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Houston Fertility Journal

    Are Stress and Infertility Related?

    [fa icon="calendar"] May 16, 2019 8:00:00 AM / by Center of Reproductive Medicine   

    Center of Reproductive Medicine

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    Infertility can be extremely stressful. It cuts to the core of one of the most basic human instincts -- the desire to have children. No wonder people struggling with infertility report higher rates of depression, anxiety, and stress. One study even found that couples struggling with infertility are three times more likely to divorce than other couples. People experiencing stress while trying to get pregnant may worry about the effects of stress on fertility. For most people, stress will not affect fertility. Here’s what you need to know.

    Debunking a Harmful Myth

    Sooner or later, most couples struggling with infertility hear the same hurtful, dismissive comment: “Quit worrying and you’ll get pregnant. Just relax!” The implication here is that it’s somehow the couple’s fault and if they just focused less on getting pregnant, everything would magically fall into place.

    Not only is that not true; it’s harmful. There’s no need to stress about fertility, but sitting back and letting nature take its course is the very worst thing you can do for your long-term chances of getting pregnant.

    Keep this in mind:

    • Infertility is not a mental health problem.
    • It’s not something you caused or can think your way out of.
    • It is a very real medical condition that may get worse with time.

    Infertility comes with a ticking clock. A woman is born with all the eggs she will ever possess, which means that each menstrual cycle her chances of pregnancy diminish. Eventually, she will reach menopause, her ovarian reserve will be depleted, and there is no longer the possibility of a pregnancy. Therefore, wasting time when what you’re doing is not working can be the death knell for fertility.

    Actually, many couples get pregnant even under immense stress. So stress alone will not cause infertility.

    Moreover, dismissing infertility as stress-related is blaming and stigmatizing. It implies that if the couple would just act or think differently, they could get pregnant. That can leave a couple feeling isolated and alone, compounding the stress of infertility. So if someone you love is struggling with fertility issues, don’t imply that it’s their fault by telling them they just need to relax.

    Don’t get us wrong, relaxation is good for many reasons. It lowers blood pressure, can improve your marriage, and helps the infertility journey feel less painful. But relaxation will not get you pregnant. So put a consultation with a fertility specialist -- not a meditation class or therapy -- at the top of your fertility treatment plan.

    Untangling the Stress and Fertility Connection

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    It’s important to note that many studies linking fertility to stress were poorly designed, or only correlative. For example, numerous studies have found that infertile couples tend to be stressed, but that doesn’t mean that the stress caused their infertility.

    It’s much more likely the opposite -- that infertility causes stress.

    It’s equally important to consider that couples facing the highest levels of stress can still get pregnant. Women have and can get pregnant under the most stressful circumstances, such as:  

    • After an emotional or physical trauma
    • After the loss of a loved one
    • Even while undergoing treatment for life-threatening conditions

    The human body is resilient, even in the face of overwhelming stress. So while stress is not good for health, stress alone is not going to destroy fertility.

    Couples who have trouble getting pregnant because of stress tend to be individuals who already have suboptimal fertility. That means they already have a fertility issue. For example, a woman with PCOS might ovulate infrequently. Stress may escalate her irregularity, lowering her chances of pregnancy. Healthy couples who do not have a pre-existing fertility condition are unlikely to become infertile.

    There is one exception to this: health issues that cause physical stress can affect fertility.

    Such as:

    • A recent injury to the reproductive system
    • Reproductive cancer
    • Certain medications
    • Serious chronic illnesses

    When any of these happen, the culprit is not the stress, but the underlying medical condition.

    A Simple Rule for Understanding Stress and Fertility

    Don’t beat yourself up if you’re feeling stressed. Instead, here are a few simple key points to remember that can help you understand the link between stress and infertility:

    1. Stress does not directly cause infertility, but infertility can cause stress.
    2. Stress can affect overall health. And over time, health problems can lead to infertility.
    3. Stress may cause some people to abandon healthy lifestyle choices or make dangerous decisions. For example, a person might smoke or drink in response to stress. These actions are what can affect fertility.

    It bears repeating: stress alone will not cause infertility.

    You do not need to feel guilty or ashamed of stress. Stress is a normal human experience, and as stated before, many people get pregnant even when under immense stress.

    So, When Does Stress Affect Fertility?

    Some research suggests that extreme forms of stress might affect fertility. One recent study found that stress decreases the chance of pregnancy by about 12%. Other research has found that as many as 40% of people struggling with infertility have also been diagnosed with depression or anxiety.

    • Stress may affect fertility by raising blood levels of cortisol, a stress hormone that can lead to inflammation and other chronic health problems.
    • Stress may also elevate blood pressure, increase the risk of diabetes, and compromise immunity.

