The Relationship Between Stress and Infertility

February 1, 2024
In vitro fertilization (IVF)

Some couples find it very difficult to conceive even after trying for many years, while others easily get pregnant. Many factors contribute to conception, but among those many factors, stress plays a major role. Though it does not directly cause infertility, it impacts conception and also delays it. There is quite a lot of research that points out that stress can adversely impact conception, even if done artificially using IVF. So, what is the relationship between infertility and stress? Read on to learn more about it. 

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Stress and Infertility: The Cycle of Harm

Several studies conducted recently show that there is a deep connection between a woman’s stress levels and her reduced chances of pregnancy. For instance, women with high levels of an enzyme in saliva called alpha-amylase (which shows stress levels) took longer to get pregnant than those who had less of this enzyme. 

Cortisol and infertility go hand-in-hand. When the body is stressed, the brain produces cortisol, which is a stress hormone. This interferes with the ovaries' functioning and signals to the brain, thereby disrupting the release of eggs and the ovarian cycle. Cortisol production not only harms a woman’s ovarian cycle but also impacts motility and sperm production in men. Along with these physical changes, the brain responds to stress by way of mood and behavioural changes. There is a decrease in sex drive and motivation for both men and women. Plus, to cope with stress, some men and women may indulge in drinking alcohol and smoking, which all lead to trouble with conception. For those patients who are already undergoing treatment, the impact of stress is more pronounced.

Impact on Treatment Outcome

There are many studies conducted on the psychological symptoms before and while taking ART (assisted reproductive treatment), and there is growing evidence that those who were stressed before or during the treatment had lower pregnancy rates. There are many possible explanations and one indication was the presence of the high alpha-amylase salivary enzyme, which is a biomarker for stress. It was found that those who had a high baseline were twice as likely to have infertility. Another recent study was done by checking for cortisol levels in hair samples. High cortisol levels were related to low pregnancy rates, so it matches the theory that psychological symptoms hurt fertility. 

Miscarriage and Repeat Failure 

Further studies reveal that as many as 10 to 25% of the pregnancies that ended in miscarriage showed that they were suffering from depression and anxiety. So, there is a link between stress and conception.

Also, some people get pregnant quite easily with ART and also conceive in the first cycle itself. But for many, it takes years, and the cause is also not always unclear. When the cause is not clear, it adds to the stress of not conceiving and leads to lifestyle changes like sleep deprivation, increased caffeine intake, etc., which decreases the chances of having a baby. 

Stress, Depression and Anxiety

The psychological impact of not conceiving can lead to distress, depression, and anxiety. Many women show off to look mentally healthier and there is inaccuracy in self-reporting. Also, some studies show that about 40% of women have depression or anxiety before being diagnosed with infertility. The same study showed that 32% of men reported symptoms of depression and anxiety. So, it can be concluded that infertile individuals have more psychiatric symptoms than those who are fertile. 

So, conception and stress become a vicious cycle. Couples who are trying to start a family become depressed as it takes a longer time, or the treatment may not work. Many people also find medical procedures taxing. For instance, couples who are undergoing IVF treatment are stressed, and that can affect their mind and body, thereby creating a vicious cycle. So, stress management must be taken seriously to get out of this cycle, which can result in conception for the couple.

Stress Management

Managing stress to break free from this vicious cycle can help with conception. Here are some of the ways: 

Identify triggers: A small amount of stress is normal, but if it is continuous and long, it has a deep impact. Understanding the cause and working towards reducing it can help manage it. If your relationship with your partner is the cause, seek professional help. If work is the reason, find ways to improve your work-life balance. Make a list of the stressors and find ways to manage them effectively. 

Exercise: Physical activity is one of the best ways to reduce stress and also increase conception chances. When you exercise, happy hormones are produced and that aids in relaxation and also getting pregnant. Include at least 30 minutes of exercise every day to manage weight and stress. 

Practice mindfulness: Do meditation or other techniques to reduce stress. Focus on the breath and your thoughts and allow them to float around without any response or reaction. 

Improve communication: Lack of communication and openness in a relationship can cause emotional distress. When you are trying to get pregnant, be transparent and honest in your communication, as that can help resolve conflicts. 

Therapy: Counselling can help with fertility stress and there are several benefits of cognitive-behavioral therapy. It is a form of therapy that is aimed at helping understand the mind-body connection and also identifying negative thoughts that trigger emotions. The aim is to let irrational thoughts out and frame realistic ones. 

Trying to conceive can be a stressful experience. While the physical factors that lead to infertility cannot be controlled in some cases, the emotional aspects can be managed. It helps to know that managing stress can improve conception chances, as it is one of the ways to deal with infertility. 


1. Is stress related to infertility?

While stress alone cannot be the reason for infertility, it interferes with the ability to get pregnant. Research suggests that those with a history of depression are more likely to suffer from infertility and anxiety can increase the time to get pregnant.

2. What is the relationship between stress and reproductive health?

Chronic stress can affect fertility and interfere with hormone production in the body, thereby affecting reproductive health. 

3. What stress hormone causes infertility?

Cortisol, which is termed a stress hormone, increases in stressful conditions. Studies suggest that high levels of stress result in higher cortisol levels, resulting in infertility. 

4. Why can I get pregnant but not stay pregnant?

The causes can be an irregularly shaped uterus, uterus abnormalities, a weak immune system or hormone abnormalities.