Although people struggling to have children often feel their problem is unusual, infertility is actually very common. One out of six couples of childbearing age has an fertility problem. These means millions of people, many of whom report that infertility is the worst experience of their lives. Undergoing an infertility workup and subsequent treatment can be a very difficult process and often impacts people on several levels: physically, psychologically, spiritually and financially.
A highly prevalent feeling for those who struggle with infertility is loss of control. Most people assume they can have children when they choose. After twenty or thirty years of assuming you would have your children when you wanted, and maybe even spending time and energy trying not to get pregnant, realizing that you may never have a baby can be very distressing.
Most of us were taught from an early age that the harder we work at something, the more likely we are to get it. Infertility is different, however, in that how hard you work at getting pregnant or what kind of person you are is irrelevant to the process of becoming pregnant. Because the idea of having children is so fundamental to our identity, those who have infertility can begin to feel that life is utterly unfair and that their own lives are out of control.
The Infertility/Stress Connection
No study has proven that being calm causes conception. However, there is preliminary evidence that very high levels of emotional stress can contribute to infertility by causing fallopian tubal spasm, irregular ovulation, hormonal changes, and perhaps by decreasing sperm production. Thus, perhaps a cycle of physiological and psychological events occur as a result of infertility stress. And the cycle goes both ways: stress affects infertility and infertility affects stress.
The infertility workup and treatment may cause stress that contributes to the infertility. Even if the original cause of infertility is treated, the extreme level of emotional distress may be causing other problems that sustain infertility. If so, taking concrete steps like eliciting the relaxation response, doing exercises to relieve tension, and challenging negative thoughts may increase the chance of becoming pregnant. However, these approaches cannot treat organic problems like endometriosis, tubal scarring, and blockages.
So, what is the relationship between stress and infertility? We know that there is a relationship between stress and infertility, but the specific nature of the relationship is unclear. We do know that most causes of infertility are physical. However, since we know that infertility causes stress, it makes sense to try to alleviate that stress. At the very least, you should feel better.
Things you can do:
Learn the relaxation response
The Relaxation Response is a simple practice that once learned takes 10 to 20 minutes a day and can relieve the stress and tension that stands between you and a richer and healthier life. The technique was developed by Herbert Benson, M.D. at Harvard Medical School, tested extensively and written up in his book entitled, of all things, “the Relaxation Response”.
I encourage you to set aside 10 or 20 minutes today and try it. The following is the technique taken word for word from his book.
1. Sit quietly in a comfortable position.
2. Close your eyes.
3. Deeply relax all your muscles, beginning at your feet and progressing up to your face.
Keep them relaxed.
4. Breathe through your nose.
Become aware of your breathing.
As you breathe out, say the word, “ONE”, silently to yourself. For example, breathe in …out, “ONE”, in …out, “ONE”, etc.
Breathe easily and naturally.
5. Continue for 10 to 20 minutes.
You may open your eyes to check the time, but do not use an alarm.
When you finish, sit quietly for several minutes,
at first with your eyes closed and later with your eyes opened.
Do not stand up for a few minutes..
6. Do not worry about whether you are successful in achieving a deep level of relaxation.
Maintain a passive attitude and permit relaxation to occur at its own pace.
When distracting thoughts occur, try to ignore them by not dwelling upon them
and return to repeating “ONE.”
With practice, the response should come with little effort.
Practice the technique once or twice daily, but not within two hours after any meal,
since the digestive processes seem to interfere with the elicitation of the Relaxation Response.
– The Relaxation Response, Herbert Benson, M.D.
Once you begin to elicit the relaxation, you may feel calmer and less anxious throughout the day, which will help you feel more in control. Enjoying life when you feel depressed, anxious, and angry much of the time is very difficult. You may remember what you felt like before you started to “try” and you may want to start feeling that way again.
Another advantage of eliciting the relaxation response is that it gives you time every day that is just for you. Most women going through or thinking about IVF tend to take care of themselves last. Between trying to keep up with work, taking care of your spouse, housekeeping, and going for seemingly endless medical tests and appointments, you tend to forget about taking care of yourself. You might feel guilty about doing things just for you, such as spending an afternoon reading a novel or soaking in the tub. Many women undergoing infertility unconsciously feel they don’t deserve things because they are angry at themselves for not getting pregnant.
