When you’re trying to conceive and haven’t gotten a positive test yet, you might start to wonder what the missing piece could be. You’re tracking your cycles and living a healthy lifestyle. But have you considered your stress levels?
Read on to learn more about the link between stress, ovulation, and fertility—plus practical tips for managing stress levels.
How Does Stress Affect the Body?
The World Health Organization defines stress as “a state of worry or mental tension caused by a difficult situation.” Stress is a natural response to the inevitable challenges in our lives. Everyone experiences stress to some degree, and some amount of stress is perfectly normal. However, in our busy and overscheduled lives, stress has become ever present for so many of us.
When the body is stressed, your muscles can tense up, heart rate and blood pressure increase, blood flow to non essential organs (like reproductive organs) slows down, and your adrenal glands release hormones like adrenaline and cortisol. These reactions can have many different effects on the body, including the following:
- Headache
- Anxiety
- Over or undereating
- Muscle pain or tension
- Mood swings
- Difficulty sleeping
- Lack of focus
- Fatigue
- Lower libido
- Gastrointestinal distress
- Compromised immunity
We all experience stress, but the way we respond to stress can profoundly impact our health and wellbeing.
How Does Stress Affect Fertility?
Mild and occasional stress may not have an impact on fertility, but constant or chronic moderate or severe stress can negatively affect fertility.
Researchers continue to study how stress affects fertility, but some possibilities include the following:
- Cortisol: Cortisol may inhibit estrogen production and disrupt ovulation.
- Alpha-amylase: This enzyme may alter the release of reproductive hormones that affect ovulation and the menstrual cycle.
- Epinephrine and dopamine: The body produces these substances when stressed, and they may affect blood flow to the reproductive organs, which is important for a viable pregnancy.
- Libido: Stress may indirectly affect fertility by reducing libido. This can decrease the desire to have sex or to correctly time sex for conception.
- Sleep: Stress can significantly disrupt sleep. This can upset circadian rhythms and potentially affect hormone production.
- Coping mechanisms: Some women respond to stress with behaviors that can negatively impact fertility, like drinking alcohol, eating processed and refined foods, or smoking.
Many studies support a connection between stress and fertility. Here is a brief summary of a few of them:
- A study published in Human Reproduction measured stress levels through the salivary stress marker, alpha-amylase. Researchers evaluated more than 500 women trying to conceive over a 12-month period. They found that women with the highest alpha-amylase had a 29 percent reduction in fertility and were twice as likely to experience infertility. This study looks at correlation and doesn't give a definitive conclusion on causation, but it provides further evidence of the adverse role that stress may play in infertility.
- Another study also looked at the relationship between alpha-amylase and fertility. This study, published in the Journal of Fertility and Sterility found that women with high alpha-amylase levels were less likely to conceive than were women with low levels, during the “fertile window” (the six days when conception is most likely to occur). In this study, researchers did not find a correlation between cortisol levels and the chances of conception.
- A study published in the American Journal of Epidemiology measured stress through self-reported questionnaires. The researchers found higher levels of stress were associated with lower chances of conception for women who did not have a history of infertility and were not receiving fertility treatment.
Can Stress Delay Ovulation?
Stress varies in severity, and so its effects on the body can also vary. However, it is likely that stress can delay or even prevent ovulation. One study that looked at the relationship between stress and ovulation by following over 1,200 women who were attempting pregnancy after previous pregnancy loss. Women with the highest stress levels had a higher risk of anovulation (no ovulation) and lower fertility.
It is believed that the mechanism that causes stress to affect ovulation relates to cortisol. Stress triggers cortisol production, which can affect the hypothalamus and its ability to stimulate the pituitary gland. The pituitary gland is responsible for stimulating your ovaries to release eggs, so if its function is disrupted, ovulation may also be disrupted.
It’s worth noting that ovulating later won't affect your chances of getting pregnant, as long as you are tracking your cycle, paying attention to the signs of ovulation, and having sex during the week leading up to and during ovulation.
Can Stress Reduction Improve Fertility?
There is a growing body of research that highlights the relationship between stress reduction and fertility outcomes. These studies have looked at both therapy and mindfulness activities.
A review of 39 studies involving more than 2,700 men and women concluded that psychotherapy (particularly cognitive behavioral therapy) for couples in infertility treatment could improve pregnancy rates.
Another analysis of 29 studies with more than 3,500 participants concluded that psychotherapy can lead to improvements in the pregnancy rate for infertile patients, especially those receiving assisted fertility treatments.
