Stress and Infertility

Infertility can significantly impact on a couple’s life. It can affect the relationship of partners, their sex life, but also their relationships with the social environment. Research conducted on women with infertility, cancer, heart disease and AIDS showed that women with infertility problems had the same levels of stress as women with other conditions.

How does stress affect fertility?

Stress can cause changes in a woman’s hormones, resulting in delayed menstruation or secondary amenorrhea. During amenorrhea, the ovaries stop producing eggs and subsequently ovulation doesn’t occur leading to inability to conceive naturally. This fact proves that stress affects the reproductive system and consequently female fertility. Women with depression are more likely to be diagnosed with infertility. Stress can also delay pregnancy and reduce the success rate of IVF.

The prevailing theory focuses on the fact that, during intense stress, the hypothalamic-pituitary-adrenal axis is activated and cortisol levels increase, which in turn suppresses the normal production of reproductive hormones in both men and women. It also activates a strong inflammatory reaction of the tissues as the body’s priority is to cope with the demanding period of stress.

Is the connection between stress and infertility scientifically confirmed?

It is difficult to determine whether stress alone can cause infertility or not. Research conducted at Ohio State University has tracked the progress of women seeking to conceive. Saliva samples were regularly collected from these women to measure α-amylase levels. This enzyme is an indicator of stress as it is secreted by the salivary glands in response to stress. The results of the study showed that women with elevated α-amylase levels were less likely to conceive.

In addition, a BMJ Open analysis that took place in couples who were undergoing infertility treatments comes to confirm the above research. The results of the analysis showed that those who attended stress reduction programs were twice as likely to have a positive treatment outcome and achieve pregnancy. The research also pointed out the positive effect of these programs mainly on women compared to men.

The American Infertility Company Society of Reproductive Medicine in a statement explicitly declares that although infertility is a very stressful process there is no evidence that stress can change the outcome of an IVF attempt.

In 2019 a study was published clarifying that healthy creative stress (eustress), equivalent to focus on work or championship stress, can help women during conception, as opposed to high levels of non-targeted stress, which may lead to delayed conception. (Daily perceived stress and time to pregnancy: prospective cohort study of women trying to conceive Psychoneuroendocrinology 110; Dec 2019, 104446)

THE EFFECTS OF STRESS ON THE LIFE OF INFERTILE COUPLES:

Despite the conflicting studies, it is widely accepted that stress can lead to the adoption of a lifestyle that doesn’t enhance the conception:

• Sleep disorders
• Eating disorders, as it is difficult to follow a healthy diet
• Excessive exercise or complete avoidance
• Increasing habits such as smoking and alcohol consumption
• Increased caffeine consumption
• Low libido

If you feel that stress wears you down in your attempt to conceive, then it is important – in combination with the proper therapeutic psychological support – to know your options. The Obstetrician-Gynecologist, after the necessary examinations, will suggest you a personalized strategy for achieving pregnancy. Dr. Melina Stasinou, specializing in assisted reproduction, has led many couples to the desired result of childbearing.