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Why “Just Relax” is Still Not Helpful Advice in the World of Infertility

You know, infertile women and men of America, the whole reason you’re not having a baby isn’t because you have a uterine malformation or clotting disorder. It’s not because you have a non-existent sperm count because you were born without vas deferens. The real reason you’re infertile is because you’re not relaxing enough.

You can thank me now for shining light on that fact.

Actually, it’s not me that you should thank for the fact that this age-old advice has been recycled again. The onslaught of media stories is due to a study in Fertility and Sterility that the media believes supports what the general public has suspected all along. A watched pot never boils. You just need to stop wanting it so much. Take a vacation and then you’ll get pregnant. Do some yoga.

And while stress enzymes very well may affect fertility levels, the reality is that infertility is an umbrella term for a disease that has a myriad of diagnostic paths, one that can’t be boiled down to a simple answer. Yes, not releasing that stress enzyme may help some forms of infertility, but it certainly won’t help the numerous other reasons for why people are infertile.

And beyond that, this case is more about the general public seeing what they wish to see. The study doesn’t actually say that stress causes infertility. Instead, it illuminates the fact that in a case study of 274 women, looking at their first cycle of trying-to-conceive, there were “reductions in the probability of conception across the fertile window during the first cycle attempting pregnancy were observed for women whose salivary concentrations of alpha-amylase were in the upper quartiles.” In other words, if you were stressed during that fertile window on your first month, you had a lower chance of conceiving during that first month. Doesn’t mean you didn’t conceive the second month, but your chances were lower during the first month.

See what I mean? Still not very helpful advice.

But that doesn’t stop the media from proclaiming that stress causes infertility. The New York Times states “Some experts still recite an old maxim: while infertility undoubtedly causes stress, stress does not cause infertility. Now researchers suggest that the two conditions may indeed be linked.” And the The Stir asks if “just relax” is good fertility advice after all (hint: no).

USAToday leads the pack in offensiveness with their opening:

Practically everyone has heard of a couple who, after fertility treatments fail, adopt a baby and then all of a sudden get pregnant … A new study in the current issue of the journal Fertility and Sterility lends credence to a link between stress and time to conception, and not just in couples dealing with infertility.

Want to know the statistical rate of those diagnosed with infertility who conceive after adopting? As stated in my book, Navigating the Land of If, the number is 8%. Want to know the statistical rate for those diagnosed with infertility who conceive without fertility treatments and without adopting? Also 8%.

The Independent goes the women-should-just-stay-at-home-and-make-babies-and-stay-out-of-the-office approach with their opening:

Living life to a tight deadline, juggling appointments and rushing from place to place may harm a woman’s chances of becoming pregnant.

WebMD crows, “There is now scientific evidence to back up the widely held belief that stress can interfere with fertility.” CNN gently reminds readers that “The practical take home from all this is that if you are having trouble getting pregnant, one of the most important things you can do is work on ways to relax.”

Luckily, there is also Rachel Gurevich at About.com who calms the flames by pointing out why the general public shouldn’t return to their mantra of “just relax”:

What the research actually found was that during the first cycle of the study, this stress related enzyme seemed to be linked to a lower likelihood of pregnancy. But, when researchers looked at all the months from the study combined, there was no statistically significant difference. In other words, when looking at the big picture, this stress enzyme did not lead to trouble getting pregnant. Also, as an interesting aside, the study found that higher levels of cortisol – another stress related hormone – seemed to be linked to higher rates of pregnancy overall. Cortisol levels may be higher in those who experience long term stress, while alpha-amylase is related to acute, short term stress. (The difference between having an extremely stressful life, as opposed to an extremely stressful day or week.) However, the article was not titled “Long Term Stress Boosts Pregnancy Success.”

Reading her post is certainly more helpful than the proposed yoga classes women trying-to-conceive should enroll in to reduce stress levels.

What are your thoughts on the study?

Cross-posted with BlogHer.

48 comments

1 Emily { 08.29.10 at 7:48 am }

Pearls of wis-dumb!

2 Rach { 08.29.10 at 7:53 am }

Arrrrgh omg, this will just give fertiles more ammo and it’s a GIGANTIC step backwards for us infertiles who have taken time and patience explaining to people that NO relaxing WON’T get me knocked up.

