Infertility is an issue which has significant emotionally taxing consequences for couples. The inability to fulfil such an important part of personal development as having children directly affects all aspects of the patients’ lives.
The individual’s core is affected and there is a breakdown in important matters such as self-confidence, future plans, life as a couple, family, social life, sexual relationships and so on. Stress and depression are common under these circumstances and, as if this were not enough, this difficult situation is often not given the attention it deserves and is even trivialised by others who make it out to be a matter of little importance. Indeed, some even suggest it has a positive side and come out with unfortunate comments such as ‘but you’re so much better off without children.’
Emotional stress increases when undergoing fertility treatment (insemination, in vitro fertilisation, egg donation, etc.). Numerous studies have been carried out on stress levels when undergoing different medical procedures. Following oncology (radiotherapy, chemotherapy…), reproduction treatments are those found to have the greatest emotional impact. This is to be expected if we take into account the fact that, during treatment, the fear of failure serves to intensify the stress brought on by infertility.
Above all, within this context of emotional baggage caused by infertility, there is an important unanswered question: could stress itself be the cause of infertility? Is the woman’s emotional involvement making it difficult for her to get pregnant?
Popular beliefs abound and women receive a clear message along the lines of ‘you’re not getting pregnant because you’re obsessed’ and ‘the day you relax, you’ll fall pregnant without any trouble’. Such comments sound credible, suggesting that stress may be the cause of ‘changes’ in hormones or some other kind of effect which makes pregnancy impossible or difficult to achieve. What’s more, they are always accompanied by some sort of anecdote by someone who always happens to know somebody who got pregnant years after trying without undergoing any kind of treatment, or another who fell pregnant after having adopted a child since she had then overcome the stress of trying to become a mother.
Such comments are very hard for infertile women to listen to since they bring on a feeling of guilt about something which is beyond their control (‘I’m not getting pregnant because I’m too obsessed’). This does nothing other than intensify feelings of stress and depression.
But what has science got to say about all of this? What evidence have we got on the effect of stress on fertility? The answer is NONE. Dr Jacky Boivin, one of the greatest worldwide authorities on the emotions involved in couples with reproduction issues, recently published the largest available analysis on this subject in which the data from 14 studies with over 3,500 patients were included. The conclusion was clear: ‘emotional stress generated by infertility or other life issues does not have a negative impact on achieving pregnancy during reproduction treatment procedures.’
Therefore, and to conclude, based on the information available to date, we can assure our patients that the feeling of stress or obsession they might be experiencing is not the reason they are not getting pregnant.
We might summarise the situation as follows:
Infertility causes stress, but stress does not cause infertility.