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Infertility and Stress :

Relax. -Take a vacation. -Stop trying so hard. -Adopt. These are among the well-intended suggestions from family and friends heard often by infertile couples. Frequently, infertility causes couples to struggle with feelings of inadequacy and failure. To suggest that they are to blame for their infertility because of an attitude or difficulty coping with the stress of the process causes couples undue pain and guilt.
Stress is the "wear and tear" our bodies experience as we adjust to our continually changing environment; it has physical and emotional effects on us and can create positive or negative feelings. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of distrust, rejection, anger, and depression, which in turn can lead to health problems such as headaches, upset stomach, rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. In so adjusting to different circumstances, stress will help or hinder us depending on how we react to it.

Does Stress Cause Infertility?
As experts in the field have stated, "Infertility causes stress; stress doesn't cause infertility." Although infertility is a highly stressful experience, there is very little evidence that infertility can be caused by stress. In rare cases, high levels of stress in women can change hormone levels and cause irregular ovulation. Some studies have shown that high stress levels may also cause fallopian tube spasm in women.

There have been a number of studies that show that high levels of stress can also decrease production of sperm, or increase production of abnormal sperm. There was a study done in Germany where a group of rapists who had impregnated their victims were put on death row. When each man was asked to give semen sample, all of them had sperm counts of zero. Clearly they had been fertile when they raped their victim, but the stress of being on death row negatively impacted sperm production.

Does Infertility Cause Stress?
Not unless you find your entire life revolving around reproduction stressful. Just a few areas that couples may find difficult:

Fighting insurance companies
Struggling to pay for treatments
Undergoing invasive, and sometimes painful tests
Feeling completely and totally overwhelmed by emotions and hormones
Making difficult decisions about appropriate treatment that may involve
religious, moral, or ethical dilemmas.
Working in doctor�s appointments with a career
Trying to keep romance alive while having to sex on command

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 stress each month, first hoping that they will conceive and then dealing with the disappointment if they do not. The toll of timed intercourse, perceived failure of one�s partner�s body, and hormones ravaged by medications means intimacy often suffers as well.

Coping with Stress
Research has, however, demonstrated the prevention power of relaxation by increasing one's immune response. Relaxation can often create a state of well-being and improve your coping ability, all of which is an added plus in battling infertility. Alice Domar, PhD, is director of women's health services at Harvard Medical School's world-renowned division of behavioral medicine. Her research on the effects of stress on female well being shows that the practice of self-nurture can treat a host of women's health problems, including infertility.

-I think the most effective techniques to reduce stress in infertile women are relaxation techniques, mini relaxation techniques, cognitive restructuring, journaling and social support. I think most infertile women find that other people getting pregnant is one of the hardest things about infertility, and I tell my patients that there are certain rules they are allowed to follow.�
-Rule number 1: do not go to baby showers. Rule number 2: do not go into baby boutiques to buy baby gifts. Both of those things are likely to make you feel worse. A really nice thing to send somebody who's having a baby is order online your favorite childhood books. They'll appreciate the gift and it's more fun for you. There's no rule that says you have to go to baby showers. During this crisis in your life, you need to protect yourself.�

-I also suggest some strategies for transforming negative thoughts into positive ones. In both of my books, we talk about a process called cognitive restructuring.

The idea is to actually challenge the negative thoughts that play over and over again in your head. If you start with a negative thought such as "I'll never have a baby," the idea is restructure it to something that is true such as "I'm doing everything I can to try to get pregnant." This may sound simple but it's effective.�

-We teach Hatha yoga to our patients for two reasons. It's a wonderful form of relaxation and it also helps women keep physically toned, because we do recommend that women going through infertility stop aerobic exercise for several months. If they continue with yoga, their muscles will stay in shape

Stress Management
What is Stress?

Stress is the "wear and tear" our bodies experience as we adjust to our continually changing environment; it has physical and emotional effects on us and can create positive or negative feelings. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of distrust, rejection, anger, and depression, which in turn can lead to health problems such as headaches, upset stomach, rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. With the death of a loved one, the birth of a child, a job promotion, or a new relationship, we experience stress as we readjust our lives. In so adjusting to different circumstances, stress will help or hinder us depending on how we react to it.

