The Times, 26 June 1989
Should childless couples simply stop worrying about their infertility?
A belief that stress can inhibit the fertility of some people has led to fears that the anxiety generated by the sophisticated fertility treatment now available could in itself act as a barrier to conception.
A fertility clinic about to open in the private Hollyhouse Hospital, Buckhurst Hill, Essex, is adding a novel counterattack to such anxiety in the form of four-week stress management courses.
Its medical director, Michael Ah-Moye, who will be moving across from the fertility unit at the Humana Hospital Wellington, London, in mid-July, has long felt that the month-by-month disappointment of childless couples must in itself be an obstacle to the longed-for event.
“We’ve all heard about patients who have finally accepted their infertility only to fall pregnant spontaneously,” he explains. .’We’ve often had patients here for consultations but told them we’ll start treatment in three months and during that time they conceive. I think it is because they think something is being done at last, so they relax.
“If a woman suffers bereavement her periods are affected and I’ve seen some who have stopped menstruating for a whole year, and therefore stopped ovulating.” I
Ah-Moye believes the basic response to stress is controlled by the hypothalamus gland in the brain, where the hormones which start the whole process of conception are regulated. He feels this goes some way to explaining why couples whose reproductive systems are found to be medically sound can remain childless even when monitored and offered artificial aids such as IVF (in vitro fertilization) or GIFT (gamete intra fallopian transfer).
Not all doctors are convinced. Professor Ian Cooke, of the obstetrics and gynaecology unit at the Jessop Hospital for Women, Sheffield, says: “It’s not that I’m against the idea; it is just that the evidence is not very good. Whether you can modify stress by stress management, or whether you can get an improved pregnancy rate is a moot point. There’s no doubt that patients will feel better for it because attending a fertility clinic is a stressful business.”
Ah-Moye points to a recent study of patients in Boston, Massachusetts, which suggests stress management might improve results by up to 15 or 20 per cent. He hopes combining it with GIFT and IVF techniques will improve success rates, currently standing at one in five attempts for IVF and one in three for GIFT.
Gynaecologist Dr Gowrie Motha will run Hollyhouse’s programme, tackling stress with a mixture of “alternative” or “complementary” therapies such as creative visualization, reflexology and aromatherapy as well as self-hypnosis and deep relaxation techniques.
“Sometimes, at a subconscious level, women don’t want to conceive, they block themselves off from getting pregnant, say, because they are scared of the birth,” Motha says. “We want to get them to tone down and not be so bothered about the treatment.
“It’s always been my dream to see all the different therapies, from the east and the west, incorporated into a whole. I am convinced that we need a multi-disciplinary approach. We are pioneers so we can’t have any figures to go on right now, but it can’t do my thing but help.”
To check the course’s effectiveness, a comparative study will be carried out on the pregnancy rate of those who embark on the £150 course and those who decline it.
“We hope at least half of our patients will take up the stress course,” Ah-Moye says. “We’ve tried to make it almost non-profitable because we believe it should really help them. At the end of the day even if it does not improve the success rate there is no way it is going to make it worse.
“If we can help these patients to cope with the stress of he treatment and subsequently cope with any failure, then that will have been beneficial.”
The Times, 26 June, 1989