Linking Stress and Infertility

by Stacey

Gone are the days of the turkey baster. Fertility treatments are now high-tech and expensive offering women the chance to freeze their own eggs, use eggs from someone else, or have fertilized eggs implanted in their uterus.

But this Q&A in the NY Times has one expert offering a different, drug-free approach.

Dr. Sarah L. Berga has devoted her career to one of the most hotly debated subjects in the fertility business: getting pregnant without costly drugs. She is one of a handful of physician-scientists exploring how chronic stress may keep some women from ovulating and how relaxation techniques may help.

Berga and others in her field are looking at how chronic stress alters brain signals. Specifically, she explores “how the hypothalamus talks to the pituitary that in turns talks to the ovary,” Berga says.

Her research suggests that a cascade of events, beginning with stress, leads to reduced levels of two hormones crucial for ovulation. And her published studies, small but scrupulous, are starting to convince her critics.

In a study of 16 women reported in 2003 in the journal Fertility and Sterility, Dr. Berga showed that ovulation was restored in 7 of 8 women who underwent cognitive behavioral therapy, compared with 2 of 8 who did not get therapy. In 2006, in The Journal of Clinical Endocrinology & Metabolism, she reported that women who did not ovulate had excessive levels of cortisol, a stress hormone, in the brain fluid.

Here’s some of what she has to say. (With some of what I have to say.)

Q. Are you saying that a woman who may have had a stressful month at work is hurting her fertility? Isn’t life without stress impossible?

A. We are talking about chronic stress related to behavior or personality. People are designed to endure acute stress. That is a part of life. I am telling women, and men, that it is important to find a balance and learn to cope with their stress.

I think she means people who are basically chronically anxious. Not just your run-of-the-mill, rushing around stressed.

Q. It sounds as if you’re against fertility drugs, which are a necessary component of in vitro fertilization.

A. We do I.V.F. in this department. I like to think we offer the least technology necessary to get the job done. I do think that with a certain population of women — women who may be infertile due to stress — benefit the least from I.V.F. Others absolutely need these drugs and procedures. I also believe that it is imperative that doctors communicate the risks of the drugs and help patients understand when they are and are not necessary.

So if I.V.F. doesn’t work for you it might be your own fault? Yikes.

Q. In the 1940s, Freudian analysts told infertile women that lurking antimaternal thoughts made them sterile. Feminists later attacked this theory. Do you think of yourself as a continuum of this practice, or do you feel your ideas are completely different?

A. Back then they did not know the mechanisms and they intuited relationships, but they were not all wrong. They were closer to the truth than we’d like to believe. The truth is that if you are not in harmony with yourself and your culture, you are stressed. That is not totally different from Freud.

Double yikes.

I was very relieved when my husband and I tried to conceive our first child and were successful within a few months. I had heard stories of others’ heroic efforts to get pregnant. Stories that involved daily shots and pills, many visits to the doctor, and enormous financial costs. The stress of it all seemed overwhelming.

So I’m wondering what you all think of this idea. Seems like infertility itself is a giant stressor. Is it just plain annoying to have someone saying that the answer to the problem is not to be stressed? Or do you think she may be onto something?