Coping with the Stress of Infertility

Everything you need to know

By Douglas Brown and Aven Kane

Infertility is Stressful

Infertility is so stressful it hurts. It could not be more stressful if it tried. Stress is not just a buzzword; it’s a physical and emotional response to demanding circumstances and, in the case of infertility, to ongoing uncertainty and repeated disappointments. Stress triggers your body’s fight-or-flight response, flooding it with various hormones and preparing it for immediate action.

Can Stress Cause Infertility?

Stress… No.

While dealing with infertility can indeed lead to significant stress, contributing to anxiety and depression, the idea that stress itself causes infertility isn't supported by research. Most studies suggest that everyday stress — the kind we all experience as part of normal life — does not have a direct impact on fertility. However, this type of stress can lead to hormonal fluctuations. While these hormonal changes can temporarily influence reproductive functions, the overarching consensus in the scientific community indicates that regular day-to-day stress is unlikely to be a profound or direct cause of infertility.

Chronic Stress… Maybe

Chronic stress, characterized by prolonged and intense psychological pressure, certainly affects the body in various ways. It can influence specific biomarkers such as cortisol, a stress hormone that has been studied for its potential effects on fertility. For example, elevated cortisol levels could theoretically affect the reproductive system and extend the time it takes to conceive. However, the direct link between chronic stress and infertility is far from conclusive.

Research has shown that while certain stress-related enzymes in saliva, like alpha-amylase, are higher in some women who took longer to conceive, these findings do not establish a straightforward cause-and-effect relationship between stress and infertility. Instead, they suggest that stress might interact with other factors influencing fertility.

Many studies indicate that stress could exacerbate existing fertility issues rather than causing infertility outright. For instance, stress might lead to behaviors or physiological changes that could indirectly impact fertility, such as reduced sexual activity, poorer lifestyle choices, or irregularities in menstrual cycles. Yet, the evidence directly linking stress as a causal factor for infertility remains disputed and is often contradicted by the resilience of the human reproductive system under stress.

One study shows that there IS indeed an association between adverse IVF outcomes and stress. Their research links female and male participants with stress, and anxiety to lower likelihood of clinical pregnancy and live birth. [1]

However, another study shows that there IS NOT an association between stress and infertility. They show that pretreatment emotional distress was not associated with treatment outcome after a cycle of assisted reproductive technology. [2]

Yet, another study shows that there appears to be NO association with salivary cortisol levels and fertility but there IS a connection with salivary alpha-amylase levels and fertility. [3]

It’s important to note that the research of these studies is done well, it’s peer-reviewed, and held to high standards. The different outcomes of the studies should highlight that understanding the relationship between stress and infertility is difficult and should be handled with nuance and attention to detail.

The impact of stress on fertility is complex and influenced by numerous factors, including psychological, physiological, and environmental elements. While it's clear that managing stress benefits overall health and well-being, the notion that reducing stress will directly and immediately increase fertility lacks robust support.

There is no straight line from stress to infertility! This can be somewhat reassuring, as it suggests that individuals dealing with infertility need not add the burden of "managing stress perfectly" to their list of concerns.

What remains true is that,

Chronic “stress affects individuals in different ways, therefore the reaction to stressors may vary depending on individual sensitivity to stress or the character of stressors. However, stress response serves to prioritize survival over less essential physiological functions…” [4]

Coping with stress and anxiety is important and as people we deserve to be equipped to confront the stress in our life with practical stress lowering techniques. This is especially true for women and men who are preparing to and actively trying to conceive.

Coping with the Stress of Infertility

Finding effective ways to cope with the stress of infertility is a daunting task. A quick internet search may not yield satisfying results, as many recommendations are overly simplistic. Rest, hydrate, go for a walk, eat healthy—these are all beneficial practices, but they are unlikely to alleviate the stress inherent in infertility struggles.

The reality is that infertility is stressful. Thinking that you will be able to maintain a perfect mental health regime to avoid stress altogether is unrealistic. Throughout the literature on coping with stress, there are certain themes that repeat themselves. Below you will see an outline of the general moves someone should be making to manage chronic stress and anxiety.

