These are stressful times. I hope that, if you are trying to get pregnant, you find this helpful. Sending love and light, Kirsten
Q: What’s more stressful than experiencing infertility?
A: Experiencing infertility during a pandemic.
It’s never a good time to be diagnosed with infertility—the inability for a woman to get pregnant for a year (if you’re under 35) or six months (if you’re over 35) or to carry a pregnancy to term. But as COVID-19 spread across the globe, many fertility clinics stopped or limited treatment, leaving those who were trying to get pregnant to forgo their dreams of becoming parents or of having another. Even as many clinics reopen and resume treatment (in full protective gear), the jury is still out on how the coronavirus impacts women who do manage to get pregnant.
Talk about stressful.
I thought infertility was stressful when I was going through four years of infertility (nine rounds of IVF and four miscarriages) before I had my daughter, but I learned some important things about stress that I hope will help moms who are trying to get pregnant now.
First, forget about the people who say, “Just relax and you’ll get pregnant.” I mean, literally forget they ever existed. Like, if that’s their starting gambit, it won’t get any prettier. They’ll regale you with stories of their best friend’s veterinarian’s aunt’s lover’s niece who had been trying forever—she did forty-five rounds of IVF! Drank witches’ blood! Took a vow of celibacy! And when she stopped everything, stopped thinking about it, lo and behold, she got pregnant.
When someone said, “just relax,” I thought: Now you’re telling me that my own stress is causing this lack of a baby? Are you saying infertility is my fault? That if I weren’t so GODDAMNED STRESSED OUT ALL THE TIME I WOULD BE @#$@# PREGNANT???? (They usually ran for the hills at that point, planning not to return till I gave birth.)
Listen: When I was interminably single, people kept telling me to “stop focusing on finding the one and it’ll happen…” You know what happened when I stopped focusing on dating? I got off all the dating websites, hung out with my girlfriends, read lots of books and grew cobwebs down there. It was only when I decided to leave Los Angeles and move to New York to find a husband that I met mine.
So I don’t buy that simply “not focusing” on conceiving is the magic pill.
Still, I want to investigate the science behind stress and its relationship to infertility.
“The relationship between stress and infertility has been debated for years,” begins a study in Clinical Neuroscience. “Women with infertility report elevated levels of anxiety and depression, so it is clear that infertility causes stress.” DUH. The study goes on to say that women who struggle to conceive are twice as likely to suffer from emotional distress than fertile women.
“What is less clear, however, is whether or not stress causes infertility,” the authors note, saying it’s impossible to prove the causality because it’s based on people self-reporting, and also because people feel really optimistic at the start (as you should!). So is the stress causing the infertility or is the infertility—and its failure—causing people to feel disappointed… and stressed?
Some studies show a physiological relationship between stress and time to pregnancy, and one study notes that “interventions to reduce cortisol prior to commencing IVF could improve treatment outcomes.”
“You need a healthy body and a healthy mind,” says Dr. Amy Beckley, creator of the at-home progesterone test Proov. “Our cortisol steals from our reproductive system, so if you’re too stressed, your body says, ‘We do not believe you can carry a child to term,’ and turns the needed progesterone into cortisol, a stress hormone.” She hates when doctors say, “Just don’t think about it.” She says, “You have to take actions to manage your stress.”
But can we really moderate our stress levels?
I spoke to Tamar Ben-Shaanan, a microbiologist and immunologist studying mice with tumors. In a study published in Nature, Ben-Shaanan and her colleagues found that “activating the reward center” in the mouse’s brain reduced the tumor, and concluded that “a patient’s psychological state can impact anti-tumor immunity and cancer progression.” Some recurrent loss specialists concluded that this would be a good line of treatment for people who fail IVF cycles: “It may be a great first step in a new protocol for IVF patients to focus on creating an environment that would lead to activation of this reward system,” they write, encouraging patients to do “activities that create enjoyment” and establish a “positive environment.”
Ben-Shaanan, who was not involved in that repeat loss study, told me, “It’s not a one-to-one ratio: The way our neurocircuitry reacts to our situations in life can perhaps have an impact. It may be hard-wired.” In other words: We may not have as much control over our stress as we want.
Of course, there’s also a lot of research showing stress has no effect on fertility. As I always say: Correlation is not causation. Yes, of course infertility causes stress. How can it not? Everyone telling you to “just relax” should try living a normal, happy life while waiting every second for a much-wanted event that hasn’t yet happened and they can’t be sure ever will. Of course infertility is stressful. Just please don’t tell me it causes infertility.
“While infertility causes stress, research shows it’s not vice versa,” says Dr. Janelle Luk of Generation Next Fertility. “Everyone’s stressed out, so it’s a silly statement,” she says. “It’s like saying, ‘Don’t eat without biting the food.’”
In fact, total fertility rates are often highest in countries that experience the harsh conditions of war, poverty and famine. In an analysis of 14 studies of 3,583 infertile women, researchers concluded: “Emotional distress caused by fertility problems or other life events co-occurring with treatment will not compromise the chance of becoming pregnant.”
Dr. Luk says, “Going through infertility treatment can be a high-stress event for most women, especially if they have been trying for a while.” She notes that while stress can cause menstrual and hormonal changes, “these changes are usually self-correcting and do not have any permanent impact on fertility.” So if, for example, you’re so stressed that you’re not ovulating, that can be fixed. If you’re so stressed that you’re not sleeping, eating properly or exercising—well, that can be fixed, too. And fixing those situations will probably help your fertility.
While you can’t fix a pandemic, you can fix your response to it.
And that’s why if you’re trying at home—or even back to your clinic—don’t worry that the added stress of our current isolation situation will negatively affect your chances of conceiving. We already have enough to worry about—stressing about stress shouldn’t be one of them.
Written by Amy Klein for Working Mother and legally licensed through the Matcha publisher network. Please direct all licensing questions to firstname.lastname@example.org.