Stress and Infertility “The Catch 22” of Fertility
Posted Feb 12 2009 12:00am
Stress and infertility are the “Catch 22” of couples struggling to build a family. The more involved the fertility process becomes the more stressful your life becomes. Well-meaning friends tell you. “You just need to relax, and then you will get pregnant.” The underlying message from this statement is that you are not getting pregnant because you are too focused on pregnancy and your intense desire to get pregnant is the problem in itself. This of course is far too simplistic but it does bare some truth. How does one get beyond this conundrum?
The fact is that infertility causes stress. It is impossible to have numerous failed attempts at conception without feeling some degree of anxiety and depression. A study done by Dr. Alice Domar at Harvard Medical School in 1993 attempted to examine the question of how stressful infertility can be by comparing the depression and anxiety scores of women going through infertility with women who were suffering from cancer, heart disease, and women who had been diagnosed HIV-positive (Domar, Zuttermeister, & Friedman, 1993). The study found that there were no significant differences in the anxiety and depression levels of women with any of these conditions. This means that, when you are going through infertility, you are just as stressed and depressed as someone who has cancer. You are just as stressed and depressed as if you had been diagnosed HIV-positive. Would you ever tell someone with cancer to “just relax and your cancer will go into remission?” Would you ever tell someone who had been diagnosed HIV-positive to “just go on vacation and your T-cells will go up?” Of course not.
Can stress contribute to infertility? The answer, unfortunately, is yes. Research shows that patients who are stressed and depressed have lower conception rates. This is true for couples that are trying naturally as well as those involved in advance reproductive technology (ART). In fact, two studies have shown that higher anxiety and depression rates at the beginning of an insemination cycle or in-vitro cycle lead to lower pregnancy rates (Demyttenaere, Nijs, Steeno, & Koninckx, 1988 and Thiering, Beaurepaire, Jones, & Saunders, 1993)). Thus a vicious cycle is created. The more difficult it is for a couple to conceive, the more likely they are to experience stress and depression. The higher the level of stress and depression, the less likely one is to conceive. It is important to reduce stress in order to maximize conception.
What can be done to break this cycle? There are several techniques that can help infertile couples to cope with stress. Therapy is an important element in helping couples. There are a variety of therapeutic approaches; individual sessions, couples therapy, group sessions or combinations of all three can help. To give the fertility perspective that they are not alone in what often seems like your elusive persuit of children. This is not the time to with-drawl from friends and family, it is a time to reach out for support.
It is also important to stay physically active. Regular exercise can greatly reduce stress. You may not feel like getting out and taking a vigorous walk, run or swim but you will feel better for having had the aerobic activity. You can also have the feeling of accomplishment that comes with completing something positive. When going through fertility treatment so much is out of your control that you can feel helpless. You are in control of your exercise routine. It is something you can check off your list and feel like you have made some progress.
One highly successful program is the Mind/Body Institute, developed at Harvard Medical School by clinical psychologist, Alice Domar, Ph.D. She has created a 10-week program for couples going through infertility. This program has been proven to reduce stress and depression and to increase conception rates. A study with 184 women in April 2000 showed a 55% pregnancy rate in couples that had taken the mind/body course versus a 20% pregnancy rate in the control group. Dr. Domar’s program has been in existence over 15 years and is replicated in several locations throughout the country.
There are multiple tools that participants learn in the mind/body program, but the one that seem to be most important is the relaxation response. The fact is that most people do not know how to relax. Maximum benefits are gained from relaxation when you are able to still your mind from wandering thoughts. When you still the mind for at least twenty minutes, you elicit the relaxation response. The relaxation response is a biological mechanism that is regulated by the hypothalamus and can be elicited through techniques such as meditation, yoga, and mindfulness. When you elicit the relaxation response, your heart rate slows, breathing becomes deeper and slower, and you release endorphins.
In addition to the relaxation response, the mind/body program teaches couples to decrease negative thoughts (such as “I’ll never get pregnant”) through comprehensive cognitive restructuring techniques. Couples also improve their communication skills, learn to express their fears and anger in a more constructive manner, and learn to incorporate laughter and humor back into their lives. Ninety-seven percent of couples that attend the mind/body program become parents, one way or another, within three years of completing the 10-week program.
As you reduce your stress you are then ready to cope with advanced methods of reproduction. You can see your alternatives as wonderful options rather than Orwellian procedures. Couples learn to embrace the wonder of being able to grow their family through a variety of ART procedures including IVF, Ovum Donorship and Surrogacy.
Choosing a donor can be an overwhelming process. Therefore you need to choose an agency that makes finding a donor easy and stress free. One of the most comprehensive programs is The Donor Source. They approach every aspect of ovum donation with sensitivity, respect, and efficiency in a warm and accepting environment. Gail Sexton Anderson the Executive Director has a masters in counseling from Harvard. Therefore The Donor Source’s focused more on helping people through this process than on closing a sale. The staff is trained to have the ear of a counselor. They take the time to hear your story. They want to know where you are in your journey so they can help prepare as you begin your search.
Often couples start by looking for the intended mother’s “twin” but most realize that while they will not find a clone, they can find someone that they like; someone who feels familiar to them; someone who will fit into their family. They may find similarities they hadn’t been looking for that come together to make the match feel right. Intended parents want someone bright, kind, thoughtful, and reasonably attractive; who understands the process and is willing to follow through cooperatively. They are drawn to the individual donor often for reasons that can’t be put into words.
This program has no upfront fees or hurtles to pass before looking at full donor profiles. Many donor programs ask you to pay them before you can have access to their donor data base, or require that you come to their offices for a paid consultation before giving you access. You can look at the profiles on-line in the privacy of your home. Others agencies do not have on-line profiles so you must spend hours in their offices looking through potential donors. You see a fully comprehensive profile of each donor, pictures, health history for her whole family, education and why she has decided to be a donor. Many agencies will allow you to see only limited information about their donors until you have paid them a non- refundable fee. The Donor Source leads you through the process from your initial search straight through to the retrieval. After all what is more frustrating than to get to the point where you are ready to look but you run into road blocks at every turn, heightening you stress levels once again. The Donor Source has over 250 donors and a readily available staff to answer your questions.
In conclusion couples can benefit by seeking programs that focus on the individual intended parents. To help them to learn the tools to cope with this naturally stressful period in their lives and then continue with programs that handle the stressful details for you.
Dr. Laurel Kline is a clinical psychologist and the director of the Mind/Body Institute in Westwood, California. For more information: www.mindbodyinfertility.com
Gail Sexton Anderson She received her Ed.M. in Counseling Psychology from Harvard’s Graduate School of Education.