Medical Contribution By Dr. Sharon Covington
Which came first? Stress? Infertility? Does it matter?
“It’s something we’ve always wondered about,” says Tami Quinn of Pulling Down the Moon, “and the general consensus has been that there’s a connection. Everyone agrees that infertility causes stress – you stop eating right, you feel anxious… But hard data is now coming to light that shows a real biochemical link between stress and fertility problems.”
Quinn, whose business provides complementary medicine services to Shady Grove Fertility patients, is referring to a recently published National Institutes of Health study that demonstrated women with higher levels of an enzyme known as alpha-amylase were 12% less likely to get pregnant. The enzyme is referred to by the study’s lead researcher as “a real-time measure of stress.”
Dr. Sharon Covington, Program Director of Shady Grove Fertility’s Psychological Support Services, says the stress related to trying to get pregnant can begin even before couples seek fertility treatment.
“For some, not having gotten pregnant after three months of trying may raise a question in their minds,” Dr. Covington explains, “while others may have a physical stress response early in their journey. For someone who’s already anxious, trying to get pregnant quickly becomes another thing to worry about.”
That individuality of response has also been documented with research. Quinn describes a study in which monkeys were stressed out by way of things like a treadmill, diet, and social isolation. The result was that some subjects ceased ovulating or menstruating, some continued to menstruate but no longer ovulated, and some showed no change.
Once someone has made the choice to consult a fertility specialist, Dr. Covington says, their stress is often reduced slightly by simply taking action. “Getting more information can be stress-relieving for some people. “
Dr. Covington and her support team prefer to meet with a couple for a one-time session when that first decision to seek treatment is made. In the privacy of a professional office, counselors will prepare couples for what’s to be expected from the fertility treatment process.
Fertility counseling can be more than simple educational discussion or a place for patients to spill their worries. Dr. Covington and the Shady Grove Fertility support staff use techniques such as guided imagery, cognitive restructuring, and meditation to help patients first identify their stress triggers and then strategize to deal with them.
She says that one of the most stressful period for many fertility patients is what’s referred to as “the two-week wait,” when there’s nothing to do, no appointments to attend, and generally not even need for a phone call to the office staff. “At that point, the patient has been engaged in some intense and very regular clinic contact for weeks prior, and now, all they can do is wait to see if they’re pregnant.”
Most of the time, though, patients seek support only after several unsuccessful treatment cycles. “By the time they come in for either private or group counseling, they feel emotionally defeated and distressed,” Covington says. Another common time for patients to inquire about counseling services is at what Dr. Covington calls “the treatment crossroads, when it’s time to consider either different types of treatment or possibly adoption.”
That delay in seeking help with stress reduction is also seen by Tami Quinn, who remarks, “We’re always advocating for patients to come in earlier on that path to pregnancy. We’d like to consult with women while they’re still seeing a regular gynecologist or following their initial consultation with the fertility specialists. Optimally, three months before they start treatment would give their bodies time to respond positively to the stress reduction techniques.”
The services offered by Pulling Down the Moon include nutritional counseling, yoga, massage, andacupuncture. Rather than prescribing any one modality to patients, Quinn encourages women to “start wherever you’re at – if you hate yoga, maybe you’d like acupuncture; or people who are hesitant to change their diet may find yoga once a week to be refreshing.” The important thing is to make a plan for stress reduction and act on it. The company’s name is a reference to the challenges that some feel when trying to conceive. “We really think that just acknowledging the fact of this tremendous life challenge is the first step in achieving an inner calm, and with that, enhanced fertility.”
Both Dr. Covington and Tami Quinn agree there is no magic pill or one-time action to alleviate stress. It takes making some adjustments, adding some activities to your way of life, and learning new ways of thinking about your struggle.
