The pain of not being able to have children can never be wholly understood, shared, or properly realized by anyone other than those who personally face this difficulty.
Although not a disease, infertility is a serious health issue. Diagnosis can be a major life event that may bring about devastating social and psychological outcomes for individuals and couples. (9)
Addressing infertility challenges can be costly, and time can be of the essence for some. Although the association between stress and infertility has never been ruled out, doctors and experts have long debated on it. It’s definitely a controversial topic in the field of reproductive medicine.
Stress and Infertility Findings
With infertility affecting millions of people of reproductive age worldwide, answers and novel therapies are always welcomed. (2)
A missing link has progressively thrown more light on certain aspects of stress, specifically how it is interconnected with the ability to conceive.
Scientists at The University of Otago in New Zealand have been working for ten years, examining this one connection. (1)
The team has confirmed a population of nerve cells near the base of the brain — the RF-amide-related peptide (RFRP) neurons — become active in stressful situations and then suppress the reproductive system. Alterations in activity can lead to changes in puberty onset, fertility, and most importantly, stress responses. (1)
They used transgenic techniques to synthetically increase the activity of RFRP neurons in mice. This replicates what happens in stressful conditions, where high levels of the stress hormone known as cortisol are released. (1)
They found that when RFRP neuron activity was elevated, reproductive hormones were inhibited, and the reproductive cycles of mice were altered. Most significantly, they found that the reproductive system continued to function normally when cortisol levels were high, but RFFP neurons had been artificially ‘switched off’. (1)
Although stress hormones such as cortisol (also known as the ‘fight or flight’ hormone) were understood to be part of the mechanism, it was also known that the brain cells that regulate reproduction can not respond to cortisol, so somewhere in the circuit, there was that missing connection.
The RFRP neurons are now shown to be the critical link, and if they can be specifically blocked, it’s quite possible to overcome stress-induced infertility. (1)
The Missing Link
Professor Greg Anderson, who led the research, added “We have now shown that the RFRP neurons are indeed the missing link between stress and infertility. They become active in stressful situations, perhaps by sensing the increasing levels of cortisol, and they then suppress the reproductive system.” (1)
The effect was more prevalent in female mice. For women struggling with infertility, drugs which block the actions of the RFRP neurons may prove to be a miracle. The hope is that with a bit of refinement, certain medications already available could help. From what scientists know about these neurons, such a drug would be unlikely to have any side effects. (1)
Professor Anderson said, “A revolutionary step forward that has become available to neuroscientists in recent years is the ability to control the activity of selected groups of neurons — to either silence or ramp up their activity, and then monitor the outcomes.” (1)
The Infertility Effect
Many humans instinctively desire to produce offspring, yet global estimates suggest that around 48 million couples, and 186 million individuals, live with infertility. (2)
Usually becoming self-evident with an inability to get pregnant, infertility is often suspected after attempts to get pregnant with frequent and unprotected sex. Medical professionals then begin to run tests in an effort to determine what might be causing fertility problems. (8)
A wide range of socio-cultural, physical, and financial problems can be caused by the inability to conceive. The various consequential emotions, including turmoil, frustration, depression, anxiety, hopelessness, guilt, and feelings of worthlessness, can be incapacitating for some. (3)
Dismal Outcomes On Diagnosis
Does infertility cause stress or does stress cause infertility? The latter question has been answered. Sadly the former may be obvious.
Men need to feel empowered in their lives, and when a man suddenly discovers that he can’t control his ability to procreate, the revelation can be unsettling. Studies show men may feel overwhelmed by a diagnosis, often developing a sense of failure or sadness that they will “miss out” on an important life experience. (5)
Studies also show psychosocial issues of infertility can affect the female gender even more adversely than the male. Pity at being told she cannot have children is perhaps one of the worst sentiments that can be offered to a woman. (4)
The complete picture itself is stressful, as post-diagnosis, relationships and marriages can go on to suffer. Many couples choose to keep their infertility struggles a secret, resulting in lots of pressure. (5,9)
There is a small amount of evidence showing infertility problems can sometimes bring couples closer together through the perception of joint hardship, but overall findings suggest that not having a child after fertility treatment, adversely affects relationships for couples with fertility issues. (10)
The Good News On Infertility
The research team from Otago has proven there is hope, and fortunately, research is ongoing. In the meantime reducing the risk of infertility is the goal of many reproductive health experts when advising patients.
Maintaining a healthy body weight, staying physically healthy with exercise, not smoking, and conceiving before the age of 35, are all common suggestions.
Never having unprotected sex before wishing to conceive is sensible advice too, as sexually transmitted infections can affect future fertility. (2,6)
For women, hormone imbalances, fibroid tumors or pelvic cysts, alcohol and drug abuse, thyroid problems, excess weight, eating disorders or too much intense exercise are all factors that can contribute to infertility, and should be monitored carefully. (2,7)
Men must be aware of certain environmental factors, like pesticides, chemicals or radiation (including cancer treatments). Cigarette smoking, alcohol, marijuana, anabolic steroids, and certain medications can also affect male fertility. Even frequent exposure to heat, such as in saunas or hot tubs, can raise body temperature, affecting sperm production. (8)
What seems to get people through the maze of advice is hope, determination and good doctor-patient relationships. This doesn’t solve all the problems of course, but it may allow some to realistically take stock of what methods of help are out there.
- Infertility in Women :: American Pregnancy Association