Mind-Body Practices for Infertility – Rebirth Wellness Centre

This is a Guest Post Michele Barnes from Rebirth Wellness Centre in London Ontario.  Michele is a Registered Yoga Teacher, a certified Kripalu Yoga Dance Teacher and a certified Phoenix Rising Yoga Therapist.

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Typically, when a couple begins to experience fertility challenges, the first thing they ask is “what is physically wrong?” and “who is at fault” (i.e., which partner is contributing to the challenges).   These questions and a corresponding fear of failure can create additional stress in an already stress-ridden situation.  If this same couple seeks medical assistance to determine what the physical issues are that might be preventing fertility, the existing stress is heightened if no evidence of physical issues can be determined and they are subsequently diagnosed with ‘unexplained fertility’. 

 Whether procedures and tests determine a physical problem or not, and whether a couple chooses to conceive naturally or with the help of Assisted Reproductive Technology (ART), the stress involved in a challenged conception journey can wreck havoc on the physical, emotional and mental well-being of any woman or man.  Dr. Alice Domar, Director of Women’s Health Programs at Beth Israel Deaconess Medical Center and Assistant Professor at Harvard Medical School, concludes from her years of infertility research that  “infertile women report equivalent levels of anxiety and depression as [do] women with cancer, HIV status, or heart disease.”¹

The negative effects of stress on a human’s physical health is no secret and yet many people struggle to make the connection between the negative impact of stress on a body’s innate fertility…be it a woman’s or a man’s.  When over seven million women in the United States alone have been diagnosed with “unexplained fertility”², it raises some critical questions about what is actually inhibiting their ability to conceive and what can be done to help them heal.  This is where the success of complementary Mind-Body modalities can supply some answers and solutions. 

Stress is not only the consequence of what is taking place in our current, daily, external environment but also an outcome of psycho-spiritual issues that arise from early life experiences.  Our bodies are a physical roadmap of all of our life experiences and our emotional and mental responses to them.  And since stress affects the functioning of the hypothalamus gland [the control center of reproductive activity], the physical affects can be experienced as “disruption of hormone production, inadequate blood flow to the uterus and poor follicular quality.”³  

The hypothalamus cannot distinguish between the very real stress of traumatic experiences or consistently overwhelming workloads or chronic self-denigrating beliefs.  When the hypothalamus responds to stress (regardless of how it is experienced), it triggers the ‘fight-or-flight’ response which causes blood to move to the extremities and away from areas that may need it more…like our reproductive organs, and more specifically, the uterine lining which needs the nourishing effects of oxygen-rich blood to support an implanted embryo.  Infertility research from the Mayo Clinic concludes that “disruption in the part of the brain that regulates ovulation (hypothalamic-pituitary axis) can cause deficiencies in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) [which, in turn]…can affect ovulation.”⁴   In layman’s terms, when the mind and, subsequently, the body is in chronic ‘survival mode’, it cannot and will not focus on reproduction.  However, when the mind feels safe and the body is  relaxed, the parasympathetic nervous system is activated which essentially sends a message to the body that all is safe and well for reproduction.

The human body responds to stress at a very cellular level.  Biologists have determined that “cells are not impartial microscopic forms with rigid programming; instead, [they] are continually changing, responding, and reacting to stimuli from their environment.”  In fact, years of research “supports the fact that our thought patterns can have a profound influence on whether or not the cells and the body support or resist conception.”⁵  

Stress triggers not only mental and emotional responses but also neurological and chemical changes in the body (via carriers called ‘peptides’) that then stimulate the cells of the body when this information is received by ‘cell receptors’.  Cells use their receptors to communicate with their environment (both their external environment – the air we breathe, the food we eat, the people and situations around us – and the ‘inner’ environment – our own private world within our minds).  Cells are constantly responding to an almost infinite number of stimuli and, if a person experiences chronic stress, it triggers a response to produce the stress hormone cortisol which, in turn, increases the heart rate, heightens blood pressure, causes skin rashes and other forms of illness and disease.  Dr. Deepak Chopra says it best when he explains that “we have a thinking body…the mind is not confined to the brain.  The mind is in every cell of the body.”⁶   And, if this is true, it is essential that we become aware of the messages that are being sent to those cells and change self-limiting messages to life-affirming ones.  This is where Mindfulness-based practices and techniques prove invaluable.

