Mental health and fertility

The emotional experience of living with a reproductive health condition, or of trying to conceive without success, is one of the most significant things many women go through. Anxiety, grief, shame, isolation, hope, and loss can all be part of it. None of this is weakness. All of it is a rational response to something genuinely difficult.

Research from India (n=1,530 women of reproductive age with delayed conception) found that 54% experienced psychological distress. 20% reported depression. 16% reported anxiety. Social isolation was one of the strongest associated factors.

A study of 485 women attending fertility services in Pakistan (Hussain and Brayne, BMJ Open 2025) found that 69% met criteria for depression and anxiety.

A global survey of 4,409 Indian women with PMOS found that anxiety and depression were the most common additional conditions, present in 64% of respondents.

These figures come from South Asian populations. They are not generalisable to all South Asian women in the UK, and the UK context differs from these settings in important ways. But they point to a consistent pattern: fertility difficulties and reproductive health conditions carry a significant mental health burden, and this burden is compounded by community and family context.

In many South Asian communities, the expectation to have children, and to have them soon after marriage, is significant. Questions from family, pressure from in-laws, comments at community gatherings, the comparison with cousins and friends who are already pregnant, these form a social environment that can make fertility difficulties feel like a public failure rather than a private medical experience.

The concept of izzat, honour, reputation, the face a family presents to its community, shapes how reproductive health is discussed and disclosed. Fertility difficulties may be kept secret precisely because of the weight attached to them. This secrecy can prevent women from getting support, from talking to people who might help, and from accessing information that could make a difference.

You do not have to carry this alone.

Research published in the Lancet Global Health (Peng et al, 2022), a systematic review and meta-analysis of 30 studies involving 7,164 women across low-to-middle income countries, found that 36% of infertile women experienced intimate partner violence in the previous 12 months. Lifetime prevalence was 47.2%. Infertility was identified as a previously underrecognised risk factor for intimate partner violence.

This research was not conducted in UK South Asian populations specifically. The UK context is different. But the finding, that fertility difficulties can be a context in which women experience harm from partners or families, is important enough to name.

If you are in a situation where you feel unsafe, controlled, or at risk of harm, you can access support without anyone knowing you have done so.

Samaritans, 116 123, free, 24 hours, every day. For anyone struggling emotionally, not only in crisis.

Karma Nirvana, 0800 5999 247, Specialist support for South Asian communities experiencing honour-based abuse or forced marriage.

National Domestic Abuse Helpline (Refuge), 0808 2000 247, free, 24 hours.

BICA (British Infertility Counselling Association), bica.net, A directory of accredited counsellors who specialise in fertility and reproductive health. Self-referral.