By Sage Breslin, Ph.D.
It’s nearing the end of the week, and I am exhausted and nearly overwhelmed. I show my last couple of the day to the office and they sit, side by side, on the couch. They are composed for the first few minutes, as I ask a series of non-threatening questions. Then, I turn, as I always do, to the more complex queries. I ask them what I know their medical team has been unable to answer, “What seems to be the problem?”
No- I don’t really ask that, but pose a more generic substitute. Given that most women respond to this question with sheets of tears, I’ve actually stopped asking it. Instead, I ask that my clients be the experts and educate me about where they are in the process. It seems to help clients feel empowered- especially around the one area over which they do not seem to have any control. “What has your team learned?” and “What have you tried?” have become far more informative than “What seems to be the problem?”
Yet, in some ways, the common response to that question may actually be a dead give-away. The frustration, desperation, anger, and hopelessness that seem to be contained in the tearful response to that age-old query may give us far greater insight into the problem than anyone ever realized. Perhaps what has been unexplained for so many couples, does have an explanation lying in wait.
That couple was the fifth I saw this week with unexplained infertility. Strangely, of the five dyads, four of the partners were school teachers. Actually, I’ve lost count of the teachers I’ve seen this year alone who have come in as a result of unexplained infertility. While some clinicians might be disturbed by this, I’ve made a study of the circumstances, and I believe that the methodical, nearly compulsive traits of the effective educator present fertility challenges. Why? Because the stress that most teachers endure, no matter how well disciplined they are in the classroom, is phenomenal. If you’ve visited any of the elementary, middle or high schools in this county in the last year, you know what I’m talking about. Stress is at an all-time high as these folks try to manage record numbers of students, including those that excel academically, those that struggle academically, those that are challenged by emotional issues and those whose behavior astounds all present.
But, it’s not just teachers that are experiencing the impact of stress in their lives: it’s the dual-income couples that are striving to keep up and stay afloat in San Diego County. It’s the high achievers who are reaching for the brass ring. It’s the couples who have excelled at all they’ve done, and put off children, “until the time is right.” Stress is ubiquitous and becoming more and more pervasive and ever-present.
And, as stress increases, so does unexplained infertility. And, in my experience, if the couple has no outlet for the stress they endure on a regular basis, they have little chance for conception or healthy pregnancy. Domar (2006) cites research studies that show that “women with depressive symptoms were half as likely to conceive as women who were not depressed, and in the most recent study of 151 women scheduled to undergo an IVF cycle the chance of a live birth was 93 percent higher in women with the highest positive-affect score. Researchers have concluded that the success rates of high-tech infertility treatment can be adversely affected by psychological stress.”
Now, don’t get me wrong: it’s my passion and life’s work to assist couples in this process. I believe that most couples who invest in creating life change, eventually become pregnant. It’s just that most couples are working so hard to achieve their dreams that changing, relaxing, and letting go are thoughts and actions that are so unfamiliar that it becomes nearly impossible to achieve this shift on their own.
There isn’t one among us who hasn’t been touched by a story of a friend, family member or colleague who tried for years to conceive, but in vain. Then, when adoption was complete and the newly designed family was chugging along, “Poof!” the stick turned pink! We’re happy initially for the newly blessed family, but sometimes secretly wonder, “Is that what we have to do to get pregnant?”
Adoption is an absolutely FABULOUS option for creating a family. It’s an option that many childless couples eventually utilize to achieve their dreams. And, for many, it does seem to be accompanied by pregnancy. But, those signatures and documents aren’t magic- pregnancy is a natural bi-product of adoption, because adoption relieves the pressure about getting pregnant. It creates family, so that couples do not have to bear that burden of conception on their own. And, when the burden is relieved, and couples are able to relax, those stress hormones decrease, and the body does what it is designed to do: it creates life when the opportunity is provided and the circumstances are optimal.
For couples who are not yet ready to adopt, integrative medicine offers an alternative for resolving unexplained infertility. Through comprehensive programming, we achieve life change, which lowers stress, reduces stress hormones, and achieves conception. There is no magic pill. Couples that are successful are those who really espouse the life change required for healthy pregnancy and childrearing.
What is required is for couples to fall in love all over again. And, when they’ve taken that leap, they learn to listen to their bodies and to one another in ways that they never dreamed they could. And, when they’ve accomplished that, they dismantle the beliefs, ideas, and thoughts that have kept them from having children- all of the tiny little intrusive ideas about who and what they are and can be, to one another, to their families, and to their unborn progeny. All of this changes as they learn to focus on one another, and invest totally in their lives together. The concept of conception just becomes a lovely “addition” to their lives together, but moves out of the spotlight. The pressure slides away, and the couple learns to cherish every day they have together. It is then that the wish, and the desire, for children, can be carried into the universe, and is often, answered.
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Selected references on the Relationship between stress and fertility
1. Boss, A. (2006). “Stress and Infertility”. http://www.conceivingconcepts.com/learning/articles/stress.html Retrieved 4/27/06.
2. Domar, A., Clapp, D., Slawsby, E., Dusek, J., Kessel, B., Freizinger, M (2000) Impact of group psychological interventions on pregnancy rates in infertile women. Fertility and Sterility Vol. 73, no.4 April
3. Domar, A., Zuttermeister, P., Friedman, R (1999) Distress and Conception in Infertile Women: A complementary approach. Journal of the American Medical Women’s Association. Vol. 54, No.4
4. Demyttenaere K, Bonte L, Gheldof M, Veraeke M, Meuleman C, Vanderschuerem D, et al. (1998) Coping style and depression level influence outcome in vitro fertilization. Fertility and Sterility. 69:1026-1033
5. Domar, A. (2006). “The Relationship Between Stress and Infertility”. http://www.conceivethepossibility.com/research/index.htm Retrieved 4/26/06.
6. Domar, A (1996) Stress and Infertility in Women: Is there a relationship? Division of Behavioural Medicine, Deaconess Hospital Mind/Body Institute, Harvard Medical School. Psychotherapy in Practice 2/2:17-27
7. Domar, A., Zuttermeister, P., Friedman, R (1993) The Psychological impact of infertility: a comparison with patients with other medical conditions Journal of Psychosomatic Obstetric Gynaecology. 14 Special issue 45-52
8. Wasser, S., Sewal, G., & Soules, M. (1993) Psychosocial stress as a cause of infertility. Fertility & Sterility, 59, 685-689
9. Domar, A., Seibel, M., & Benson, H (1990) The Mind/Body Program for Infertility: A new treatment program for women with infertility. Fertility and Sterility, 53, 246-249
10. House, A. “Stress Reduction Program for Infertility”. http://www.mcg.edu/SOM/psychiatry/InfertilityStressandDepression.pdf. Retrieved 4/27/06.
11. ICBS (2000). “Stress and Infertility”. http://www.holistic-online.com/REMEDIES/infertility/inf_stress.htm Retrieved 4/27/06.
12. Pennebaker, J., Kiecolt-Glasser, J & Glasser, R. (1987) Disclosure of traumas and immune function. Health implications for psychotherapy. Journal of consulting and Clinical Psychology, 56, 239-245
Dr. Sage de Beixedon Breslin has worked in the field of Psychology for more than two decades. Reproductive Wellness™ is the only integrative fertility treatment center in San Diego.