Marriage Stress Affects Infertility Treatment
Researchers Say Infertility-Related Stress Affects Chances of Pregnancy
June 24, 2005 -- Ask any couple who has been through it and they will tell
you there is little as stressful as wanting a baby and not being able to have
Infertility-related stress is known to take its toll on relationships, and
now a new study shows it can also affect the success of fertility
Researchers reported that the stress of infertility on marriages was a
stronger predictor of treatment failure than personal stress or
infertility-related strains on other relationships.
Women who reported the most marital stress required more assisted
reproduction cycles to get pregnant than women who reported less stress in
their marriages, researcher Jacky Boivin, PhD, tells WebMD.
"The bottom line is that if infertility is causing a lot of stress in a
partnership it could very well have an impact on whether the woman gets
pregnant or not," Boivin says.
She says she did not believe stress played a significant role in infertility
until recently, but the mounting evidence in favor of a link was impossible to
ignore. She makes it clear, however, that biologic factors such as age and
embryo quality are much more important in the success or failure of infertility
treatments than stress.
Male Stress Mattered
The study is one of the largest ever to examine the role of stress on the
success or failure of infertility treatments.
Boivin and colleague Lone Schmidt, PhD, followed roughly 800 Danish couples
undergoing infertility treatments. All of the participants completed
questionnaires at the beginning of the study to assess stress levels. The
researchers then looked at pregnancy rates one year later.
During the one-year study period:
- 71% of couples required 1 or 2 infertility treatment cycles
- 26% had 3 to 5 cycles
- 2% had more than 5 cycles
Roughly 60% of couples achieved an ongoing pregnancy or live birth and 40%
Couples who did not achieve a pregnancy tended to be older than those who
did, and they had been infertile longer and had more treatment cycles during
While stress in men was an independent predictor of treatment success, the
impact was much smaller than the impact seen in women. Boivin says the finding
suggests that infertility-related stresses compromise sperm quality or other
factors associated with male fertility.
"It has been thought that it was all about the woman and what is going
on with her psyche," Boivin says. "But this suggests that the same
stresses that affect female fertility can affect male fertility."
Does Counseling Help?
It is not clear from the study if stress plays a direct role in infertility,
or is instead a predictor of other lifestyle behaviors that can have an impact
on the ability to conceive.
"Couples who are highly stressed may smoke more or drink more or
generally not take good care of themselves," Boivin says.
The research has been mixed on whether psychological counseling may help
stressed couples overcome infertility, although the benefits in terms of stress
reduction are clear.
In a study reported by researchers at Harvard's Beth Israel Deaconess
Medical Center the pregnancy rate among infertile women who got counseling in
addition to fertility treatments was more than double that of women given
fertility treatments alone.
But infertility psychotherapist Alice Domar, PhD, who led the study, said
more study is needed to establish a definite link between psychological
counseling and better pregnancy results among infertile women.
"I don't want to give the impression that if a woman doesn't get
pregnant it is due to stress alone," says Boivin. "In most cases the
reason that infertility treatments don't work are biological, not
psychological, and the importance of psychological factors probably differs
from person to person."