Can Stress Contribute to Infertility?

Stress has become an everyday constant for many individuals. Work, personal life, and other responsibilities keep us awake at night, force us to develop unhealthy habits, and disturb our moods. Add to these the anxieties of trying to get pregnant, and you will see a fair portrayal of many women today. Could this stress affect one’s ability to conceive? In my experience, the answer is: quite possibly so. Many researchers, however, disagree.

My Take

I hate to blame stress for everything, and I always look for a different culprit first, but when all other potential causes are examined and eliminated, and stress is the only nagging factor that persists, I have little choice but point the finger at all the worries and excitements stirring in my busy brain. Do you also feel preoccupied with life and find it hard to shut down your mind at night? Do you wake up at odd hours of the night and then operate purely on adrenaline during the day?

I am very good at worrying; I do it diligently every day. Conflicts at home, emergencies at work, doctor’s visits, driving on ice or in heavy traffic—everything is a potential cause of distress for me. That was why I took every precaution during my fertility treatments: I selected one of the best reproductive endocrinologists in the area, had all recommended tests performed (including all optional ones), never deviated from my medication schedule, ate responsively, took prenatal vitamins every day, exercised moderately and regularly, and had frequent check-ups by my doctor, complemented by blood tests and ultrasound imaging.

My reproductive endocrinologist also determined that I had no anatomical problems that could prevent me from getting pregnant. In fact I did get pregnant as a result of my second intrauterine insemination (IUI), proving that my uterus was healthy and able to accommodate a fetus. The only known problem I had was with the poor quality of my eggs due to my age. Therefore, as part of my in vitro fertilization (IVF) cycle, I had ordered preimplantation genetic screening of all fertilized eggs so we can winnow all chromosomally defective embryos and implant only the healthy ones.

In my opinion, and my doctor agrees with me, I could have done nothing more to ensure a successful treatment. Still, despite the perfectly executed frozen embryo transfer (FET), the health of the implanted embryo, and the optimal thickness of my uterine lining, my post-IVF pregnancy test was surprisingly and disappointingly negative. My doctor had no explanation other than “bad luck.” Medical journals and the Internet also did not offer insight into the possible cause of this failed attempt. A few articles, however, hinted at a link between fertility and stress, and since I have stress in abundance, I am willing to accept this explanation as possibly true.

I have several friends who were unable to get pregnant for many years and then, when they finally stopped worrying about it, were able to conceive and not just once. Here I am talking specifically about stress induced by one’s unsuccessful attempts to achieve pregnancy, but stress borne out of any other reason (finances, relationship, work, etc.) can be equally detrimental. In fact, some researchers claim that as much as 30% of infertility problems are associated with stress in one way or another.

Some Researchers’ Opinion

Recent research published by Oxford University Press aimed to investigate the impact of stress levels on fertility. The results from this couple-based study (called the LIFE study) reveal a correlation between salivary stress biomarkers and time to pregnancy, indicating that women who experience higher preconception stress also face a higher risk of infertility and longer time to pregnancy. Similarly, according to a WebMD article, researchers at the University of California at San Diego have concluded that test subjects whose stress levels were highest ovulated 20% fewer eggs than those who were less stressed, and their eggs had 20% less chance of being successfully fertilized.

Allen Morgan, MD, director of Shore Institute for Reproductive Medicine in Lakewood, New Jersey, reports that reducing stress may increase blood flow to the uterus and have a beneficial effect on proteins in the uterine lining that are involved in implantation. To boost patients’ fertility, some clinics even go as far as recommend acupuncture, massage, guided imagery, meditation, yoga, listening to music, and any other way of stress management and relaxation.

Other Researchers’ Opinion

The exact correlation between stress and fertility has still not been firmly established, and some researchers have even offered evidence for the absence of such a link. Indeed, most articles you will find on the Internet suggest that preconception stress plays no role in determining the outcome of fertility treatments. I am not sure if such claims are an attempt to garner attention by refuting a “myth,” but it is certainly trendier and more newsworthy to present information that contradicts a common belief. Still, I would admit I felt certain comfort reading that so many studies have found no statistical evidence that stress can negatively impact one’s chances to conceive.

Conclusion

While the research society is divided on the subject, with many pointing at a lack of sufficient data to establish a clear relationship between stress and fertility, stress-reduction techniques may still be worth it to pursue. Don’t blame yourself if you experience heightened levels of stress, but do try to find ways to reduce it. Regardless of whether this would have any impact on the outcome of your pregnancy attempt, it would doubtless improve your overall state of mind and well-being.