Stressed out woman

Can Stress Impact Fertility? Unraveling the Complex Link Between Mental Health and Infertility

Struggling to conceive is a daunting and, undeniably, stressful journey. But could stress itself be sabotaging your chances of achieving and sustaining a pregnancy? This question can intensify the emotional load for couples and individuals grappling with fertility issues. In today's article, we will delve into the research behind the relationship between stress and infertility.

The Link Between Stress and Infertility

The belief that stress plays a role in fertility issues goes a long way back, and unfortunately, more often than not, women and women’s minds have been blamed for it. In the 1940s, unexplained infertility was linked to psychological causes attributed to women, assuming factors like their (lacking) desires for motherhood, marital relationship troubles, or even childhood traumas as potential sources of "sterility".

Thankfully, our understanding has evolved significantly. We've acknowledged the role of men in fertility issues and have gained a more in-depth understanding of the complexity of the mind-body connection. However, the myth linking mental stress to fertility issues persists, leaving us to ask: does stress and anxiety truly affect fertility negatively?

One thing is clear: common advice like "just relax, and it'll happen" doesn't help (if something they probably do the opposite, as comments like that can create feelings of anger and hurt).

What Does Science Say About The Impact of Stress on Fertility?

Recent research does, however, suggest that stress may influence fertility, although the relationship between stress and infertility remains intricate and not fully comprehended.

For instance, a study involving over 500 women in the United States revealed a potential link between high levels of silvery α-amylase, an enzyme released in response to stress, and a prolonged time to pregnancy and infertility. Other studies have also indicated an association between long-term elevated levels of cortisol, known as a "stress hormone," and delayed time to pregnancy.

Another study involving 135 in vitro fertilization (IVF) patients, using hair samplings to measure cortisol levels from the preceding 3-6 months, found that heightened cortisol levels correlated with lower pregnancy rates. This led the study's authors to suggest that interventions aimed at reducing cortisol levels before fertility treatment might enhance treatment outcomes.

Moreover, this scientific study involving stressed rats demonstrated a lower fertility rate in those, compared to their non-stressed mates. However, blocking a specific stress hormone led to equivalent pregnancy outcomes in both groups. (This potential “blocker” of the influence of stress is still a long way from being available to humans though).

5 Ways Through Which Stress Can Negatively Influence Fertility

The research delves into various factors through which stress potentially influences fertility:

1. Disruption of Hormonal Balance: Chronic stress can disrupt the normal hormonal balance, potentially affecting menstrual cycles and ovulation, complicating the conception process.

2. Negative Impact on Implantation: Mental stress during early pregnancy might hinder the endometrial lining's function, making healthy implantation more challenging to achieve.

3. Impaired Immune Response: Studies suggest stress could negatively affect the immune system response, critical for reproductive outcomes. However, the role of the immune system in pregnancy outcomes remains an area of debate.

4. Impact on Sperm Quality: Self-reported long-term stress among men has shown correlations with sperm quality. Ironically enough, certain stressful events, like leaving a semen sample, seem to also adversely affect semen quality.

5. Stress & Libido: It's widely acknowledged that stress and sex don't mesh well, and in fertility cases, it's a combination that's far from favorable, potentially affecting the time taken to achieve pregnancy.

Measuring stress accurately remains challenging, with inconclusive or unsupportive results in some studies. Nonetheless, research implies that therapeutic interventions might enhance fertility treatment outcomes, a finding that indirectly supports the idea that mental health and stress influence fertility.

Does Therapeutic Support Improve Fertility Treatment Outcomes?

Could therapeutic support decrease time to pregnancy and increase fertility treatment outcome?

Several studies suggest it might! For instance, a comprehensive 2015 analysis encompassing 39 studies and involving over 2700 women and men highlighted the potential efficacy of psychosocial interventions, particularly Cognitive Behavioral Therapy (CBT) and mind-body techniques (techniques that link the body and the mind, e.g. yoga, meditation, guided imagery). This analysis found that those using psychological strategies to manage stress were twice as likely to achieve pregnancy compared to couples who did not use such methods. While these findings are promising, researchers underscore the need for more extensive studies to establish a definitive link between therapy and fertility outcomes.

Regardless of the exact link between stress and fertility, it’s clear that working on your mental health while struggling with fertility can have a positive impact on your mental well-being and quality of life. And, that potentially it might even up your chances of success on your fertility journey!

*Note from co-founder of Tilly:

As a former fertility patient, I absolutely don't want to add stress by sharing the above findings. I myself have wrestled with worries about how stress might affect my chances of having a baby while I was trying to have a baby. When I founded Tilly, one of my main goals was to support others through the tough journey of fertility struggles, equipping them with research-based information on mental well-being and fertility (while acknowledging ongoing debates). My intention with the above is thus not to scare you but to shed light on pressing questions you might already be pondering about how stress impacts fertility. On a brighter note, once you (hopefully) get pregnant, and if you, like I was, are freaked out during the whole pregnancy, research actually suggests that high levels of the stress hormone cortisol in the third semester might positively impact the language development of your children.

About the authors


Maya Maria Brown, M.A., is an infertility mental health expert. She has a master’s in Counseling Psychology, and has worked with individuals and couples on infertility and relationships. She also has personal experience with infertility and is currently in treatment.

Jenny Ann

Jenny Ann Johnson is the founder of Tilly. She’s spent a decade working on digital educational products prior to founding Tilly. After struggling with infertility and miscarriages for many years she finally found her path forward and is today blessed with four children. She is now creating the supportive and educational tools she herself was missing while going through fertility treatments.


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