UNLABELLED:Infertility and its treatment can be a very stressful experience. Some countries have legislation governing the provision of counselling for assisted conception treatments. All licensed IVF clinics in the UK are required to offer patients counselling. OBJECTIVES:To determine the proportion of patients who were offered counselling, the proportion of those who then received counselling, how useful they found it, and to establish the main reasons why patients may opt not to receive counselling. METHODS:An internet-based survey of users of an independent infertility website. Two-hundred-and-forty-four patients participated in the survey, of which 62% received treatment in the UK. CONCLUSIONS:Seventy-three per cent of all couples were offered, or obliged, to receive counselling compared to 91% of those patients treated in the UK. Of the patients who took part in the survey, only 30% received counselling; over half of those patients found it either 'very helpful' or 'helpful'. No differences were observed in the perceived usefulness of counselling, comparing those patients who were offered, and chose to receive, counselling versus those who received mandatory counselling. In patients who did not receive counselling, the main reasons cited were: 'felt I can cope on my own' (37%), 'counselling was not offered' (21%), and 'did not think it would be beneficial' (15%).