Sure for someone who perhaps doesn’t have crappy eggs, or a womb of death, or some sperm that swim the wrong way or no sperm or attack cells, sure perhaps relaxing MAY work but for those of us who suffer from the above [and other stuff] relaxing will do stuff all!!

This post just makes me mad [not at you], you can tell those articles have been written by people who haven’t been there, who haven’t struggled, who haven’t lost.

3 Natasha Marchand { 08.29.10 at 9:07 am }

Relaxing is not going to help ONE BIT for those of us who have medical reasons for not getting pregnant. Yes I get that reducing stress will help us as we TTC with medical assistance, but cortisol was NOT the reason we didn’t get knocked up.

Also, the study from the ‘Independent’ article should have at least considered MFI….should men stay home and just make babies too? should the whole planet? Why is it always us?

4 Heather { 08.29.10 at 9:15 am }

Saying “infertility” is like saying “cancer” – what kind? Can something be done? One vague, giant umbrella.

Is stress good – no, not for anyone.

And I’ve never adopted – but I can only assume that having a new person of any age in your home is NOT stress-relieving. Babies are difficult and I can only imagine the myriad of difficulties of adopting an older child (attachment issues, abandonment issues, etc).

But I needed that laugh this morning…

5 Baby, Interrupted { 08.29.10 at 9:19 am }

That sound you hear is my head hitting the desk. Repeatedly.

Now, if stress is proven to cause stage four endometriosis, then I’ll pay attention.

6 Jendeis { 08.29.10 at 9:20 am }

Arrrgh!!! (Rips hair out)!

7 myinfertilitywoes { 08.29.10 at 10:29 am }

So frustrating!! Most of us have a reason or reasons as to why it isn’t happening, way beyond stress. I just had a fibroid removed and I’m convinced we wouldn’t have ever gotten pregnant had it not gotten detected and recommended to be removed. We’re still waiting but there was a problem and now I’m hoping we can relax and get pregnant now that that’s out of the way! I just hope others are able to too.

8 Rebecca { 08.29.10 at 10:31 am }

F**k them. Absolutely f**k them and their stupid studies.

9 May { 08.29.10 at 10:33 am }

After three years of infertility (anovulatory PCOS, oh, and polyps), and several goes of Clomid, I started ovulating on my own, and found I could, in fact, get pregnant in the old-fashioned ‘fun’ way in my own bed. According to my mother, this was because I was ‘more relaxed’ and ‘not trying so hard’. Well, I was trying to do a degree and hold down a job at the same time. My Father-In-Law needed major surgery. Grandparents developed cancer. That sort of relaxing thing. As for ‘not trying so hard’, seriously?

Anyway, given that she may have been right, that eating healthier and exercising more count as ‘relaxing’, well, relaxing didn’t help me stay pregnant FIVE TIMES IN A ROW. Funnily enough, relaxing doesn’t do jack for thrombophilia. Who knew?

I have noticed that some people (hi Mum!) seem to get actively hostile when you point out to them that your infertility and recurrent pregnancy loss is actually treatable with drugs. Drugs? Drugs work and relaxing doesn’t? Medical science is more helpful than positive thinking? OH MAH GAD HERESY! Why do people find it so amazingly hard to accept that infertility and RPL are medical problems, with medical causes? Why do they need to pin the ‘blame’ on our emotional states and issues, turning it into a moral issue all the time? And if stress is such a good contraceptive, how come women who have been bombed or starved or raped or flooded out or imprisoned etc. etc. still conceive? And they do, and it’s heartbreaking to hear their stories in the news, followed up by some smug little journalist telling ME, with my nice home and reasonable wages and plentiful food and clean water and no-one trying to murder me, that I need to RELAX. No sense of irony, these people.

10 mrs spock { 08.29.10 at 10:45 am }

I always like to point out to those wielding the relaxation argument, that most of us were perfectly relaxed until it had been a year or two with no success.

