Stress Reduction Key To Fertility

By Nancy K. Crevier

A recent British study confirming that stress “significantly reduced the probability of conception each day during the fertile window, possibly exerting its effect through the sympathetic medullar pathway” gives teeth to what the doctors at Reproductive Medicine Associates (RMA) of Connecticut have suspected for years, said Dr Joshua Hurwitz, fertility specialist there and division director of reproductive endocrinology and infertility services at Danbury Hospital.

“For years and years we have always acknowledged a mind and body connection in what we do. Our group has always looked at women holistically,” he said.

The mind and body connection, which includes stress, is taken seriously by RMA, which specializes in treating infertility issues at its Sand Pit Road office in Danbury. “This paper confirms beliefs we have held for years,” Dr Hurwitz said.

In addition to using the most scientifically advanced treatments, considering a patient as a whole includes giving her tools to reduce stress, said Dr Hurwitz. “Specifically,” he noted, “we treat individually.”

That can mean encouraging a patient to utilize acupuncture, to take part in the fertility yoga classes offered by RMA, as well as using the services of the specialist in reproductive nutrition and meditation. “Support groups and individual counseling with therapists who specialize in fertility related issues are also important,” Dr Hurwitz said.

One of the biggest stress issues that a couple is dealing with when they contact RMA, he said, is that inability to conceive. Women under the age of 35 who have not conceived within a year on their own, or within six months for women over the age of 35, should contact a professional, if there are not other, obvious health reasons for the infertility.

“Not being able to conceive gets to the core of people,” Dr Hurwitz said, but taking steps to reduce stress can result in the building of a family.

 He has seen firsthand the negative effects of stress on women hoping to conceive. Sometimes there are physical reasons for the man or the woman that impact the ease of conceiving a child; other times female hormonal imbalances contribute to the difficulty. The “biological clock” plays a large part in fertility, pointed out Dr Hurwitz, as women delay childbearing to accommodate careers. “The aging process is faster for the ovaries than other parts of the body,” he said.

Family pressures and work pressures to maintain a certain lifestyle can add stress. When couples do not easily conceive, stress can build up in the relationship. “We help them accept that infertility is a medical problem, and that we can help,” said Dr Hurwitz. He is proud that RMA has pregnancy rates “well over 60 percent in women under age 35. It’s phenomenal.”

Sandy Hook resident and RMA patient “Tina” — her real name is concealed to preserve her privacy — is one of those who believes that using stress reduction was central to her success in becoming pregnant. There were many stressful factors in her life, she said, that she was concerned would prevent her from achieving a successful pregnancy when, at the age of 42, she and her partner decided to start a family.

“I have had a highly stressful job for the past 15 years in corporate insurance, as a sales manager, working in New York City,” said Tina. “It’s a high pressure job anyway, but at the time we decided to get pregnant my biggest stress was that my company was on the block to be sold. There was a real threat to my job and livelihood, so I was looking for a job then, too, just in case,” she said.

She was also worried that her age and one blocked fallopian tube might create complications, and prevent pregnancy. “Anxiety has affected my life prior to getting pregnant, so it was a great fear of mine,” Tina said.

RMA requires one session with a psychologist, she said, and it was suggested that she look for ways to find some peace from the fears plaguing her. She had already begun the year before to prepare her body physically for pregnancy by joining a gym, and continuing on there was one method of stress reduction. “Then my therapist recommended some meditative, stress reduction CDs that I listened to, and they were probably one of the most useful tools I used,” Tina said. In addition, for two months prior to a successful insemination at RMA, she took part in weekly yoga classes. “They were very relaxing and grounding,” she said. “It was like a little support group.”

Tina was extraordinarily lucky that the first attempt at insemination took. “I really feel that lowering my stress level was an important factor in that success,” she said. She continued to use the meditation tapes right through delivery. In August, she gave birth to a son.

Generally, patients who use stress reducing techniques feel better because they are active participants in their own treatment, Dr Hurwitz said, but added that every individual varies in response to particular treatments.

“This study gives me another tool to help counsel patients,” Dr Hurwitz said. “Some patients want hard scientific proof to help get them to a better place.”

Stress reduction techniques in combination with assessing physical and hormonal issues can result in a positive outcome. “We’re confident that we can help almost anyone build a family,” said Dr Hurwitz.

The complete abstract of the study can be viewed at ncbi.nlm.nih.gov/pubmed/20688324.