Effects Of Stress And Infertility In Women

Stress is something that you, and everyone else in this world go through on a regular basis. However, if you go for its scientific definition, stress is the emotion or physical tension that we feel, which often manifests as rage, frustration, and anxiety.¹ Moreover, stress can also be described as the body's response to overwhelming or under-pressure situations.² 

Mild stress for a brief period of time, such as the kind we experience when working towards a deadline, is thought to be beneficial for us and helps keep us motivated.³ However, a person may experience both physical and emotional symptoms if they undergo long-lasting or persistent stress episodes. Although many people frequently experience chronic (long-term) stress, they may ignore some obvious signs and symptoms.³

It’s recommend to seek medical attention if you’re experiencing any of the listed below symptoms or signs on a regular basis-^3,4 

• Body aches
• Chest aches or pacing heart sensation
• Dizziness
• Exhaustion
• High blood pressure
• Insomnia
• Irregular menstruation
• Lowered sexual drive
• Muscle tension or jaw clenching
• Weight related issues or obesity
• Stomach or digestive issues
• Skin issues such as eczema and acne
• Weakened immune system 

However, if an individual has any chronic health condition, stress can worsen it.  Additionally, stress has a negative impact  on a person's fertility. But before learning about it in detail, let’s discuss “what does your body go through under stress?” it in the next section.

From the brain to the body, the human body is controlled by a sophisticated neurological system. The sympathetic nervous system (SNS) is the component of the nervous system that responds to stress. As a result, anytime your body experiences stress, the SNS must display the fight or flight response. This is where the body chooses to use its energy to either stay put and battle the problem or to just flee from it.^5,6,7                                                        

During stressful scenarios, the SNS signals the adrenal glands via adrenocorticotropic hormone (ACTH). After which, cortisol is produced by the adrenal glands. Apart from synthesising the so-called "stress hormone," cortisol, and adrenaline, the adrenal glands also help in regulating the blood pressure, immune system, and metabolism.^5,8 

The release of adrenaline and cortisol is something that specifically causes stress-related symptoms. These hormones increase breathing rate and heartbeat as well as dilate the blood vessels (when the blood vessels in the body widen, causing a peak in blood flow) in the legs and arms. In addition, these hormones give rise to changes in the digestive system and an increase in blood sugar (glucose) levels.⁵

How Can Stress Affect Fertility?

Uptill now, we’ve talked about what stress is and how it can impact the human body. Under this section, we’ll discuss how stress affects fertility in women. If you're thinking about starting a family or trying to conceive, you've probably heard that stress is bad for you. That is entirely correct. When planning for a baby, it is important to prevent stress.

Following are some of the specific effects of stress that can arise during different stages of reproductive health in women- 

1. Effects Of Stress On Menstrual Cycle 

Stress-induced irregular periods are a prevalent concern among women of reproductive age.⁹ Irregular periods or persistent anovulation (when the ovary does not release an egg after menstruation) have been linked to decreased fertility in women.¹⁰ Additionally, stress often causes hormonal imbalances, which can be a primary factor in female infertility. Moreover, hormone imbalances can also lead to conditions such as polycystic ovary syndrome (PCOS) and anovulation in women.¹¹ 

2. Effects Of Stress On Implantation

After the egg has been fertilized, the process of implanting begins. Egg fertilization is the fusion of an egg (from the ovaries) with sperm. This fertilization produces a mass of cells that must enter the uterus. Once inside the uterus, it attaches itself to the uterine wall or endometrium.¹² If implantation fails, the risk of losing the pregnancy increases.¹³

• According to one study, psychological stress can cause infertility in many women. The same research reveals a relationship between stressors (things or situations that cause strain or tension) and lower reproductive hormone levels.¹³
• Another study revealed that stress has a direct effect on endometrial (the inner lining of the uterus) functioning in women, which may impair fertility.¹⁴ This study further says that stressors not only alter female hormones but also impacts the balance of the endometrial environment.¹⁴
• In conclusion, if a woman experiences prolonged stress, she may develop endometrial ( endometrium is the tissue which lines the uterus) dysfunction that increases the risk of infertility.¹⁴ 

3. Effects Of Stress On Pregnancy 

Many couples seek the assistance of ART (Assisted Reproductive Technology) in order to fulfill their reproductive goals. ART is a technique used to help couples (or individuals with infertility) conceive by collecting eggs from the ovaries and sperm (from the respective partner or donor) to create an embryo in vitro (process wherein the egg and sperm are fertilized in lab). Moreover, once the embryo reaches a certain developmental stage, it’s planted in the mother's womb.¹⁵

The most popular and efficient kind of ART is IVF (In Vitro Fertilization).¹⁵ We shall now examine how stress affects ART outcomes- 

• Studies show that women experiencing high levels of stress, before and during ART treatments, have higher risk of unsuccessful pregnancies.¹⁶ Couples undergoing IVF frequently experience anxiety and stress, which is a fact. However, expectant parents frequently experience anxiety or feel "under stress" as a result of their anticipation of IVF treatment outcomes.¹⁷
• Stress is known to trigger many factors. One such is the increased α- amylase levels (enzyme that breaks glycogen and starch into shorter chains & also a biomarker for stress). In a study, it was found that pregnant women who had the highest rate of α- amylase, were likely to experience infertility due to increased stress levels.¹⁶

Furthermore, significant cortisol (stress hormone) levels were retrieved from the hair of same women (those who were examined for α-amylase), demonstrating an even greater link between stress and infertility.¹⁶ 

The most stressful phase for parents receiving ART assistance may be the 2-week waiting period (when the embryo is transferred to the mother till the pregnancy test). However, it becomes even more  imperative for couples undergoing this procedure to have a stress free living environment.¹⁶ 

In many cases, people who used self-administered coping techniques and relaxation routines reported better quality of life and decreased anxiety.¹⁶

In the final section of this blog, we will talk about different ways couples can manage stress.

Coping With Your Stress

One may experience  stress even while engaging in routine daily tasks. It is, therefore, more crucial for you to recognise your stressors ( activities or external factors that can induce stress). Nevertheless, no matter what your stressors may be, implementing the suggestions given below may help you manage your  stress-¹⁸

• Being active, doing exercise or yoga
• Practicing meditation and relaxation techniques like breathing exercises
• Spending time with friends, family or close ones
• Listening to music, or reading a book
• Working on a hobby

However, if even after following the above-mentioned tips, high stress levels persist, then it is strongly advised that you seek professional assistance.

We understand that starting a family can be an emotional rollercoaster for some people, which is entirely natural. If you are a couple who is trying to conceive or undergoing ART or IVF, it is recommended that you seek assistance or communicate your feelings with your loved ones. As doing so can minimize the stress, increasing the odds. However, it must be noted that stress is not the sole factor that should be considered, but having a “stress-free” self, helps!

Before getting on your pregnancy journey, you can also take a “fertility test,” or “hormone test,” which will allow you to learn about your reproductive health.¹⁹ These tests are easy-to-do and could be done from the comfort of your home. 

Final Note!

Being someone who’s about to embark on the motherhood journey may give you anxiety and stress, which may or may not affect fertility. But if it does, it's best for you to take preventative and proactive steps to increase your chances of getting pregnant. Additionally, taking simple yet imperative steps like scheduling a doctor's appointment and monitoring your reproductive health (with the help of Ovascore) could immensely aid you on the path to parenthood!