Can OCD Make It Harder to Get Pregnant?

If you have Obsessive Compulsive Disorder (OCD) and are trying to conceive, you may find yourself wondering whether your OCD is somehow getting in the way of becoming pregnant. Maybe you worry that stress is affecting your fertility, that your thoughts are somehow interfering with conception, or that something you ate, drank, did, or failed to do has made pregnancy less likely.

Having OCD does not mean that you cannot get pregnant. OCD is not the same thing as infertility, and having intrusive thoughts does not cause infertility.

What can happen, however, is that trying to conceive can become a particularly powerful trigger for OCD. There is so much you cannot know. You don't know exactly when you'll get pregnant, whether this will be the month, whether something you did affected your chances, or whether there is something else you should be doing. For someone with OCD, that uncertainty can create a powerful urge to check, research, monitor, and seek reassurance.

You might find yourself repeatedly tracking ovulation, researching ways to increase your chances of conceiving, taking pregnancy tests earlier or more frequently than you intended, or searching for signs that implantation has occurred. You might replay something you ate or drank and wonder whether it could have affected your chances. You might avoid activities because you're afraid they could interfere with conception, feel compelled to have sex at exactly the “right” time, or spend a significant amount of time trying to determine whether you're doing everything possible to get pregnant.

These behaviors can make trying to conceive feel all-consuming. And because compulsions often provide temporary relief, it can be difficult to recognize when something that initially seemed helpful has become part of the OCD cycle.

When Trying to Get Pregnant Becomes Trying to Get Certainty

No one likes working toward something without knowing whether or not it will work out. Your OCD really doesn't like it.

Trying to conceive can involve an enormous amount of waiting and uncertainty. You may know when you ovulated, but you don't know whether conception occurred. You may know when you can take a pregnancy test, but you don't know what the result will be. And if you don't become pregnant this month, you may find yourself starting the process all over again.

For someone with OCD, that uncertainty can quickly turn into questions that feel as though they need to be answered.

What if I miss my fertile window?

What if I did something wrong?

What if I should have done something differently?

What if this happens again next month?

These questions may not simply come and go. They can start to feel like problems that need to be solved. And once OCD decides there is a problem, it offers a familiar solution: get more information, check one more thing, ask someone who might know, or find some way to make sure you haven't missed anything.

So you track your cycle more carefully. You research supplements. You monitor physical sensations. You ask your doctor another question. You look through online forums to see whether other women experienced the same thing. You take a pregnancy test as soon as it could possibly tell you anything.

And for a little while, these things may actually make you feel better.

The problem is that the relief doesn't last. Soon there is another question.

But what if I tested too early?

What if I miscalculated when I ovulated?

What if that symptom means something else?

What if I didn't do enough?

So you check again.

This is the OCD cycle: the very behaviors intended to make uncertainty more manageable can ultimately make uncertainty feel more threatening.

When “Doing Everything Right” Becomes the Problem

Trying to conceive comes with no shortage of advice. Eat this. Don't eat that. Take this supplement. Avoid that activity. Track your temperature. Watch for ovulation. Have sex on this day. Don't miss this window.

Some of this information may be useful. You may reasonably decide that certain changes are worth making, particularly when they are recommended by your medical provider. The problem isn't taking care of your fertility. The problem is when OCD turns reasonable care into a demand for perfection.

You may start with a question like, What might help? But OCD can quickly turn that into, What if I don't do everything perfectly?

Then suddenly you're not just trying to conceive. You're trying to eliminate every possible reason pregnancy might not happen.

You might research one more supplement, change your exercise routine, eliminate another food, recalculate when you ovulated, search for implantation symptoms, or look for reassurance that something you did three days ago hasn't reduced your chances of becoming pregnant.

And sometimes the behavior itself looks completely reasonable. That's part of what makes OCD around fertility so difficult to recognize.

Tracking ovulation isn't inherently a compulsion. Asking your doctor a question isn't inherently reassurance seeking. Taking a prenatal vitamin isn't a compulsion. Even doing quite a bit of fertility research isn't necessarily a problem.

The more useful question is what happens after you do those things.

Can you take the information and move on? Or does OCD immediately ask another question?

But what if I missed something?

What if I should be doing more?

What if that wasn't enough?

There is an important difference between making an informed choice and trying to reach a level of certainty that doesn't actually exist.

When Fertility Becomes Something You Feel Responsible for Controlling

One of the hardest parts of OCD around conception can be the feeling that if you just do enough, you can make the outcome happen.

If you eat perfectly, take every supplement, exercise the right amount, have sex at exactly the right time, manage your stress, get enough sleep, avoid anything potentially harmful, and do everything correctly, maybe you can make sure you get pregnant.

And if you don't?

It can be very easy to turn that uncertainty back on yourself.

What did I do wrong?

What did I miss?

Maybe I should have known.

Maybe I didn't try hard enough.

For someone with OCD, this can become especially painful because it creates the illusion that the outcome is entirely your responsibility. If you could just identify the missing variable, perhaps you could finally make pregnancy happen.

But fertility doesn't work that way. There are many things you can reasonably do to support your fertility, and there are many situations in which medical care can help. None of that means you can completely control whether or when you become pregnant.

That distinction can be incredibly difficult for OCD to tolerate.

What If There Really Is a Fertility Problem?

This is where things can get complicated, because sometimes there really is a medical problem to address.

