In social situations, when people find out I’m a fertility doctor, they often ask me how much I think stress impacts fertility.
They often tell me of their friend who went on holiday, or of their sister-in-law who adopted and then conceived the very next month. Implicit in the story, of course, is if the couple had just relaxed from the beginning, there would have been a natural conception.
But I think those stories put implicit blame on the couple involved.
For subfertile couples, there is often a low, but very real chance of natural conception on any given month. By low, I mean very low: If a couple has been trying for six months, there is a 5% chance per month. After a year, it will be 2% or less, perhaps significantly less.
Under such circumstances, it is hard to know when a pregnancy will occur. Of course, it might happen in the first year of trying, or it might happen in the fifth year, well after the couple have tried a number of fertility treatments or perhaps even adopted. And so people tend to look at the activities that led up to that pregnancy as being the cause when, in fact, it was just the couple’s time.
We cannot unstress away compromised fallopian tubes or endometriosis. No one is to blame for that.
That being said, I do not want to discount the role of stress entirely.
There can be little doubt that timing intercourse to two lines on a blue stick or a sway in basal temperature can be very stressful. At its worst, couples can see sex as a chore. Rather than having intercourse, they fight. He may have concerns around erections, or the couple so aggressively force themselves to have sex on one day (which happened to be the wrong day) and not again that month that there truly was no other opportunity that cycle.
Stress can manifest in other ways like depression, or eating too much or too little, or exercising too much, or drinking too much, or guiltily turning back to cigarettes. How many ways does stress impact our overall health? If we are only sleeping three hours a night, it must run us down in all aspects of our health.
I cannot quantify in a fertility clinic setting how much stress makes a difference. For goodness’ sake, all our patients are stressed – they are going through treatments – and sometimes I think a fertility clinic setting can make things worse, not better.
So, what to do? The most important thing, of course, is to be mindful and to take the steps necessary that can help minimize negative consequences of what is an inherently stressful time. Counselling can be a great place to start.
Try not to shame or blame yourself for fertility challenges. It takes a great deal of strength to face them.