Stress, scourge of modern times, is it an obstacle when you want to get pregnant? While studies tend to confirm the impact of stress on fertility, the mechanisms involved are not yet clearly understood. But one thing is certain: to get pregnant quickly, it is better to manage your stress well.

Studies do tend to confirm the negative impact of stress on fertility.

To assess the impact of stress on fertility problems, American researchers followed 373 couples for a year who were starting their baby trials. The researchers regularly measured two stress markers in saliva, cortisol (more representative of physical stress) and alpha-amylase (psychological stress). The results, published in the journal Human Reproduction, showed that if the majority of women had become pregnant during these 12 months, in women with the highest saliva alpha-amylase concentration, the probability of conceiving was reduced by 29% with each cycle compared to women with a low level of this marker (1).

Another study published in 2016 in the journal Annals of Epidemiology has also attempted to quantify the effects of stress on fertility. According to statistical analyzes, the likelihood of getting pregnant was 46% lower among participants who felt stressed during the ovulation period (2).

In humans too, stress would have an impact on fertility. According to a study published in 2014 in Fertility and Sterility, stress could lead to a decrease in testosterone levels, with an impact on the quantity and quality (mobility, vitality, sperm morphology) of sperm (3).

There is no scientific consensus on the mechanisms of action between stress and fertility, only hypotheses.

The first is hormonal. As a reminder, stress is a natural reaction of the organism which, when faced with a danger, will set up various defense mechanisms. Under stress, the hypothalamus-pituitary-adrenal gland axis is stimulated. It then secretes a quantity of hormones called glucocorticoids, including the stress hormone cortisol. The sympathetic system, for its part, triggers discharges of adrenaline, a hormone that will allow the body to put itself in a state of vigilance and extreme reactivity. When this natural protection system that is stress is too heavily used, the danger is to disrupt hormonal secretions, including those of reproduction.

• in women : the hypothalamus secretes gonadotropin-releasing hormone (GnRH), a neurohormone which will in turn act on the pituitary gland, a gland which secretes follicle-stimulating hormone (FSH) essential for the maturation of ovarian follicles, and luteinizing hormone (LH) which triggers ovulation. Over-activation of the hypothalamus-pituitary-adrenal axis under stress could lead to inhibition of GnRH production, with consequences for ovulation. During stress, the pituitary gland also secretes increased amounts of prolactin. However, this hormone could also have an effect on the secretions of LH and FSH.
• in humans: the secretion of glucocorticoids could reduce the secretion of testosterone, with an impact on spermatogenesis.

Stress can also indirectly affect fertility:

• by having an impact on the libido, it can be at the origin of a decrease in the frequency of sexual intercourse, and therefore the chances of conceiving in each cycle;
• in some women, stress leads to food cravings and overweight, but fat cells disrupt hormonal balance;
• some people, under the effect of stress, will tend to increase their consumption of coffee, alcohol, tobacco, or even drugs, yet all these substances are recognized as harmful for fertility.

Stress management begins with a healthy lifestyle, starting with regular physical activity, the benefits of which have been shown to be beneficial to physical and mental well-being. A balanced diet is also a key point. Omega 3 fatty acids, carbohydrate foods with a low glycemic index, group B vitamins, magnesium are particularly important in the fight against stress.

The ideal would be to be able to eliminate the sources of stress, but this is unfortunately not always possible. It therefore remains to learn to manage this stress and cope with it. Various practices that have been shown to be effective in stress management:

• relaxation
• meditation and more specifically MBSR (Mindfulness Based Stress Reduction);
• sophrology;
• the yoga;
• hypnosis

It’s up to each person to find the method that suits them.

Significant stress during pregnancy could have consequences for the good progress of the pregnancy and the health of the baby.

An Inserm study has shown that when a particularly stressful event (bereavement, separation, job loss) affected the expectant mother during her pregnancy, her child had an increased risk of becoming asthmatic or of developing other so-called pathologies. ‘Atopic’, such as allergic rhinitis or eczema (4).

A Dutch study, published in 2015 in Psychoneuroendocrinology, when she showed that significant stress during pregnancy could interfere with the proper functioning of the baby’s intestines. In question: a disturbed intestinal flora, with in newborns of stressed mothers, more bad bacteria Proteobacteria and fewer good bacteria such as bifidia (5).

Here again, we do not know exactly the mechanisms involved, but the hormonal track is privileged.

But if it is good to be aware of the harmful effects of stress during pregnancy, be careful not to make future mothers feel guilty, often already weakened during this period of great psychological change that is pregnancy.