In this webinar, Mandy Rodrigues is talking about stress and its impact on your IVF treatment. Watch the video and learn new tips on how to manage your stress and deal with it daily.
Mandy Rodrigues emphasized in her presentation that it is very important to deal with stress, either when you’re trying to conceive naturally or through IVF. First, to decrease the time for pregnancy, but also to empower yourselves, the infertility journey and everything that is connected to this can be out of your control. Also, to eradicate the intense guilt associated with that.
Mandy showed an example of the research done by ESHRE, which was a pilot stud looking at salivary amylase as a measure of stress. They correlated it to how stressed the patient was. They didn’t take that much further, but they knew that if they could decrease that salivary amylase level, they could decrease the time to pregnancy.
Other studies were highlighting the role of emotional support, saying that clinics should be encouraged to develop nonmedical support for couples, depression, and anxiety levels in IVF patients with endometriosis beyond emotional factors, so addressing things like stress and what positive relationship existed between pregnancy outcome and the relationship between spouses.
Some papers presented on stress and the impact on assisted reproductive technology outcomes showed that acute stress had no outcome on the number of eggs, the number of gametes produced and pregnancy outcomes. What they were saying is stress and aspiration, and depression and aspiration was kind of acute stress, and it was normal, and that wasn’t what had an impact on the outcome of that result. They were saying that although aspiration might be painful and stressful, a moderate increase in stress did not appear to impact the outcome. However, there was research starting to emerge that job-related stress increased pregnancy loss in those patients.
Some reports say that those patients who were less chronically stressed reported lower miscarriage rates and higher full-term pregnancies, and when all that research was put together, they said we are missing something also in carrying your pregnancy to term.
Back in 1996, Mandy got involved with a doctoral study, and she started looking at doing laparoscopies on patients who were stressed, and they looked at a whole realm of stress tools, including depression and anxiety, and they used a sample study of women who had undergone 1 IVF and were planning for their next IVF. The patients underwent a laparoscopy, and the team measured how many of them had endometriosis, and then they measured all these stress levels and what was found was a definite relationship between endometriosis and a certain personality type which they called the time urgent perfectionist personality. These women were put through a stress management course for 10 weeks, and there was a huge improvement in not only their stress, but before their first IVF, a third of them would fall pregnant following stress management, and over two-thirds of them fell pregnant in the subsequent IVF, and that was back in 1996. It was done originally on 54 patients, the average pregnancy rate in the initial sample group was about 83%, in the second study, about 4000 patients were studied, and the pregnancy rate was around 67% plus in a second IVF.
The field of psychoneuroimmunology is just a fancy word to say that the way you think has a big impact on your physical self. There’s a big relationship between the mind and the body, and there are two types of stress. There’s something called good stress, and there’s something called bad stress. Good stress is the stuff that is not going to cause an impact on your IVF, good stress is kind of the stuff that a relaxed person would worry about. The right side of the learned stress, which is what is called bed stress, is the self-induced stress, it’s acute, it kind of reacts, and it gets out of that situation. However, when people are secreting adrenaline long-term, the body changes that to no adrenaline and cortisol. This has an impact on their immune system, and 90% of the stuff people stress about is self-induced, and that is the stuff that people are worried about in terms of infertility. When is it healthy to stress? That was in 10% of the time, it’s normal to be stressed during IVF, but not 90% of the time.
Good stress vs bad stress
Stress releases adrenaline, it’s usually acute with real stress or good stress. We acutely get stressed, and then we get off it, and again it’s 10% of our lives, so there’s a flood, there’s COVID-19, there’s an aspiration, we get stressed acutely and then we get over it.
When we look at bad stress, it becomes self-induced, we are worried about getting somewhere on time, we are worried about a diversion on the road, it has no impact on the result, and 90% of the stuff you worry about in terms of self-induced was a problem.
Therefore, stress was divided into what is predictable and what is unpredictable. The bottom line is that 90% of the stuff we go through is predictable, we know when we’re going through IVF, the more predictable we make that process, the better we’re going to go. The more we plan for what we’re going to go through and when are our bad days, and while we’re waiting for the lab results, that is predictable. In theory, if we can predict something, we can plan for it, and we can manage it better.
Unpredictable stress is the things or triggers that happen that we have no control over. In theory, you’re allowed to be a bit more stressed about something unexpected, such as a negative result, but each time we are faced with something unpredictable, we’ve got to try to move it to: Could I have predicted this?
IVF as a trigger
- familiarize yourself with the process
- be aware of medication effects
- be aware of the impact on your relationship
- number of eggs, embryos, gametes
The first IVF is always very daunting because it is unpredictable, when people go through the 2nd and 3rd cycle, they tended to cope far better because they are already familiar with the medication, the roller coaster effect and what it did to the relationship. The unpredictable side of going through a 2nd IVF or the next one is always what is the result going to be and how many eggs, embryos, and gametes you’re going to get.
Ultimately, this is called hook time, the amount of time you remain stressed about a particular event. People can have different times of the hook time, some may have 5 minutes, while others’ time of noradrenaline secreting is more than 24 hours. If we’re worried about an excessive amount of time, we’re secreting more noradrenaline and cortisol, which is going to have an impact on our IVF.
Mandy and her team have divided stress into triggers, so a trigger is anything that creates a negative reaction and includes something like a negative IVF, but it includes the simpler things like a conflict, traffic, an email, deadline. What happened is this pushed us into a stress cycle, and we took every field of psychology and put it into an algorithm. They’re 4 reactions to stress, there’s physical reaction, behavioural, thinking and self-talk.
Learning how to manage stress better through specialised counselling that provides relevant and specific coping mechanisms will certainly help you deal with the challenges. It will not only increase pregnancy rates and improve your outcomes, but will also improve your ability to make important decisions, and provide a sense of control over your IVF treatment.