11 Emmy { 08.29.10 at 11:45 am }

My MIL has repeatedly told me that now that I am pregnant, I won’t need IVF to get pregnant again. “It’ll just happen!” Um, last I checked, pregnancy is not a cure for azoospermia, thanks. She knows about the azoo, too! The ignorance amazes me.

12 Illanare { 08.29.10 at 12:06 pm }

Ah, so it’s stress that caused my PCOS, anovulation and womb of death? Phew, thank goodness for that – I’ll go and tell my partner and take a bubble bath and bam! I should be knocked up by Hallowe’en. Stupid study. I can’t believe it passed peer review.

13 Jenn { 08.29.10 at 12:07 pm }

Ok I was wriggling in my seat the entire time, wishing there was someone in front of me to punch. These people are such IDIOTS! I should tell my DH if he would just relax, his sperm would miraculously grow to high numbers. Voila!

14 Kate (Bee In The Bonnet) { 08.29.10 at 12:11 pm }

Hmm. I’m definitely against prescribing relaxation as a cure-all for infertility, but I know the incredible effect that stress has on my life and my health. I am a big pusher of the idea that overall health is comprised of many small pieces that add up to a bigger picture: diet, exercise, stress-levels, general emotional well-being, adequate sleep, adequate hydration, the occasional glass of wine, etc.

And so, yeah. It doesn’t surprise me that stress may lead to a temporary inability to conceive, which is NOT the same as infertility. I mean, if you are unable to conceive for three months because you abuse drugs, does this make you infertile?

I don’t know. I feel pretty strongly about how our body-systems are all tied together, working in tune with one another. Excess weight can alternately cause or be caused by wonky hormones. Unregulated sugar levels alternately cause or can be caused by wonky hormones. Stress levels can be measured in one’s hormones– why would it be a question that stress can impact fertility *in some cases*? In my instance, I have no idea what caused my husband’s low counts and low motility. But I do know that I did everything I could to improve our cycle’s success (including reducing stress as much as possible. Of course, I would have practiced voodoo if I thought that could have helped…). Maybe my attempt at lowering stress had nothing to do with our success, but regardless, I was a happier person during my cycle by feeling like I was proactively doing all I could to help things along (and I have to think that forcing some relaxation along the way at the very least made me somewhat happier than I would have been otherwise…).

Feh. I don’t know exactly what I’m saying, other than I’m not surprised that there would be some sort of provable tie between stress hormone levels and overall success in conception, while at the same time, also staunchly agreeing that being told to relax is bullshit (in the same way that telling someone with perfect sperm that using ICSI will “cure” their infertility… if that makes any sense).

15 Battynurse { 08.29.10 at 12:38 pm }

A bunch of dumb asses that are throwing in their two cents worth to influence more dumb asses into believing that infertility is all our fault and that it shouldn’t be covered by insurance. I wonder if the insurance companies pay for these “studies”.

16 jamie { 08.29.10 at 12:46 pm }

Oh PLEASE!!! Seven years, two surgeries. One on me and one on hubby later. No baby. His boys don’t swim. I have PCOS and severe scarring. No amount of vacation time will cure that. Yes, when people think of infertility they cringe and hope its not them. To test ONE cycle and call it a study is laughable. How the hell is that scientific proof??????????

17 Nic { 08.29.10 at 1:07 pm }

I am so pleased I now know what I am doing wrong. I am stressed, maybe if I just relax……!
Of course I have endometriosis and hypothyroidism because I am stressed. Of course my IVF did not work because I am stressed even though I put myself on bed rest for a week and watched movies that whole week! Maybe if I had just relaxed…!
It frustrates me when things like this comes out, it belittles our struggles. It makes me feel that they are putting the blame onto us. We are causing our own fertility issues, because we are stressed.
Oh how I could go on how about how it infuriates me, but that would mean I would be getting stressed!

18 Geochick { 08.29.10 at 1:16 pm }

Oh G-d, I wish my friends wouldn’t read the news. I just got one of those stupid comments last night and I wondered where it came from. Apparently from these articles. I guess my experiences and knowledge count for nothing when it’s in the freakin NYT. Argh!

19 Carrie { 08.29.10 at 2:40 pm }

Simply irritating. Feels like it pushes infertiles into deeper hiding.

