Medically, we haven’t yet conclusively proven a link between stress and infertility. Most fertility experts kinda agree on this, but there's still a lot of back-and-forth about it. Let’s dive in…

So, does infertility cause stress, or does stress cause infertility?

Peddling the myth that stress causes infertility places more blame on (typically) the woman for something out of her control. “Just relax” is a phrase frequently thrown at anyone experiencing infertility (and often having the opposite effect), and it’s clear that infertility causes stress, with people frequently suffering in silence. Fortunately, that is changing, and sharing stories with friends and families is becoming more commonplace. 

What is the stress response?

So, what’s the deal with the stress response? Well, there's this fancy system in your body called the hypothalamic-pituitary-adrenal (HPA) axis in charge of dealing with it. It's like a hormonal control centre. But here's the kicker: when you're under chronic stress, this system goes haywire. Your main stress hormone, cortisol, gets all out of whack. And guess what? That affects your reproductive hormones, impacting your menstrual cycle, ovulation, and even embryo implantation. For women trying to get pregnant, these issues can really throw a wrench in the works. The silver lining: just because you're stressed doesn't mean it’s all doom and gloom when it comes to fertility. Plenty of stressed-out women still manage to conceive, despite all the hormonal chaos.

Stress and mental health

Stress has been linked to depression and anxiety and may mess with your sleep, give you  (or exacerbate) tummy troubles, or give you killer headaches. Research has also shown that women with a history of depression are twice as likely to experience infertility (WTF)!

Stress and fertility research

So, researchers have been digging into how stress levels affect reproductive hormones and conception rates. What was interesting is that higher levels of specific hormones and enzymes associated with stress have been observed in individuals struggling to conceive. Studies looking at stress and outcomes of in vitro fertilisation (IVF) have given us mixed results, so what this tells us is there’s a complex interplay between stress and IVF outcomes. Poor IVF treatment outcomes may induce stress rather than the reverse (can we say UNO reverse?). The challenge of research in this area is figuring out whether stress precedes infertility or vice versa, and it is difficult to isolate other factors that could influence fertility, such as sperm and egg health, regular ovulation, etc…

Impact of Stress on Ovulation and Menstrual Cycles

Being in a state of chronic stress can mess with your period schedule. Remember cortisol, the stress-related hormone we talked about earlier. Well, elevated levels may disrupt luteinising hormone (LH) levels and follicular development, potentially resulting in anovulatory cycles. 

What are anovulatory cycles?

Picture this: normally, when everything's running smoothly, your body releases an egg during your cycle. But in anovulatory cycles, it's like your body forgets to do that part. So, instead of ovulating and getting ready for possible embryo-making, it's like, "Nah, not today." It's like your reproductive system hitting the snooze button on making an embryo this month.

So, is stress and infertility a causal relationship?

When we discuss causal relationships in terms of fertility, we consider how different factors can affect a person's ability to conceive. For example, if someone has a hormonal imbalance, like too much cortisol from stress messing with their reproductive hormones, that could make it harder for them to get pregnant. In that case, you could say that stress causes fertility issues.

Similarly, if someone has a health condition like polycystic ovary syndrome (PCOS), which can mess with ovulation, it can lead to difficulties getting pregnant. Here, you could say that PCOS causes infertility because it directly affects the reproductive system's function.

On the flip side, let's say someone has a healthy lifestyle with balanced nutrition, regular exercise, and good mental health. These positive factors can enhance fertility by keeping hormones in check and promoting overall reproductive health. So, you could say that a healthy lifestyle causes better fertility outcomes.

Essentially, in the realm of fertility, causal relationships help us understand how various factors—whether physical, mental, or environmental—can influence a person's ability to conceive. It's all about one thing leading to another in a cause-and-effect kind of way.

How to cope with the stress of infertility: 

• Get active. Physical activity, even if it just involves going for a 30-minute walk, is great for stress and overall health.
• Remember that you can only control the controllables.
• Lean on friends and family - surround yourself with supportive people.
• Take time for yourself. Block 15 minutes every day. Whether meditating, writing, reading, or simply enjoying a cup of tea, do something that makes YOU feel good.

Whether you’re camp easy peasy lemon squeezy or stressy depressy lemon zesty. There is a complexity of biological, environmental, and psychological factors influencing reproductive health. While stress undoubtedly plays a role in overall well-being, attributing infertility solely to stress oversimplifies the complex interplay of physiological processes involved in reproduction. 

Key takeaways 

• Stress, stemming from various sources such as work, life challenges, or health issues, manifests in our physiological responses.
• The correlation between stress and poor mental health is well-established, with potential exacerbation of conditions like sleep disorders and digestive issues.
• While some data suggests a tentative link between stress levels and fertility challenges, the causal relationship remains uncertain.
• Chronic stress may disrupt menstrual cycle regularity, although accurately quantifying stress levels and duration is hard.
• Enhancing overall mental well-being is beneficial, regardless of your fertility intentions.
• Effective stress management strategies include physical activity, journaling, spending time outdoors, and seeking support from loved ones.