There is no direct evidence that stress causes fertility problems. It shouldn’t be treated in the psychological room — you have to go to the gynaecologist, to the IVF clinic, and find out the reason. Sometimes, even without finding the reason, like idiopathic infertility, we also know how to manage it, because we simply cannot know what caused the infertility, but the reason can exist; it can be a physical reason, not psychological.
But of course, then we understand that stress is more about the behaviour. There was this data last year in ESHRE — in Amsterdam — where they presented that up to 30% of couples, because of emotional burnout, stop the whole process early, even with good prognosis and financial capacity.
It means that stress can cause some depression, stress disorders, anxiety disorders, and you have no more power to continue — you say stop, I cannot anymore. This is sad, because those are the patients who had real chances. Of course, sometimes it takes one treatment, it doesn’t work, maybe you need the second, the third, and it’s not easy. You need to be supported, so it’s very important. That’s why, in my opinion, we know that stress can also cause amenorrhoea and so on — but we can see that, and we know how to treat that.
If you have a regular cycle, if you are ovulating, then telling you that stress caused your infertility — it’s not correct. But stress can bring you to say, No, I cannot do this anymore. That’s why maybe this support from the beginning of the process is very important.
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.
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.
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.
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.