❤️ Coping Mechanisms that Address Chronic Stress

Get Grounded

Addressing bodily anxiety is the first step toward feeling grounded. Techniques such as mindfulness, deep breathing exercises, and meditation can help establish a sense of calm and presence. Feeling physically connected to the present can also significantly mitigate feelings of disconnection from oneself. Try a grounding technique below. 👇

Get Connected

Humans are wired for connection. As John Bowlby famously said, “all of us, from the cradle to the grave, are happiest when life is organized as a series of excursions, long or short, from the secure base provided by our attachment figures.” -Bowlby 1988

Our relationships are the basis of our psychological makeup. Strengthening relationships with supportive friends and family or joining groups where experiences can be shared openly can help manage the emotional toll of infertility

Live in Reality

It’s essential to be authentic with yourself and in your interactions. Presenting the ‘real’ you to others can help address mental disconnection and provide significant stress relief. Reflective journalling and honest communication with others can also foster deeper connections and reduce feelings of isolation.

Take a Break

Not all infertility stress is avoidable. Trying and treatments are overwhelming. Sometimes, the only way to feel grounded and connect to people and reality is to take a break. Breaks are beneficial, even though they often feel like losing precious time. Temporarily removing yourself from the situation that is causing your stress can allow you to recharge and refocus.

Infertility, Anxiety, and When to Reach Out for Help

Knowing when stress has morphed into anxiety can be difficult. Often, you only realize the need for help after it has become undeniable, typically far later than would have been ideal. The anxiety of infertility is real, and it really hurts. Seeking support is not a sign of weakness; it’s a proactive step toward resilience.

Process Groups for Infertility

Process groups provide a safe and confidential environment for members to share their personal experiences, anxieties, and emotions while fostering deep, emotionally fulfilling connections. They are professionally facilitated spaces that promote relationship-building, community, and resilience. In many ways, they are small microcosms of community designed to navigate through the difficult season of isolation and anxiety brought on by infertility.

Therapy for Infertility

For some, infertility brings up traumas and feelings from the past. The daily stress of infertility, compounded by past stresses, quickly becoming overwhelming. A trained infertility therapist can connect the dots between aspects of infertility and past traumas, providing valuable insights and coping mechanisms.

Take 3 Minutes to Calm Yourself Down

If you are reading this, we see you. Browsing the internet to identify ways to deal with the stress of infertility can be stressful in and of itself. We hope you trust the research and understand that getting grounded and connecting with others are tried and true methods for combating stress. If you are willing, try this now:

Breathing and Calming Technique:

  • Sit up with your feet on the floor.
  • Relax and lower your shoulders.
  • Unclench your jaw and drop your tongue from the roof of your mouth.
  • Relax your eyebrows.
  • Take some deep breaths through your nose.
  • Rest and keep breathing until you feel a bit more calm.

Connect with Someone Safe: Consider the safest person you can think of. Text them today, schedule a hangout, or have a heartfelt chat. Safe, understanding relationships can be profoundly supportive during this difficult time.

Conclusion: Embracing Support and Finding Strength

Infertility is a journey marked not just by challenges but by the resilience it demands from those it touches. The emotional toll is undeniable, but remember that you are not alone in this struggle. By grounding yourself, connecting with others who understand, and occasionally stepping back to recharge, you can navigate this challenging path with purpose and support.

It is crucial to recognize when stress may be turning into anxiety and to take proactive steps toward seeking help. Whether through therapy or simply sharing your story with a trusted friend, every step forward is a step toward resilience. If you find yourself in need of additional support, joining a Uniquely Knitted process group may be a valuable first step. Remember, you are not alone in this journey.

Listen to a podcast episode about Infertility and Stress Here 👈

References

[1] Haimovici, F., Anderson, J. L., Bates, G. W., Racowsky, C., Ginsburg, E. S., Simovici, D., & Fichorova, R. N. (2018). Stress, anxiety, and depression of both partners in infertile couples are associated with cytokine levels and adverse IVF outcome. American journal of reproductive immunology (New York, N.Y. : 1989), 79(4), e12832. https://doi.org/10.1111/aji.12832

[2] Boivin J, Griffiths E, Venetis C A. Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies BMJ 2011; 342 :d223 doi:10.1136/bmj.d223

[3] C.D. Lynch, R. Sundaram, J.M. Maisog, A.M. Sweeney, G.M. Buck Louis, Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study—the LIFE study, Human Reproduction, Volume 29, Issue 5, May 2014, Pages 1067–1075, https://doi.org/10.1093/humrep/deu032

[4] Lewinski A.,Brzozowska M., Female infertility as a result of stress-related hormonal changes, GREM Gynecological and Reproductive Endocrinology & Metabolism (2023); 02-03/2022:094-098 doi: 10.53260/grem.22302035