Can Stress Cause Infertility?

The relationship between stress and infertility has been discussed for decades – if not centuries. In the popular costume drama “Downton Abbey,” a doctor tells one of the characters who is worried about infertility that “anxiety is an enemy to pregnancy” – reflecting the beliefs of Edwardian England.

But the relationship between stress and infertility is not just a Brontë era “old wives’ tale.” Recent scientific research has actually proven that there is a direct relationship between stress and anxiety, and the ability to conceive.

Which Comes First Stress or Infertility?

Complicating this research is the well-established fact that being unable to conceive a child often leads to elevated levels of anxiety and depression. So, while we know that infertility causes stress, the converse question becomes: does stress cause infertility?

The answer appears to be “yes.” Recent research has demonstrated that psychological intervention that lowers psychological stress is associated with significant increases in pregnancy rates.

The Unenlightened History of Studying Infertility

In the 19th century many doctors claimed — without evidence of course — that the stress of learning could damage a woman’s childbearing abilities. Dr. Edward H. Clarke, M.D., a professor at Harvard Medical School (who specialized in the ear), wrote in a 1873 book that when a woman studied math, botany, and chemistry, it would “divert blood from the reproductive apparatus to the head.”

By the 1940s, doctors developed a similarly ignorant and ill-founded explanation for infertility called psychogenic infertility. This term was applied to women whom they believed to be too ‘ambitious’ to get pregnant. They posited that career-driven women could not conceive because they possessed “anti-maternal unconscious thoughts” that stole the hormones from their brains and ovaries.

And, in 1947, Dr. Viola Bernard, M.D., a prominent New York psychiatrist, infuriatingly claimed that an “unconscious dread or aversion to pregnancy can indirectly disturb ovulation and hence conception.”

Modern Psychology & Infertility

Thankfully, modern medicine and the study of infertility has come a long way.  Science now has the ability to precisely measure stress hormone levels – and the technology to analyze how stress-related hormones might impact fertility.

A 2018 study published in the American Journal of Reproductive Immunology found that among 45 couples who were undergoing in vitro fertilization (IVF) due to fertility issues, women who had higher blood levels of a specific kind of molecule that rises with stress were less likely to get pregnant after one cycle of IVF.

Alpha-amylase found in the saliva is an enzyme that’s secreted by salivary glands in response to stress. Another study published in The Journal of Human Reproduction in 2017, found that of 400 test subjects in the United States, women who had the highest levels of alpha-amylase (indicating a higher level of stress) were 29 percent less likely to get pregnant after a year of trying — and more than twice as likely to be declared infertile.

But while there is strong evidence that stress is related to conception problems, precisely how stress might reduce fertility is still not 100% certain. Some experts have hypothesized that stress may dampen the immune system in a way that hampers egg implantation.

Other specialists note that stress also creates an inflammatory response in the entire body. And inflammation underlies many bodily problems and dysfunctions, and is at the core of many diseases and illnesses.

Additionally, stress also triggers the “fight or flight” response in the body that stimulates the body to produce certain stress hormones. These stress-induced hormone imbalances may then disrupt a woman’s production of estrogen, progesterone, thyroid hormones, prolactin, follicle stimulating hormone (FSH), luteinizing hormone (LH) which can all affect ovulation and fertility.

Other Ways Stress Can Impact Fertility

Chronic stress may also impact fertility in less direct ways. Stress can disrupt sleep, which can then throw a woman’s natural circadian rhythms out of balance – upsetting the normal ebb and flow of hormones.

Stress may also lead to poor eating habits as well as increased alcohol consumption and even smoking. And it is already established that dietary deficiencies, alcohol and nicotine can all lead to irregular or absent periods, and other imbalances in the body that can impact fertility.

Male Stress and Infertility

Stress in the father is also believed by some researchers to be linked to lower sperm quality.  A study, published in the journal Fertility and Sterility in 2014, interviewed 193 men between 38 and 49 and analyzed their sperm samples. That study reported that life stress (but not work stress) was linked to reduced sperm concentration and speed, as well as abnormally shaped sperm.

Researchers have suspected that stress also might reduce sperm concentrations by producing a rush of glucocorticoids, which are steroid hormones that suppress the secretion of testosterone.

Managing Stress to Treat Infertility

In 2015 an analysis was conducted of 39 different fertility studies published between 1978 and 2014. The study, published in the journal BMJ Open, found that people who practiced cognitive-behavioral therapy (a type of talk therapy) and mindfulness training were more than twice as likely to become pregnant than couples who didn’t use these stress-reducing strategies.

Stress management techniques such as deep breathing, meditation and yoga are easy to incorporate into one’s daily routine. And these simple practices have been proven to reduce stress for hundreds of years. Moderate, regular exercise – even daily walking – is also an excellent stress-releasing activity.

By making some simple but impactful lifestyle changes – including proper diet, adequate sleep, moderate exercise, and stress-reducing meditation or yoga – there is a good chance that you can naturally help boost your fertility, increasing your chances of conception and healthy pregnancy.

Infertility Doctor – Austin, TX: 512.343.9355