Infertility Is Not In Your Head

“Just Relax” and Other Useless Advice

People who are TTC are often inundated with well-meaning but bad advice, from old wives’ tales to the latest snake oil in social media.

Friends and family usually don’t mean to be hurtful, but their comments can feel that way when you’re struggling with infertility.  Telling someone to “just relax and you’ll get pregnant” is not only dismissive and unkind—it’s just not true.

Stress and Infertility

Research has found that infertility causes stress, but studies have not found a direct relationship between stress and infertility.  It is not clear if or how anxiety and stress affect fertility.  Stress-induced hormonal changes are usually self-correcting and self-limiting.  Women can conceive under extremely stressful conditions if there aren’t physical conditions to prevent it.  War prisoners and victims of sexual assault get pregnant.  Stress can, however, lead people to cope with behaviors that do affect fertility negatively, such as drinking too much alcohol, smoking, taking drugs, or avoiding having sex.  A few recent studies point to stress affecting hormones in both men and women, but there is not clear evidence of causation, i.e., stress causing infertility.

What Does Cause Infertility?

Infertility means not being able to get pregnant after trying for a year, or six months if you are over 35.  Infertility is not only a woman’s problem. About one-third of infertility cases are caused by women’s problems. Another one third are due to male factor issues. The other cases are caused by a combination of male and female problems or by unknown problems.

The major causes of infertility in women are maternal age and diminishing ovarian reserve, hormonal issues, and structural issues.  The number and quality of a woman’s eggs starts to decline in her early 30s and declines more rapidly after age 35.  By age 40 her chances of getting pregnant naturally are five percent each month, and by age 44 her chance is close to zero.  Hormonal issues include thyroid and gland disorders.  PCOS is increasingly common, affecting one in 10 women in the U.S. of childbearing age, and is a significant cause of infertility in women.  Structural issues like blocked fallopian tubes, fibroids, and endometriosis can prevent pregnancy.

Male factor infertility is caused by anything that limits sperm production and quality or a man’s ability to “deliver” sperm to a woman’s uterus.  Undescended testicles, varicoceles (enlarged veins), diabetes, DNA damage, and other chronic diseases like cystic fibrosis can reduce sperm volume and quality or make it impossible for sperm to mix with semen.  Overexposure to heat can also reduce sperm production.  A man’s fertility, too, is negatively impacted by smoking, drinking excess alcohol, and using drugs.

In about 20 percent of infertility cases there is no apparent cause.  Known as unexplained infertility, this diagnosis means that the available tests and current medical knowledge have not found a cause.  It doesn’t mean your problem is in your head.  And fertility treatment can help you conceive.

What Next?

Having less stress in your life may not help you get pregnant.  It’s important to consult a reproductive endocrinologist and get a personalized plan for treating your infertility.  Managing stress can improve your quality of life and help support you through fertility treatment, which is known for emotional ups and downs.  Reduced stress is good for your health, whatever your situation may be.  Aerobic exercise in moderation, yoga, meditation, acupuncture, massage therapy, journaling, support groups, counseling and therapy are all ways to calm that voice in your head and slow that speeding heart rate.