A study this month in the British Medical Journal showed that children conceived through IVF and other fertility techniques are more likely to be premature, born by caesarean, admitted to intensive care or suffer fatal complications. The emotional rollercoaster of fertility treatment, it seems, does not end with conception. Nor does it begin there. One psychological study found that the stress levels of infertile women are equivalent to women with cancer, Aids or heart disease.

These days about 15% of couples who want a baby end up with some kind of assisted conception: this can involve dehumanising tests, injections, operations, scans and medications. Women quickly become experts in hormones, clinical techniques and high-tech terminology, fluent in IVF, Gift, Zift, ICSI or Mesa. They may endure extraordinary disappointment and distress without telling a single friend or family member. Their finances (the average course of IVF alone costs £2,000 -£4,000) may be stretched to the limit, their relationship put under strain; and yet they may never become parents this way, and if they do, they face even more complications. Despite this, fertility clinics currently do little to tackle stress. This, according to a growing number of fertility experts, could prove a short-sighted attitude.

Research has shown that the more distress a woman reports prior to infertility treatment, the less likely she is to conceive. Infertility clinics in Britain today are obliged to offer all patients access to a counsellor (a regulation imposed by the Human Fertilisation and Embryology Authority). But a new breed of "mind/body" infertility specialists believes this is not enough. Psychologist Dr Alice Domar - dubbed "the Fertility Goddess" by one Boston newspaper - is the director of the Mind/Body Centre for Women's Health, which runs the "Mind/Body Programme for Infertility", an increasingly famous 10-week course for women attending the Boston IVF fertility centre. "There is no doubt that stress and depression can negatively impact a woman's chances of success in infertility treatment," says Domar. Her results appear to back this up: women on the programme, she says, have nearly triple the birth rate of other women undergoing IVF.

Domar's patients are not just those with "unexplained infertility" (which, according to the NHS, affects as many as 26% of infertile couples). To explain her success, she reels off numerous studies. One, in 2001, found that women suffering from prolonged stress were likely to have a reduced implantation rate during IVF. Another showed that women with a history of depression are twice as likely to suffer from infertility than those without. Another showed that women's depression levels peak in the second to third year of infertility (which is exactly the time they are likely to be undergoing stressful fertility treatment). And severe stress, Domar maintains, may affect more than IVF implantation rates: one study, presented at last year's international fertility conference in Texas, examined women living near ground zero in New York who were undergoing IVF around the time of 9/11. Those who got pregnant after 9/11 were 67% more likely to miscarry than those who became pregnant before 9/11.

Michael Pawson, consultant gynaecologist and until recently chair of the British Society of Psychosomatic Obstetrics, Gynaecology and Andrology, says that while virtually all doctors would agree that extreme stress can disrupt ovulation, the real problem is that the precise biological links between stress and fertility remain vague. Though scientists know that the hypothalamus, the body's "master gland", controls the pituitary gland, which produces both female and stress hormones, the exact relationship, he says "has not been properly understood. It's terribly difficult to measure exactly what proportion of infertile couples is affected by psychological factors. Some women who are under dreadful stress continue to produce a child a year and the pregnancy rate in women who have been raped is as high as it is among normal women. There are so many unknowns that it is easy for the pure scientist to pour scorn on psychogenic explanations for infertility."

Critics of the mind/body approach to infertility say they foster dangerous self-blame. Many infertile women are already tormented by anecdotes about people who begin adoption procedures only to become pregnant and many blame themselves for their failure to become a mother (obsessing on anything from past abortions to smoking or drinking). "Your mind cannot completely control your ovaries, your tubes or your uterus," Domar confirms. The programme's relaxation techniques and cognitive behavioural therapies, she explains, aim to manage the process of IVF, whatever the outcome. The Mind/Body Centre also works hard to tackle self-blame, and patients are given much practical information about alternatives to IVF, such as adoption and egg donation.

