Does Stress During Your Cycle Reduce Your Chances of Getting Pregnant? (Episode 528)

Full Transcript: Episode 528

Lisa: Today I’m sharing a brand new episode in my FAM research series, and I’m tackling what I think is a really interesting question. And basically, the question is: does stress during the menstrual cycle have a negative impact on your chances of conception?

The study that I’m looking at is called “The Impact of Disturbances in Natural Conception Cycles.” These researchers were actually looking at the menstrual cycles of women who were successful in conceiving and comparing whether or not different disruptions and stressors had a negative impact on their chances of conception. And I find this question to be really interesting because many of you may be thinking, well, duh, of course it would have a negative impact. I think that we naturally assume that stress would have a negative impact, and we know that stress can have a disruptive effect on the cycle. But what I find interesting about this particular study is that these researchers wanted to actually look at the data and determine if this is really having a negative impact and to what extent. And that really helps us to be more confident in those recommendations.

I think this comes from that kind of concern — especially when you’re working with women who are trying to conceive — they’re often being told all of this information, and we’re just kind of taking for granted that it’s true. So to what extent do we really have to change our lifestyle? To what extent do we need to take a step back and relax? And when we’re being told that we need to do these things, is it really based on sound, solid research? So I appreciate the study for asking that question and going a little bit deeper into it.

One of the interesting things about this study in particular is that they drew their data from a very interesting dataset. The women who are part of this large dataset were charting their cycles using the symptothermal method. Therefore, they were gathering a lot of very specific details about their menstrual cycle. The researchers were able to not only look at the conception cycle — the cycle of the participants who successfully conceived — but they were able to look at up to three previous cycles prior to that conception cycle. And they had a lot of really specific data about what stressors they were experiencing, what events, what things were happening — again, because the women in this dataset were charting in a very specific way.

I think that makes the study unique and it just adds a lot of interesting data and information to this conversation. And I do think that this is one of the reasons that the researchers chose to go about this, because they’re wanting to make sure that those recommendations that women are commonly getting are actually warranted. So what they say as they introduce the study is: “For all couples wishing to have children, it is of great importance to know which factors — for instance health, lifestyle, everyday factors like stress — favor or possibly disrupt conception.” They’re talking about how women are being given all this advice by their healthcare professionals, but what has actually been researched? And they comment that scientific publications on this particular subject are quite rare. But then there’s a whole bunch of advice on the internet that says do this and do that and don’t do this and don’t do that. So what is really an evidence-based suggestion in this case?

Obviously, from the start, we should say that we do know that severe stressors or medical emergencies or serious illnesses do have a potentially negative impact. In this particular study, they’re not looking at those extreme cases. They’re actually looking at more of the common issues that we face all the time — like having a cold, having some pain or a fever, a variety of different things, even sexual intercourse during the implantation phase in a cycle where conception takes place. So they’re looking at those everyday things that we all experience.

In this particular study, a total of 237 subjects were included, and as I mentioned, up to three conception cycles were included along with the conception cycle. This is potentially the first study and systematic scientific evaluation on this question done this way. One of the reasons this may be among the very first — if not the first — study is because much of the research is done not on natural spontaneous conception cycles, where a couple is trying to conceive and they just get pregnant, but these types of studies are often done on IVF cycles or assisted reproductive technology cycles. So that’s something to keep in mind, because it applies to what’s happening when you’re out in the wild, so to speak.

So what the researchers found — in the study they went through a list of what they were picking up on, based on what the participants were noting in their cycle charts. They were looking at diseases or pain — different illnesses around the time of ovulation. Things like common fever, colds, headaches, sore throat, migraines, flu, gastrointestinal issues, infections, back pain. Just kind of the run-of-the-mill variety of common complaints or minor illnesses that a person could experience. They also looked at ovulatory pain. They looked at stress factors around the time of ovulation — whether it’s work-related, like somebody’s on call or their sleep is disrupted, or if there was an issue with their home, or if they had to move, or if there was a death in the family, night shift, insomnia — stuff like that. A variety of negative stressors.

Interestingly, they actually didn’t look at what they termed “positive stressors,” which is something interesting, because I often look at that. An example of a positive stressor would be your sister’s getting married or you’re going on a vacation. They chose only to look at the negative stressors. I tend to include all of those things under the category of stress, even if they’re so-called positive stressors.

