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Health 101: Stress and Fertility

Anyone who's heard the conception advice "just relax and it'll happen" may wonder if stress really plays a role in how soon you're able to get pregnant. The answer: More and more research seems to confirm a link between stress, anxiety, depression, and infertility, says Alice Domar, PhD, executive director of the Domar Center for Mind/Body Health at Boston IVF.

First, when you're stressed out, you're probably not having sex as often -- a pretty obvious fertility derailment. "You're also more likely to smoke and binge drink," says Dr. Domar, both of which have been known to negatively impact conception.

For some women, chronic stress can affect ovulation by altering signals to the hypothalamus, the center of the brain that regulates some of the hormones that trigger the ovaries to release eggs each month. Women under nonstop stress may ovulate less regularly, making it more difficult to plan babymaking for the exact window when they're most fertile. Some research shows that stress may also affect testosterone levels and sperm production in men.

Other research indicates that stress may have an impact on other aspects of fertility beyond ovulation, including problems with fertilization and implantation in the uterus. One study from the University of California San Diego found that the most stressed women undergoing IVF had less success every step of the way (fewer eggs retrieved and fewer eggs successfully implanted) compared to women who were not as tense. Another study from Israeli researchers tested whether helping women de-stress while undergoing IVF could impact the success rate. They found that women who were entertained by a clown after they received the treatment (laughter is a known stress-soother) were more likely to conceive than those who were not.

Being unable to get pregnant when you want to can be a huge source of stress, anxiety, and depression, says Dr. Domar. One Japanese study found that about 40 percent of women with fertility problems were clinically anxious or depressed before they even started getting treated for infertility.

"Most people who cannot get pregnant have an actual physical explanation," says Dr. Domar. "But as month after month goes by, feelings of stress, anxiety, and depression often kick in. So even if the physical cause of infertility is treated medically -- say, surgery for endometriosis -- it's possible that high levels of stress can still make getting pregnant more difficult."

Most of the studies on stress and fertility have looked at women already experiencing fertility problems (like those seeking IVF treatment), not your average Jane and Joe, so no one really knows this answer for sure.

But everyone experiences stress -- it's a part of life -- and it's unlikely that a couple of rough days a week at the office will have a major impact on your pregnancy timetable, says Dr. Domar, especially if you can shake it off at the end of the day and don't feel like you're worried or anxious all the time, or are not experiencing other symptoms like trouble sleeping, eating more or less than usual, or losing interest in things you normally love to do. Your body adjusts well to everyday stresses over time, but it's the sudden big ones -- like the death of a family member, losing a job, or moving to a new city -- that can suddenly throw your menstrual cycle out of whack.

Anything that helps you relax and unwind -- catching up on the latest celeb tabloids over a pedicure, meeting your best friends for brunch and shopping -- is certainly a step in the right direction. But certain tricks are especially beneficial for women dealing with trying-to-conceive-related stress, says Robert A. Greene, MD, coauthor of Perfect Hormone Balance for Fertility.

  • Strike a warrior pose. "If you're not the type to sit and meditate for an hour every day, yoga may be the next best thing," says Dr. Greene, who recommends hatha yoga, a style that focuses on breathing and movement without concentrating directly on meditation. Taking a yoga class or popping in a DVD a couple of times a week can have a huge impact on lowering stress hormone levels that can mess with fertility.
  • Conk out earlier. Interesting fact: More than 80 percent of women ovulate between midnight and 8 a.m., so getting too little sleep -- and the hormonal imbalances this causes -- can have a surprising impact on conception. Sleep is super-regenerative and gives your body a chance to relax and recover from a taxing day. While sleep needs vary from person to person, if you tend to wake up and still feel tired, or feel like you're running on empty as the day drags on, chances are you're not getting enough.
  • Have sex -- but not the babymaking kind. As fertility-related stress takes its toll on you and your partner, it's common for your sex life to start feeling more like a science project. Do it when you're not ovulating -- just for the fun and intimacy.
  • Do this 10-minute stress Rx. Called progressive muscle relaxation, this exercise involves tightening and relaxing every part of your body from head to toe. Furrow your forehead for five seconds, then relax your face for five seconds. Then wrinkle your nose for five seconds, and relax it for five seconds. Do the same with your jaw, and so on, for 10 minutes, or more if you have time. "This helps you to physically feel what your body is like when it's tense versus when it's relaxed," says Dr. Domar.
  • Scribble it down. Dr. Greene is a big fan of journaling to zap stress. "Putting your worries on paper is one of the best ways to get perspective and feel like you're more in control of your problems," he says. Writing in a journal regularly, even for just a few minutes a day, can help you feel more positive and less anxious about whatever's bothering you.
  • Talk to a pro. If you still feel like you can't get your stress in check, or tend to be prone to extended bouts of anxiety or feelings of hopelessness, sadness, or total ambivalence that won't go away, consider seeing a psychologist or psychiatrist who is experienced with infertility patients. Find one through asrm.org. Getting your emotional health on track is a must for a healthy pregnancy and beyond.

Sources: Alice Domar, PhD, executive director of the Domar Center for Mind/Body Health at Boston IVF in Boston, Massachusetts, and author of Conquering Infertility; Robert A. Greene, MD, co-author of Perfect Hormone Balance for Fertility

Copyright © 2008 Meredith Corporation.

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