20 Roccie { 08.29.10 at 3:30 pm }

I just threw up on my keyboard.

21 Lut C. { 08.29.10 at 4:38 pm }

Thanks for dissecting the articles around that study. I hadn’t the heart to look into it so deeply – though my stress-levels shot up when I read the headlines. Not helpful!

22 Rachel { 08.29.10 at 4:50 pm }

What. Ev. Er.

We adopted. Trust me – it’s not relaxing having a baby in the house. Plus, I quit my job to stay home…so, according to their dumbass wisdom, shouldn’t I be knocked up by now?

Again. Whatever.

23 Deathstar { 08.29.10 at 5:24 pm }

You know I have no intention of actually wasting my time to read the study. From the second I started to tell people (2 years ago) that we were going to adopt, I got the “Oh, NOW you’ll get pregnant!” peptalk. No, no, I did not get pregnant. Sorry to burst your bubble folks. I did get perimenopause, but thanks anyway.

24 a { 08.29.10 at 5:34 pm }

Well, thanks for the link to the abstract…from that, it appears to be a totally meaningless study. Based on WebMD’s info, the 6 cycles were tracked, and only the first cycles were used to come to this conclusion? Am I interpreting this correctly?

I get highly irritated when studies are irresponsibly used to reach inaccurate conclusions. In my field, a psychologist has parlayed a study using 6 people into a huge conclusion that essentially claims that we are all biased…and people in my field are falling for this.

This is where I suggest that all scientific studies should come with a “Do Not Use This Study To Leap To Conclusions” warning label.

25 Joy { 08.29.10 at 6:18 pm }

People see what they want to see, and in this case, it is the hidden belief that women are to blame for their infertility. Which is the signature of our culture’s deep ambivalence about women’s power, which in some contexts includes fertility. We’ll always be subtly blamed by “studies” and the outrageous misinterpretations thereof, for all of it. Having too many children, not having any, wanting them too much, not wanting them; being too able to have them, being unable to. Working, not working, relaxing, whatever. Maybe society needs to feel better by blaming someone. It sucks.

26 JL { 08.29.10 at 6:33 pm }

Hmmm, I thought my ovaries are so relaxed that they don’t respond to FSH and that’s why my brain pumps so much through my body. Ha.

The fact that studies like this get so much media make my head and heart hurt. I get this feeling that the majority who hasn’t gone through infertility truly believe it’s in our heads and studies like this getting so much attention just feed the ignorance.

Yep, if I were more relaxed, my ovaries wouldn’t be aging much faster than I am, and I wouldn’t have crazy endometriosis threatening to bind my organs together again. Sure, whatevs.

I just sprained my eyes by rolling them so hard.

27 Another Dreamer { 08.29.10 at 7:01 pm }

All the news stories this study has spurned have done nothing but made me sooo angry that I wanted to punch something.

Sure stress can play a part in it, and maybe for some people it would make a little bit of a difference- but a majority of us have medical conditions, and you can’t “relax” away medical conditions. My endocrine system isn’t going to right itself by me de-stressing. My clotting disorder isn’t going to mysteriously vanish. And my uterine septum didn’t resect itself (my doctor did that, in a hospital… you know, because it was a MEDICAL issue). It just makes me angry. I hate all the news reports that make it out like this is out fault, like we caused our own infertility. I sure as hell didn’t ask to be born with several genetic problems, or to get PCOS at puberty. And since they’re medical conditions, I’m seeing a doctor for them… you know, the same thing you’d do if you had any other medical condition.

What scares me the most, is people who aren’t educated in all this will take those articles at face value and wait longer to seek treatment… because the media just told them a scientific study says it could just be from stress. So they’ll keep post-poning going to the doctor, and then finally go after waiting and waiting, to find they have… wait for it… a medical problem! Just saying…

28 Another Dreamer { 08.29.10 at 7:11 pm }

And I agree with Joy too! I wish they’d stop finding ways to blame us. Someone want to blame my genes, my body- fine, because I did hit the jackpot of crap, sure. That’s stuff I had no control over, and I have proactively treated, been to several doctors, had surgery to correct, etc… But someone wants to blame me personally, saying I’m not “relaxed enough”… hhheeeelllll no. Nuh uh. Sick of that song and dance.

