Stress: Infertility & the Biological Imprint in the Uterus
Stress can be present in many different forms in one's life. In fact, so many of us are constantly exposed to various forms of stress everyday that we may not even consciously register that we are "under stress." Instead it is a way of life that we have become accustomed to. Consider that stress, for the mind and body, can be emotional, environmental, physical, and ecological.
Medically, what is Stress?
Stress, in its essence, is an adaptive mechanism of the body to help deal with an external or internal stimulus. While this serves many vital functions important to survival and well-being, the chronic stress we have adopted in our society as our norm is associated with a host of negative health consequences, and Fertility and Reproductive Function are no exception.
The Different Forms of Stress:
Emotional: related to our own mental well-being. This is probably the most "Hollywood" representation of stress, the type of stress most commonly recognized in our society. It could be anxiety, depression, constantly worrying about an outcome, preoccupied with thoughts relating to the future and/or past.
Environmental: stress that manifests as a result of an external stimulus from our immediate location. For example, auditory stress, stress from consistent sounds disrupting your state of calm. This could be construction noise, drilling, and really anything that is eating away at your patience.
Physical: more commonly defined as physical exhaustion. This could be from something you might even enjoy doing (i.e. high intensity exercise or sports), or from working long hours or high amounts of physical labour.
Ecological: chemical and/or environmental pollutant stressors on our body that may increase the amount of oxidative stress in the body and interfere with hormone function.
A recently published review gave a succinct overview on all of the clinical trials evaluating for stress and its impact on fertility, pregnancy, and the health of the child.
How does Stress relate to Infertility?
Stress, and the increase in stress hormones, reduce the quality of ovarian follicles (eggs) and impairs their normal physiological signals and functions
Stress will actually alter the composition of the follicular fluid (the environment in which the follicles rest) leading to a less favourable microenvironment for the eggs to develop
Stress will alter the hormone balance in the body, decreasing the release of gonadotropins from the brain (FSH and LH) and altering the ratio of estrogen:progesterone in the body
IVF Cycles: eggs which are unable to fertilize have been associated with a higher concentration of cortisol (an important stress hormone) in the follicular fluid than eggs which do fertilize. The study that evaluated this suggested that the elevated cortisol levels were a marker or stress, and it may be related to the decreased rate of fertilization in those eggs.
May cause decreased embryonic development
Stress can cause decreased cell development on the internal surface of the uterus and lead to decreased quality of the arteries that develop to support the uterine lining. The result of this is that there are fewer and poorer spots for implantation to occur in the uterus.
Stress and its Biological Imprint on the Health of the Baby:
Fetal exposure to stress and the hormones that increase in response to stress during pregnancy is normal and also crucial to healthy development of the baby. In fact, stress hormones play a very significant role in the maturation of the respiratory system for the baby. However, elevated amounts of stress and stress hormones during the pregnancy, can alter immune function, gene expression, and predispose the baby to lifelong health concerns as a child and adult.
Stress can decrease the birthweight of the baby
Stress may increase the risk of cardio-metabolic diseases and hormone dysfunction (i.e. diabetes, increased risk for coronary artery disease, increased blood pressure response to stress)
Decreased cognitive function and IQ
Increased amygdala size and increased incidence of anxiety as a child and and preadolescent
Some of the studies have suggested that the effects of stress during pregnancy on the fetus can persist for generations forward.
How to Deal with Stress:
Including activities that naturally help you decrease anxiety and worry are crucial. It is in their ability to reduce stress that practises such as mindfulness, meditation, yoga, and physical exercise (low to moderate intensity) prove useful. This helps to address the component of emotional and possibly environmental stress.
Working with a Naturopathic Doctor can help to address the ecological forms of stress as well. Practises such as acupuncture, massage therapy, and various botanical medicine therapies can help to lower stress hormones and reduce physical exhaustion, improve recovery, reduce anxiety, and improve vitality.
This article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor or Primary Care Provider.
1. Joseph, D., & Whirledge, S. (2017). Stress and the HPA Axis: Balancing Homeostasis and Fertility. International Journal of Molecular Sciences, 18(11), 2224.