Sarah SteventonAnxiety and Stress Specialist
Warwick, Leamington Spa, Stratford-upon-Avon, Solihull

Stress and Fertility

It is commonly accepted that stress and anxiety can be the cause of a failure to conceive, though it is also generally held that nobody really knows why this should be the case.

Some think that the mind somehow inhibits conception when ‘the time isn’t right’ or when there are issues that might cause difficulty during pregnancy or after the birth. They might well be right. But still, nobody is really certain of the mechanism. In fact, it appears to be a rather odd state of affairs when you consider how often people conceive when the time is most definitely not right for one reason or another, and when the pregnancy will cause catastrophic problems.

These people were worried that might conceive, so constantly worrying and visualising being pregnant… and maybe there’s a clue there.

Fear has a peculiar way of making an individual think about the very thing they don’t want. Consider:

Someone who is frightened of flying imagines crashing

Someone who is frightened of an exam imagines failing

Someone who wants sex but fears pregnancy imagines being pregnant - so they are continually imagining being pregnant

Someone who is frightened they won’t conceive imagines her period starting - continually imagining not being pregnant.

But it’s not quite as simple as changing the thinking processes because something more physiological than psychological might be going on, though psychology might well be at the root of it. The failure to conceive is often perceived as a personal failure, a weakness; any form of weakness is a threat to survival (in this case of the tribe, rather than the individual) and so it becomes a matter of some urgency to:

(a) Resolve the situation; or
(b) Prove there was no weakness after all.

When under threat it is a natural process to focus upon the threat and when neither of the above outcomes have proved fruitful the focus is intensified… until desperation sets in.

And desperation is an insistent phenomenon, insisting that we apply more and more focus on the situation until it’s the focal point of our life for as many of the twenty fours hours daily we are conscious. It matters not whether that desperation is about money, a failing relationship, a potentially terminal illness, somewhere to live, potential public humiliation… or a failure to conceive. As far as the brain and body is concerned the outcome is the same – massive anxiety and stress. And the assertion “We’ve been trying for a baby for ages but it’s just doesn’t happen…” will only add to that desperation, since past failure has now been dragged into a confirmation of present inability. A better statement would be “We’re going to go for a baby sometime this/next year…” This will help avoid subconscious despair and self-recrimination.

It’s not necessarily the specific anxiety about not conceiving that is at the root of the difficulty though, since it seems to be the case that those who are highly stressed about anything tend to have a higher incidence of infertility than those who don’t. And there’s probably a very good reason for that.

Anxiety increases the activity of the Hypothalamic-Pituitary-Adrenal Axis usually referred to as the HPA axis. This is one of the body’s feedback loops involved in the regulation of blood chemistry and our immune system.

The hypothalamus responds to the level of cortisol in the blood by increasing or reducing the production of CRH (Corticotropin-releasing hormone) which, in turn, governs the output of ACTH Adrenocorticotropic hormone)… and that controls the amount of cortisol produced by the adrenal glands. And this is where it starts to get very important for the situation we’re working with here… because when cortisol rises the result is oestrogen imbalance, progesterone deficiencies, and lowered testosterone levels.

To put it even more succinctly:

The adrenal glands use progesterone to make cortisol. The more cortisol is needed as a result of stress and anxiety, the more progesterone is ‘stolen’… and pregnancy cannot start or be maintained if progesterone levels are too low. Not only that, when testosterone levels fall, so does the sperm count, and possibly the sperm quality as well.

So it’s not a surprise that when both halves of a couple are suffering stress and anxiety, the chances of conception occurring are greatly reduced.

Now we’re moving on to another aspect of life that can hinder fertility – fear.

There are many fears that individuals can have, and these can sometimes fee overwhelming or completely stupid - but thoughts sometimes cannot be helped... such as

Supposing I get pregnant then don’t love the baby?

I’m frightened I’ll be no good at sex afterwards

I’m scared I might die

I’m scared I might miscarry

Supposing I look really ugly while I’m pregnant?

I’m frightened my partner doesn’t really want a baby

I’m frightened I won’t be able to cope

or guys might worry about more practical things such as

Supposing I lose my job?

I don’t have a clue about handling kids

I’m frightened my partner might die

I’m scared she’ll go into labour when there’s no one to help

I’m not sure I’ll fancy my partner afterwards

I’m very anxious about being at the birth

Supposing my partner loves the baby more than me?

In practice, it doesn’t really matter what fears are expressed – and it would be a very strange situation indeed if neither side had any fears… but whatever comes to light can be dealt with easily enough.

If you are experiencing difficulties conceiving or you are going through IVF and feel a little stressed, then please get in touch.

Stress and Fertility. quality

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