How Stress Can Affect Your Chances at TTC
You've probably heard stories of women who had been trying to conceive unsuccessfully for a period of time, only to become pregnant after quitting a stressful job. Or you may have known a couple who were trying to conceive and only succeeded when they gave up and "just relaxed." Prolonged and intense stress can lead to a host of health problems, and for couples who are trying to have a baby, it may affect their ability to conceive.
The hypothalamus is the gland in the brain that regulates the stress response as well as the reproductive system, providing a direct link between the two. Many scientists believe that stress triggers the hypothalamic-pituitary-adrenal system (HPA) to release a number of neurotransmitters, including the primary stress hormone cortisol and increased amounts of prolactin, both of which can inhibit ovulation, fertilization, and implantation of a fertilized egg in otherwise fertile women. In men, the stress response may lead to impotence, low sperm count, and decreased sexual activity.
A demanding job, financial concerns, or familial or relationship tensions can all cause stress; even excessive exercise can stress a woman's body and affect ovulation. And couples who cannot conceive may experience intense stress; infertile women often report a loss of self-esteem, depression, anger, and anxiety, while men may feel guilt and question their "manliness." The couple may also find it stressful to schedule sexual intercourse based on the woman's ovulation cycle, and experience disappointment each month when the woman's menstrual period arrives, signaling another failure. In addition, infertility treatments are often uncomfortable and invasive for the woman, and can be financially taxing for the couple. Unfortunately the stress-infertility connection can become a vicious cycle when stress decreases fertility, which causes more stress, which decreases fertility, and on and on.
Several studies cited in a 2005 issue of the Italian journal Minerva Ginecologica found that otherwise healthy women with fertility trouble tend to have high levels of cortisol in their blood. In fact, Alice Domar, PhD, Director of the Women's Health Programs at the Mind/Body Institute at the Harvard Medical School, equates the amount of stress experienced by women who are unable to conceive to that of women with cancer, HIV or heart disease.
In 2000, the journal Fertility and Sterility reported on a study conducted by Dr. Domar in which 184 women who had tried unsuccessfully to get pregnant over a period of one to two years were divided into three groups: one that learned mind-body techniques (such as meditation and deep breathing); another that formed a support group that met once a week; and a control group which received no intervention. Within one year, 55 percent of the women in the mind-body group and 54 percent in the support group became pregnant, compared to only 20 percent of the control group. Domar states "Alleviating depression and other psychological distress in infertile women appears to make it easier for them to become pregnant."
Another study conducted by Professor Eliahu Levitas and his team at Soroka Hospital in Beersheva, Israel, found that out of 185 women in the study, 28 percent of them who were hypnotized for their IVF treatment became pregnant, compared to 14 percent in the control group. According to Levitas, "Performing embryo transfer under hypnosis may significantly contribute to an increased clinical pregnancy rate."
Stress can also affect the sexual performance and the health of sperm in men. The journal Fertility and Sterility reported in 1987 on a study of 500 men whose sperm counts dropped when their partners were going through in vitro fertilization treatment. Another study published in 1992 in the Journal of Reproduction and Infant Psychology found that couples were less likely to achieve pregnancy if the man was depressed or had low self-esteem. Experts believe the brain chemicals that are released in men during times of intense stress constrict the smooth muscles of the penis and its arteries, reducing the blood flow to the penis and preventing erections.
There are other experts, however, who insist that too much emphasis is placed on stress as a factor in infertility. Dr. Estil Young Strawn Jr., Director of Reproductive Endocrinology and Infertility at the Medical College of Wisconsin, states that "Women can and do become pregnant in life situations far more stressful than what many couples consider stressful. Specifically, in countries where there is open warfare and starvation conditions, women are becoming pregnant." Strawn believes that stress plays only a small role in infertility, and that stress more likely leads to relationship problems and loss of sex drive. Research published in a 2005 edition of the journal Human Reproduction backs up Dr. Strawn's assertion, showing that psychological stress does not appear to influence the outcome of IVF. In addition, the official position of prominent organizations, such as RESOLVE and the American Society of Reproductive Medicine, remains that stress does not cause infertility.
Despite this ongoing scientific debate, if you have been categorized by your physician with "unexplained infertility," you may be helped by taking steps to reduce the level of stress in your life and find healthy ways to cope with unavoidable stress. Cognitive behavioral therapy (CBT), which addresses negative thinking, may be helpful to couples who are struggling to conceive. Berga and her colleagues recently conducted a study in which a group of women who had stopped ovulating for no clear reason underwent five months of CBT. Nearly 90 percent ovulated in the two months following their therapy, as opposed to only 25 percent of the women who didn't receive therapy.
Try the following tips to reduce stress:
- Keep the lines of communication with your partner open.
- Seek emotional support from a counselor, support groups, friends, and family.
- Learn yoga or meditation techniques.
- Avoid excessive intake of caffeine and other stimulants.
- Exercise regularly to relieve physical and emotional tension.
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