Fertility Challenges Mental Health Screener (FC-20)©

Fertility Challenges Mental Health Screener (FC-20)©

This 20-statement screener is a space to reflect on what you may be experiencing, it is not diagnostic. Ingram Screening recognizes that infertility can be a sensitive subject, and there is no need to suffer in silence or navigate this journey alone. After submission, you’ll receive a personalized report within 24 hours that can support your own reflection or help guide conversations with your provider, partner, family, or others in your circle. If a statement doesn’t resonate, simply skip it.
Full Name or Anonymous*

First NameLast Name
Email Address (for results/report)*
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1. I feel a deep sense of loss or sadness related to my fertility journey.
2. Sometimes I feel like I’m not allowed to fully grieve my experience because others have been trying longer or facing more.
3. I feel sadness that is hard to explain to others.
4. I feel constantly worried about my chances of becoming pregnant.
5. My thoughts often spiral around "what if" scenarios.
6. I feel on edge or unable to relax, especially around timing or treatment.
7. I feel like my body is failing me.
8. I question my identity or worth because of fertility challenges.
9. I compare myself to others who are able to conceive.
10. I feel overwhelmed by the medical aspects of fertility care (appointments, procedures, medications).
11. I feel emotionally drained by the cycle of hope and disappointment.
12. I feel like I have little control over what happens next.
13. My fertility journey has created tension or distance in my relationship(s).
14. I feel alone in this experience, even when I have support.
15. I find it hard to communicate how I'm feeling to others.
16. Pregnancy or parenting announcements are difficult for me to process.
17. I find myself pulling back from people, places, or conversations because they feel emotionally difficult right now.
18. I feel like others don’t fully understand what I’m going through.
19. I feel emotionally exhausted and unsure how much more I can handle.
20. I have had moments where I feel hopeless or question how I will get through this.
Should be Empty: