May 1, 2017

Stress & Fertility

Most western medical doctors will say the stress has very little or no effect on fertility. However, specialists from Harvard medical school have said that stress along with depression can have an effect on ovulation irregularities.  They also said that in men, stress can be associated with abnormal sperm development.

Depression among infertile women is found to be just as severe as the depression experienced by those with life-threatening illnesses such as cancer, AIDS, and heart disease. This depression can then further interfere with fertility.

A study of women undergoing IVF (In Vitro Fertilization) showed that it appeared to be those who exhibited lower levels of measurable physiological stress who had a higher chance of success. Feeling relaxed and unstressed favors conception, according to one study which measured mood states on standard psychometric tests, and the positive effect was thought not to be due to increased frequency of intercourse.

TCM Point of View of stress and fertility

Heart-Qi (Energy)

Feeling relaxed and unstressed indicates a healthy and unobstructed heart and liver-Qi (energy). Heart Qi stagnation (or blockage) can have an impact on ovulation. According to TCM, the heart is the emotional centre of the body and houses the spirit. When the Qi of the heart becomes obstructed due to emotional causes, the messages which the heart should send to the ovaries via the Bao vessel do not arrive and the eggs are not stimulated to ripen. Mental stress that affects the heart can upset the rhythm of the menstrual cycle. If the effect of the stress on the heart is very severe, then menstruation can stop altogether (there may be no messages from the heart to the ovaries for a long time). When ovulation is disrupted for a very long time, it can be difficult to re-establish the Bao vessel function. Difficulty in becoming pregnant can create feelings of anxiety and mental anguish which are emotions that affect the heart.

Liver Qi (Energy)

The liver-Qi is also easily obstructed by stress. The liver is in charge of the emotions and is in charge of promoting Qi (energy) flow throughout the body. Stress, anxiety, tension, and frustration all lead to obstruction of the liver Qi.

When the liver Qi is obstructed, there is a lack of movement of Qi through the pelvis and chest areas. There will be build up of tension in the fallopian tubes, inhibiting the passage of the egg, sperm, or embryo. There will also be significant PMS symptoms such as breast tenderness and swelling, bloating, and cramps. Liver Qi stagnation will also eventually lead to blood stagnation causing the endometrium to not be favorable to implantation.

How Stress influences fertility

Biologically, since the hypothalamus regulates both stress responses as well as the sex hormones, it’s easy to see how stress could cause infertility in some women. Excessive stress may even lead to complete suppression of the menstrual cycle. In less severe cases, it could cause irregular menstrual cycles. When activated by stress, the pituitary gland also produces increased amounts of prolactin which could cause irregular ovulation. The female reproductive tract contains catecholamine receptors. Catecholamines produced in response to stress may potentially affect fertility, for example, by interfering with the transport of gametes through the Fallopian tube or by altering uterine blood flow. However, more complex mechanisms may be at play, and researchers still don’t completely understand how stress interacts with the reproductive system.

Research has shown that the brain produces special molecules called neuropeptides, in response to emotions, and these peptides can interact with every cell of the body, including those of the immune system. In this view, the mind and the body are not only connected, but also inseparable, so that it is hardly surprising that stress can have a negative influence on fertility.

Stress can reduce sperm counts as well. Testicular biopsies obtained from prisoners awaiting execution, who were obviously under extreme stress, revealed complete spermatogenetic arrest in all cases. Researchers have also showed significantly lower semen volume and sperm concentration in a group of chronically stressed marmoset monkey, and these changes were attributed to lower concentrations of LH and testosterone (which were reduced in the stressed group). However, how relevant these research findings are in clinical practice is still to be determined.

How Acupuncture helps

Acupuncture is very beneficial for decreasing stress in the body by regulating the sympathetic branch of the autonomic nervous system. Possible hormonal imbalances and circulatory problems are also addressed by acupuncture.

Acupuncture deals with stress from both a physical and emotional cause. For example, extremely painful cramps at menstruation or mid cycle pain can be debilitating. This type of physical stress, no doubt produces emotional stress as it can result in missed work for many women. Both physical and emotional stress has an effect on the reproductive system.

Aceto corticotropic hormone is released as a response to acupuncture needle stimuli. ACTH has an antiinflammatory mechanism which may for example, help with tubal factor based infertility as a response to pelvic inflammatory disease.

The insertion of acupuncture needles has been shown to effectively increase blood circulation. Acupuncture is very effective in treating, for example, Reynaud’s Syndrome. Enhanced microcirculation to the uterine lining does, undoubtedly contribute to a healthier and more growth oriented endometrium.

Existing evidence regarding the role of acupuncture in the treatment of infertility has been reviewed.  A number of studies have been identified indicating that acupuncture can be beneficial as an adjunct to other infertility treatments, including IVF. Only one randomized controlled study examined the independent effect of acupuncture on IVF outcomes, but this indicated a positive effect.

Evidence has shown the effects of acupuncture may be mediated through neuropeptides that influence gonadotropin secretion, which could in turn affect the menstrual cycle. The technique can also reduce stress, which is known to adversely affect fertility, and has been implicated in the regulation of uterine blood flow.

Noting that acupuncture has been shown to affect the autonomic nervous system, Dr. Wolfgang Paulus (Christian-Lauritzen-Institut, Ulm, Germany) and colleagues postulated that the therapy could increase endometrial receptivity via control of related muscles and glands.

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