflict, or when daily functioning is impaired. Referral is also warranted for complex decision-making (donor gametes, surrogacy), perinatal anxiety after conception, or long-term grief after treatment discontinuation. Fertility clinics are encouraged to offer proactive referrals and integrate mental health screening into care.What immediate steps can a person take if they or their partner are in crisis?If there is any risk of harm to self or others, seek emergency help or call 988 for the Suicide & Crisis Lifeline in the United States. Contact a reproductive clinic for urgent counseling referrals, reach out to a trusted clinician, or use crisis text lines and local emergency services. Share the concern with a partner or family member who can help facilitate immediate care.

Neelam is working as a full-time International Fertility and Surrogacy Consultant representing IVF Conceptions and Complete Surrogacy Consulting.