Stress and Infertility: What Comes First, the Chicken or the Egg?

We are all familiar with the metaphor of  “the chicken and the egg.” That is, does A cause B or does B cause A? Stress is the underlying agent instigating much if not all illness, either as its cause or as an aggravator of illness.

Fertility requires ovulation and physiology to allow normal reproductive events to occur.  Reproductive biology is exquisite; in its simple beauty and technical complexity.  Our existence depends on it; yet it seems so complicated on the cellular and molecular level.

Stress has long been acknowledged as interfering with procreation.  Stress graphically can cause amenorrhea, which is an interruption of the menstrual cycles and an interruption of ovulation.  Stress can be in the form of psychological or physical stress, like starvation or extreme exercise.  Moderate stress can lead to missed cycles or oligo-ovulation and masquerade as polycystic ovarian syndrome. Implantation issues can even develop as stress may affect hormone production, such as progesterone, and lead to defects in luteal development of the endometrial lining.

As an irony of life, infertility can in itself lead to stress, which can aggravate the conception delay.  The frustration of conception delay is well known to lead to anxiety if not rumination about the delay in conceiving or pregnancy loss. On too many occasions the journey patients are on with regards to family building is rocky and challenging and may take an inordinate time. Adding this to the already complex and stressful 21st century lifestyle, we lead can certainly ratchet up our stress levels.  This is turn can cause physical changes in our reproductive physiology making basic processes for both women and men malfunction.  Thus a snowball effect is created between stress and conception delay, causing more stress, and aggravated conception delay.

Breaking this cycle, is part of the therapeutic holistic approach we practice at Washington Fertility Center.  Whether it be simply to “listen more to our patients’ or have the highest level of customer service or utilize all available adjunct support  for stress reduction (such as acupuncture, massage therapy, counseling, or formal treatment options for overwhelming anxiety)  - we always strive to monitor and assist our patients cope more successfully with their conception delay and the process of the evaluation and treatment.  Fertility care is not just about the outcome but the process in getting there.