Kathleen Boht and her husband, Brian, started trying to have a baby shortly after they got married in their mid-twenties. But after eight months without a positive pregnancy test, Boht started to wonder if her body “didn’t know how” to get pregnant. She bought ovulation kits, started tracking her cycle and timing their efforts. Eventually she visited a fertility clinic where the doctors ran a test and told her that her fallopian tubes were blocked.
About four years after they first started trying, Boht and her husband began in vitro fertilization and Boht gave birth to a baby boy. Five years later, in 2014, their daughter was born, also by IVF, and the couple declared their family complete. They were so done, in fact, that they started researching a vasectomy for Brian, just in case—although they really didn’t believe they could get pregnant naturally.
In 2016, after going through years of stressful IVF procedures, miscarriages, shame that she wasn’t able to conceive naturally and the financial strain brought on by it all, Boht began focusing on herself again. She got a fitness tracker and made sure she walked her target number of steps. She was eating well, going to Pilates classes and indulging in things like getting her nails done. And in December 2016, when her youngest was two and a half, she took part in the ultimate relaxation: a day at a thermal spa, complete with a massage.
“That’s the cycle when I got pregnant,” she says.
Sony Sierra, a reproductive endocrinologist and infertility specialist at the TRIO fertility centre and Women’s College Hospital in Toronto, says imaging tests that show blocked fallopian tubes are not always accurate, and Boht’s obstetrician wasn’t surprised she got pregnant—he’s seen other couples with similar fertility issues experience the same thing.
Boht says she’ll never know why, after more than a decade of infertility, she managed to get pregnant naturally, but she credits a large part of it to her lifestyle changes. She knows that crediting her pregnancy to “relaxing” is a delicate subject. “For years and years we’ve been told to relax and it will happen. When you’re going through infertility, nothing makes you more angry,” says Boht. Yet, she says her stress-reducing habits seemed to be key.
Sierra says stress can impact fertility in a number of ways, and sometimes the association is more clear than others. For example, if stress is stopping you and your partner from doing the deed on a regular basis, then it follows that you may have trouble conceiving. Stress can also affect lifestyle choices, like sleep, alcohol consumption and exercise, all of which can play a role in your body’s ability to get pregnant.
But for some women, stress can even affect ovulation. “Stress is managed in the hypothalamus, which is very close to the centre which controls your hormones that stimulate ovaries,” says Sierra. “Stress can lead to hormonal disturbances that prevent normal ovulatory cycles.” That’s why some women stop having periods during a particularly stressful time in their lives, like after a death in the family or during high-pressure exams in university.
There’s also evidence that chronic, everyday stress can affect your chances of getting pregnant, although measuring this is difficult, says Alice Domar, a psychologist who runs the Mind/Body program at Boston IVF. In an effort to determine the relationship between stress and trouble conceiving, many studies have looked at the effect of therapy and other psychological interventions on women going through IVF. Overwhelmingly, the women who take measures to reduce stress get pregnant more often.
“What I tell my patients is, ‘This whole relationship is pretty unclear. We do know that women who do something to lower their stress levels feel a lot better, are more likely to stay in treatment, and have higher pregnancy rates,” says Domar. The good news? “There’s no downside to learning tools to help you feel less stressed.”
At TRIO, when patients first visit the clinic, doctors ask them about lifestyle factors, like what they do for work, how often they exercise, how much sleep they are getting, what their diet is like and their stress levels. They also advise them to make changes, like getting more sleep, following Canada’s Food Guide and exercising three times a week before embarking on more invasive treatments. These lifestyle habits are often impacted by stress in our lives.
“We also offer naturopathic supports and complementary therapy like massage therapy or acupuncture, to increase their well-being and therefore manage stress and hopefully improve their fertility,” says Sierra.
Domar says she recommends anyone thinking of starting a family first take a look at their lifestyle and look for ways to improve their diet, exercise and sleep habits as a means to increase their chance of conception and prevent the stress that comes with fertility difficulties. “Because once you start trying to get pregnant and fail, then your stress level goes up,” she says.
Boht’s third child, a boy, was born last fall. “Everyone always talks about how stress affects the body, but I knew other stressed out people who were getting pregnant, so I thought, why not me?” she says. “After my natural little miracle, I think maybe there is some truth to it.”