stress and fertility

Stress and fertility

Psychologists usually define stress as a form of psychological and behavioural interaction between people and their environment, i.e. the person responds to what is happening to them and around them.

There are essentially two types of stress – acute stress and chronic stress. Acute stress is a response to an immediate threat, such as an exam or public speaking. Chronic stress is a response to more prolonged or frequent, situations such as work pressures or unemployment.

The effects of stress can be beneficial and enable the ‘fight or flight response’ to help us escape from a perceived dangerous, or harmful, situation. However, the effects of stress can also be harmful by mediating a series of physical changes and responses in the body. Negative consequences of these stress responses can impair our thinking, metabolism, immune function and, potentially, even reproduction.

Fertility issues

Primary infertility is the term used when a couple have never conceived and is usually diagnosed after a year of sexual intercourse without contraception. Secondary infertility is the term used when there has been at least one prior conception, even if the pregnancy wasn’t carried to term. Other common infertility problems include early pregnancy loss and recurrent miscarriage. There are many known biological causes of fertility problems but some remain ‘unexplained’. Fertility problems are very common worldwide and are estimated to affect over 24 million women.

Fertility and stress: what the research says

There has been huge debate over the years about whether a link really exists between stress and fertility issues. Numerous studies over the years have found an adverse impact of stress on women’s reproductive health. Stress has been implicated in everything from causing premenstrual pain, loss of sex drive, sexual problems, absent periods to infertility, miscarriage, still birth and low birth weight in babies.

Most women have probably experienced their periods becoming irregular – or maybe even disappearing altogether during times of stress. Anovulation (not ovulating) is a medically recognised consequence of high-level stress. Equally, women who lose a great deal of weight due to stress may also find that their periods become irregular.

The general day-to-day stress of modern-day life can negatively impact couples’ sex lives and if partners are just too tired, or too unhappy, after a stressful day to have sex – or if they are only having sex infrequently – then that is also going to reduce the chances of having a baby!

stress and fertility

The stress connection

A link between psychological stress and reduced pregnancy rates has been highlighted. For example, one study found that high stress levels were associated with poor responses to fertility treatments and lower pregnancy rates. Another study of women who planned their first pregnancies, found that women with higher stress scores had lower pregnancy rates and higher early miscarriage rates than those with lower stress scores. Scientists have also found that, both in rats and in humans, stress can induce repeated miscarriage by negatively impacting small protein and cell changes. In women with recurrent miscarriage, some research findings have indicated that high stress levels are associated with an increased risk of subsequent pregnancy loss.

In one of the most recent studies, released in March of this year, American scientists from Ohio State University studied an enzyme found in saliva that provides a biomarker of stress. They found that for women with high levels of this biomarker were 29% less likely to get pregnant each month and doubled their chances of infertility.

So, based on some of this evidence, it does appear that stress plays a significant role in fertility problems but doctors, psychologists, scientists and researchers remain very much divided on the issue. There are an equally abundant number of scientific studies showing that stress is merely a side effect of fertility problems and not the central cause. The bottom line for the majority of health professionals working in, and researching, this area is that infertility is largely a medical problem and not a psychological one.

Reducing stress

For millions of people, trying to conceive a child brings cycles of hope as well as misery. Fertility problems can turn life into an emotional roller coaster affecting how people see themselves, their sex life, their relationship with their partner and their relationships with other people. Without doubt, the vast majority of individuals and couples that I see are suffering from some form of fertility-related stress. Many feel that they are no longer in control of their bodies or their life plans. Fertility investigations and treatments can also be physically, emotionally and financially very stressful.

However, attempting to reduce stress by giving up a job or suddenly and dramatically changing your lifestyle isn’t particularly recommended except in very extreme cases. There are many stress reduction techniques which may be helpful such as mindfulness, meditation, yoga, reflexology or acupuncture. Excessive caffeine and other stimulants such as alcohol should be avoided and regular exercise should be a normal, and important, part of your routine.

Therapy can help

Counselling is, unfortunately, very often viewed as the last ditch effort in fertility-related stress but in reality it is simply a better way of understanding fertility problems and their effects. Counselling can help individuals to develop better coping mechanisms, boost emotional reserves and facilitate couples in communicating more effectively.

