The biggest myth in the field of infertility is the one that goes: “just relax and you will get pregnant.” That myth is followed closely by: “just adopt and you’ll get pregnant” (which, incidentally, is the stupidest thing you can say to someone struggling with infertility). The truth is, relaxing or adopting a child is no guarantees of pregnancy. But the question remains — what is the connection between stress and infertility?
Infertility Causes a Lot of DistressBelieve it or not, women who can’t easily conceive have the same level of distress as do women with cancer, heart disease, or who are HIV-postive. (Trust me, I was the one who did the research on this.) The impact of infertility is huge. It affects every aspect of the couple’s life. Men and women often don’t react to infertility the same way, so it can have a negative impact on their relationship. In addition, their sex life gets slammed — who wants to be told when they can or can’t make love?
Infertile people may be surrounded by the fertility of everyone they know — siblings, friends, co-workers, and neighbors — which makes them isolated, alone, and frequently unbearably jealous. And the financial impact can be frightening: A single treatment cycle can cost in the range of $15,000, with about a 30% chance of success. So it shouldn’t be surprising that infertility patients report high levels of anxiety, depression and hostility. Almost half of women with infertility problems have symptoms of anxiety, depression, or both before they even start treatment.
Distress Equals Fewer PregnanciesThere are a couple of ways that a person’s psychological state can impact pregnancy rates. First, a number of studies have shown that the more distressed a woman is when she starts her treatment cycle, the less likely she is to get pregnant. In fact, the most distressed women have half the pregnancy rates of the least distressed women. Secondly, more recent research has shown that the more distressed the woman is when she starts treatment, the more likely she is to drop out of treatment after only one cycle. For the vast majority of women, doing two or three cycles is going to give you double or triple the pregnancy rates of doing just one.
How Can You Reduce Your Distress Level?
If you are going through infertility, you have probably noticed that you have greater mood swings than you used to and, in fact, you often seem to be like a roller coaster — feeling hopeful and happy mid cycle, and then crashing two weeks later when you get your period. This is completely normal. Not fun, but normal. If you find yourself feeling sad, irritable, jumpy, and not so optimistic about the future, chances are that you need to take some action to improve your quality of life and hopefully improve your chances of conception. Research shows that attending a group that provides stress management skills training offers you the best chance of feeling psychologically healthier and getting pregnant. Learning coping and stress-reduction skills may even be more beneficial than talking to someone about your feelings. Ask your infertility doctor about any local stress management (often called mind/body) groups in your area.
One of the hardest things about infertility is that you feel out of control, so whatever you can do to increase your feeling of control over your fertility can help. One place to start is with your lifestyle habits:
1. Try to keep your body mass index (a measure of your weight in proportion to your height) in the normal range. Being underweight or obese can contribute to infertility
2. Don’t smoke or be exposed to secondhand smoke. Smoking adds ten years to your fertility; a 25 year old smoker is as fertile as a 35 year old nonsmoker
3. Limit alcohol intake. The more you drink, the longer it can take to conceive
4. Examine how much caffeine you ingest, which has been connected to both infertility and miscarriage.
5. Think about decreasing the intensity of your exercise regimen for a couple of months to see if you are reproductively sensitive to exercise.
Infertility SucksThere is no question that infertility sucks. (I actually considered naming one of my books that, but found, to my chagrin, that a book by that title already exists.) But believe it or not, women who hit bottom psychologically during their infertility can feel normal and healthy within weeks of learning mind/body techniques. And about half get pregnant within six months.
Do you have any questions about stress and infertility? Want to learn some snappy comeback lines when people say stupid, thoughtless things? Let me know — I might answer your question in a future blog post.
Alice D. Domar, Ph.D, is Executive Director of the Domar Center for Complementary Healthcare at Boston IVF, and an Assistant Professor at Harvard Medical School.
Dr. Domar is co-author of the book, Six Steps to Increased Fertility, with Drs. Robert Barbieri and Kevin Loughlin, a Fireside Book published by Simon & Schuster in 2000.
Click here to join the group Harvard Med: Talking About Health on Gather
You can find the following related articles on Gather:
Trying to conceive: First steps for a healthy pregnancy
Dealing with infertility: Be good to yourself
Stress and infertility
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Comments: 25
It is interesting to see how life comes full circle. My parents went through infertility (both primary and then secondary) before having my sister and I am sure that my mother's traumatic experience influenced me in in my decision to go into this field. When I first started the mind/body program almost 20 years ago, she said the same thing as you. But I have to tell you that when I did start researching the stress/infertility connection, I was subject to a lot of criticism so 26 years ago it would have been even harder.
Ali
I am always careful to tell patients at the beginning of the program that the only way that this approach can positively impact fertility is to undo the potential harmful impact of stress and lifestyle factors. My impression of unexplained is that it is actually often "not yet diagnosed". If someone goes through the mind/body program and follows the recommendations and does not conceive, she can always know that she did everything in her control to increase the chance. And although our stats show half conceive within six months, about 95% become moms within two years, someway.
Ali
I am not an expert on the impact of smoking on fertility per se but my guess would be that getting away from smoke would get you (and your eggs?) healthier pretty quickly. I know that IVF programs wants smokers to stop at least a few months before cycling, which suggests that one can clear the nicotine. I don't know of any connection between PCO and smoking. But be aware that although smoking lowers your chances somewhat, think about the birth rates in the 1950's and 1960's (think baby boom) when many women smoked. Nothing is absolute.
ok?
Ali
I am so sorry about your loss. I have a list of snappy comeback lines which I give to my patients since people's comments never cease to amaze me with their stupidity. Think of a few good ones, memorize them, to protect yourself for the next time.