Recent research led by Peter Eriksson of Sweden and Fred Gage of the Salk Institute in neurogenesis (how new neurons grow and develop in the brain) concludes that new neurons can be generated from neural stem cells that exist not only in the human brain but throughout the entire human body.  From the perspective of Mind-Body research, this “suggests that we [can create] new cells with a different belief system or replace unhealthy cells with vital cells programmed for positive change.”⁷  This is underscored by additional research in neural plasticity (connections made between neurons) “conducted at Brown University where researchers observed…changes in the neurons and synaptic connections, [indicating] that new thoughts are continually being integrated into our belief system and transmitted to our bodies.”⁸   Why does this matter to a couple trying to conceive?  It means that humans “are not fixed and unchangeable.  [Their] thoughts, beliefs, and attitudes can have a profound influence on their ability to have a baby.”⁹   

In a 1970’s research study in psychosomatic behavior, an infertility patient’s stated desire to have a baby was being sabotaged by her stated fears around pregnancy and labour because her involuntary nervous system was contracting the muscles surrounding her fallopian tubes at the time of ovulation.¹⁰   The importance of addressing emotional issues that can negatively impact a person’s ability to conceive was underscored by additional research conducted at Yale University in 1985.  In this research study, a group of women were split into two groups – one group worked with a therapist while the control group did not.  “The group that worked with the therapist on issues that were related to their infertility had a 60 percent conception success rate.  The control group had an 11 percent pregnancy rate.”¹¹

Over 20 years later, “in a 1993 study [conducted by Wasser, Sewall and Soules] found that psychosocial distress contributes significantly to the etiology of some forms of infertility.”¹²   More simply put, the women in the study who were experiencing consistent stress in their lives faced greater challenges conceiving.  When an individual’s response to continued stress is a developed state of depression, the ability to conceive is challenged even more so, as evidenced in another 1993 study published in The Journal of Psychosomatic Research that observed the effects of depression on women undergoing IVF treatments.  The participants underwent an evaluation prior to entering into IVF treatment to determine their degree of depression.  “The findings were that women with elevated depression levels had less than half the conception success rates of the women who were not experiencing depression.”¹³  

The outcome of this and other similar studies is highly relevant as women who face conception challenges “often report feelings of sadness or hopelessness, feelings of inadequacy or feelings that they are letting down people in their lives.”  In fact, according to Dr. Alice Domar, “30 – 50% of women who experience infertility report ‘depressive symptoms’.”¹⁴   When “every thought has an emotional connotation; every emotion…triggers numerous biochemical changes not only in the brain, but in different parts of the body”¹⁵   is it not unreasonable to consider then that the emotions of anxiety, despair, fear and anger that tend to create the building blocks for depression, when experienced consistently and chronically and without the means to allow them to be processed mindfully, can have a devastating impact on an individual’s health, and more specifically their reproductive health?

As Mind-Body practices and programs became more mainstream in the West, medical doctors and researchers started to consider how they might positively impact a person’s conception health.  A landmark study in 1995 “introduced a Mind-Body program to 132 infertility clients [and] produced a 42% success rate (published in the Journal of the American Medical Women’s Association in 1999).  In four published studies on several hundred women with an infertility duration of 3.5 years, 42% conceived within six months of completing the program [with] significant decreases in all measured psychological symptoms including depression, anxiety and anger.”¹⁶ 

 Another ground-breaking, Dr. Alice Domar study at the Harvard Medical School included 184 women who had been struggling with infertility for 1 – 2 years.  “The participants were divided into two groups:  one group took part in a ten-week Mind-Body program and experienced a 55% pregnancy success rate, as opposed to a 20% conception success rate with the control group.”¹⁷

And a more recent 2006 study conducted by Professor Sarah Berga, M.D. at Emory University in Atlanta, Georgia, observing the effects of Mind-Body practices for women experiencing amenorrhea “found that [the] women experiencing excessive stress produced high levels of cortisol…[experienced an inhibition of] the release of GnRH…(the gonadotropin-releasing hormone…that stimulates ovulation” and “a staggering 80% of the women who [participated in Mind-Body therapy] started to ovulate again, as opposed to only 25% [of the women in the control group].”¹⁸

So, what does all of this mean to the growing numbers of women (and men) who struggle with fertility?  First, and possibly most importantly, in a culture that requires scientific proof to support claims of non-allopathic healing modalities (and in many cases this is a good thing!), there is overwhelming evidence supporting the fact that Mind-Body and Mindfulness-based practices are integral in the conception journey, regardless whether a couple chooses to take that journey naturally or with the help of ART.  Additionally, these practices are so portable that even long after a couple undergoes their journey with the support of their health-care providers, they can continue to engage in these practices to help them maintain a consistent awareness of the very natural Mind-Emotion-Body connection and subsequently continue to benefit greatly from them.