The way society and the media treat infertile people, reminds me of how rape victims are often treated, or aids victims. Often society assumes it’s your fault if you are raped (they say well, she was asking for it. she shouldn’t have worn such revealing clothing. etc…) and if you get aids they assume it’s your fault too (they assume you used drugs, were asking for it, were loose, uncouth, etc…) With infertiles, they think we’re making it up enough as it is, assume we should relax because we’re not really infertile- we’ve just made ourselves sick with worry, etc… It’s absolutely ridiculous. Blaming the victim for what happened to themselves… absolutely ridiculous.

29 Jackie { 08.29.10 at 8:26 pm }

Well I guess I’ll just take that $10k I was going to spend on ivf and add on that meditation room I’ve been dreaming of.
On the bright side, since infertility is so easily curable, why don’t we get our insurance companies to pay for some spa trips?

30 Chloe { 08.29.10 at 8:31 pm }

The journalists who produced those offensive articles should read Susan Sontag’s Illness as Metaphor. Sontag has a pretty damn compelling explanation of how cultural understandings of various illnesses (cancer and AIDs in particular) serve to blame the victims and solidify the privilege of able-bodied people. This stuff infuriates me. I should read this crap instead of drinking coffee in the morning — it would wake me up quicker.

Thanks for raising the issue.

31 Barb { 08.29.10 at 11:03 pm }

My thoughts on the study are that it sets us back quite a bit in helping people understand infertility and its causes and doesn’t really shine much light on anything useful. Besides, how many times do scientists have to say it, “ONE STUDY IS NOT ENOUGH.” There needs to be a TREND. One study can be affected by so many things. It drives me crazy how one study oriented we are right now. sigh sigh sigh.

Thank you Mel for continuing to shine the light.

32 Kristin { 08.30.10 at 12:00 am }

Emily got it right…pearls of wis-DUMB indeed. GAH, this crap drives me insane.

33 Jonelle { 08.30.10 at 12:48 am }

It frightens me a bit that here it is 2010 and news articles are still printing the rubbish of “just relax” and passing it on as research. I highly doubt that “just relaxing” will help me grow eggs instead of cysts, or help grow back my right tube, or make mycycles regular.

And yes we are adopting and have heard the “oh you’ll get pregnant” and as much as I was to shush them, my best friend is part of the 8% that was able to get pregnant after adoption, so yes, they bring her up too. Lovely.

34 Melissa G { 08.30.10 at 2:13 am }

Nothing induces a rage filled rant like baseless, useless, and patronizing advice. I’m proud to say that after three years of IF (and still no baby) I’m starting to overcome my embarrassment and shame, and find the courage to correct and inform anyone who dares to offer unsolicited counsel. If only more of our voices could reach the media.

Thanks for posting this Mel.

35 S.I.F. { 08.30.10 at 2:50 am }

You’ve got to love people and their oh so flawed studies… I’m pretty sure reducing my stress isn’t going to make my left tube grow back or my endo stop scaring my ovaries in to the point that they can’t even release an egg anyway.

But hey, what do I know?

36 Michele { 08.30.10 at 7:51 am }

Wow… All along my PCOS (and hey- maybe even my IC!) could have been cured with relaxing! Finally! I have the answer!

Really? REALLY? I dont even have words for this!

37 Gail K. { 08.30.10 at 9:12 am }

This study just made me feel like I’m to blame for my infertility. Since I am currently diagnosed with “unexplained infertility” there isn’t any medical reason that can be found as to why I can’t get pregnant, but maybe my stress levels are doing it. But, if that were the case, I would have gotten pregnant while on vacation or after we sold our house. Yeah, I don’t buy it and think it is a load of crap!

38 Carla { 08.30.10 at 9:23 am }

I’m with Jackie! If my wonky, non-fluid producing cervix and my husband’s lack of morphology (just to name two issues) are caused by “stress”, then stress MUST be a medical issue, for which my insurance company (which does not cover a dime of infertility treatment) had darned well better pony up the cash for us to take a relaxing vacation, since that is apparently all it will take! They are right about one thing though—I AM stressed. But I didn’t start out that way. The countless blood draws, the drugs and their side effects, the endless ultrasound wands, the incredible high of seeing a heartbeat one week that is gone the next, and oh yeah, the thousands and thousands of dollars that was our savings, now gone with the wind…the thought that my uterus is now 5 years older than when we started. Who the heck could help but be stressed???