Did you ever receive a diagnosis for your infertility?
Ali
Good idea but it is beyond my area of expertise!
Ali
thanks. Glad you liked it.
Ali
Thanks,
Debbie
Fifty years ago, women smoked. They still got pregnant. (I'm not saying smoking is good...just trying to make a point.) There were canned foods, years ago, and people did eat in restaurants and some of them ate the greasest food that you can imagine. My grandmother cooked with oil and real butter and made sinfully delicious desserts that would be frowned on, today.
I don't think people exercised, or at least I don't ever remember seeing even one member of my family, jogging or lifting weights or doing push ups.
In those days, lots of people drank coffee and alcohol, too.
My conclusions: Things ingested in moderation, aren't going to harm you. I don't think they have any effect on pregnancy, at all. What I think might harm you, is how things are manufactured, today. With all the artificial ingredients in both foods and tobacco and even our water supply, how can we be sure that it's not those things, that are causing some negative, physical changes to all of our bodies? In the long term, is the body really meant to ingest things that are not natural?
Secondly, the big stress issue, I think, is a real one. Anyone who grew up in the 50's, knows for darned sure that life was incrediably less nerve wracking, then it is now. People weren't in so much of a big hurry. Most people worked their job, came home, and relaxed. Many actually spent time with their families, on weekends. Now, a lot of people work on weekends, cause they have to. That's how society has change. What used to be important, is now on the side lines.
I think change is good. But I don't think ALL change is good. We can go too far in how and what we change. The result is, we end up changing that which we never wanted to change...like the very simple act of becoming pregnant...
It seems to me that "getting everything removed" is a pretty drastic step, especially as you so clearly want a child. Your husband's refusal to be tested is obviously a huge issue. There is a new product, called Fertell (I was on the advisory board so I actually know a fair amount about it) where he can test himself at home. Not ideal as far as your doctor is concerned, but if the test is normal your doctor might be willing to proceed with treatment. Any way your husband would be willing to go talk to a therapist with you to see how he might be more helpful in this journey? This is not an easy process, especially alone.
I wish you the best of luck.
Ali
I agree with a lot of your points, especially the one about the difference in stress levels between the 1950's and now. In terms of your comments about health habits, women in those days tended to start trying to get pregnant when they were far younger than women do today. A 22 year old who has borderline health habits is more likely to get pregnant than a 32 year old with comparable health habits. So the women of today, who are older, do need to take their health habits into account. And there was infertility in those days as well. My mother took years to get pregnant and looking back, there were several couples in the neighborhood where I grew up who never had kids so I am guessing that they had infertility. The prevalence has not changed; the only difference is that women are older and treatments are far more successful, so we hear about it more.
make sense?
Ali
My hat is off to you for two reasons. One- for recognizing that you didn't want children and thus didn't have any. I wish more people would be honest with their feelings. And two, for being able to be supportive to your friends who are going through infertility, even though you may not necessarily relate to their situation. You are a good friend.
Ali
KF
As what was once said by a very sagely lot quite sometime ago " If not now? When"
I'd like to take a moment , now, to say thank YOU and your instructors in Waltham,MA for being an integral part in helping my wife and me receive the greatest gift we have ever received - Mary. We are alumae/i of your 16 week "class" for couples in the theroes of infertility. Make no bones about it ... the infertility road is a rough one ... like you said Infertility Sucks ( more than the Yankees! ) It is fraught with every known set of factors and variables ... from insurance coverage ( or not - there ARE ways around this if your company doesn't cover it ) , to questions like " maybe I wasn't meant (by the Creator) to have children ... he might become the next Bucky Dent or shoe bomber " ... succotash , we said. Every emotion and philosophy can become raw and rehashed and tenderized ... my advice is to .... strap on your hard hat and go to work ... infertility is tough ... what makes it extra tough is that the pressure is already turned WAY up beyond normal by the time most couples go down the road of infertility treatments ... arm yourselves with information ... quite often , from what I've seen , it is difficult to get both partners fully engaged in the process ... THAT'S OK !! Help one another along ... support is key ... yes, sexual relationship might be in tatters from months or even years of "tryin" ... from a guys perspective --- ejaculating into the little plastic cup is awesome after some less than romantic romps whilst "tryin"! ...
To the guys / partner
This is a very perscnickety issue ... you / we need to be on our A #1 best behavior here .... this is a time when the woman we love/wish to have a family with needs us the MOST ... as my wife put it -- she felt like her body was playing the most wicked trick on her - denying her the ability to conceive ... it doesn't matter why or b/c of whom or what so much as she needs reassurance that it's a team effort .... I said my wife ... we married because we were in love NOT because I expected you to pump out chitlins .... it is a miracle ... it is unrealistic to EXPECT miracles , in my buddalikehumblest of opinions ....
Again , thanks for the class .... we are very,very friendly with five couples we met at your Boston IVF class ... I HIGHLY recommend your class and those like it ....
Be like a Maccabee when it comes to infertility
Interesting ( to me ) aside .... my wife is due on 8/6/07 from embryoes frozen in October 2002. My daughter was born in the early summer of 2005 from a "fresh cycle" ... I'll let the Mathematicians , biologists and theologians battle it out to say who is "older".
Thanks for reading .... I'd be amazed if many bothered to get this far !!!!
Hi I just wanted to say thanks for the information. That said I have been trying to have children for 5 years now and my husband and I have been checked. Unexplained infertility is what I have been told and my husband is fine. I hate that and feel like I have no control over my own body and the worst of it is my nephew who just turned 18 just had a baby. Buy the way I am 26 years old. My sister who is 35 years older than I has 3 children. I just feel like less of a woman now because of it.