1. 1.        Alice D. Domar.  The Journal of Psychosomatic Obstetrics and Gynecology 14, Suppl.  (1993):  45 – 52.
2. 2.       James Schwarz.  The Mind-Body Fertility Connection (Minnesota:  Llewellyn Publications, 2008), 5.
3. 3.       James Schwarz.  The Mind-Body Fertility Connection (Minnesota:  Llewellyn Publications, 2008), 53.
4. 4.       Mayo Foundation for Medical Education and Research (MFMER).  “Diseases and Conditions:  Infertility” from  MayoClinic.com  June 15, 2006.
5. 5.       James Schwarz.  The Mind-Body Fertility Connection (Minnesota:  Llewellyn Publications, 2008), 123.
6. 6.       Chopra, Deepak.  Magical Mind, Magical Body:  Mastering the Mind-body Connection for Perfect Health  and Total Well-being  Audio CD (Nightingale Conant, 1991), CD #1, Track 3.
7. 7.       James Schwarz.  The Mind-Body Fertility Connection (Minnesota:  Llewellyn Publications, 2008), 128.
8. 8.       Wendy Lawton, “What Can Change the Brain?  Electrical Synapses, Research Shows.”  Press Release from Brown University, http://www.brown.edu/Administration/News_Bureau/2005-06/05-055.html, December 15, 2005.
9. 9.       James Schwarz.  The Mind-Body Fertility Connection (Minnesota:  Llewellyn Publications, 2008), 129.
10. 10.   Lewis, Howard R. and Martha E. Lewis.  Psychosomatics (New York, New York:  Pinnacle Books, 1972).
11. 11.   Sareel, and a. DeCherney, Fertility and Sterility 43 (1985):  897-000.
12. 12.   S. Wasser, G. Sewall, and M. Soules.  “Psychosocial stress as a cause of infertility,” Fertility and Sterility 59 (1993):  684-689.
13. 13.   P. Thiering, J. Beaurepaire, M. Jones, et al., “Mood state as a predictor of treatment outcome after in vitro fertilization/embryo transfer technology (IVT/ET),” Journal of Psychosomatic Research 37 (1993):  481 – 491.
14. 14.   James Schwarz.  The Mind-Body Fertility Connection (Minnesota:  Llewellyn Publications, 2008), 15 – 16.
15. 15.   Jim Schwartz, BCH, “The mind-body approach to fertility, An Interview with Dr. Elizabeth Muir,” Resolve Newsletter (Winter 2004):  10 – 11.
16. 16.   A.D. Domar, P.C. Zuttermeister, M. Seibel, and H. Benson, “Psychological improvement in infertile women after behavioral treatment: a replication.”  Journal of the American Medical Women’s Association (1999):  144 – 147.
17. 17.   A.D. Domar, et al.  “Impact of group psychological interventions on pregnancy rates in infertile women.”  Fertility and Sterility, 73 (2000):  805 – 811.
18. 18.   Kathy Jones, “Behavioral therapy helps stress-induced fertility” http://www.foodconsumer.org/cgi-bin/777/exec/view.cgi/20/3939/printer, June 21, 2006.

Recommended Reading

1. 1.       Conquering Infertility: Mind-Body Guide to Enhancing Fertility and Coping With Infertility by Dr. Alice Domar, Ph. D. and Alice Lesch Kelly
2. 2.       The Mind-Body Fertility Connection by James Schwartz
3. 3.       Molecules of Emotion:  The Science Behind Mind-Body Medicine by Candace B. Pert, Ph.D
4. 4.       The Brain That Changes Itself:  Stories of Personal Triumph From the Frontiers of Brain Science by Norman Doidge, M.D.
5. 5.       The Mindful Brain:  Reflection and Attunement in the Cultivation of Well-being by Daniel J. Siegel
6. 6.       Full Catastrophe Living by Jon Kabat-Zinn, Ph.D