Every day more importance is given to how stress can affect fertility, based on studies on the physiological effects of stress and its impact on reproductive processes. Although the relationship between stress and fertility remains a mystery, many scientific journals emphasize that stress significantly reduces the likelihood that a woman can become pregnant , even when she resorts to assisted reproduction techniques.
How stress affects each person and what reactions it can cause depends on individual factors. Therefore, how each member of the couple will be affected in their reproductive response will also be very personal. In terms of sex we know that:
At the biological level, the hypothalamus regulates the responses to stress and sex hormones, and in some stressed women may cause fertility problems. Excessive stress can cause anovulation or irregular menstrual cycles. In the most severe cases, it can even cause the suppression of the menstrual cycle.
When the pituitary gland is activated by stress, it produces higher amounts of prolactin causing an irregular ovulation. The increase of this hormone also leads to a decrease in libido, with which the interest in having sexual relations will decrease. If the frequency of keeping them decreases, of course, the probability of getting pregnant will also decrease. On the other hand, in order for a good implantation to take place, good levels of estrogen and progesterone are necessary. Faced with a deficit of these, it is not possible to finish the process and the pregnancy will not continue even if the ovum has been fertilized.
Although all this research, we still do not fully understand the complex processes that may be at play in the relationship between stress and its influence on the reproductive system.
Stress can also reduce the quantity and quality of sperm. Research in a group of men has shown lower semen volume and sperm concentration in groups of men with chronic stress. Research continues to determine its clinical relevance. In addition, it can suppress libido or cause erectile dysfunction, affecting the frequency of sexual intercourse and therefore the probability of pregnancy.
Research has shown that women undergoing treatment for infertility have a similar, and often higher, stress level than women who face serious illnesses such as cancer or heart disease. The effects of this stress on the quality of life of the couple tend to be substantially higher in women than in men (Guerra et al, 1988) .
Lemmens et al. (2004) and Alper et al. (2002) conducted conclusive studies about the need for couples undergoing assisted reproduction techniques to have psychological support before, during and after treatment. This is due to anxiety and the feeling of loss of control, which translates into psychosomatic symptoms in both partners.
Moreno et al. (2007) conducted an investigation on infertility in women. He found that following a psychological support program there is a marked reduction in stress in women. It emphasizes the need for couples in assisted reproduction processes to have psychological support.
Other studies that show that couples with fertility problems have a better response to medical treatment when it includes psychological support. Domar et al. (1999) showed that a program to reduce psychological stress is associated with a higher percentage of viable pregnancies in infertility treatments.
Although the relationship between levels of anxiety and the probability of success of treatments is inconclusive, many authors found a statistically significant relationship between the role of psychological intervention and the number of conceptions (Alice Doman et al. (1990, 1992), Annette L. Stanton & Christine Dunkel-Schetter (1991), Jane Read (1995) or Sandra & Leiblum (1997) among others) .
We know for sure, however, that stress is the main cause of abandonment of fertility treatments.
Improving our quality of life and putting stress at bay can be the first step on the road to improving our fertility. Stress and infertility create a vicious circle where both of them aggravate each other.
If we attend an assisted reproduction center, we can have a psychological support that will provide us with personalized help. They will help us to manage both the stress derived from the difficulties to conceive and the stress produced by the development of the treatments.