The relationship between stress and fertility is a complex and fascinating topic. Hypnotherapy for anxiety might be one way to help.

My PhD explored psychological aspects of Polycystic Ovary Syndrome (PCOS), a condition in which fertility problems are relatively common. I have researched and developed a Stress Management programme specifically for PCOS (Barry et al, 2017), which significantly reduced anxiety, depression, and stress hormones.

Infertility is clinically defined as being unable to conceive within 12 months. Fertility problems can, understandably, cause a lot of distress (and in a later blog I will write about how men and women tend to experience distress differently when caused by infertility).

The impact of stress on fertility, and fertility on stress is a fascinating topic because it involves the interaction between complex mind/body systems, sometimes referred to as pysychoneuroimmunology (PNI) or, Psychoneuroendocrinology. Hypnotherapy, which helps the mind and body in a holistic way, is, therefore, a sensible choice for dealing with the stress around fertility issues.

In his famous series of studies, Hans Selye (1950) found that exposure to stress damages the ovaries. Since then we have learned that stress hormones (e.g. cortisol) are known to reduce levels of fertility hormones (e.g. LH and FSH). Anxiety and depression have been associated with lower pregnancy rates from fertility treatment (Smeenk et al, 2001).

Klonoff-Cohen et al (2001) suggest that while the anxiety generated by fertility treatment procedures affects biological outcomes (for example, number of oocytes fertilized) baseline measures of acute and chronic stress are related to pregnancy outcomes such as birthweight. A recent meta-analysis of the impact of stress on miscarriage found that the risk of miscarriage in early pregnancy was significantly higher in women with a history of exposure to psychological stress (Qu, Wu, Zhu, Barry et al, 2017). This doesn’t mean that stress inevitably leads to problems in pregnancy, but it demonstrates that too much stress has, potentially, harmful consequences.

Cwikel et al (2004) suggest that chronic (long-terms) stress should be treated prior to fertility treatment. There is some evidence that this can help, though the studies tend to be small and more research is needed in this area. Having said this, Levitas et al (2006) used a single session of hypnosis with 89 patients during the embryo transfer procedure and found a significantly higher pregnancy rate than 96 no-hypnosis controls (58% Vs 30%). The hypnosis group also had a higher implantation rate (28% Vs 14%). However not all studies find benefits, for example, Domar (2000) found no significant benefit for pregnancy outcomes of cognitive behavioral therapy (CBT) + relaxation in a randomized controlled trial (RCT).

Having a successful pregnancy and a healthy child is a truly wonderful thing. With so many factors involved in fertility, it is not guaranteed the stress management will help outcomes. However, where stress is a significant factor, hypnotherapy is a sensible course of action to take.

About the author
Dr John A. Barry is a Chartered Psychologist and Professional Researcher. He is a leading expert in the areas of male psychology including men’s mental health and the psychological aspects of polycystic ovary syndrome (PCOS). His new book, Perspectives in Male Psychology: An Introduction (ISBN: 978-1-119-68535-7), co-authored with Louise Liddon, is published in the new year and is available to pre-order now.

References

Barry J, Leite N, Sivarajah N,... & Hardiman, P. (2017). Relaxation and guided imagery significantly reduce androgen levels and distress in Polycystic Ovary Syndrome: Pilot study. Contemporary Hypnosis and Integrative Therapy, 32(1), 21-29.

Cwikel, J., Gidron, Y., & Sheiner, E. (2004). Psychological interactions with infertility among women. European Journal of Obstetrics & Gynecology and Reproductive Biology, 117(2), 126-131.

Domar AD, Clapp D, Slawsby EA, Dusek J, Kessel B, Freizinger M. (2000). Impact of group psychological interventions on pregnancy rates in infertile women. Fertility and Sterility, Apr;73(4):805-11. Erratum in: Fertil Steril 2000 Jul;74(1):190.

Klonoff-Cohen, H., Chu, E., Natarajan, L., & Sieber, W. (2001). A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. Fertility and Sterility, 76(4), 675-687.

Levitas E, Parmet A, Lunenfeld E, Bentov Y, Burstein E, Friger M, Potashnik G. (2006). Impact of hypnosis during embryo transfer on the outcome of in vitro fertilization-embryo transfer: a case-control study. Fertility and Sterility, May;85(5):1404-8.

Qu, F., Wu, Y., Zhu, Y. H., Barry, J., Ding, T., Baio, G., ... & Hardiman, P. J. (2017). The association between psychological stress and miscarriage: a systematic review and meta-analysis. Scientific reports, 7(1), 1731. Full article available here https://www.nature.com/articles/s41598-017-01792-3

Selye, H. (1950). Stress. A Treatise Based on the Concepts of the General-Adaptation-Syndrome and the Diseases of Adaptation. Acta Inc. Medical Publishers, Montreal.

Smeenk JM, Verhaak CM, Eugster A, van Minnen A, Zielhuis GA, Braat DD. (2001). The effect of anxiety and depression on the outcome of in-vitro fertilization. Hum Reprod. Jul;16(7):1420-3.