How Stress (Really) Affects Fertility
You have heard it millions of times: relax and pregnancy will come. It is a well-intentioned comment, but one that tends to annoy those who are seeking pregnancy.
First, it wasn't that easy! And second ... is it real? Just relaxing will improve my fertility and get pregnant?
In this article we want to give you the scientific vision: no comments from neighbors or friends. And it is that the interaction between emotional stress and infertility has been investigated from the science of reproduction for many years.
Many infertile couples experience significant stress during assisted fertility processes. That's how it is: it is a process that often causes stress.
But ... what was before, the chicken or the egg? Does stress cause difficulty in conceiving, or is this stress the result of difficulties in getting pregnant?
Research conducted over the past two decades shows that, in most cases, stress is the result rather than the cause of infertility. So it seems clear that infertility causes stress.
However, what is less clear is whether stress causes (or promotes) infertility, and if so, how and why it does so. Let's see what science says about it ...
Stress is good for the body… and for fertility?
Acute stress yes, chronic no
The human being needs stress. It is a condition that amplifies our capacities as humans: we hear better, we see better, we concentrate better, we perform more, we endure pain and fatigue more, we function metabolically more efficiently ...
All of this is good in certain situations, especially dangerous ones. Stress prevents us from them and helps us save our lives.
But although stress (in its fair measure) can be good for the body, it means pushing "the machine" to the limit of its capabilities, so it can only be maintained for short periods of time.
The human body is very well prepared to deal with demanding, but punctual stresses. What we are not prepared for is a level of stress maintained over time for days, months or years.
Therefore, acute stress does. Chronic, no.
Chronic stress can lead to fertility problems
Biologically, stress involves the activation of certain hormones and the deactivation of others. The stress hormones at the brain level, catecholamines (adrenaline, norepinephrine and dopamine) are able to influence the axis that connects the brain and the adrenal glands with the hormones responsible for normal ovulatory cycles.
That is, these stress hormones interact with gonadotropin-releasing hormone (GnRH), with the production of prolactin and the hormones LH and FSH.
Stress affects the body's "natural" system of pain relief
The human body has an innate system for relieving pain: it is known as the endogenous opioid system (from within the body itself, so we understand each other). There are also those who know them as endogenous opiates.
The point is, these endogenous opiates (like melatonin) are altered by stress. And… guess what melatonin is related to?
bingo, la melatonin It has to do with the ovulation process, which ends up conditioning the woman's fertility.
Finally, the innervation of the sympathetic nervous system, always active in times of stress, on the female reproductive system provides routes by which stress can influence fertility at the level of the sexual organs.
That is, if we are in a time of acute stress, the body prepares for action: fight or flight. And in fight or flight contexts, reproduction is not a priority.
If our existence is lived with continuous stress, every day of our life, reproduction will be negatively affected.
Stress and its weight in fertility processes
Infertility is often a silent fight. People who are forced to go through these processes admit to having feelings of depression, anxiety, isolation and even loss of control.
In fact, some studies speak that the levels of depression in patients with infertility can be compared with those of patients who have been diagnosed with cancer.
It is estimated that 1 in 8 couples have problems getting pregnant or maintaining a pregnancy. Despite the prevalence of infertility, most infertile women do not share their history with family or friends, increasing their psychological vulnerability.
The inability to reproduce naturally can lead to feelings of shame, guilt, and low self-esteem. These negative feelings can lead to varying degrees of depression, anxiety, distress, and poor quality of life.
Of course, this load of negative feelings ends up causing stress, which does not help the process either, be it getting a pregnancy naturally, or through assisted reproductive methods.
It has been shown that patients who undergo assisted reproduction treatment have a significantly higher risk of suffering from psychiatric disorders. It is important to recognize and assist these patients as they cope with their infertility diagnosis and treatment.
Above all, because this sustained stress ends up negatively affecting the couple's ultimate goal, fertility.
Lastly, in vitro fertilization (IVF) programs are considered by many couples and even physicians as the final step in evaluating a couple's fertility potential. Couples come to IVF processes with the illusion of achieving their desire to be parents despite having had to cross some lines that they never thought they would have to cross or accept external help for a process, in principle, natural.
