Stress and Fertility

infertility ovulation stress

As an infertility veteran myself, I know that being told to “Just relax” or “Let it happen” is not helpful. Period. But as a PhD scientist, I also know there is science that shows that stress can actually impact fertility. Keep reading to learn more about the link between stress, hormones, and fertility! 

The Science Behind Stress and Fertility

While there is still research to be done on all the ways stress can impact fertility, studies show that our bodies can adjust the ability to get pregnant in response to environmental factors, such as diet, stress, exercise, or chemicals. This makes sense when thinking about evolution: if your body was going through a period of famine, it would save energy and resources that would otherwise be used to get pregnant in order to survive. This same system unfortunately recognizes the stress associated with battling infertility as an environmental factor. 

A recent study published in Fertility and Sterility found that women with high levels of alpha-amylase — an enzyme correlated with stress — have a harder time getting pregnant. In this study, saliva samples were taken from 274 women over six menstrual cycles (or until they got pregnant). This study showed that women with the highest alpha-amylase concentrations during their first menstrual cycle were 12% less likely to get pregnant.

Another study conducted by Sarah Berga, MD, at the Emory School of Medicine found that women with functional hypothalamic amenorrhea (meaning they had stopped ovulating for more than 6 months) had high levels of cortisol, the stress hormone. The regions of the brain that regulate reproductive hormones required for ovulation also respond to cortisol.

Of these women who were not ovulating, some participants received stress management therapy, while others did not. Seven out of the eight participants who received the therapy began ovulating again, while only two out of eight participants who did not receive therapy began ovulating.  

Finally, a study in Taiwan found that 40% of participants seeking infertility treatment were diagnosed with depression or anxiety. Other researchers have found that women struggling with infertility have the same levels of anxiety and depression as women diagnosed with cancer or HIV.

Since infertility is a real medical condition with major implications to one’s life, it’s not surprising that it can cause the same levels of anxiety as other serious medical conditions.

Stress and Progesterone

Stress and cortisol production also directly impact the production of progesterone. Progesterone and cortisol are connected because they are made on the same steroid hormone pathway. 

Progesterone is the hormone produced by the empty follicle after ovulation occurs. It stabilizes the uterine lining and makes it “sticky” enough for an embryo to implant, should the egg be fertilized. Sufficient progesterone levels are critical when trying to conceive, and lack of or suboptimal levels of progesterone can make it more difficult to get pregnant.

In the hormone pathway, progesterone is used to produce cortisol. If you are experiencing a lot of stress, your body produces cortisol in order to control bodily functions during the stressful period. So, when you’re stressed out and your body needs more cortisol to deal with it, it may “steal” progesterone from your reproductive system to produce more cortisol. This could mean your reproductive system may not have enough progesterone in order for you to successfully conceive. 

Proov is the first and only FDA cleared PdG test kit to confirm successful ovulation at home. PdG is a urine metabolite of progesterone and is only found in urine when progesterone levels are elevated in blood. Testing with Proov on days 7, 8, 9, and 10 after peak fertility confirms that successful ovulation did in fact occur, meaning an egg was released and PdG levels remained adequately elevated for long enough to allow for the best possible chance at conception.

While testing with Proov can help ensure stress isn’t harming your PdG levels, I’ve also heard that confirming successful ovulation with Proov relieves stress by providing valuable information surrounding chances at conception! 

How can I cope with stress?

If you are currently struggling with infertility or stress in general, there are many ways to reduce stress. Here are a few options:

✿ Try journaling: Journaling allows you to get some emotions off your chest without having to share openly with others. Writing is a great outlet for stress, feelings, or just general thoughts. 

✿ Stay active: Light exercise can help release serotonin and endorphins, both of which improve your mood. Even setting aside time to do your favorite activities can relieve stress. (Note that strenuous and excessive exercise can increase cortisol production, therefore not relieving stress.)

✿ Meditation or yoga: Meditating can help clear your mind and relax your body. Or, if you’re not into meditating, you can try yoga for “moving mediation.” Hatha yoga specifically focuses on breath and movement, without concentrating on mediation specifically. 

✿ Enlist your partner: You and your partner may deal with the stress of infertility in different ways — women often seek social support, while men lean towards problem-solving. This can create tension, so try to seek out some special, one-on-one time. Maybe go out to dinner, have a movie night in, or go for a walk!

✿ Seek support: In times of stress and uncertainty, reaching out to others can be beneficial. Your friends and family are there for you during this time. However, if you don’t feel comfortable talking to them, there are plenty of infertility support groups with couples who are going through similar experiences. Our Proov support group has thousands of amazing women who are always around to lend an ear or words of advice. Our team is also available for support at [email protected]. Don’t hesitate to reach out!

Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.

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