A study published in Fertility and Sterility followed more than 140 women beginning IVF treatment and found that women who participated in a mind-body program for stress reduction had a significantly higher pregnancy rate during their second IVF cycle than those who didn't attend the program.
Another small study of 37 Japanese women published in General Hospital Psychiatry concluded that a five-session mindfulness program not only decreased psychological discomfort but also significantly increased the rate of pregnancy within one year.
What to do About Stress While Trying to Conceive
Stress while trying to conceive can feel like a vicious cycle. You want to lower your stress since you know it could help you conceive, but the phase of trying to conceive can feel stressful itself.
Start by identifying the top few sources of stress in your life, and see if there are any changes you can make to reduce your stressors. If removing sources of stress isn’t realistic (quitting your job may not be an option, for example), look for ways to manage stress:
- Exercise regularly, including light walks and yoga
- Attend regular therapy sessions with a professional (ideally one with experience in fertility and the perinatal stages)
- Prioritize sleep
- Practice meditation and mindfulness
Understanding Infertility
Infertility is defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sex. Infertility may occur due to male, female or unexplained factors.
There are many causes of infertility, but there are certain things that you can do to help support fertility in general.
Track Ovulation
Knowing when you ovulate is key for conception, so learning how to track your cycle is important.
Your menstrual cycle begins on the first day of your period and starts over when your next period begins. A typical menstrual cycle is 28 days, but cycles can be shorter or longer. About halfway through your cycle, one of your ovaries releases a mature egg. This is ovulation.
The day of ovulation is your best opportunity to get pregnant. However, sperm can live in your uterus for up to five days after ejaculation. So while there may not be an egg in your uterus yet in the days leading up to ovulation, it is beneficial to have sperm waiting in the uterus when an egg is released. Therefore, the week leading up to and surrounding ovulation is the best time to have sex frequently. Knowing when you ovulate is key!
Make Sure You’re Getting all the Nutrients You Need
Optimal nutrient intake is helpful at all stages of life, but it is especially during the nutritionally demanding perinatal phase, from fertility to postpartum.
Several studies on the relationship between nutritional intake and fertility have explored the importance of diet when trying to conceive.
Consider Supplementation
Certain supplements have been studied for their ability to support egg health, which can support overall fertility.
- CoQ10: Coenzyme Q10 (CoQ10) is a compound that helps generate energy in cells and acts as an antioxidant to protect cells and their mitochondria against oxidative stress. For high-quality egg cells to develop into mature eggs that can be successfully fertilized, their mitochondria need to function properly.
- Omega-3 fatty acids: Research suggests that Omega-3 supplementation improves fertilization rates. Getting sufficient levels of Omega-3s from diet alone can be difficult, especially if you don’t eat much fatty fash. Omega-3 supplements are a great way to support optimal levels of Omega-3s.
- Zinc: Zinc has been shown to play an important role in egg maturation and fertility.
- Folate: Adequate folate levels are important for egg quality, maturation, fertilization, and implantation.
- Acetyl L carnitine: Acetyl L carnitine is an antioxidant that may protect against lipid peroxidation and membrane breakdown, which is vital to mitochondrial structure and egg cell health.
- Alpha Lipoic Acid (ALA): ALA is a versatile antioxidant that also supports energy production for normal egg cell health.
- Pyrroloquinoline quinone (PQQ): PQQ is a powerful antioxidant that has been shown to support optimal mitochondrial number and function, which are key to normal egg cell health.
It’s also recommended to take a comprehensive prenatal vitamin once you begin trying to conceive (and even a few months before, if time allows). All of the nutrients and antioxidants listed above are included in the Needed Prenatal Multi, Egg Quality Support, and CoQ10. These supplements are intentionally provided separately, but safe and effective to take together.
Consider Male Factors
It takes both an egg and a sperm to conceive, so a healthy diet and lifestyle with targeted supplementation is important for both partners. It is estimated that male factor infertility contributes to 50% of infertility cases.
It’s More Than Relaxation
The concept of making a baby sounds simple, but the foundations of fertility can be quite complex. There are so many causes of infertility, including some that are still not fully understood.
This article is not meant to suggest that managing stress is all you need to conceive. But since research shows a strong relationship between stress and fertility, and since managing stress can benefit so many aspects of your life and your health, stress management is worth considering as you try to conceive.