In this way, the Couples participating in an IVF program place added extra stress on their backs. They have put their last hopes on it. A failed IVF is a devastating blow for couples.
Causes of stress in reproduction processes
Among the causes of stress are the isolation of the couple, not wanting to share their grief with others or not wanting to participate in the social or family life in which there are other pregnant women; the interruption of her life project, in the sense of paralyzing or postponing plans in pursuit of the expected motherhood; the denaturalization of sexual relations in the couple, which now have to be scheduled whether they want to or not; the frustration generated by the lack of control over the situation or the feeling of the couple that they are not in control of their own lives.
How many couples suffer emotional stress in the reproductive processes?
The impact of stress anxiety on the outcome of reproductive treatments is technically difficult to investigate due to a number of factors such as subjective appraisals, inaccurate responses, or feelings of greater optimism at the start of fertility treatment.
However, more recent research has documented the efficacy of certain psychological interventions in reducing psychological distress. And, at the same time, it has shown that there is a direct association between the application of these therapies and the significant increase in pregnancy rates.
Infertility causes stress, that worsens with the passage of time if the couple remains infertile.
Emotional, financial and physical stress.
Based on studies, it appears that a group, cognitive-behavioral approach may be the most efficient way to achieve both goals.
In a 2004 study, a total of 22 women were interviewed before their first visit to the infertility clinic. The results were surprising.
40% of the women were diagnosed with anxiety, depression, or both. Other studies conducted after this one have supported these findings. In another recent study of 174 women undergoing infertility treatments, 39% met the criteria for major depressive disorder.
In one of the largest studies to date, 352 women and 274 men were evaluated at infertility clinics in Northern California. It was determined that 56% of the women and 32% of the men reported significant symptoms of depression and 76% of the women and 61% of the qualified men reported significant symptoms of anxiety.
Finally, the results of a recent study on suicide in 106 women with infertility are worrying: 9.4% of women reported having suicidal thoughts or attempts.
Solutions to emotional stress during assisted reproduction processes
The most recent research has documented the efficacy of certain psychological interventions in reducing psychological distress. And, at the same time, they have shown that there is a direct association between the application of these therapies and the significant increase in pregnancy rates.
Separating the focus of attention from fertility
Addition psychological support it is advisable to regain control of one's life, separating the focus of attention on fertility. This does not imply abandoning the chosen fertility processes but it does equate them in importance to other aspects of personal life and the life of a couple that have been relegated.
"Get off" a little in the assisted reproduction process
More does not always mean better. Sometimes more is less. That is to say, sometimes the excessive involvement and the fact of organizing the entire personal and couple life around the issue of fertility becomes counterproductive. And it is through the stress it generates.
Get back out and socialize
Yes, although it may be difficult, going out again, socializing again or traveling again could be good advice.
Recovering an active life, especially physically, practicing sports outdoors or dancing is highly recommended at this time in life;
Maintain a proper diet: focused on fertility and happiness
Eating a proper diet that is capable of nourishing the body and not only satiating the feeling of hunger, it will be equally advisable. And in this sense, it is important to lead a healthy lifestyle, but also, as we said about separating the focus from fertility, to be able to indulge yourself from time to time, which always helps to lift your spirits.
Looking for hobbies with your hands
And, in the more mental sphere, doing work with your hands, crafts, painting or DIY, is usually an easy way to practice Mindfulness.
LINK 50 exercises to improve concentration and promote well-being
Although there are still few studies, it is clear that there are biological evidence that stress does not promote fertility, and on the other hand, that stress usually appears in assisted reproduction processes.
If you find yourself in this situation, remember these tips to alleviate your situation.
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References:
- Simionescu, G. et al. The complex relationship between infertility and psychological distress (Review). Experimental & Therapeutical Medicine. 2021 Apr; 21 (4): 306.
- Rooney, K. Domar, A. The relationship between stress and infertility. Copyright © 2018 AICH - Servier Research Group.
- Santa-Cruz, D. Agudo, D. Impact of underlying stress in infertility. Fertility, IVF and reproductive genetics. Copyright _ 2020 Wolters Kluwer Health, Inc.