Relieve stress to fight infertility

Some experts still recite an old maxim: while infertility undoubtedly causes stress, stress does not cause infertility.

Now researchers suggest that the two conditions may indeed be linked. In a study published online in the journal Fertility and Sterility, the scientists reported that women who stopped using contraceptives took longer to become pregnant if they had high saliva levels of the enzyme alpha-amylase — a biological indicator of stress.

The authors say this is the first study to link a biomarker for stress with delayed conception in normal, healthy women, and they suggest that finding ways to reduce or manage stress may be a low-tech solution for some infertile couples.

“Even when couples just start trying to conceive, people are really stressed out,” said the study’s lead author, Germaine Buck Louis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.  Repeated failures to conceive month after month could potentially set off a vicious cycle in which it becomes ever more difficult to become pregnant, she said.

Home fertility test

The study tracked 274 British women ages 18 to 40 who had just started trying to conceive, following them for six months or until they became pregnant. The volunteers were given at-home fertility test kits to track their monthly cycles, and on the sixth day collected saliva samples that were tested for the stress hormone cortisol and for alpha-amylase, which is secreted when the nervous system produces catecholamines, which initiate another stress response. Although there was no adverse effect apparent from high cortisol levels, women with the highest concentrations of alpha-amylase were 12 per cent less likely to become pregnant each month than those with the lowest levels.

“This is one more piece of the puzzle that’s adding up to the same conclusion: that stress is not necessarily a good thing for our reproductive system,” said Alice Domar, executive director of the Domar Center for Mind/Body Health at the fertility center Boston IVF.

The surprising finding was that even low levels of stress can have an impact on conception, said Dr Sarah Berga, head of obstetrics and gynaecology at Emory University, who has studied the effect of stress management on women who are not ovulating.

Cortisol concentration

Curiously, the odds of conceiving were higher for women who had elevated concentrations of cortisol during the fertile period. Women who have been treated for infertility say the process can be highly stressful. Amy Cafazzo, 38, of Framingham said stress-reduction classes at Boston IVF taught her coping skills she uses to this day — now to cope with her active 19-month-old twin boys. “When you’re going through this, people often say, ‘Relax, it’ll happen,’ and you just want to smack them,” Cafazzo said. “You can’t just relax.”

 The classes taught breathing techniques, yoga and other relaxation strategies and provided her with a support network of women going through the same experience. Did it actually help her conceive?

“I just don’t know,” she said. “But I’m a Type A personality that needs an actionable plan, and this gives you something to do, so you feel productive and aren’t caught in a downward spiral of stress.”

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