Claire Brown, executive director of the Infertility Network, the UK's biggest infertility support organisation, agrees that such systematic support would be helpful for many women undergoing fertility treatments: "The number one emotion expressed to us is isolation." Indeed, she says, many couples currently turn down counselling because they fear that if they accept it, the clinic might think they are "failing to cope" and might therefore stop treating them.

In Britain, then, we are a long way from a mind/body approach to infertility. The Birmingham Women's Hospital, a busy, large, well- respected NHS unit, is fairly representative: "We have an independent counsellor available to all patients on a need-to basis, but ultimately the individual has to take responsibility for themselves," says their spokesperson. "There's only so far you can go. IVF is stressful. It's life, isn't it?"

Things may, however, be changing. Domar has contributed to a forthcoming UK textbook and will next month speak at a conference jointly organised with the (British) Sims Fertility Clinic. And some British clinics are realising that a woman's emotional state may indeed have a significant effect: "Lowering stress levels is the most important thing we do after making sure that people are physically fit," says Mary Power, unit manager of the private Lister IVF Clinic, in London. "It's very hard to eliminate stress. But we talk to patients a lot about reducing external stress in their lives, and we try to make the treatment as simple as possible, to make sure they see the same medical team each time, and to provide access to complementary therapists and a counsellor."

Elsewhere, help is available. The British Association of Infertility Counsellors offers specialist psychological support for infertility. Zita West, best known as midwife to such stars as Kate Winslet, also runs "fertility awareness training" and "pre-IVF consultations" at her private practice. "Women going through IVF can be at their most fragile," she says. "They're having hormones to stimulate their eggs, mini-operations, stressful scans, and all the while they're hoping to get, and stay, pregnant."

Many women "ignore the basics" - or have never been told them (even if they've had courses of IVF). They may have no idea how body weight, nutrition, rest, medications, smoking, drinking or exercising can affect conception. West also gives practical advice on how to research clinics ("people spend more time researching holidays than IVF clinics"), and provides complementary therapies, such as acupuncture (which some studies have shown may help ovulation), relaxation therapies and counselling to help women through potentially gruelling IVF treatments.

"I believe Zita's programme is utterly responsible for my pregnancy," says Julia, 41. She and her husband turned to IVF after their second child (conceived naturally) died of meningitis at the age of four. "We had started IVF six months after our son died. We knew there were medical complications that meant it was unlikely that we would conceive naturally, and we were frantic to have another child." After five failed attempts, Julia heard about West. "It completely changed the direction of my life," she says. "I realised I was totally ill equipped for IVF: I was still grieving for my son, exhausted from the fertility treatments and I didn't have a clue how to choose a clinic.

"Having IVF is like being kicked in the gut by a horse. But no one once mentioned anything to me during those five fertility treatments about rest or nutrition. After one IVF treatment I remember getting straight into the car and driving to the West End to have lunch with a friend. I really had no idea." After following West's program and choosing a new clinic, Julia got pregnant on the first cycle of IVF. Her son was born in August last year.

Blocked fallopian tubes will not, of course, miraculously unblock themselves with a bit of deep breathing and toe-rubbing. What's more, many women can't afford private treatments alongside the expense of IVF. But too many women are going through traumatic treatments alone, without basic skills, knowledge or emotional support. Mind/body courses may sound like a luxury; they should be essential.

'It genuinely changed my life'

· Lisa Marks Schwartz went through Dr Domar's Mind/Body IVF programme, through which she conceived her two daughters, Isabel (four) and Lucie (seven months).

We started trying for a baby six and a half years ago and I got pregnant straight away. When I miscarried eight weeks later I was shocked, horrified and upset. Since then I have had five miscarriages, one ectopic pregnancy, eight intrauterine inseminations, four IVF cycles, four uterine surgeries and two operations on ovarian cysts. I now have two beautiful daughters.

From the day I got into the mind/body programme, everything changed. For a start, it was the first time I had been in a room with 18 other people, all with fertility problems. Before this, I had felt so isolated. When you are in your early 30s everyone's getting pregnant. I started avoiding friends like the plague. I would avoid situations where someone might announce a pregnancy, or a party where I knew there would be five pregnant women. This really affected my relationship with my husband. He found it hard to see me pushing friends aside and our sex life became stressful.

