Does anxiety affect fertility? Reproductive specialists address the 'just relax and it'll happen' mindset.

·6-min read
Reproductive specialists address stress and infertility. (Photo: Getty Creative stock image)
Reproductive specialists address stress and infertility. (Photo: Getty Creative stock image)

"It'll happen once you stop trying." "Relax — the stress isn't helping." "Your body is just under too much pressure right now."

These are the sorts of things people who are trying to conceive tend to hear after they've been dealt another blow on their quest to become parents: a negative pregnancy test, disappointing news from the doctor. And if the pandemic has taught us anything, it's that a) we're all stressed out, and b) that stress can take a toll in a lot of unexpected ways. But is it enough to impede conception?

Possibly — if we're talking about "very extreme levels of stress," says Dr. Olivia Carpinello, a reproductive endocrinology and infertility specialist at CCRM Fertility in Northern Virginia. "That anxiety and stress that most of us deal with on a daily basis is not at that extreme level."

But in "rare circumstances," significant trauma or grief — think, the death of a loved one — could "potentially affect your ability to conceive" by disrupting the menstrual cycle, Carpinello tells Yahoo Life.

"There's a pathway from the brain to the ovaries in terms of hormones that are produced," she explains. "The brain has to talk to the ovaries in order for a follicle, which contains an egg, to develop and ovulate. And if you are under extreme levels of stress, that can interfere with the brain's ability to signal the ovaries."

If the ovaries aren't signaled, a woman won't ovulate or get a period, both of which are essential to reproduction. It's why those who suffer from polycystic ovarian syndrome (PCOS) may experience infertility, on account of their irregular periods and inability to ovulate and release eggs to be fertilized.

In such a case, a reproductive specialist can help get the menstrual cycle back on track via fertility drugs and other interventions.

"We're usually taking control over that signaling," Carpinello says. 'We're either causing the patient to ovulate, if she's doing ovulation induction or IUI (intrauterine) cycles, or we're trying to get a whole bunch of eggs to develop by doing IVF. With these treatments, basically, we're taking control; we're sort of bypassing that signaling pathway. So it's very rare that fertility treatments would be less effective because of extreme stress."

It's not just women who could, in rare cases, be impacted physically by extreme stress.

"Men have the same signaling pathway that women do, [but] from the brain to the testicles," Carpinello says. "And so if the signal is not being produced by the brain because they're under extreme stress, then that can certainly impair the ability for the testicles to create sperm."

Again, she emphasizes that "most patients do not experience sufficient stress to cause this type of dysfunction in the pathway. It really is the rare patient, either man or woman, that is under sufficient stress to affect this pathway."

That's not to say that stress should be shrugged off. Dr. Jenna Turocy of Columbia Fertility Center tells Yahoo Life that more research is needed to determine just how much of an impact stress may have on infertility. But it's clear that infertility in itself "can cause high levels of distress."

"Feelings of anxiety, sadness, irritability and loneliness are all normal reactions to such a challenging experience," the board-certified OB-GYN says. "We might not be able to really determine if stress specifically can make treatment less successful, but what we do know is that these negative feelings can truly decrease one's quality of life."

This can result in "weakened coping strategies" to manage feelings of hopelessness or even guilt, with some blaming themselves for being unable to conceive, triggering another wave of stress in the process. Turocy notes that these low, anxious feelings may make it harder for people undergoing fertility treatment to stick with the process because of the "emotional burden" it entails. After financial concerns, Turocy cites this emotional toll as one of the top reasons why people stop their treatments. And by calling it quits, those who need medical intervention may be less likely to go on to have a child.

"So we know that stress can, at least inadvertently, affect one's outcomes if they stop treatment early because of the significant emotional burden that comes along with infertility treatment," she notes.

But what about those couples who do put their baby plans on hold — or even, say, end up adopting — and then conceive naturally out of the blue? Sometimes, Turocy says, "spontaneous conception happens."

"The chance is never 0%," adds Carpinello. "And I think that's where this myth of 'oh, if you just relax it'll happen' comes from, because people stop trying or time passes and hormones and the body change and they get spontaneously pregnant. It is still possible for many couples; however, we know that with the passage of time, the odds go down."

Both Turocy and Carpinello see a benefit in finding ways to reduce stress generally, through something like light exercise, acupuncture or even just 10 minutes of quiet meditation before bedtime. That's not because it improves one's chances of conceiving, but because it's considered part of a healthy lifestyle.

They also agree that it's not helpful to play the blame game or attribute infertility to caring too much, or trying too hard or feeling stressed out by what is inherently a stressful process.

"Your stress does not cause a miscarriage; your stress did not cause your infertility," Turocy says. "Infertility, miscarriages — these things happen and it's not because of something you did. So I think that's the clearest message I can give, is the fact that they didn't cause this. Decreasing your stress is always a good thing for quality of life, but I don't want somebody to put so much pressure on themselves, that they think they're the reason that any of these bad things happen."

Says Carpinello: "At the beginning a lot of people have this self-imposed pressure: 'Oh, now because I'm stressed, my chances [to conceive] are going to go down even more.' And I think people should be reassured that we don't have any evidence that that happens. And a lot of the people who give recommendations [like] 'oh, just relax and it'll happen' are misinformed."

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