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Stress can reduce sperm counts as well. Thus, testicular biopsies obtained from prisoners awaiting execution, who were obviously under extreme stress, revealed complete spermatogenetic arrest in all cases. Researchers have also shown significantly lower semen volume and sperm concentration in a group of chronically stressed marmoset monkeys, and these changes were attributed to lower concentrations of LH and testosterone (which were reduced in the stressed group). However, how relevant these research findings are in clinical practise is still to be determined.
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In addition to these direct effects, stress can also suppress libido, cause erectile dysfunction, and result in a reduction in the frequency of intercourse, which in turn could also reduce fertility. Also, many women start overeating in response to the stress of infertility. The increased fat cells then disrupt the hormonal balance, making a bad situation even worse.
While studies have shown that infertile couples do show psychologic dysfunction and even psychiatric abnormalities (such as depression or anxiety), this is actually a chicken and egg problem, and in reality the response of the infertile couple is a perfectly "normal" response to their abnormal situation, which is designed to help them to cope with the difficult circumstances they find themselves in. However, many people start blaming the couple, and many couples themselves start believing that it is the stress which they are under which is causing them to be infertile. Victim blaming is popular - especially where fertility and women are concerned, and instead of providing them with support, couples receive completely gratuitous and unwanted advice. Ironically, victim blaming has become more prevalent today because of the fashionable "holistic health" belief about the influence of the mind on the body, which holds that even patients with cancer can cure themselves by the power of positive thinking. Many IVF couples too may subscribe to the belief that success is practically guaranteed if the patient remain optimistic and relaxed. Thus, if the attempt fails, it was because the patient was "too tense" or "too stressed out".
This myth has been perpetuated by anecdotes of friends or relatives who have conceived while on holiday, and stories of couples conceiving after many years of infertility after they have adopted a baby are a part of today's "urban myths".
Stress and infertility often have a circular relationship, and they can aggravate each other, setting up a vicious cycle. Infertile couples, who are under stress because of their infertility, start blaming themselves for their infertility. This increases their stress levels and further aggravates the problem! As one mind-body expert has said, "Stress causes illness which causes more stress which causes more illness."
Research has shown that women undergoing treatment for infertility have a similar, and often higher, level of "stress" as women dealing with life-threatening illnesses such as cancer and heart disease. Infertile couples experience chronic (long-term) stress each month, first hoping that they will conceive and then dealing with the disappointment if they do not.
It is helpful to differentiate between external stress and internal stress; as well as stressors you can control and those which you cannot. Internal stress arises when you are not able to achieve the goals you set yourself while external stress is created by relatives, friends, and work pressures. Some stressors you can do nothing about - for example, the frustration you feel when your period starts. However, there are many others which you can control. As an example, many patients get upset when they are forced to wait in the doctor's clinic. Waiting can be stressful, so do carry a book to read while you cannot control the stressor, you can modify your response to it, and this helps to decrease your distress.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