Remember, a certain amount of stress is normal and whilst the link between stress and fertility does remain unclear it will only ever benefit our overall wellbeing to reduce stress levels as much as we possibly can. If high levels of stress continue for a long period of time, consider seeking professional help or talk to your GP about your concerns.

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Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….


Ask Allison

Q My sister-in-law and I both work three-day weeks and we help each
other out with child minding on our working days, which up until recently has worked out really well. Between us, our kids are aged between five and nine years – the problem is that it’s now become quite apparent that we have very different parenting styles. I prefer my two daughters (seven and nine) to have a structured day. For example, in my house, we have allocated times for television and iPads, etc. My sister-in-law, however, lets the kids run loose after school – homework is ignored and my kids end up wired after eating sugary treats all afternoon. I am considering looking at after-school childcare for the kids, but I’m worried that this is going to cause a family argument. Is there a diplomatic way that I can ask my sister-in-law to introduce some discipline into her child-minding days? It certainly doesn’t do her two kids any harm when I am minding them in my own house!

In a word, no, there is no diplomatic way to do this as it may very likely seem like your saying that your parenting style is better than
hers. As L’Óreal says, ‘now here comes the science bit.’ Dr. Kaylene
Henderson, a child psychiatrist, wrote a very interesting blog about ‘the
science behind the Mummy Wars’. She explains that before she had
children of her own she hadn’t been aware of how parents have a
very specific sense of the right parenting style. She also found that parents could be very definite in defending their chosen parenting style. Dr. Henderson, who describes herself as a curious, scientific, open-minded person, was surprised at how defensive parents could be and, at times, of their judgemental attitude towards each other. She explained the neurology of the Mummy Wars; okay, I’ll need you to bear with me for a second. Warning; I’m about to use some neuro-techie language.

Why do we judge each other?
As we have all had different experiences, this means that we all have very different memories stored in our brains. Most of our memories are ‘explicit’ memories – these are ones that we can recall easily such as important dates that mean something to us; important birthdays, special events or stories of and about our lives.
There is another type of memory called ‘implicit’ memory that plays a
key role in our parenting. This type of memory is the stuff that you do on autopilot. Psychologists call these heuristics or rules of thumb –
such as tying your shoelace, or driving your car (once you have learnt
to do both first!). Otherwise we’d really waste a huge amount of time
pondering over tasks that we have readily available to us. This seems to be where the science bit of our parenting style kicks in. This implicit memory goes all the way back to when you were an infant being parented by your parents. This is when you started the process of storing up how they did it into your memories.
Unless you make a conscious choice and effort to parent differently, what you saw and unconsciously learnt will be your automatic go-to parenting style.

We learn habits
This can really kick into gear when we feel our parenting style is
being mirrored or highlighted by disapproval from another parent. I know the cold sweat you feel when your child decides to make their outstanding bad behaviour performance at, of course, the most public and worst time. The implicit autopilot of how your parents dealt with these outbursts will flow unconsciously from you if you haven’t worked super hard to be aware and consciously change the old habits.
What’s happening for the on-looking parent is that they see you doing something they are used to doing, but you are doing it all wrong. Simply, because that is not how they know how to do it.

Find a way that works
You both have different parenting styles – who is to say which type is correct? You just need to know what works best for your family and that’s the bottom line. The irksome feelings won’t go away. You can talk to your sister-in-law, but I’m adding a caveat that it would be hard not to hurt her feelings. What we’re possibly looking at is that you prefer a more structured form of parenting, whereas your sister-in-law has a more permissive style. I’m not sure the two styles can mix, the mixture is a bit like oil and water.
If a collaborative shared form of parenting style can be agreed upon, then that is great, but our learnt hardwiring may prove difficult to change despite the intent to do so.
Perhaps, your own instinct of changing childcare might work best for you. In terms of making childcare work; the fit is ultimately the most
important aspect as you want a cohesive congruent feeling of the other caregiver to just ‘getting it’, like in any good partnership. Best of luck
with this and I wish you both well.