Positive Health Online

If you and your partner have been trying to get pregnant for a while then you’ll no doubt have had the stock response from family and friends telling you to “just relax and it will happen”. Although comments like this can be infuriating, it seems there is some truth to the claim that stress actually reduces the chances of conceiving. According to a new US study, high levels of stress can cause infertility. The research, published in the medical journal Human Reproduction, revealed that women with high levels of the alpha-amylase enzyme, which indicates stress levels in the body, were 29% less likely to get pregnant each month compared to women with low levels.

The study, led by Dr Courtney Denning-Johnson Lynch at Ohio State University, looked at 373 women aged between 18 and 40, with no known fertility issues, who had just started trying to conceive. The study tracked the women over one year, or until they conceived, and the results showed that not only were women with higher stress levels 29% less likely to conceive each month but also more than twice as likely to be declared infertile. The medical definition of infertility is a failure to become pregnant after 12 months of regular unprotected sex.

Dr Denning-Johnson Lynch commented on the results, “For the first time, we’ve shown that this effect is potentially clinically meaningful, as it’s associated with a greater than two-fold increased risk of infertility among these women”. Since this study was published, the results have been questioned by experts at the NHS, who have claimed that the study was very limited and only reveals a possible connection between stress and the chances of spontaneous conception.

However, coping with infertility can have a serious impact on an individual, who is likely to go through a highly stressful and prolonged grieving process. Writing in the Guardian freelance writer Louise Williams describes the heartache of infertility, “I have known grief before: I have lost dear family members, and I have experienced gut-hollowing relationship-breakdowns. Those losses have been terrible events, points of excruciating pain which must be endured and assimilated over time. But unless something goes wrong in that process, that grief can progress: it is, in many ways, clear and uncomplicated. But this grief, this other grief, has no event and no end. This grief has me crying strange unpredictable tears that seem almost physiological. This is the pain of infertility.”

A similar scenario is given by social worker and infertility expert Iris Waichler, in a blog post on the American Fertility Association website, “Infertility can bring the painful experience of physically losing a child and the grief associated with that. In this fragile state when our mind tells us “there is no hope” our body and emotions respond accordingly.”A factsheet produced by Resolve, The National Infertility Association, reports that research has shown that women with infertility, “have the same levels of anxiety and depression as do women with cancer, heart disease and HIV+ status”.

“There is also a link between the stress hormones and ovulation,” says Mr Sachchidananda Maiti, Consultant Gynaecologist at Pall Mall Medical, Manchester, “At the extreme, emotional stress can not only stop ovulation but can also stop periods.”So it’s clear that trying for a baby long-term can be a very emotional and stressful time. Stress about infertility, combined with the daily stress all of us feel in our lives can mean that the situation can feel impossible. However, there are some simple ways women can reduce their stress levels and in turn potentially boost fertility levels.

Taking the First Step

Mr Maiti says, “Trying for a baby for some time without success can be extremely stressful emotionally and physically if left unattended to. So it’s important that the couples feel their medical practitioners are taking both their infertility and the emotions around it seriously. Speaking to professionals is a crucial first step at this stage to receive on-going support from an expert team.”

Finding the Cause

Often, not knowing what the problem is which is leading to difficulty conceiving can be very stressful. Couples may feel they’re in ‘limbo’ if they don’t know what’s causing the issue. Of course, in some cases there is no problem and it’s just a matter of time. However, if there is an issue then this can help couples decide the best course of action to take for their situation, which can ease stress by giving couples a sense of control. Diagnosing a fertility issue can be a simple process and involve everything from simple blood tests and ultrasound scans to minor operations such as a hysteroscopy, where the inside of the womb is examined or a laparoscopy, a key hole procedure through the belly button, to look inside the abdomen.

