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Can Infertility be caused by stress?
Now that is a very interesting question. Many research studies and papers have tried to address this question.
Let’s start by defining stress within sub-fertility.
On the one hand we have acute stress circumstances, related to the treatment and the medical procedures – Blood tests, ultrasounds, hormonal stimulation through oral or injected medication, going through minor surgical procedures such as egg retrieval and embryo-transfer.
On the other hand, there is chronic stress involved, which comes about with failed cycles, the feelings of loss and bereavement many people experience, challenges in your relationship with your partner, your sexual life, your social life, dealing with the idea that you may not experience parenthood the way you have imagined…all the things we were discussing before…
Both of these types of stress are present in fertility challenges.
We know that sub-fertility causes stress, but can stress cause sub-fertility?
The research here is ambiguous.
And that depends very much on how you define stress. One of my great mentors Alice Domar points out that until recently in most research, stress was interpreted as anxiety and therefore anxiety markers were used when looking for a connection between sub-fertility and stress. And yes, some research suggests that anxiety does influence fertility, while others have failed to prove such a relationship.
However, if you define stress as a combination of feelings of depression, anxiety and isolation that many people feel cycle after cycle, year after year when they fail to get pregnant, you get a clearer picture of how such feelings can exacerbate sub-fertility.
Another point to consider here is the obvious connection that both the emotional experience of stress as well as to a great extent the outcome of fertility are both linked and dependent on HORMONES. Therefore, this correlation is meaningful, it makes sense.
So, you can draw your own conclusions.
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I think one of the other issues that people should try address is trying to make sure that just their general lifestyle is good and that they do things to help alleviate stress which is part of everyday life these days but I encourage people to, it doesn’t matter whether it’s yoga or dancing or swimming or horse riding or whatever but do things that do think might be cooking it, might be painting – I think things that allow people to escape from the stress of day-to-day life. We know stress by itself can switch off the menstrual cycle and if you switch off the menstrual cycle, you won’t ovulate – you will not get pregnant.
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This is a really interesting question and one that I’ve been fascinated by and done a lot of research and written a paper on. There’s a lot out there and a lot of chatter around there saying ‘is my stress causing my infertility?’ and it’s definitely another area of creating stress and guilt for someone going through it when you feel you’re getting stressed and know that’s impacting on your body. Of course, we do know that stress does impact our body. We’re all aware of that. We also do know that there are studies that show that stress can impact infertility but there are also studies that show they don’t and so unfortunately from a scientific basis the jury is still out.
Personally, as I’m working as a coach in the infertility sector over the last decade, I have seen in the minority of cases that stress alone can cause stress linked with depression and that serious mental ability has been a cause or a past trauma. For example, once we’ve worked through and cleared that that can sort of has cleared the way for pregnancy. I would say in the majority of cases that stress is just a minor factor along with all of the other factors. Often infertility is multi-factorial; it’s not just one reason. There may be a diagnosis but there could be other factors as well such as lifestyle factors, environment, and all the other things. But the good thing about this is that stress is an area that we can take control of. We can’t change a diagnosis but we can work on our stress. There have been some really great studies showing how positive the impact can be when we do work on our stress.
I think rather than worrying around ‘is infertility causing my stress?” forget that question almost and just say “that actually doesn’t matter, what does matter is what I’m doing to counteract the stress of infertility”. Perhaps doing some research around those stress reduction strategies, the relaxation practices that are going to work for you because it’s very individual. Have a look at that because there are some wonderful tools like fertility meditations, visualizations, fertility yoga that can really help you deeply relax your body and counteract that stress.
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No, it cant. However, being stressed isn’t beneficial when you are struggling to conceive because the mind body connection is powerful. So whilst you are finding out what could be causing your infertility diagnosis and that will be through different tests and conversations with medical professionals, it is really important to consider your emotional well-being and think of things you can add into the mix to help how you’re feeling. That could be focusing on more holistic things like doing yoga, having acupuncture, understanding more about mindfulness whether that is medication. There are various apps available or it could be focusing on your breath, journaling the different ways to help how you’re feeling in terms of managing your stress. But your stress isn’t causing your infertility.