    Each of these factors is independently correlated with infertility. So when stress is severe enough to affect health, it may also be severe enough to affect fertility.

    Signs and Symptoms of Infertility Due to Stress

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    So are you at risk for stress-related infertility? Stress may lower your fertility if:

    • You have recently suffered a catastrophic loss or injury, such as the death of a close loved one or being the victim of a crime.
    • You already have a condition that is known to compromise fertility.
    • Your health has suffered in other ways, such as weight gain or high blood pressure, because of stress.

    What are the symptoms of stress-related infertility? Like other forms of infertility, stress-related infertility does not always cause any obvious symptoms. It’s impossible to tell who will be infertile based on symptoms alone.

    Some warning signs that stress may compromise your fertility include:

    • Making lifestyle changes because of your stress. For example, if you smoke or drink to deal with stress, this can erode fertility.
    • Stress has caused you sudden weight loss or weight gain.
    • Stress can cause a woman’s menstrual cycle to change in response, especially if the cycles have become longer and irregular. Fewer menstrual cycles mean fewer chances to get pregnant.
    • Stress has caused you physical health symptoms such as high blood pressure or chronic pain.

    For people experiencing these symptoms, treating the underlying health manifestations of the source of your stress first may be key to treating infertility. However, admonitions to “just relax” are not enough.

    On the Other Hand, What About the Stress Infertility Causes

    If you’re facing stress due to infertility, the first thing you need to know is this:

    It’s not your fault. You did not cause your infertility.

    Stress is a natural, normal, totally predictable response to infertility. Being stressed does not mean you won't get pregnant, or that your stress is to blame for your infertility. Agonizing over this issue, or blaming yourself for infertility, won’t help things. It will make life more difficult, and can even affect your marriage. Worse still, if you blame yourself, you might be less likely to seek quality, skilled help for fertility issues.

    So what can you do to better manage the stress that infertility causes? A few tried-and-true strategies can help:

    • Carve out time to get a break from focusing on fertility issues with your partner. Many couples find that all or most of their time becomes about getting pregnant. Schedule a date night. Take a vacation. Plan a day of fertility-free discussions. Turn your attention to each other.
    • Spend time doing something you love. Refocus your mind and energy into something that brings you joy and happiness.
    • Consider therapy, both for yourself and your partner. It’s important to take care of your mental health just as much as your physical health. A therapist can help you process your feelings and find a way forward.
    • Join a support group. You’ll gain wisdom and tips from people who have been there, and more importantly comfort and support in that you are not alone.
    • Practice relaxation techniques such as deep breathing or meditation.
    • Take care of your body. Eat a balanced, healthy diet and get plenty of exercise.
    • Work with a skilled fertility specialist. This alleviates the burden of worrying about whether you’re correctly treating the issue. A fertility specialist is your partner in the journey to pregnancy and can help lighten the emotional load you carry.

    When to see a Fertility Specialist

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    Seeing an infertility specialist is the very best thing you can do to alleviate your infertility-related stress. That’s because an infertility specialist can accurately diagnose the problem and advise appropriate, evidence-based treatment.

    Fertility specialists stay on top of recent research and new techniques, making them much more effective than your family physician or gynecologist. Faster, more effective treatment means less time spent agonizing over infertility, less strain on your marriage, fewer fertility-related expenses, and best of all, a shorter timeline to pregnancy.

    Your fertility specialist can also help you with cultivating stress management techniques. They’ll discuss with you whether you’re at risk of stress-related fertility problems, and may also be able to offer reassurance that your stress won’t harm your fertility. For people worried about the effects of worrying, that can be a source of immense comfort and relief.

    So when should you see a fertility specialist? We recommend seeking treatment when:

    • A woman is over the age of 35 and has tried for six months or longer to get pregnant.
    • A woman is under the age of 35 and has tried for a year or longer to get pregnant.
    • The stress of trying to get pregnant is affecting your mental health or marriage, even if you have only been trying for a short period of time.
    • Stress has affected your health or menstrual cycles. This may indicate stress severe enough to trigger infertility.

    At the Center of Reproductive Medicine, we understand how painful infertility can be. We walk alongside you, working to make the journey as manageable as possible. You don’t have to suffer through this alone. Put your health and parenting future in the hands of a trusted expert.

    Along the way we can also help you find ways to manage the stress of infertility while offering you the profound reassurance that there is hope and you are not alone. Give us a call today to start this journey towards parenthood together!

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    Topics: Fertility Journey, Fertility Myths, Stress and Infertility

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