“A thorough customised one-stop investigation to find the possible causes and contributory factors for subfertility and detailed inclusive plan of care are essential initial steps,” Mr Maiti says, “One of the biggest stresses of infertility is the unknown of what’s wrong with an individual or couple and why conception isn’t happening for them yet. This confusion can quickly turn into frustration and anger which can increase stress levels. This is itself counter-productive and starts off a vicious circle. This is why a complete diagnosis of what could be preventing a couple from conceiving, with a realistic expectation, plus options and timescales for treatment, can make a patient feel as though they are back in control, which helps to remove the guesswork around infertility and a lot of the stress.”

Once there’s a diagnosis, some women choose to have alternative therapy as well as medical treatment. Acupuncture is a popular choice of alternative therapy which is thought to enhance fertility and this treatment is often combined with diet changes and Chinese herbal medicine. Many women find alternative therapies such as acupuncture, qigong (similar to Tai Chi), reflexology and osteopathy very relaxing so these techniques can help to reduce stress levels in general. It’s worth speaking to your GP or a Consultant before trying alternative therapy to ensure these therapies are working with, rather than against any medical treatment you might be having.

A Problem Shared

How much you talk about infertility is a personal preference but for many women having at least a couple of friends or family members they can open up to helps to ease the stress. There are also support groups specifically aimed at women coping with infertility. Make sure you choose who you speak to about infertility carefully as you won’t want to be met with a barrage of unsolicited advice. Anyone who has experienced infertility will be familiar with the scenarios presented by friends and family about ‘friends of friends’ who tried to conceive for years before giving up and then falling pregnant. While people mean well, conversations like these are unlikely to make you feel better.

In a fact sheet produced by Resolve, the National Infertility Association, Patricia Payne Mahlstedt, EdD, describes the problem of discussing infertility with friends and family, “One of the main reasons that family and friends have trouble helping is that they know so little about the emotional aspects of infertility. From the shocking diagnosis and demanding treatment to the disruptive day-to-day experiences, this emotional assault can leave an infertile individual depressed, angry and guilt ridden.”

Depending on your situation, it might be worth speaking to a professional about how you’re feeling and they should also be able to give you some practical advice and exercises for dealing with the emotions and stress which infertility can bring up. Instead of one-on-one support, some women feel more comfortable attending support groups, either in person or online. Other women share their stories through blogging about infertility or on infertility forums. Whatever an individual’s preference, talking about infertility with people who understand can certainly help to reduce stress levels.

Avoid Comparison

Social media can be a minefield when you’re trying for a baby and every time you see a baby scan appear on your Facebook timeline it’s easy to plunge into despair and jealousy. Although this is completely normal, it isn’t going to reduce your stress levels. It’s very difficult, but try not to compare your own fertility journey with others’. You can’t know how long it took other people to get pregnant and they may well have had their own struggle. It can be especially hard when people you are close to become pregnant. If you know that other women close to you are trying for a baby then ask them to break the news to you gently when it happens, perhaps even by email or text so you can process the news in your own time, rather than having to deal with it face-to-face.

If you find you’re being invited to numerous baby related events such as showers or christenings, then remember that you don’t have to go to them all. It’s perfectly acceptable to look after yourself and decline invitations if you’re feeling vulnerable. It’s important to recognize your feelings and accept that it’s OK to feel angry about other people’s pregnancy announcements or births and this doesn’t make you “a bad person”. It’s always going to be tough to hear other people’s baby related news, even though you’re happy for them, but try to remember that feeling upset and angry is totally normal.

Exercise and Meditation

Exercise is a great way to deal with stress and according to an article published by the Harvard Medical School exercise has “a unique capacity to exhilarate and relax, to provide stimulation and calm, to counter depression and dissipate stress”. As well as cardio, exercise such as yoga can help to reduce stress mentally and physically through stretching and deep breathing practises. Exercise is also a great way to prepare your body by making it as healthy as possible for when you do become pregnant.

Although some experts recommend that women trying to conceive shouldn’t do any exercise beyond walking, for some women going for a run, a swim or a bike ride can boost endorphins, expel anger and frustration and ease stress. While excessive exercise such as training for a marathon or hitting the gym seven days a week may hinder conception, regular, gentle exercise can be an enjoyable way to maintain health and reduce stress.