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Everybody believes and says almost without fail that stress can affect fertility and that you must really really try hard not to get stressed. Anybody that is trying for a baby for a long time and is starting to get increasingly agitated and upset and worried and anxious about it and getting more and more stressed by the day. Starts to worry “oh my god now I’m going to be causing”, “I’m going to make things worse because I’m so stressed”. If you’re trying naturally, people say: you’re just too stressed, you need to relax, you’re working too hard, you just need to chill out and stop thinking about it and stop trying so hard and then you’ll get pregnant. Then they’ll have lots of anecdotes of things from people they know and the thing about it is that apparently there is no relationship between stress and pregnancy. When you’re trying naturally now most people think there is kind of but it’s a kind of a secondary relationship and the relationship is that actually if a couple are very stressed for whatever reason in their lives, maybe he’s being made redundant, they’re facing financial worries, they’re starting to argue about money or their stuff, he’s starting to worry about his work or she’s worrying about something that affects the relationship, it does of course and if you’re going through a stressful time in your life it affects your relationship with your partner. Then of course when people aren’t getting on very well, they’re more argue, are more touchy with each other and as a result they don’t have sex as often because they are stressed. That’s the relationship between. It’s not that stress causes the infertility – it’s that it causes the couple to have less sex so when they go on holiday, have lots of glasses of wine and they chill out and they relax, they come back pregnant and it’s like yes because they were able to finally have a lovely time together. That’s to do with trying naturally then of course everybody thinks that if you are having IVF, all the nurses and everybody in the doctor will say oh you just relax, chill out, just be relaxed, don’t get stressed, don’t get stressed whatever you do. People think they’d better not get stressed because otherwise it’s going to have an impact on their fertility treatment, the outcome and then people get stressed about how stressed they are .
When I first started to do this work it became very clear to me quite quickly that stress couldn’t possibly have anything to do with it because I knew for a fact that when couples start to have a try for a baby naturally when they’re when they’re together they’ve been together a couple of years married or something and they decide they want to have a baby they’re usually not particularly stressed at all. They’re trying having sex whenever they want to and they’re happy and relaxed and chilled and it didn’t work. It doesn’t work for them now. If being relaxed made you pregnant and being chilled and unstressed then there wouldn’t be any fertility clinics because everybody would get pregnant right at the very beginning when they were still very very happy and very chilled and very relaxed equally. I realised that everybody I spoke to as a fertility counsellor was stressed. They were all stressed. It’s a very stressful experience. First of all everybody that I saw had already been trying for two years before they came to the clinic. That is stressful in itself, then they would have been through investigations and tests and perhaps been told there’s something wrong and then they might even be in treatment and that’s an incredibly we all know a very stressful process. I thought to myself well everybody I see is stressed and yet a percentage of them get pregnant of course they do and if stress made a difference this fertility clinic would fold, it would go under because nobody would get pregnant so I kind of knew like instinctively that there was no relationship between stress and distress and pregnancy through either trying naturally or specifically through IVF, fertility treatments.
When I first started to do this work it became very clear to me quite quickly that stress couldn’t possibly have anything to do with it because I knew for a fact that when couples start to have a try for a baby naturally when they’re when they’re together they’ve been together a couple of years married or something and they decide they want to have a baby they’re usually not particularly stressed at all. They’re trying having sex whenever they want to and they’re happy and relaxed and chilled and it didn’t work. It doesn’t work for them now. If being relaxed made you pregnant and being chilled and unstressed then there wouldn’t be any fertility clinics because everybody would get pregnant right at the very beginning when they were still very very happy and very chilled and very relaxed equally. I realised that everybody I spoke to as a fertility counsellor was stressed. They were all stressed. It’s a very stressful experience. First of all everybody that I saw had already been trying for two years before they came to the clinic. That is stressful in itself, then they would have been through investigations and tests and perhaps been told there’s something wrong and then they might even be in treatment and that’s an incredibly we all know a very stressful process. I thought to myself well everybody I see is stressed and yet a percentage of them get pregnant of course they do and if stress made a difference this fertility clinic would fold, it would go under because nobody would get pregnant so I kind of knew like instinctively that there was no relationship between stress and distress and pregnancy through either trying naturally or specifically through IVF, fertility treatments.
Some years ago I heard about a lady professor, Jackie Bueva who is quite famous. She’s the professor of psychology at Cardiff University and her specialist field of expertise is fertility. She’s a very prolific researcher, she’s done an enormous amount of work in the world of fertility and assisted reproduction. She works with people from all over the world who do lots of research projects with her. She did what’s known as a meta analysis of all the fertility, all the good fertility studies that had been done on the relationship between stress and distress and IVF treatment outcome and she reviewed about 15 different studies from all over the world: America, Australia and Europe. They were very good studies. Each of them in their own right but she did what’s known as a meta-analysis where she looked at all of the studies and reviewed them all systematically and she reviewed all their data and she reviewed all their statistics that they had done and their conclusions and everything and she concluded in the end there is no correlation at all between stress and distress and IVF treatment outcome. I was like oh well it’s nice to know that somebody’s found out it’s almost like I could have told you that because I knew that already I could have saved you a lot of time but it’s very very good that there’s been this incredible piece of work which stands alone anyway.