How Can I Eliminate Stress from My Life?
As we have seen, positive stress adds anticipation and excitement to life, and we all thrive under a certain amount of stress. Deadlines, competitions, confrontations, and even our frustrations and sorrows add depth and enrichment to our lives. Our goal is not to eliminate stress but to learn how to manage it and how to use it to help us. Insufficient stress acts as a depressant and may leave us feeling bored or dejected; on the other hand, excessive stress may leave us feeling "tied up in knots." What we need to do is find the optimal level of stress which will individually motivate but not overwhelm each of us.

How Can I Tell What is Optimal Stress for Me?
There is no single level of stress that is optimal for all people. We are all individual creatures with unique requirements. As such, what is distressing to one may be a joy to another. And even when we agree that a particular event is distressing, we are likely to differ in our physiological and psychological responses to it.

The person who loves to arbitrate disputes and moves from job site to job site would be stressed in a job which was stable and routine, whereas the person who thrives under stable conditions would very likely be stressed on a job where duties were highly varied. Also, our personal stress requirements and the amount which we can tolerate before we become distressed changes with our ages.

It has been found that most illness is related to unrelieved stress. If you are experiencing stress symptoms, you have gone beyond your optimal stress level; you need to reduce the stress in your life and/or improve your ability to manage it.

How Can I Manage Stress Better?
Identifying unrelieved stress and being aware of its effect on our lives is not sufficient for reducing its harmful effects. Just as there are many sources of stress, there are many possibilities for its management. However, all require work toward change: changing the source of stress and/or changing your reaction to it. How do you proceed?

1. Become aware of your stressors and your emotional and physical reactions.
Notice your distress. Don't ignore it. Don't gloss over your problems.
Determine what events distress you. What are you telling yourself about meaning of these events?
Determine how your body responds to the stress. Do you become nervous or physically upset? If so, in what specific ways?

2. Recognize what you can change.
Can you change your stressors by avoiding or eliminating them completely?
Can you reduce their intensity (manage them over a period of time instead of on a daily or weekly basis)?
Can you shorten your exposure to stress (take a break, leave the physical premises)?
Can you devote the time and energy necessary to making a change (goal setting, time management techniques, and delayed gratification strategies may be helpful here)?

3. Reduce the intensity of your emotional reactions to stress.
The stress reaction is triggered by your perception of danger...physical danger and/or emotional danger. Are you viewing your stressors in exaggerated terms and/or taking a difficult situation and making it a disaster?
Are you expecting to please everyone?
Are you overreacting and viewing things as absolutely critical and urgent? Do you feel you must always prevail in every situation?
Work at adopting more moderate views; try to see the stress as something you can cope with rather than something that overpowers you.
Try to temper your excess emotions. Put the situation in perspective. Do not labor on the negative aspects and the "what if's."

4. Learn to moderate your physical reactions to stress.
Slow, deep breathing will bring your heart rate and respiration back to normal.
Relaxation techniques can reduce muscle tension. Electronic biofeedback can help you gain voluntary control over such things as muscle tension, heart reate, and blood pressure.
Medications, when prescribed by a physician, can help in the short term in moderating your physical reactions. However, they alone are not the answer. Learning to moderate these reactions on your own is a preferable long-term solution.

5. Build your physical reserves.
Exercise for cardiovascular fitness three to four times a week (moderate, prolonged rhythmic exercise is best, such as walking, swimming, cycling, or jogging).
Eat well-balanced, nutritious meals.
Maintain your ideal weight.
Avoid nicotine, excessive caffeine, and other stimulants.
Mix leisure with work. Take breaks and get away when you can.
Get enough sleep. Be as consistent with your sleep schedule as possible.

6. Maintain your emotional reserves.
Develop some mutually supportive friendships/relationships.
Pursue realistic goals which are meaningful to you, rather than goals others have for you that you do not share.
Expect some frustrations, failures, and sorrows.
Always be kind and gentle with yourself -- be a friend to yourself.

Researches : Infertility and Stress