39 Frenchie { 08.30.10 at 11:10 am }

Thank you for posting this! I fall into that 8% ‘urban legend’ status: After years of TTC we adopted, and 2 years later we found ourselves pregnant on our own. This elicits the old refrain from about everyone we know: See! You just needed to adopt/relax for it to happen….that ALWAYS happens! I often want to say, “No, I wasn’t any more relaxed. I had surgery. And my doctor found a thyroid problem which was treated.” But people’s eyes glaze over when you destroy the myth they are so fond of believing. So I just smile and nod. Trust me, I was PLENTY stressed the month we actually conceived. Anyway, people are dumb.

40 Chickenpig { 08.30.10 at 2:18 pm }

This study is such a joke! My husband and I haven’t used birth control since the year 200, and while we certainly have had times where we were stressed, I would say that overall I live a happy and relaxed life. If all it took was to relax, surely we would have gotten knocked up w/o medical intervention at some point by now? ;)

41 mash { 08.30.10 at 3:09 pm }

Sigh.

Last week I got a facebook message saying – just stop trying to fall pregnant. Really? Because I haven’t even started trying to fall pregnant yet (unless you count the old fashioned attempts) and for two and a half years nothing’s happened. Would you say to someone who had cancer, just stop trying to get rid of it?

42 loribeth { 08.31.10 at 9:48 am }

ARGH. I’m not a scientist, but even I know that one study (of ONE cycle??!!) of 274 women in their first cycle of ttc is not much of a scientific basis to ground conclusions on. But given the state of science education these days, I’m not surprised. I’m sure fertile people will seize on this as “proof” that we all just need to relax & take a vacation for a baby to magically appear. Yeah, right.

I do believe that stress management/relaxation can help us cope with all sorts of stressful situations, & that stress can affect biological functions to some degree. I found yoga enormously helpful in dealing with the anxiety attacks I was having in the aftermath of our fertility treatments.

But relaxing is not a cure and it is not a fertility treatment.

43 Denise { 08.31.10 at 5:55 pm }

It is such F’ing bullcrap……

44 nonlineargirl { 09.01.10 at 12:33 am }

I am one data point for stress being helpful. When I had IVF (successful on the first try) with my older daughter, I had a very stressful job and had been crying daily for months over it. (even before taking hormones)

After a year of unsuccessful IVF, I got pregnant once I decided it was hopeless, so I like to say I am a strong believer in the power of negative thinking!

45 Annie { 09.01.10 at 12:44 am }

I saw this is the newspaper awhile back, too. Aaarrggh! Articles about the wonderful curative powers of “just relaxing” really stress me out!!! How about a study on exactly HOW I’m supposed to “just relax” after all the trauma of the past few years? Now that would be useful.

46 Bea { 09.01.10 at 6:07 am }

Do they even have editors anymore? Or am I assigning too much responsibility to newspaper editors, and it is all about punctuation? Because even if you accept the argument that relaxing makes a statistically significant difference to an infertile couple (which it seems isn’t proven here given the cortisol results… but we’ll gloss…) surely nobody, nowhere, with any sort of authority, has ever, ever claimed that relaxing is the “one of the most important things” you can do to fix your infertility? I’ve heard it being credibly sold as the icing on the cake, but anything more is ridiculous.

My computer keeps eating my comments on this blog. Let’s give this one a try and see what happens…

Bea

47 Bea { 09.01.10 at 6:09 am }

Oh yay! Ok, so… the whole upheaval with the graduation! I hope the nightmares are under control and that things feel a little less emotional now. Or should I hope that? There’s a time to be emotional, after all, and you wouldn’t necessarily want to miss it.

Bea

48 Lyn { 09.07.10 at 7:34 pm }

Wow. I’m glad I’m not the only one who wants to punch people in the face when they tell me to “relax and just stop trying”. (!)

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