STRESS CASE

“Just relax and let it happen”: More scientific evidence to annoy stressed out women who want to get pregnant

Eat grass-fed beef. Cut out dairy, gluten, caffeine, and alcohol. Press hard against the femoral artery and allow the “blood to ‘back flow’ into the pelvic region.”

The suggestions women who have trouble getting pregnant encounter drive them to drastic, at times wacky, measures. A study from the University of Louisville suggests just the opposite: Women who want to get pregnant should focus less on extreme interventions and more on everyday stress.

Researchers found that women who reported feeling more stressed than usual during their ovulatory window were 40% less likely to become pregnant that month. Women who reported stress at the end of their menstrual cycle—called the luteal phase—were more likely to become pregnant, but the authors attributed that to women who had conceived during that cycle, which likely led to hormonal changes.

Epidemiologists at the University of Louisville and Emory University came to these conclusions after analyzing data from The Mount Sinai Study of Women Office Workers, a broad survey of reproductive health that ran from 1990 to 1994. It asked women to keep a record of their periods, sexual activity, and use of contraception through 20 menstrual cycles. The participants also completed a daily logbook to document how much alcohol, caffeine, and cigarettes they consumed.

For the recent research, which was published in the Annals of Epidemiology, scientists identified 400 women from the Mount Sinai study whose dedication to their logbooks was consistent enough to produce meaningful data. Stress during the ovulation window, the research showed, translated into a three-month delay in conception. The effect of stress was significant even after adjustments for age, weight, lifestyle, and frequency of sexual intercourse.

The study’s limitations include that stress was self-reported on a scale from 1 to 4, making the definition of “stress” subjective. The day of ovulation was estimated and not confirmed, though the findings revealed a significant effect from stress during the ovulatory window, regardless of when ovulation actually occurred. Also, not all women in the study were trying to conceive, which “reduces the ability to generalize these results to a population that is actively trying,” the authors said.

Still, the findings add to past research on stress and fertility, which were limited by their focus on single points in time, rather than an entire menstrual cycle. The latest study was the first to use self-reported stress levels, which the authors argued offer a more comprehensive picture of how women experience stress.

One large study from Ohio State University assessed women’s stress by measuring the enzyme alpha-amylase in saliva samples, but using a single biomarker “only represented one aspect of the body’s complex stress response,” said Kira Taylor, an epidemiologist at the University of Louisville’s School of Public Health and Information Sciences.

The authors said their findings emphasize the importance of guiding women toward stress-reduction techniques before infertility treatments. The stress of coping with infertility can be a self-fulfilling prophecy. Women categorized as infertile under time window guidelines set out by reproductive medical groups can feel hopeless and rush to intervention. In turn, the physical and emotional toll of infertility treatments can induce more anxiety and depression than a diagnosis of cancer or a heart attack. Some women confront their life stress only after undergoing expensive IVF treatment, as a way to boost the treatment’s efficacy.

Life stress may take an even greater toll on lower-income women who work long hours with less support, and are often excluded from efforts to address infertility that focus on the affluent.

More research is needed to understand how stress muffles the hormonal signals that regulate reproduction, which could lead to better treatments.

In the meantime, women who are stressed out about reducing their stress might just stick with snake-oil remedies.

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