Uncovering the Science of Stress and Fertility – The First of its Kind

Image                Anecdotally, it is known that stress and pregnancy are not good to combine together – especially when trying to conceive. The National Institutes of Health advocates for stress reduction techniques for those trying to get pregnant. Until now, surprisingly there has been no evidence to support this recommendation.

                The journal of Human Reproduction published the first prospective study in the world showing an association (not causation) between stress and infertility. The conclusions from the study specifically show that higher levels of stress, measured by salivary alpha amylase, are associated with a longer time to pregnancy and an increased risk of infertility.

                Upon a quick analysis of the journal article, it appears that the prospective cohort study had a substantial sample size, not an extensive loss to follow up, biomarkers for quantitative analysis, baseline questionnaire and daily journal for qualitative analysis. The results of this study among couples in Michigan and Texas were adjusted for female age, race, income, and use of alcohol, caffeine and cigarettes when trying to conceive. Women who had the highest levels of alpha-amylase exhibited 29% longer time to pregnancy and two times the risk of infertility.

                This research is certainly an excellent step forward in the field of reproductive health. Stress and infertility is a perceived problem across all cultures and societies. As further research is pursued and is tailored to different populations of women under different social and environmental circumstances, I wonder if it will be possible to prove a causative connection between stress and infertility. I am also curious to understand if current research is able to decipher how one is able to decrease high alpha amylase levels. I can imagine that there are combinations of behavior, socio-economic, and environmental causes to high alpha amylase levels. Understanding factors of causation will enable further fertility interventions to target these specific factors.

                 Further research on this topic will also provide insight into the understanding of worldwide fertility patterns and associated tailoring of interventions. For example, how does the association of stress and infertility play out in countries experiencing foreign or domestic warfare? How might this source of stress impact fertility, or lack thereof, in such countries. It is certainly tactless for healthcare providers to suggest a woman “decrease her stress levels” when such situations causing stress are substantially out of her control.

                 Even with the lack of evidence behind stress reduction techniques, at this point, do you still think they should be universally recommended for women trying to conceive?


For the complete journal article:

Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study – the LIFE study. Human Reproduction, Vol 0, No 0 pp. 1-9, 2014.

As seen in the news: http://well.blogs.nytimes.com/2014/03/24/stress-may-affect-fertility/?_php=true&_type=blogs&_r=0

Picture: http://womensmentalhealth.org/specialty-clinics/infertility-and-mental-health/



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