Stress & Infertility
In research published in the journal Human Reproduction, doctors compared pregnancy rates in couples that reported being stressed and those who were not. What they found: Pregnancy was much more likely to occur during months when couples reported feeling "good" --
happy and relaxed. It was less likely to occur during the months they reported feeling tense or anxious.
But it's not just natural (unassisted) pregnancies that are affected. In research published in Fertility and Sterility, experts at the University of California at San Diego reported that stress may play a role in the success of infertility treatments, including in vitro fertilization (IVF).
After administering a series of questionnaires designed to measure patients' stress levels, the researchers found that women who scored highest -- indicating the highest levels of stress -- had ovulated 20% fewer eggs compared with women who were less stressed. Up to 40% of couples, no discernible reason for infertility can be found and it is in this group that the researchers believe the effects of stress are most profound.
Animal breeding also is affected by stress. Zoos, in particular, have difficulty getting some animals to reproduce in captivity
Biologically, since the hypothalamus regulates both stress responses as well as the sex hormones, it's easy to see how stress could cause infertility in some women. Excessive stress may even lead to complete suppression of the menstrual cycle, and this is often seen in female marathon runners, who develop "runner's amenorrhea". In less severe cases, it could cause irregular menstrual cycles. When activated by stress, the pituitary gland also produces increased amounts of prolactin, and elevated levels of prolactin could cause irregular ovulation.
Stress can reduce sperm counts as well. Thus, testicular biopsies obtained from prisoners awaiting execution, who were obviously under
extreme stress, revealed complete spermatogenetic arrest in all cases. Researchers have also shown significantly lower semen volume and sperm
concentration in a group of chronically stressed marmoset monkeys, and these changes were attributed to lower concentrations of testosterone (which were reduced in the stressed group).
Research has shown that women undergoing treatment for infertility have a similar, and often higher, level of "stress" as women dealing with life-threatening illnesses such as cancer and heart disease. Infertile couples experience chronic (long-term) stress each month, first hoping that they will conceive and then dealing with the disappointment if they do not. Infertility treatment can be physically stressful as well! Blood tests; injections; hysterosalpingograms, inseminations, and surgery can be painful, awkward, and embarrassing.
There is considerable financial stress too and this is especially acute for poor patients. Infertility treatment is expensive, and this represents a major hurdle. Many patients drop out of treatment because they cannot afford it, and this can be very hard to come to terms with,
especially when they know they could have gotten pregnant, if only they could have afforded the treatment. Some of the hormonal medications you may need to take can also cause mood swings and emotional upsets, making it harder for you to cope with the stress.
Since stress can lead to Infertility - this, in turn can lead to increased stress leading to a vicious circle. Women who are unable to conceive often experience a loss of self-esteem, depression, anger, and anxiety over disappointing their partner. Men may begin to feel guilty, and start questioning their "manliness" resulting in relationship problems and reduced sexual activity. The couple does not enjoy sex anymore. The focus changes to making a baby instead of making love putting them on a roller-coaster ride that ends with dashed hopes once a
month when their periods arrive. Tracking ovulation can take all the fun and spontaneity out of sex, and marital disruption is common. All of this reinforces the cycle of stress and infertility.
Can stress reduction aid in conception?
In 1978, the Mind-Body Institute of Harvard Medical School developed a ten-week group program for women with unexplained infertility. Based on coping-skills training, learning to shift from the stress response to the relaxation response, guided imagery, gentle yoga stretching, good nutrition, education in topics pertinent to fertility, and support from other women in the group, the program has an excellent track record in reducing women's stress. The emphasis of this program is on shifting the focus of life away from conceiving a baby to living a creative, fulfilling life in other regards.
Results from this program had been excellent. Almost all the women who completed it had significant reductions in anxiety, anger, and depression, and an increase in vitality and well-being. Although the program is designed only to reduce stress, statistics compiled from the nearly three hundred women who completed the program and were available for follow-up indicated that 57 percent of them became pregnant within six months of completing the ten-week course. This certainly shows that reducing stress can certainly be beneficial in decreasing
infertility.
Stress-management programs can reduce depression, anxiety, anger, and fatigue, all of which are commonly part of the lives of people struggling with infertility. It seems that as these negative emotions diminish, the chance of becoming pregnant increases.
Laughter can be the key to success in IVF treatment. One infertility clinic found pregnancy rates soared when patients were visited after treatment by a comedian who cracked jokes and performed magic tricks.
From evolutionary perspective, I suggest to relate to the negative effect of stress on fertility, as an old "positive computer program" in our body that contributed to survival of our ancestors. When predators moved to live closed to their cave, although men wished to continue to have sexual relationship their chances to impregnate women was lower. At the same time, it was very dangerous for women to escape predators
while they were pregnant. As a result, God or Nature made men and women less infertile, until they moved to a safer place and felt happier. Although it is impossible to "delete completely this old program" from our body, it is possible to reduce its negative effect by guiding stressed women how to relax.
My approach in treating infertile women during a short-term individual or group therapy is based on the following steps:
1) Explaining that infertility is like an old computer program that's goal was to aid survival in the jungle but is interfering with women who live in modern societies. It is impossible to delete that program completely from the brain, but women can learn to remove it from their mind like we remove an unwanted program from the computer desktop by clicking a few buttons.
2) Searching for a variety of reasons that provoke in patients stress about being pregnant or being mothers.
3) Guiding patients in a variety of relaxation techniques such as: deep breathing, meditation, self-talk, self-hypnosis and mental visualization.
At the end of each session, patients are guided to visualize their future in stages:
(1) Imagining how one sperm meets one egg in their ovary and fertilizes.
(2) The fertilized egg becoming a baby.
(3) The baby growing slowly during nine months.
(4) The patient gives birth to a healthy baby while feeling very relaxed.
(5) Breast feeding the baby.
(6) Bathing him/her.
(7) Watching while he/she is growing and going first to kindergarten, then to school.
(8) Becoming a teenager and then an adult.
(9) He/she getting married to a lovely spouse.
(10) Eventually having grandchildren.