Stress and Infertility

10219554_sFor the most part the only people who get pregnant without stress are those who conceive without knowing it. Given the inefficiency of the human species at reproduction it’s amazing that anyone does get pregnant -and even more amazing that any of us are here at all. Of course when a woman wants to have a baby it seems to her that everyone around her is pregnant – an emotional distortion I call Conception Parallax. The heartbreaking truth is that a young woman in her mid to late 20s has only about a 20% chance on any cycle of conceiving and carrying to term. That percentage diminishes as a woman ages and it drops drastically after age 35. A woman of 40 will only have a 5 – 10% chance of success on any one cycle. The conundrum: biologically we were meant to conceive in our late teens and early twenties; socially we were not. Nevertheless the parallax metaphor works in a philosophic sense: a woman desirous of pregnancy will perceive “every woman” in her visual field to be pregnant; reproductive physicians ‘see’ pregnant women as a select few – a difference of position seen from two opposite sides of the desk. It is this distortion that greatly increases stress for a woman (or couple) trying to build a family.

IVF can increase a woman’s chances of a successful pregnancy and, depending upon the age of her eggs, the normalcy of the sperm, and the receptivity of her uterus percentages of success can far exceed those of the ideal couple in their 20s. With IVF treatment by “bumping up” the number of eggs available for fertilization, take-home-baby rates can, and do, approach 65-75%.

But the IVF process is replete with its own stressors. If you think about it ,all that with the good old-fashioned way of conception(traditionally) occurs behind closed doors or within the dark confines of the female pelvis is,with IVF, broken down, dissected, scrutinized and critiqued by every member of the IVF team. And then there are the injections (albeit with thin,humane needles), monitoring with blood tests and sonograms and, ultimately, sex in separate rooms! Egg retrieval is followed by anxiety over the box scores: how many decent blastocysts are there available for transfer or freeze and, ultimately, did it work.

Infertility is an emotional cauldron and the IVF process adds additional stress to the bubbling brew. How to cope? Dumping it all into the lap of one’s partner can be a recipe for disaster. A not uncommon consequence of this action is for one party to want to opt out of treatment and to express a wish for pregnancy to ‘happen naturally.” When I am confronted by couples in treatment discord such as this I gently point out that: 1) “Naturally” wasn’t working and that’s why they came to begin with.2) What’s common to everyone who comes for help is that no one wants to be here and that 3) When a couple “tries” to get pregnant relaxed spontaneity is a guise and either one or both parties is faking this behavior.

What to do with the stress? Some patients find help from support groups in which people undergoing the same treatments and who are experiencing the same feelings can feel understood. Resolve and the American Fertility Association are good organizations to contact for advice and to find local support groups. For those who prefer to cope privately I recommend Helen Adrienne’s book, On Fertile Ground. Healing Infertility. Helen is a psychotherapist with >30 years of experience in the field of infertility. Her timely book demonstrates her compassion, creativity, and insight into the psychological and social pain of infertility. It can be obtained through Helen’s website www.mind-body-unity.com.

Finally, I tell all my patients that,when they see a happy woman pushing a baby stroller,they have no idea what that person went through to have that baby. They have no idea how it happened. And, as for all those twins- they should just use their imagination! Success requires medical know-how and, often, aggressive treatment. Patience, time and love are essential. And no, you are not crazy! Don’t give up your dream. Perseverance pays off…