Stress & Fertility

There are many reasons why choosing IVF can be stressful, but the two biggest reasons reported by my clinic patients are money and time. According to a study in the Journal of Urology (2014), the average cost of patients using in vitro fertilization without insurance coverage was $19,234. This is the price for the one cycle as described in the example above. This price includes all procedures, medications, and appointments in the total cost. For those lucky enough to have insurance coverage for IVF, the cost reduces greatly. The other main stressor with IVF is time. It not only takes several months to complete a cycle, but it also takes time out of your daily life to take your medications, have regular blood tests, and regular ultrasounds. In addition, the retrieval and transfer days are tentative; if the patient responds slowly to the medications the procedure dates can be pushed out and additional medications need to be acquired. This is a common stressor amongst my patient population as it is difficult to navigate work and scheduling these appointments and time off when the patient isn’t sure when she’ll actually need to take off of work.

So what happens to a woman when she is undergoing this prolonged period of emotional stress? It is likely that she will find herself experiencing some form of psycho emotional symptoms - anxiety, sadness, and potentially anger. In addition to the changes in mood and mental status, there are also physical changes that occur in the body. Muscle tension, anovulation (the absence of ovulation), early menses, late menses, headaches, palpitations, and weight gain are common physical health problems that women with infertility diagnoses experience. These symptoms arise not only as a side effect of the medications that they may be taking, but also as a result of prolonged periods of stress as the women move forward with their fertility treatments. The stress of infertility, even after only a few months of not conceiving, can lead to high, sustained cortisol levels in the body. Cortisol is a naturally occurring hormone in the body that naturally rises and lowers throughout a 24 hour period. It helps us wake up in the morning and stay awake during the day before it lowers again at night to allow us to rest peacefully at night.

When we’re experiencing prolonged periods of stress, our cortisol levels rise and can remain high if we don’t work at reducing stress. According to an article by the Cleveland Clinic (2020), these higher levels of cortisol disrupt our sleep, and cause increased inflammation in the body that can lead to conditions such as anxiety, weight gain and heart disease. Common ways to try and stabilize cortisol levels revolve around the idea of stress management including yoga, meditation, diet, moderate exercise, sleeping, and being in nature.

In addition to these practices, acupuncture is an excellent way to combat your stress. There are a few different concepts on how it works, and one of those is that the needles help to release endorphins in your body through the effect on the body’s nervous system. According to the research done by the organization Evidence Based Acupuncture, When the body is under stress, an area of the brain called the hypothalamus releases Neurochemicals, and research shows that acupuncture can calm this response.

Acupuncture has also been shown to increase the release of endorphins, the body’s own ‘feel-good’ chemicals, which play an important role in the regulation of physical and emotional stress responses such as pain, heart rate, blood pressure and digestive function, (Junghans, paras. 5-6).

How can acupuncture play a positive role in stress reduction for fertility patients? Women going through ART treatments find that their schedules become filled with frequent appointments to their doctor for blood tests, ultrasounds, and procedures. While the addition of acupuncture treatments to this already busy schedule may feel daunting, women find that they often look forward to their acupuncture treatments. The mechanisms of how acupuncture works aside, the experience of going to an acupuncture treatment is unique in comparison to a visit at the RE clinic. At acupuncture, the patient is allowed time to sit and discuss where they are at with their treatments. This includes not only how they are progressing on their medications, but how they are doing mentally and emotionally through the cycle. The acupuncturist evaluates that status of the patient’s stress level and chooses acupuncture points accordingly to help provide a treatment that reduces the effect of stress on their body. Many research studies focus on the success of acupuncture treatments around the time of embryo transfers, however there has been an increase in studies looking at how receiving acupuncture treatments leading up to the embryo transfer can be even more beneficial long term. In a study published in Fertility and Sterility (2015), it was found that patients who received treatments leading up to the day of embryo transfer (ET) versus the transfer day alone reported “stress was significantly lower when compared to those undergoing acupuncture on the ET day only”. It is never too late to begin working with an acupuncturist while going through fertility treatments. You might just find that it’s the needed rest and relaxation you have been looking for along your fertility journey.