Stealing Potency: The Link Between Stress And Infertility

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Infertility is a silent struggle, so is dealing stress. Together, it is a deadly combination which disrupts an individual’s physical, emotional and mental well-being, and affects not just the individual but also, his family and relationships. Short-term stress does not impact negatively on fertility but, in fact enables many to handle critical situations better. Reproductive glands also require right levels of stress hormones to function well. However, being under constant stress for longer periods disrupt the balance of reproductive hormones, which may compromise fertility in both, males and females! Inability to get pregnant after 12 months or more, even after having regular unprotected intercourse is medically termed as infertility. Within a patriarchal society like ours, infertility is mostly seen as a woman’s problem, but the condition may have its impacts either of the genders. Surveys show that of all the infertility cases in India, almost in 30-40% cases males are affected and in 40-50% cases females are affected. Chronic stress due to infertility further has a negative impact on the trials to concieve. This is because of stress that alters the levels of sex hormones in men as well as in women, and this in turn does not favour conception.

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Stress Impacts Fertility

When a threat approaches, stress response system secretes hormones called glucocorticoids (example – cortisol). These hormones reallocate resources to tackle stress and shut down any system that is not necessary for survival– like reproductive system at that moment. A logical biological effect for survival of self rather than maintenance of species explains why women experience irregular menstrual cycles if they go through high levels of stress for longer periods. Male infertility is mainly caused by sperm abnormalities or low sperm production. Chronic stress experienced by men due to family or job issues, financial distress or medical condition can affect normal sperm production and reduce the sperm quality. Also, anxiety and stress experienced by male partner can lead to conditions like erectile dysfunction. This leads to withdrawal from establishing imtimate contact with the partner, bringing bitterness and conflicts between the couple, and ultimately landing in the vicious cycle of stress again.

Stress Shuts Down Reproductive Axis

Glucocorticoids affect functions of reproductive organs – testis (male) and ovaries (female). Stress induces higher levels of stress hormones, which act directly on the hypothalamus gland to decrease synthesis and release of Gonadotropin-Releasing Hormone (GnRH). GnRH is essential for secretion of key reproductive hormones- Luteinising Hormone (LH) and Follicle Stimulating Hormone (FSH). In females, FSH and LH together help in maturation of ovarian follicles and ovulation (release of egg from ovary) – events which facilitate fertilization. They stimulate production of female sex hormones- Estrogen and Progesterone from the ovary. In males, LH and FSH stimulate sperm cell production and secretion of male sex hormone – Testosterone. Next, stress hormones direct the pituitary gland to inhibit synthesis and release of LH and FSH. They increase secretion of Gonadotropin-Inhibitory Hormone (GnIH), which inhibits secretion of GnRH/LH further. This suppresses sexual behavior, decreasing chances of pregnancy. Chronic stress in women can block estrogen-induced uterine development and embryo implantation, all necessary for fertilization.

High levels of stress hormones released due to life events or unhealthy lifestyle habits (drinking alcohol, smoking, drug use) to cope with stress, increase production of free radicals that cause excessive oxidative stress. Chronic oxidative stress can have damaging the effect on standard semen parameters, sperm functioning and fertilizing capacity in males. In females, it can affect quality of oocytes (cells that form ovum/egg) and embryo development. Thus, stress leads to lack of/poor fertility outcome after natural conception or assisted reproduction. It has damaging effect on subsequent fertilization, pregnancy and even, offspring health.

Infertility Affects Mental Health Too

Psychological stress due to infertility presents in the form of acute or chronic stress in the affected couple. Diagnosis of infertility itself is so upsetting that it affects their capacity to respond. Women face various restrictions, gender-based discrimination and negative remarks causing psychological distress, helplessness, and a sense of loss of control. Stress levels become extreme when frequent implantation or assisted reproductive treatments fail, which are unexpected and terrifying experiences for those planning to have a child for long. Social stigma and threat of a failed marriage worsens the chronic stress in the affected partners. Psychological response by such individuals is in the form of grief, anxiety, anger, guilt, denial, complaints, self-blame, feelings of lack of support, poor body image, etc. Their mental health takes a blow, increasing the risk of depression, anxiety disorders to even suicidal tendencies, though of all these are in turn inversely affecting the fertility of the couple.

Conclusion

Speaking about reproductive problems, they are considered as taboo in many societies, so much so that they are always discussed behind closed doors and seldom a physician is approached by the patients. Proper counseling along with treatment, medications and assisted reproductive techniques, if needed, can help to restore fertility. The endless loop of stress-induced lowered fertility, infertility induced stress, which in turn impacts fertility, compromising the overall reproductive health. A timely diagnosis and open minded consultation could help save a lot of physical and mental stress; the number risk factor of infertility.

References

  1. Sharma, K. (2018, April 27). 27.5 million couples in India suffering from infertility. Times of India. Retrieved from: https://timesofindia.indiatimes.com/life-style/parenting/getting-pregnant/27-5-million-couples-in-india-suffering-from-infertility/articleshow/63938393.cms
14 May 2021

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