A study published in September 2016 reported that women who are stressed have a lower chance of conceiving…cue the social media buzz and the spike in questions to doctors everywhere. In this study, from a collaboration between University of Louisville and Emory University, 400 women 40 years old or less who were sexually active recorded their daily stress levels and other lifestyle factors over the course of several months.
The authors reported that during the cycles where women were stressed during their ovulation window, they were 40 percent less likely to conceive. Furthermore, the women in the study who felt more stressed in general were 45 percent less likely to conceive compared to the other women in the study.
This study is not groundbreaking. It used a small number of patients, and self-reported data is inherently flawed. So why all the buzz? Because, as a fertility provider, the single most common question I get from patients struggling to complete their family is, “Does stress cause infertility?” Everyone wants to know the answer to this question, but as a provider, there’s no easy way to respond:
I can’t say, “YES, stress causes infertility,” because then I will add to the worry and already-mounting anxiety that my patients are under when their efforts to have a baby haven’t worked yet. Instead, I tell my patients, “If I say that stress causes infertility, then you’ll stress about being stressed, and then stress some more about how to un-stress, so let’s talk about stress management instead.” I’m already stressed writing the word stress so many times, but let’s keep going...
I can’t say, “NO, stress does not cause infertility,” because there is research that links stress and infertility, like the one published this week. But there are also studies that show no relationship between stress and infertility, and people conceive under extreme situations like war and famine all the time. However, there is some biologic plausibility to considering a link between stress and reproduction. When we are stressed, we release cortisol and other “fight or flight” hormones that shift our bodies’ goals away from reproduction and toward survival mode. Everyday stressors are not usually sending people into full “fight or flight mode,” but we cannot ignore a possible causal link.
I can answer, “MAYBE, but regardless, we can all work on better ways to deal with stress.” Whether or not stress causes infertility, what matters is that anyone struggling to conceive can benefit from stress management tools. We cannot control what happens to us, but we can work on ways to help ourselves deal with what happens to us. Self-care is essential in all aspects of health, but especially when it comes to infertility.
Research regarding stress and infertility is inherently biased and somewhat flawed since many people struggling to have a baby become stressed in the process. Infertility and stress is a chicken and egg scenario – which comes first? Infertility can be isolating, frustrating, devastating. Infertility can lead to self-doubt, can strain relationships, and often has no clear explanation. Infertility is just plain stressful. It does not really matter if stress is the chicken or the egg of infertility – what matters is that patients have access to and awareness of the care they need.
Every person is different and has different needs. In my fertility clinic, we review a variety of support and wellness options for patients with infertility, including individual counseling, support groups through the patient advocacy group Resolve, yoga for fertility, mind/body classes, book lists, etc.
We may not have a definitive answer to the question, “Does stress cause infertility?,” but it’s nothing to get stressed about. Instead, shift your focus toward looking for ways to get the support you need on your journey to completing your family. Stress is unavoidable and there are many other factors that cause infertility. In the meantime: take time for yourself, do activities that you enjoy, limit exposure to toxic people, get outside, be a little selfish, ask for help, connect with your partner, do whatever it takes to be kind to yourself.