The stress-infertility-stress cycle

Stress is linked to many health problems, including depression and cardiovascular diseases. Less known is the fact that stress can also cause infertility.

A joint study by the National Institutes of Health and the University of Oxford reports that stress can prevent a woman from becoming pregnant. The researchers identified the substance as alpha-amylase which is an enzyme secreted by the parotid gland via the saliva to help digest starchy food. However, starch is not the only thing that triggers alpha-amylase secretion. It is also secreted in response to the presence of catecholamines, “compounds that initiate a type of stress response.”

The researchers followed up 274 English women of reproductive age (18 to 40 years) who were trying to conceive and charted their ovulation cycles. The women were participants in the Oxford Conception Study that investigated whether daily information from a fertility-monitoring device would increase the chances of conception. The phases of their monthly cycles were tracked using home fertility test kits.

In the current study on alpha-amylase, the participants were asked to collect a saliva sample on the 6^th day of their ovulation cycles. The saliva samples were tested for stress-related substances, including alpha-amylase and the stress hormone cortisol. The saliva analyses were performed till the participant conceives or until 6 menstrual cycles were completed.

The results showed that women with high levels of alpha-amylase in their saliva are less likely to conceive compared to those with normal or low levels during the fertile window –e.g. the 6 days of the cycle when conception is likely to occur.

According to study author Germaine Buck Louis, director of the NICHD’s Division of Epidemiology, Statistics, and Prevention Research:

“Overall, the 25 percent of women in the study who had the highest alpha-amylase levels had roughly an estimated 12 percent reduction in getting pregnant each cycle in comparison to women with the lowest concentrations.”

Cortisol levels on the other hand were not associated with the chances of conception. Dr. Cecilia Pyper who heads the Oxford Conception Study comments:

“This is the first study to show an association between a biomarker of stress and a reduction in women’s chances of conceiving throughout the fertile window — underscoring the importance of considering stress when attempting to identify the determinants of conception.”

In addition, it also highlights the need for finding ways to alleviate stress in women who are trying to get pregnant. This is especially difficult since each failed attempt brings even more stress that sets off a vicious cycle.