At first you're only having sex to get pregnant. Then, when you can't conceive, you think, "Why bother with sex at all?" You don't even want to think about sex. Sex becomes associated with failure.

Infertility affects your work, too. You can't concentrate properly. You're juggling doctor's appointments and scans and it can be hard to share this sort of information with your supervisor. We did tell our families, and they were wonderful (although my mother's initial reaction was: "Why don't you just relax?"). Now, after six years, she does understand that it's more complicated than that.

Coming to the course changed my whole way of thinking. We learned new skills every week - mini-relaxation techniques to use in stressful moments, things you can carry with you while you're having the treatments.

I conceived my first daughter during the course. Once I was pregnant, though, the anxieties seemed like they were just beginning. Because of my previous miscarriages, every time I went to the bathroom I expected to see blood. Every ultrasound or check, I was scared there would be no heartbeat. It's not until you hold your baby that you know that you've done it.

The course helped me survive this entire ordeal. It gave me the inner strength to get through the medical procedures, and it also helped me change some of my negative thinking. I went from thinking, "I'm never going to have a baby" to "I can be a mother if I want to."

We also went to sessions about adoption and egg donation, and came away really positive, thinking, "That's what we would do if this doesn't work - it's not second best."

The course also taught me basic lifestyle changes - how to provide a healthy environment for the pregnancy by cutting back on things like caffeine and alcohol, and stopping high-intensity exercise and smoking. (I was running five to six miles a day, and when I stopped I got pregnant within two months.)

I went back to the course when we wanted to have our second child. A "secondary infertility" group had just started. Lots of the women there had not had fertility treatment the first time round. Secondary fertility can, in a way, be even harder: you know how great motherhood is. You know that your body is capable of doing it. And there's the peer pressure again - everyone is having second and third babies and asking you: "When are you going to give that child a sibling?"

The course helps you cope with all this. I don't generally go in for all that hand-holding stuff, but this really was different: it genuinely changed my life.

Boosting your chances

STDs Have a full sexual health screen. Infections or conditions you do not know about could affect your ability to conceive naturally.

Weight If you are obese and lose 10-14lb, you can dramatically raise your chances of getting pregnant, says Domar. In one study, 70-80% of under-weight women who gained just 8lb conceived.

Smoking Some studies show that smokers have half the conception rate in IVF.

Caffeine More than one cup of coffee a day, says West, can increase the time it takes to conceive by up to 50%. And according to Domar, a study showed women who drank more than 50mg caffeine daily had significantly lower IVF rates.

Alcohol Studies have shown that women who drink less than five units a week are twice as likely to conceive within six months as women who drink more, says West.

Nutrition Adequate protein, iron and overall good nutrition are important for getting and staying pregnant, and maximising your body's chances of responding to fertility treatment.

Attitude Learn visualisation techniques; have counselling for any negative thoughts.

Relaxation Yoga, acupuncture, reflexology or massage may be helpful in lowering stress and coping with gruelling fertility treatments.

Exercise Gentle walking is fine, but both Domar and West advise against high-intensity exercise such as aerobics or running.

Rest As much as possible. West recommends 2-3 days' bed rest after an IVF treatment.

Medications Some over-the-counter medications may interfere with fertility, says West: lubricants can slow the passage of sperm; some painkillers, specifically ibuprofen, may affect ovulation; decongestants may alter your cervical mucus.

Herbal supplements Studies have suggested that St John's wort, gingko and echinacea negatively affect fertility.

· Boston IVF: tel 001-781 434 6578. Conquering Infertility by Dr Alice Domar is published by Viking Press. Fertility & Conception by Zita West is published by Dorling Kindersley. Info on Zita West's clinic at www.zitawest.com or tel: 020-7224 6091. British Association of Infertility Counsellors tel: 0114-263 1448. www.bica.net. Infertility Network: tel 01424 732361.