All people need time for themselves
If you feel you absolutely cannot find twenty minutes every day for the relaxation response, examine your priorites. You deserve time to help yourself feel better. Look carefully at how you spend your time and on whom. The first step in having more control over your life is to make yourself more of a priority.
Elicit the relaxation response daily to help feel less anxious and more in control throughout the day. Choose a thought, word, prayer, or phrase that is calming and meaningful to you at this time in your life.
Become aware of your thoughts, feelings, emotions
Thoughts, feelings and emotions influence health. Automatic thoughts, which tend to be negative in any case, can become even more automatic and negative after months or years of not falling pregnant. Patients report automatic thoughts such as “I’ll never get pregnant, I’ll always be infertile. Why me? I’ve been a good person, She doesn’t deserve to have another child. What did I do wrong?”
Sound familiar? Stop. Take a Breath, and Reflect on your automatic thoughts. Challenge thoughts that are exaggerated, distorted simply not true.
Become aware of how belief and expectation contribute to stress.
Much of your stress may be explained by your expectation of being able to conceive at your own discretion. When this does not occur, you feel internal conflict (stress) usually manifested by feelings of loss of control over your choices, your body, and your life. As you begin to reflect on and challenge your automatic thoughts, you may notice the emergence of certain irrational (exaggerated) beliefs and/or cognitive distortions such as all-or-nothing thinking or overgeneralisation. In this case, failure to conceive within a few twenty-eight day cycles becomes “I’ll never conceive” and then being a “failure” in life. Realise these patterns and challenge them Look at what your thoughts are saying to you. See if you can challenge them and turn them into a more positive alternative, which you believe in your heart to be true.
Every women having difficulty conceiving has been told at least once “Just relax and you’ll fall pregnant,” “You’re working too hard at it,” “Go on vacation,” “Just have a glass of wine,” “Adopt, and then you’ll get pregnant right away.”
Not only are these statements offensive, hurtful and guilt-producing, they are not true. Following the suggestions here will not guarantee conception. The main reason to use these techniques is that infertility can be a very difficult experience. Most women with infertility feel anxious and depressed. Experience has shown however that women using the techniques described above feel significantly less anxious, depressed, angry and tired; they feel they have more control over their lives and can lead a more normal life.
The main thing is to stop living in twenty-eight day cycles, and start getting more enjoyment out of your life.
Focus on other goals
It is all too easy to start to centre your whole life around getting pregnant. One woman decided not to work because she wanted to be constantly available to the infertility clinic. Another woman realized she stayed with a job she hated because the hours accommodated her infertility treatment. She applied for and was awarded a promotion, found she could still pursue treatment, but was much happier in the process.
Infertility can occupy not only your time, energy, and money, but also exerts control over your body. Many women experiencing infertility tend to focus on controlling all aspects of their lives. Some feel their lives are so regulated by infertility treatments that they rebel with unhealthy habits such a smoking, frequently drinking caffeinated beverages, and not exercising. Others are very careful for the second two weeks of their cycles, but indulge themselves once their period comes. Still others work very hard to maintain exemplary habits in an effort to increase the chance of conception.
In general, moderation is the answer
Because infertility arouses many feelings of deprivation, severely restrictive diets and punishing exercise regimens are neither appropriate nor productive. Approach healthy lifestyle habits with balance and perspective. Do things you enjoy and that bring you pleasure rather than frustration and deprivation. Make choices and changes that are both healthful and emotionally acceptable.
How about. . .
- inviting your husband to take a long stroll in the moonlight
- taking an Chinese cooking course and practicing at home one night per week
- a girls’ night out to visit a comedy club
- a new activity: dancing, pottery, gardening, bicycling, painting, etc.
- adopting a puppy or kitten from a local shelter
- taking a deep breath and tackling a new challenge; do something you always dreamed of but were unable to try
(This page was adapted from Mental Medicine Update, Fall 1992 – see http://www.ishk.net/mbh_newsletter.html)