Fertility and the Mind Body Connection
by Joy Koenig, M.D., M.S.
Board Certified in Preventive Medicine
Originally published on www.ourmaine.com (1999 - 2000)
© Joy Koenig 1999-2008 All Rights Reserved
(Internet links may no longer be operational)
Sharon is one of those friends who prove Einstein's theory that the passage of time is relative. Whatever bonds our friendship seems to transcend time, and a year seems like only a week. Within minutes of our quick hug "hello", she has me laughing so hard I can barely maintain my composure -- just like in college.
This time, we'd decided to splurge. Sharon had left her daughter with her next-door neighbor, and we went to a popular business lunch restaurant. Amid the hushed voices and stiff white cloth napkins, Sharon began describing the problems she'd had conceiving a second child.
I almost spit my ice tea across the table when she described some of the antics she and her husband were using to become pregnant. It wasn't until I looked carefully into her laughing blue eyes that I realized she had been pulling my leg. Having never tried to get pregnant, how was I to know which suggestions were ridiculously true and which were merely ridiculous?
She and her husband were now in the hands of a fertility specialist, so her hopes were up in spite of the fact she'd already miscarried once since the birth of her daughter.
Sharon's laughter shifted from her eyes to a suppressed giggle, and she took off for the Ladies Room. Her eyes were still sparkling when she returned, but she wasn't smiling. Looking down at the remains of her Chinese chicken salad, she asked me if we could leave. "No problem, Chicklet," I replied, and suppressed my need to ask her what was wrong -- how she could have changed so fast from laughter to tears?
Out in the parking lot she told me what had happened. Her period had started, and with it her doubts and fears had returned. Her jokes and laughter had reassured me that she was handling her disappointment and frustration well. Now I realized that she was only pretending to be optimistic. Deep inside, she still feared she'd never become pregnant again.
I've never really wanted to have a family, so it was difficult for me to understand how important a second child was to her. I knew what I shouldn't say -- "It will be okay, just be patient," or worse yet, "At least you have Alicia already," -- but I didn't really know what I could say.
I defaulted into my role as a physician, and told her about an area clinic that has group programs for managing the emotional and psychological issues around infertility. I knew there were three separate issues that needed resolution:
- the stress of not conceiving;
- the stress around the process of intentionally enhancing the process of conception; and
- poorly managed stress possibly contributing to her infertility.
Many women don't realize that stress can interfere with proper function of the hypothalamus and the pituitary glands, both of which are involved in hormone production and regulating ovulation. Stress may also interfere with the immune system. The immune system which plays an important role in implantation and the body's ability to recognize pregnancy.
There is no way to objectively determine whether your stress levels are affecting your fertility. Since stress undermines your health in many different ways, the best thing to do is manage your stress -- regardless of whether you can prove it is affecting your ability to conceive.
The Mind/Body Institute at the Beth Israel Medical Center in Boston uses a variety of mind/body exercises such as deep relaxation, guided imagery and anger management, to help infertile women cope with their depression and anxiety. Alice Domar, Director of the Women's Program at the Mind/Body Medical Institute noticed that as the women in the program became less stressed, pregnancies occurred. She followed almost 200 women who had been trying to conceive for one to two years.
The study found that after one year, women who were in either a support group or the mind/body program had nearly triple the pregnancy rate of women who had no psychological intervention. Most of the women in the study got pregnant by combining the clinic's behavioral approach with traditional infertility treatment.
Depression, as well as anxiety, affects one's ability to get pregnant. According to Dr. Domar, women with a history of depressive symptoms prior to trying to get pregnant were almost twice as likely to report subsequent infertility compared with women who didn't have a history of depression prior to conception attempts.
If you are struggling with infertility issues, visit Harvard Mind/Body Medicine's page for infertility.
Here is another web site with a list of tips for managing stress around the issue of fertility/infertility.
You might also want to find a copy of this daily meditation book: "Pennies from Heaven : 101 Meditations for Couples Trying to Get Pregnant" by Frances Stone, Philip Stone.
This step-by-step program is written by an infertility specialist. It can teach you how to approach and overcome emotional and psychological stress related to infertility.
If you do better with hard copy, there is a comprehensive list of fertility/infertility books here.
Want to conduct more extensive internet research? This page has a good list of links related to fertility/infertility.
We've all been taught since Junior High health class that a woman's menstrual cycle is 28 days long, and that ovulation occurs on day 14. That's appropriate generalization when you're only 11 or 12 years old. As with everything else, there's a lot of normal variation in the length of a normal menstrual cycle -- anywhere from 21 and 35 days is considered okay.
A research team from Denmark has identified that women who are under high levels of stress and have longer than average menstrual cycles (35-days or longer) have a decreased fertility rate and an increased miscarriage rate. They studied nearly 400 couples who were trying to conceive their first child. The couples had no known fertility problems. Both partners were given questionnaires that identified their stress levels (anxiety, depression, and fatigue). Women with menstrual cycles less than 35 days in length and low stress scores were more likely to become pregnant and less likely to miscarriage. More about this study
Learn how to chart your own cycle.
Pregnancy adds its own stress to our bodies and lifestyles. If you have been successful with conceiving, visit this web site for tips on managing the stress of pregnancy.
Scientific research continues to document the link between our physical health and our mental/emotional health. http://www.mbmi.org/pages/mp_mc.as
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Design, Content and Images © Joy Koenig 1999 - 2008 All Rights Reserved. 
