It makes intuitive sense that stress should lead to decreases in fertility. It has certainly been observed in the animal model. If you stress animals by crowding them or limiting their access to food, their fertility rates decrease. When you put them in more comfortable surroundings or give them more food, they quickly begin to reproduce normally.
Until recently, there was less evidence about this relationship in humans. A recent study published by Courtney Lynch, Ph.D, and her colleagues at Ohio State University, for the first time documented that stress levels in women were in fact related to how long the women took to get pregnant. The women who had the highest levels of a stress-related hormone when they tried to conceive were twice as likely to experience infertility compared to women who had the lowest levels.
What about women who are not simply trying to get pregnant but are already experiencing infertility (defined as 12 consecutive months of unprotected intercourse without a pregnancy)? Most of the research does show that the more stressed the woman is when she begins treatment, the less likely she is to conceive. It is a difficult field to research however, since there are so many contributing factors. For example, a 26 year old female with normal hormone levels will likely report far less stress than a 42 year old whose hormone levels indicate that she is approaching menopause. The 26 year old is also more likely to get pregnant from treatment since in most cases, her eggs will be healthier. So if the 26 year old reports less stress and then gets pregnant, did she get pregnant because she was less stressed or did she get pregnant because she had more normal eggs? I don’t think there is an answer to this question.
It doesn’t really matter, since reducing stress is a good idea for several reasons. First, infertility is incredibly stressful. Women who are experiencing infertility report the same levels of anxiety and depression as do women with cancer, HIV+ status, or heart disease. It is a very challenging time; the infertile couple is surrounded by fertile family and friends who get pregnant easily and talk nonstop about their pregnancies and babies. These women likely don’t feel comfortable telling their employers and therefore make up constant excuses to explain frequent work absences to make it to doctor’s appointments. Their sex life suffers since they are basically told by their doctor when they should and should not be having intercourse, and many begin to associate sex with failure. Finally, infertility treatment is not covered by many insurance companies, is only mandated in a handful of states, and treatment can cost thousands of dollars per cycle. It is no surprise that most individuals have depressive feelings as they pursue fertility treatments, contributing to more stress.
Reducing stress not only can make the whole process more bearable, but may help couples cope far better with the rigors of treatment. Women who are depressed before they start infertility treatment are far more likely to drop out of treatment after only one cycle, thus limiting their chances of getting pregnant. In addition, there have been numerous studies which have shown that women who learn specific stress-reduction skills become less anxious and depressed, but also have increased pregnancy rates.
Some of the best ways to relieve stress during infertility are to increase social support and learn specific ways to cope. Infertility can be so isolating, which tends to happen since most people don’t tell anyone they are going through it. Connecting with other women in a similar situation is incredibly helpful. One of the best ways is through Resolve, the National Infertility Organization. Resolve offers support groups throughout the USA as well as an incredible amount of online support via their website. At Conceptions, we offer fertility support groups sessions if you are looking to connect on a more personal level. It might surprise you how much better you can feel after simply hearing someone else voice the feelings you thought only you were experiencing.
Another important way to feel better is to learn specific skills, designed to decrease stress and increase a sense of control. There is a lot of research on mind/body groups, which combine social support as well as very specific skills acquisition training on stress reduction. Research shows that women who attend a mind/body group not only see their level of depression and anxiety return to normal, but also double their chance of pregnancy.
Remember: most couples don’t handle the emotional aspects of infertility in the same way. Don’t try to convince your partner to feel the way you do. You are each coping in the best way for you. Respect each others’ coping style. Infertility is not a permanent crisis. Most people who receive treatment do indeed conceive a healthy baby. Infertility will not have a permanent negative impact on your quality of life, believe it or not.
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