Stress and its impact on infertility
Infertility is a problem that generates very important emotional consequences for the couple. The fact of not being able to satisfy such an important aspect of personal development as ‘having children’ directly affects all spheres of patients’ lives.
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Psychological impact
When a person wishes to have a child and is unable to do so, certain symptoms begin to appear, generating a state of discomfort. As a consequence, important aspects such as self-esteem, sleep, life as a couple, sexual relations, plans for the future, social life, etc. deteriorate significantly.
In these circumstances, feelings of anxiety and depression are widespread. As if this were not enough, this situation of ‘suffering’ is often minimised or even trivialised by society, which sees this problem as something of little importance. Sometimes, advice is even received with ‘positive’ but unpleasant aspects such as ‘you are so well off without children…’.
Emotional stress during reproductive treatment
This situation of emotional stress is intensified during Assisted Reproduction Treatments (Artificial Insemination, In Vitro Fertilisation (IVF), Oocyte Donation, etc.). Several studies have been carried out to measure the levels of anxiety in different types of medical treatments, and assisted reproduction treatments are the most emotionally stressful after cancer treatments (radiotherapy, chemotherapy…), according to the World Health Organisation. This makes sense if we consider that at that moment the fear of failure, of suffering or of not becoming a mother significantly intensifies the anxiety caused by infertility.
Above all, in the emotionally charged context of infertility, an important question remains: can this chronic stress be the cause of infertility? Does the fact of a woman being emotionally affected make it difficult for her to become pregnant?
Does stress cause infertility?
The popular belief is clear and the woman receives a strong message. ‘You are not getting pregnant because you are obsessed’ and, in addition: “The day you relax, you will see how easily you will get pregnant”. These statements can be credible. Anxiety would provoke hormonal or other ‘alterations’ in the organism that would make it impossible or difficult for pregnancy to develop, would affect the ovaries’ function, the menstrual cycle or the ovarian reserve, as the high levels of cortisol due to stress would affect the nervous system. Moreover, they are based on popular anecdotes, we all hear cases of women who became pregnant after many years of searching without any treatment. Some even did so after adopting a child, so that the anxiety about becoming a mother would already be suppressed.
These statements are terrible for the infertile woman. They give her a feeling of guilt about an aspect that she cannot control. ‘I don’t get pregnant because I’m obsess’, “I can’t manage to be relaxed on the day of the embryo transfer” … which increases even more the feelings of anxiety and depression. But,
- What does science have to say about this?
- Do we have evidence on the influence of stress on fertility?
The answer is ‘NONE’. Recently Dr Jacky Boivin (one of the world’s leading authorities on the study of the emotional aspects of couples with reproductive problems) has published the largest analysis on this subject. Collecting data from 14 studies with more than 3500 patients included. The conclusion is very clear: ‘emotional stress caused by infertility or other aspects of life do not influence the likelihood of achieving pregnancy during reproductive treatments’.
Therefore, and as a conclusion, we can assure our patients, with the data currently available to us, that this ‘anxiety’ or ‘obsession’ is not to blame for not achieving pregnancy. However, self-care is key during the infertility journey, which is why we offer all our patients the Psychology service to provide them with emotional support during these complicated and special moments, helping them to prepare themselves for welcoming their baby.
We could try to sum it up in the following sentence:
Infertility produces stress, but stress does not produce infertility.
Natalia Romera, Psychologist at the Instituto Bernabeu and specialist in reproductive problems.
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