Stress, Chronic Stress and Infertility

Is It All In Your Head?

Infertility is known to cause stress.  Women with infertility report high levels of anxiety and depression. But does stress cause infertility?  The answer to that is not clear.

Researchers don’t understand the role of stress in infertility.  Even intense stress doesn’t always cause fertility problems; women can and do become pregnant from being sexually assaulted.  While short-term, everyday stress doesn’t appear to cause infertility, recent studies point to physical effects from chronic stress that could negatively affect fertility.

Chronic Stress vs. Stress

Stress is often described as feeling overwhelmed, worried or tense.  Your body reacts to stress by increasing blood pressure and heart rate, focusing your attention, and preparing for “fight or flight.” Everyone feels stressed from time to time, and it’s not always bad.  A little dose of stress can give a person the drive and energy to do their best in a difficult situation.

Chronic stress happens when stress is constant and runs for an extended period of time.  This prolonged state of fight-or-flight is like revving an engine for too long.  Chronic stress can result in serious health problems like anxiety, insomnia, muscle pain, high blood pressure, heart disease, depression and obesity.  Many people try to cope with chronic stress in unhealthy ways, such as overeating, drinking too much, or using drugs.

Chronic Stress and Infertility

Researchers are trying to establish whether there is a physical effect on fertility from chronic stress.  A recent study found that women whose saliva had high levels of alpha-amylase, an enzyme that is a stress marker, took 29 percent longer to get pregnant than those with lower levels.  Other studies have found that women who stop ovulating for more than six months had high levels of cortisol, another stress hormone.  But is stress causing infertility, or is infertility causing stress?

A new animal study from Australia points to a possible connection between chronic stress and fertility problems.  The study suggests that high levels of the hormone ghrelin, which is released during stress and also stimulates appetite, could have a harmful impact on ovarian function.  Ghrelin is part of the reason why we want to eat when we’re under stress.  The study found that female mice who experienced chronic stress had fewer primordial follicles, the immature eggs females are born with and cannot replace if they are damaged, than mice who weren’t stressed.  But the researchers found that if they blocked the effect of ghrelin on its receptor, the number of primordial follicles was the same as those in mice who didn’t experience chronic stress.  There are no clear answers here, but the study may show the way to a promising area for further research.

Managing Stress

Clearly, finding constructive ways to deal with the stress of infertility can’t hurt, and it may help.  Exercise, counseling or therapy, learning and practicing ways to relax like yoga or meditation, and limiting the amount of time each day that you and your partner discuss fertility problems are all ways to help fertility patients cope.   Perhaps the most important is to stop blaming yourself and your partner.  Learn to counter those negative thoughts, and be kind to yourself, and each other.