At some point I managed to talk with Jackie Brevard and I was talking to her and I said what is it about this whole thing where everybody thinks that stress affects fertility treatment outcome and she said well it kind of does but in an indirect way. She says first of all, two things: one, if women respond in a particular way when they are stressed it can affect their fertility so for example if when they are stressed they eat chocolate and buns and ice cream and they put on a lot of weight, we all know that BMI affects fertility. Equally, if you’re the sort of person that stops eating when you’re anxious and your BMI plunges and you go below the kind of the guidelines that also affects your fertility. If people smoke when they’re stressed, we know smoking affects fertility and also if they drink, if women drink, obviously women aren’t supposed to drink when they’re trying for a baby. I think that’s pretty clear so she said indirectly the stress can affect the woman and that can affect her fertility but in itself it doesn’t affect this fertility directly. I found that really interesting but she did say one thing: she said it’s not that people should not try to reduce their stress levels and she said the reason is that it’s an incredibly difficult pathway to be on. It’s very taxing, it’s very demanding, it can go on a long time, it’s a it’s a really difficult thing to be doing to try for a baby through IVF and she said if if women or couples become too stressed and too distressed what can happen is they’re more likely to give up before they’ve given it the best shot. If under ordinary circumstances they could afford to go on several more times and have more frozen embryo transfers or more IVF cycles, she said, if they become too stressed and it affects them so much they might say let’s not do this anymore, it’s too awful, it’s too terrible and they are more likely to bail out of the process earlier than they should before they’ve given themselves the best chance as it were given themselves in them the number of cycles really that they need to do to give themselves the best chance. She was like definitely working with people on their stress levels, helping them to manage their expectations, helping them to realize that you know what the chances are and that it might take several goes at this and to be able to continue on as long as you need to.
At some point I managed to talk with Jackie Brevard and I was talking to her and I said what is it about this whole thing where everybody thinks that stress affects fertility treatment outcome and she said well it kind of does but in an indirect way. She says first of all, two things: one, if women respond in a particular way when they are stressed it can affect their fertility so for example if when they are stressed they eat chocolate and buns and ice cream and they put on a lot of weight, we all know that BMI affects fertility. Equally, if you’re the sort of person that stops eating when you’re anxious and your BMI plunges and you go below the kind of the guidelines that also affects your fertility. If people smoke when they’re stressed, we know smoking affects fertility and also if they drink, if women drink, obviously women aren’t supposed to drink when they’re trying for a baby. I think that’s pretty clear so she said indirectly the stress can affect the woman and that can affect her fertility but in itself it doesn’t affect this fertility directly. I found that really interesting but she did say one thing: she said it’s not that people should not try to reduce their stress levels and she said the reason is that it’s an incredibly difficult pathway to be on. It’s very taxing, it’s very demanding, it can go on a long time, it’s a it’s a really difficult thing to be doing to try for a baby through IVF and she said if if women or couples become too stressed and too distressed what can happen is they’re more likely to give up before they’ve given it the best shot. If under ordinary circumstances they could afford to go on several more times and have more frozen embryo transfers or more IVF cycles, she said, if they become too stressed and it affects them so much they might say let’s not do this anymore, it’s too awful, it’s too terrible and they are more likely to bail out of the process earlier than they should before they’ve given themselves the best chance as it were given themselves in them the number of cycles really that they need to do to give themselves the best chance. She was like definitely working with people on their stress levels, helping them to manage their expectations, helping them to realize that you know what the chances are and that it might take several goes at this and to be able to continue on as long as you need to.
Obviously how people manage their stress varies enormously. Different people do different things. Some people like to go for a long walk, some people do yoga, some people like to do meditation, some people talk to their friends and family and get support or they talk to a professional. Everybody tries to reduce their stress in the best way they know.
How talking to somebody about how to reduce stress can be helpful anyway?
Can infertility be caused by stress – no. How do you cope with the stress of infertility?
I guess you just kind of need to acknowledge that you might be in this. You’re not in control of this process and you might need to accept that it could go on for a while and you might have to just endure this for longer than you would normally want to.
