Stress & Infertility

Which comes first, the chicken or the egg, stress or infertility?

Although the chicken or the egg question can spur an ongoing debate with no real right answer, the stress and infertility question is much easier. While many believe stress causes infertility, the research does not support this claim. What research does show is that an infertility diagnosis, decision making about treatment options, and the ongoing roller coaster ride of emotions associated with failed cycles and ongoing treatment, can be very stressful! The stress can then have a definite impact on conception rates for women undergoing medical treatments such as artificial insemination and/or in vitro fertilization.

How does stress impact fertility?

The specific ways in which stress impact a woman’s or couple’s fertility varies. In general, what most women and couples find to be stressful about the inability to conceive is the way in which the experience affects every aspect of their lives

The couple’s relationship is impacted in numerous ways by infertility. One of the first areas to be affected is the sexual relationship. For a man and a woman, when the “normal” way of conceiving proves unsuccessful for a couple, the disappointment, stress and tension then becomes associated with sexual intercourse, making the ability to have a spontaneous, playful and joyful sex life extremely challenging.

In the context of a relationship, no two people are going to respond to the stress related to infertility in the same way. In addition, research shows that men and women respond differently to infertility. Communication difficulties about these differences can create a wide array of feelings such as guilt, blame and anger. Many times, couples then shut down and turn away from each other at a time when they really need each other the most.

Infertility can also impact relationships with family and friends. For any woman who has been struggling with infertility, the undesirable feelings of jealousy and anger that can occur when a close friend or family member becomes pregnant understands how much those emotions can influence a relationship. This can be particularly difficult because in the past these same people may very well have served as a support system to you. That support is no longer available because of the painful emotions that come from interacting with them. There are several other ways these relationships can be impacted, and will depend on individual circumstances.

Careers and jobs are influenced by infertility and treatment for infertility. Frequent office visits and medical treatments require time away from work, and often times it is uncomfortable to share the reasons for absences. This can cause unfavorable comments or opinions from bosses and coworkers. In addition, men and women may be distracted at work and unable or uninterested in being productive at work.

The financial strain of medical treatments for infertility can lead to difficult decision making about what family building options to pursue, especially if funds are limited.
Financial problems can cause arguments for a number of reasons, and are very common if a couple disagrees on what avenues to pursue such as adoption or in vitro fertilization.

Finally, infertility can be a significant challenge to spiritual and religious beliefs. It may be the first time prayers have not been answered. Some people feel God is punishing them or are angry with them. It is not uncommon for those struggling with infertility to doubt God’s very existence. For Catholics, infertility can be especially stressful when deciding on potential treatment options as the Catholic Church prohibits some forms of assisted-reproduction treatments.

How does stress impact conception rates?

According to Dr. Alice Domar, a leading researcher in the field, to know how stress impacts conception rates depends on how stress is defined. Many researchers in the past have defined stress as anxiety and have been unsuccessful finding a relationship between high anxiety levels and infertility. Dr. Domar’s research has defined and examined stress as a combination of the depression, anxiety, and isolation that many women experience when they are unable to get pregnant or stay pregnant month after month, year after year.

Recent studies that have primarily focused on depression’s impact on fertility suggest it has a strong impact on a woman’s likelihood of conceiving. One study found that women with a history of depressive symptoms were nearly twice as likely to report subsequent infertility than were women who were not depressed. Another study determined that women who had experienced at least one unsuccessful in vitro fertilization (IVF) cycle, and who had depressive symptoms before continuing IVF treatment, experienced a 13 percent subsequent pregnancy rate in contrast to a 29 percent pregnancy rate in women who did not experience depressive symptoms before their IVF cycle. There are other studies that support depression’s impact on fertility. The point is that the presence of depressive symptoms while undergoing treatment for infertility decreases a woman’s chances of becoming pregnant.

If a woman is experiencing mild to moderate depression before trying to conceive, infertility may be slightly compromised. And then if she does not get pregnant right away, depression may rapidly deepen making her less likely to conceive. Many women do not realize they are depressed, especially if the symptoms are mild. A consultation appointment with a mental health professional is the most accurate way to determine if you are suffering from depression.

How does mind/body medicine help alleviate the stress associated with infertility?

First, notice the question said alleviate, not eliminate. The only factor that can completely eliminate the stress associated with infertility is the resolution of infertility. What mind/body medicine, and mind/body programs for infertility, can do are give people a different, more effective option for coping with the stress. Although these strategies can not stop the causes or triggers of stress related to infertility, they can help in changing the reactions people have to the stress of infertility.

The specific techniques associated with mind/body medicine, that can be learned in Complementary Care Group’s Mind Body Program for Infertility, help people gain some control over the uncontrollable feelings of stress, anxiety, and depression that are often a part of the infertility journey. These techniques once mastered, are also a lifelong way to reduce stress, anxiety and depression.