The stress that couples with subfertility undergo in their journey towards becoming parents can be immense. It is obviously an emotional endeavor with ups and downs due to the difficulty that they may have experienced in conceiving; the hopes that each month’s attempt brings, and the disappointment if the result is negative after the two week post-ovulatory wait, are potential highs and lows that add to stress.
Women over age 35 should seek a fertility evaluation if they have not conceived after six months of unprotected intercourse — if a woman over 35 has a known factor (for example, infrequent or absent periods, endometriosis, male partner with a known history of low sperm parameters), then an earlier evaluation is warranted. Fertility evaluations and treatments can amplify stress to varying degrees in couples and I have found that the initial consultation is so important in terms of addressing stress. The patients should be aware that they are not alone – approximately one out of seven couples in the United States experiences infertility. That is over seven million people. A comprehensive overview of fertility factors and treatment options helps to inform and empower women who are trying to conceive, and answering their questions helps address the concerns they have about their own fertility.
As patients subsequently have tests done and pursue fertility treatment, some may achieve a successful pregnancy within a shorter time span and others may have a longer, more difficult journey towards parenthood. The intensity of emotions can change over time; therefore, it is vital to check on how every patient is doing emotionally and to make sure they are doing relatively well, considering the circumstances.
Sometimes, my patients ask what they can do to reduce their stress levels. Stress has been shown to affect fertility; most studies have shown that stress has an adverse effect on fertility although some have shown no effect. It is difficult to measure stress, and we all do experience some degree of stress at work and/or home. It is a tall order sometimes, but I ask my patients to not stress about being stressed. Exercise, acupuncture, support groups, and activities that patients personally feel have reduced their stress in the past can be very helpful. It is impossible to determine whether patients who achieve successful pregnancies via fertility treatment are able to do so because of or in spite of decreased stress levels. Either way, at that point, the fact that the inner transition from “trying to conceive” to “Mom” has occurred is all that matters.
Dr. Kavoussi is a Reproductive Endocrinologist with Austin Fertility and Reproductive Medicine-Westlake IVF in Austin, Tx.