Research studies have documented the correlation between stress and infertility since the 1980s. Recently, a look at depressive symptoms and their impact on biology has offered new hope and a mind/body approach has proved to be a heartening success for some women.
Women with a history of depressive symptoms reported twice the rate of subsequent infertility (Psychosomatic Medicine, 1995, vol. 57).
Women with depression, when treated showed a 60 percent viable pregnancy rate within six months, contrasting with 24 percent when depression went untreated. (Journal of American Medical Womens Association, 1999, vol.54)
Women who experienced depression following the failure of their first in vitro fertilization (IVF), had much lower pregnancy rates that their non depressed counterparts during their second IVF cycle (Journal of Psychosomatic Research, 1993, vol. 37)
Another study (Fertility Sterility, 1998, vol. 69) suggests that because mind/body programs are effective for reducing negative emotions that may impair IVF success, patients should be offered such a program in conjunction with IVF.
How does this mind/body connection between depression and fertility work? Stress brought on by anxiety and/or depression can alter immune function. We all know about how the effects of depression can lower our immunity, making us more vulnerable to colds and other viruses during emotionally stressful periods. If you continue with that thought process, if is easy to see how our system can get out of balance by our thoughts! Even our ability to conceive!
Reproduction is a very delicately balanced biological systems. Psychological stress can affect our ability to get pregnant on multiple levels, including inhibition of the hypothalamus that helps regulate hormonal levels, or over activation of the hypothalamus which can change the pituitary and adrenal responses. The pituitary regulates both how much of a hormone is made and how much is released in the body, its alteration can have dramatic effects on the hormonal balance necessary for ovulation, fertilization, tubal functioning or even successful implantation of the egg once it reaches the womb.
Even when women have not been depressed previously, depression often occurs by the second to third year of infertility and does not return to normal levels until six years later. However, researchers have recently become proactive in studying the effects of treatment for non depressed women before they get depressed. Here is certainly a place for hypnptherapy!
A study reported in Reproductive Endocrinology (April 2000, vol. 73, issue 4), treated women who were in their second year of infertility and not yet depressed. The women who received group psychological interventions to change the tide of depression caused by infertility, had significantly increased viable pregnancies compared to those who did not receive preventative treatment for depression.
Research indicates that psychological distress may impair fertility and that depressive symptoms may reduce the efficacy of infertility treatment. Several studies support the theory that psychological distress can have a significant adverse impact on successive rates in-vitro fertilization. In one study, women with depressive symptoms were half as likely to conceive as women who were not depressed, and in the most recent study of 151 women scheduled to undergo an IVF cycle the chance of a live birth was 93 percent higher in women with the highest positive-affect score. Researchers concluded that the success rates of high-tech infertility treatment can be adversely affected by psychological stress.
Mind/body treatment of infertility patients has been shown to both increase pregnancy rates as well as reducing psychological distress. In another study conducted, at the MBMI, 185 women who had been trying to conceive for one to two years were randomized into either a 10 week mind/body group, a ten week support group, or a routine care control group. The birth rates during the one year follow up period were as follows: - Mind/body 55%, support 54%, and controls 20%. The mind/body patients reported significantly greater psychological improvements than the support or control patients.
Patients in the clinical Mind/Body Program for Infertility show benefits as well; in four published studies on several hundred women with an infertility duration of 3.5 years, 42 percent conceived within six months of completing the program and there were significant decreases in all measured psychological symptoms including depression, anxiety and anger.
Infertile women report elevated levels of psychological distress and this distress may reduce their chances of conceiving. Mind/body treatment has been shown to be effective in both significantly increasing pregnancy rates as well as reducing psychological stress.
Selected references on the Relationship between stress and fertility
1. Domar, A., Clapp, D., Slawsby, E., Dusek, J., Kessel, B., Freizinger, M (2000) Impact of group psychological interventions on pregnancy rates in infertile women. Fertility and Sterility Vol. 73, no.4 April
2. Domar, A., Zuttermeister, P., Friedman, R (1999) Distress and Conception in Infertile Women: A complementary approach. Journal of the American Medical Women's Association. Vol. 54, No.4
3. Demyttenaere K, Bonte L, Gheldof M, Veraeke M, Meuleman C, Vanderschuerem D, et al. (1998) Coping style and depression level influence outcome in vitro fertilization. Fertility and Sterility. 69:1026-1033
4. Domar, A (1996) Stress and Infertility in Women: Is there a relationship? Division of Behavioural Medicine, Deaconess Hospital Mind/Body Institute, Harvard Medical School. Psychotherapy in Practice 2/2:17-27
5. Domar, A., Zuttermeister, P., Friedman, R (1993) The Psychological impact of infertility: a comparison with patients with other medical conditions Journal of Psychosomatic Obstetric Gynaecology. 14 Special issue 45-52
6. Wasser, S., Sewal, G., & Soules, M. (1993) Psychosocial stress as a cause of infertility. Fertility & Sterility, 59, 685-689
7. Domar, A., Seibel, M., & Benson, H (1990) The Mind/Body Program for Infertility: A new treatment program for women with infertility. Fertility and Sterility, 53, 246-249
8. Pennebaker, J., Kiecolt-Glasser, J & Glasser, R. (1987) Disclosure of traumas and immune function. Health implications for psychotherapy. Journal of consulting and Clinical Psychology, 56, 239-245