They were also looking at specific illnesses during the suspected implantation phase — specifically at that post-ovulatory part of the menstrual cycle. If someone was experiencing a fever, cold, sore throat, headache, et cetera, during that time, to see if it had a negative impact. As well as stress during that time and even sexual intercourse during that time. So not only were they looking during the time of ovulation — they were also looking at disturbances during that kind of post-ovulatory implantation window to see if it would have a negative effect.

I love that they had this dataset of women who were charting their cycles, because most studies are not necessarily looking to this level — to see not only if there was a disturbance during the cycle, but what part of the cycle, to see if it could have a specifically negative impact if it happened at a certain time versus a different time.

So the results of the study — contrary to what you would think, contrary to thinking there had to have been a negative effect — they actually found that these types of everyday disturbances did not have a negative impact on the participants that they had looked at. They did have a control group — participants who did have these disturbances prior to this conception cycle, but also participants that did not have these disturbances prior to that conception cycle. And they found that there was not a negative effect. In these cycles, the stressors did not have a negative impact.

And compared to the control group, they found that there were significantly more conception cycles with disturbances than without. They found that 61% of the disturbed cycle group had those conceptions versus 39% of the control group. So that was just an interesting finding. Ultimately, when they looked at all their data, not only did they not find a negative impact, but they also found a positive one.

I think that it potentially just doesn’t have the negative impact we thought — and because these things happen so frequently and regularly, it’s just one of those things. In many ways, it’s like Murphy’s Law. Maybe you’re more likely to have some sort of disturbance than not, because if we track our cycles and note these things down, every time you have a menstrual cycle — every month or so — you probably do experience some sort of disruption.

They specifically looked at sexual intercourse and stress in the implantation phase, and again, they didn’t find a negative result. They did discuss other research studies that have looked at these questions as well, and they brought up one research study that had found a negative impact of post-ovulatory intercourse on the chances of conception. But then they also shared a different study — not a natural cycle, it was an IVF cycle — where couples who had sex in that kind of two-week period after an embryo transfer actually had an increased chance of pregnancy. In this case, the researchers suggested that the additional exposure had a positive immunological reaction.

I’ll just read from the study: it says, “This has led to appropriate clinical use in the form of intravaginal injection of homologous seminal plasma at the time of oocyte retrieval or embryo transfer.” So they’re saying that because they found that exposure to the partner’s seminal fluid had a positive impact on the rate of success after an embryo transfer, they started doing it as a protocol — specifically placing the seminal plasma into the vagina as a way to try to trigger this positive immune reaction.

Interestingly, the researchers in the study that we’re looking at suggested that maybe the reason that not only did these stressors not have a negative impact, but they had a positive impact based on the results, is that similarly, they may have a positive impact on immune function that increases the chance of pregnancy. So they were making some connections with the potential that part of the reason is that it’s kind of strengthening that immune function and leading to an increased chance of pregnancy.

So what does this study tell us? What does this add to our understanding? I think that again, as I said at the beginning, we know that extreme stressors potentially have a negative effect. This study was looking at more of the everyday stressors — having a cold, a flu, a minor fever, some stomach upset. The kinds of things that most women experience whether it’s during that cycle they are actively trying to conceive or during the time frame when they’re working towards conception.

I feel like what this study adds to the conversation is that we can have reasonable recommendations and expectations, and we don’t have to fear every little thing. And one of the things the researchers said — I’ll read the sentence — is: “Unfounded statements about possible disturbances in conception cycles can force affected couples into an unnecessary corset of rules of conduct and, above all, significantly increase the sensitivity of stress in those who undergo infertility therapy.”

This goes back to why I believe the researchers conducted the study in the first place: they’re observing this trend for women trying to conceive to be told that they need to follow all these rules and do all these things and you can’t do this, you can’t do that. And they’re trying to figure out which things are warranted and which things are not warranted. And so I think it’s really interesting and really useful. I love that they actually took this question and looked at it systematically to provide an evidence-based answer.

It’s like a relief. We don’t have to stress about every little thing that happens — while we still understand that major stressors, serious medical issues, and things like that could still have a negative impact. But those everyday things and regular disruptions may not have as negative of an effect as we thought.