In Fertility and Sterility a research article delved into the stress component of conceiving. By obtaining salvatory samples from women, the researchers found a clear link between stress induced hormones and infertility. Women in the study were tested for the hormones called alpha-amylase, which is secreted from the adrenal gland in response to perceived stress. Saliva testing indicated a clear relationship to increased alpha-amylase and non conception for that tested fertile cycle.
Western medicine is uncertain how alpha-amylase can impact the reproductive system. One theory believes it may decrease pelvic blood flow/fallopian tube movement and resulting in poor egg transportation. Unfortunately, the reproductive system contains many receptors for alpha-amylase and is highly reactive to it.
With time research is demonstrating how acupuncture has become a tool to improve fertility. Acupuncture has been found to decrease stress hormones and increase pelvic blood flow – two simple factors which can be significantly changed with Chinese medicine. Plus Chinese medicine is continually reviewing all components of a women’s life, thus allowing the practitioner discuss with the client when other therapies may need to added to address stress. Many acupuncturists have associates who are involved in other therapies which could provide a different type of support to de-stress.
This is such an important topic. Stress can be ignored but the physical body will show the signs. Over the years I have noticed a very clear trend with women who experience high levels of stress; anxiety and depression have a much harder time conceiving. It is very important for women and their partners to reach out and de-stress. Decreasing stress is a complicated topic as each person responds to different therapies. Some find yoga helpful, while others find meditation to be the key. It is important to explore and find people, places and activities to support your emotional health. If you can view the situation to de-stress as a different way to approach life and not as failing against ourselves, it could change you by preparing you for life’s other surprises.
Stress reduces conception probabilities across the fertile window: evidence in support of relaxation
Germaine M. Buck Louis, Ph.D.a, Kirsten J. Lum, M.S.a, Rajeshwari Sundaram, Ph.D.a, Zhen Chen, Ph.D.a, Sungduk Kim, Ph.D.a, Courtney D. Lynch, Ph.D.b, Enrique F. Schisterman, Ph.D.a, Cecilia Pyper, B.S., M.B.c
10.1016/j.fertnstert.2010.06.078
Discussion
To our knowledge, this is the first study to empirically demonstrate that stress is statistically significantly associated with reduced female fecundity as measured by a lower probability of conception for each day during the fertile window as women’s salivary α-amylase concentrations rise. Moreover, the reduction in fecundability was mediated via the sympathetic medullar system (SAM) pathway rather than through the hypothalamic-pituitary-adrenal (HPA) axis as evidenced by the opposing directions in fecundability odds ratio (FOR) and the day-specific probability of conception for salivary α-amylase and cortisol. Irrespective of the day or frequency of sexual intercourse during the fertile window, women with higher concentrations of α-amylase were less likely to conceive than women with lower concentrations, underscoring the importance of a statistical model that is biologically responsive to the timing of intercourse relative to the fertile window and inclusive of other relevant covariates. Although the findings were statistically significant for α-amylase and the daily-specific conception probabilities in the first cycle, the results based on all cycles per woman were not. This most likely reflects a loss in statistical power, with the most fecund women contributing one cycle coupled with the variability associated with α-amylase while trying.
Our findings do not support an earlier study involving 13 women prospectively followed that reported no differences in urinary adrenaline, noradrenaline, or cortisol concentrations between conception and nonconception cycles). Among Chinese textile workers trying to conceive, perceived stress during the follicular phase was associated with dysmenorrhea, underscoring the importance of timing when assessing stress-related effects. We did not measure dysmenorrhea in our study, but all saliva samples were collected during the follicular phase. A recent cohort study of women undergoing their first IVF/intracytoplasmic sperm injection cycle reported greater treatment success for women with lower urinary adrenaline concentrations at oocyte retrieval and lower adrenaline and noradrenaline concentrations at embryo transfer in comparison with women with unsuccessful cycles. In addition, stress reduction behavioral therapies have been shown to improve IVF outcomes.
The mechanisms by which α-amylase may reduce fecundity are as yet unknown, but the reproductive tract has long been known to contain catecholamine receptors, which may alter blood flow through the fallopian tubes and gamete transportation. Alpha-amylase is the principal salivary protein whose secretion from the parotid gland is regulated by the SAM system in response to sympathetic stimuli (physical and/or emotional stressors), resulting in increased blood catecholamines. Because this biomarker is produced locally in the oral cavity, it is in relatively high concentrations compared with other salivary markers such as cortisol that are serum constituents produced elsewhere in the body and transported to saliva via ultrafiltration. To this end, α-amylase may be a novel biomarker for assessing psychosocial stressors and reproductive end points as mediated via the sympathetic nervous system. The opposing effects for stress biomarkers and fecundity observed in our study underscore the importance of measuring multiple stress biomarkers of stress-related systems such as the HPA and SAM.
We have found a promising biomarker, but several important methodologic issues await further study to help interpret the findings. Our cohort was constructed within the Oxford Conception Study, a three-arm randomized trial to assess the efficacy of fertility monitoring in helping women conceive. Our Bayesian models incorporated a woman-level random effect term to accommodate unobserved heterogeneity. The findings need to be interpreted within the context of using the LH surge as a proxy for ovulation. Given the variability associated with ovulation, we have no reason to believe that the variation is nonrandom in this study cohort. Nater et al. observed 76 participants who contributed 857 α-amylase measurements during the course of the day and reported a marked diurnal profile that was unrelated to perceived stress. However, a 4% increase in α-amylase was observed for every 1 point increase in the perceived psychosocial stress scale completed by participants.
Our findings support a reduction in the day-specific probability of conception among women with higher salivary α-amylase concentrations in comparison with women with lower concentrations. Our data support clinical and public health messages aimed at helping couples relax and minimize stressors when attempting to achieve pregnancy. This message becomes even more important when considering the maternal-fetal unit, given the longstanding concern that stressors during pregnancy adversely affect fetal and infant well-being.