You may have been trying to conceive for a while. Your doctor may recommend testing. You may be pursuing fertility treatment. You may have unexplained infertility. OCD doesn't mean those concerns aren't real.

You don't need to avoid fertility testing or pretend that everything is fine in order to treat OCD. You can follow your doctor's recommendations and still have OCD. You can ask an appropriate question and still have OCD. You can make a thoughtful decision about fertility treatment and still have OCD.

The difficulty is that getting information and getting reassurance can look remarkably similar from the outside.

You may ask your doctor a reasonable question. Then you ask your partner. Then you search online. Then you find another study. Then you call your doctor again because you're still not completely sure.

The information itself may be legitimate. But if you're repeatedly seeking information because you're waiting for the feeling of certainty to arrive, you may find yourself caught in the OCD cycle.

There is a difference between getting the information you need and trying to get information that will finally make you certain.

This can be especially difficult when you're pursuing fertility treatment because there are real decisions to make and legitimate reasons to want more information. At the same time, OCD may continue asking questions that medicine simply cannot answer with certainty.

What if this treatment doesn't work?

What if we should try something else?

What if I make the wrong decision?

What if I don't do enough?

At some point, the work may be recognizing, I've gotten the information I reasonably can. Now I have to make a decision and live with some uncertainty.

That's not the same thing as giving up or failing to advocate for yourself. It's recognizing the point at which further information is no longer helping you make a decision and is instead becoming another attempt to feel certain.

What About the Fear That Stress Is Preventing Pregnancy?

Another particularly difficult OCD trap is the fear that your own anxiety is causing the problem.

You may have heard that stress affects the body or read that stress can affect fertility. Then OCD can take that information and turn it into another impossible responsibility.

What if my anxiety is preventing me from getting pregnant?

What if I'm too stressed?

What if worrying about getting pregnant is making it harder to get pregnant?

Now you have a new problem: you need to stop being anxious in order to get pregnant.

And trying desperately not to be anxious tends to make you more aware of your anxiety. You start monitoring how stressed you are, judging yourself for feeling anxious, and worrying that the fact that you're worrying is making things worse.

I've worked with women who become caught in exactly this kind of loop. They aren't only worried about whether they'll get pregnant; they're worried that they're responding to the possibility of not getting pregnant incorrectly, and that their response itself is somehow making the situation worse.

You don't need to achieve some perfectly calm emotional state before you're allowed to try to conceive. And you don't need to stop having intrusive thoughts in order for conception to happen.

Trying to eliminate every anxious thought can simply become another way of trying to control an outcome that cannot be completely controlled.

Learning to Try Without Trying to Control Everything

Treating OCD while trying to conceive isn't about convincing yourself that fertility doesn't matter or telling yourself that you shouldn't care so much.

You can take your prenatal vitamin. You can track ovulation if that's useful to you. You can follow your doctor's recommendations. You can pursue fertility testing or treatment when appropriate. You can make thoughtful decisions about your health.

And you can still have OCD.

The work is learning to recognize when reasonable fertility care has crossed over into an attempt to eliminate uncertainty.

That might mean noticing the urge to search one more time and choosing not to. It might mean taking an ovulation test without then spending an hour researching what the result means. It might mean allowing yourself to wonder whether this month will be the month without trying to figure out every possible variable. It might mean having a thought like What if I did something that prevented this from working? and resisting the urge to go back through the last several days looking for an answer.

Sometimes it means allowing yourself to say, I don't know.

I don't know whether this month will work.

I don't know exactly when I'll get pregnant.

I don't know whether I could have done something differently.

I don't know whether everything will happen the way I hope.

And I don't have to solve those questions right now.

OCD Treatment While Trying to Conceive

Treatment for OCD during this stage of life isn't about convincing yourself that everything will work out. It's about learning that you can experience uncertainty without needing to solve it.

Evidence-based OCD treatment such as Exposure and Response Prevention (ERP) can help you practice experiencing uncertainty without responding with the compulsions that temporarily make you feel safer. Acceptance and Commitment Therapy (ACT) can also help you make room for difficult thoughts and feelings without allowing them to dictate what you do.

For women trying to conceive, treatment may focus specifically on the situations that have become difficult: fertility testing, ovulation tracking, sex and timing, pregnancy testing, researching fertility, physical sensations, medical appointments, or the uncertainty of whether conception will happen.

You don't have to care less about becoming a mother. You don't have to stop hoping that this will be the month. And you don't have to give up on appropriate fertility care.

You can want this very badly and still learn not to let OCD run the process.

Fertility OCD Therapy

If trying to conceive has started to feel like something you have to monitor, research, control, or get exactly right, you may be dealing with more than ordinary fertility anxiety.

You don't have to wait until OCD is taking hours out of your day or interfering with your relationships to get help. And you don't have to choose between taking your fertility seriously and treating OCD.

At Red Elm Psychotherapy, we specialize in OCD and perinatal mental health, including OCD that shows up while trying to conceive, during fertility treatment, and throughout pregnancy. Our approach incorporates Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), and other evidence-based treatments for OCD.

Treatment can help you learn to distinguish between reasonable fertility care and compulsive attempts to eliminate uncertainty, so you can make informed decisions about your fertility without feeling like you have to control every variable.

If you're spending more and more time checking, researching, seeking reassurance, or worrying that you've done something to prevent pregnancy, you don't have to figure this out on your own.

Or, if you're ready to talk with someone about whether therapy might be a good fit, contact Red Elm Psychotherapy to get started below.