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Can stress cause infertility—now or later?

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Can stress cause infertility—now or later?

Many women who have difficulty conceiving, and those who have stressful jobs (isn’t that all of us?), wonder about the connection between stress and infertility. This is compounded by well-meaning advice from friends and family to just “relax” or “take a vacation” when trying to conceive. So, what is the relationship? Can stress cause infertility now—and does it have long-term effects on your fertility?

For those trying to conceive

Do women have difficulty conceiving because they’re stressed, or are they stressed because they’re having difficulty conceiving? The latter is known to be true; infertility is associated with feelings of anxiety and depression amongst men and women. But the former is a little less clear.

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While it’s unlikely that everyday stressors, like traffic or a big work project, can have a real impact on fertility, it’s possible that long-term stress or a major upheaval could affect your ability to get pregnant. There are a few possible mechanisms for this.

Stress may affect ovulation. When your brain experiences stress, it sends signals to the hypothalamus, which links the nervous system with the endocrine (hormone) system and regulates the pituitary gland. Together, the hypothalamus and the pituitary manage the hormones involved in ovulation, so it’s possible that adding stress to the mix could prevent or delay ovulation.

Stress could also impact the process by which an embryo implants in the uterus, as the development of the uterine lining, which is key to a successful implantation, is also regulated by—you guessed it—hormones. Along those lines, a 2011 study of women undergoing in vitro fertilization (IVF) showed higher pregnancy rates in those who saw a 15-minute clown performance after their embryos were transferred.

But these theories have mixed evidence. In a study published in Fertility & Sterility in 2011, researchers found that while increased levels of alpha-amylase, a stress-related enzyme, were associated with decreased conception rates, increased levels of cortisol—the body’s primary stress hormone—weren’t.

It’s important to note that women have been getting pregnant and having babies throughout history, during wars, famine, and myriad other stressful experiences, so it’s clear that conception under stress is possible. There’s also the impact of other factors to consider. People who are stressed are more likely to turn to smoking, alcohol, and unhealthy food, and less likely to get regular sleep—all of which can contribute to difficulty getting pregnant.

And obviously, if infertility stems from issues like diminished ovarian reserve (low egg count or egg quality, often due to age), anatomical issues, illness, or something else entirely, no amount of relaxation or vacation is going to fix it.

How about in the long term?

We can be fairly certain that, even if stress may impact ovulation or implantation for women trying to conceive now, stress doesn’t affect fertility or egg health in the long term. This is important: women who have difficulty getting pregnant sometimes feel guilt and shame because they “worked too hard” or “stressed too much” earlier in their lives. But even in studies that determine that stress may affect conception, like this one from 2016, the effect is limited to only stress felt during a particular ovulation window.

That’s because, until ovulation, your eggs remain tucked away inside your ovaries, generally unaffected by the majority of the wear and tear the rest of your body weathers, stress included. The state of your egg quality (or genetic health), which is the primary driver of fertility, is more or less solely dependent on your age.


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