Is stress linked to infertility?

Virginia Hampton
The Daily Telegraph, 11 July 1989

For many infertile couples the route to conceiving a longed for child is an emotional roller coaster of hopes raised only to be as quickly dashed. While stress has been thought to play at least some part in infertility, some experts now think that .the added trauma of trying to conceive the high tech way is on a par with that of a family death.

“It is absolutely gruelling,” says one veteran of three unsuccessful attempts, a 37-year-old businesswoman. “There are side effects from the drugs you take, the stress mounts up through the different stages of egg collection, fertilisation, replacing the embryo… then there’s an interminable wait to see if you’re pregnant. ”

But is it possible that the stress of the techniques themselves can cause, or contribute to, continuing infertility? Despite the mass of scientific data compiled on in vitro fertilisation since the birth 11 years’ ago of Louise Brown, the first test-tube baby, the impact of stress during treatment has been largely overlooked.

Into this unchartered territory a small London fertility clinic is poised to launch itself. Opening on Friday at the private Holly House Hospital in Buckhurst Hill, Essex, the new unit will offer, in addition to the range of infertility services, a “stress management” course.

Devised by Dr Gowri Motha, a specialist in alternative obstetrics and gynaecology, the four-week programme is a combination of complementary treatment such as reflexology, self-hypnosis and group therapy, tailored to couples’ needs. They will be encouraged to take the course, costing £150, before their IVF treatment begins.

However, Prof Robert Winston, consultant gynaecologist, at Hammersmith Hospital, London, says bluntly: “There is no hard evidence that stress causes infertility, though there is a lot of anecdotal evidence that infertility causes stress.”

Undeterred, the medical director of the Holly House unit, Mr Michael Ah-Moye, formerly at London’s Humana Hospital IVF Clinic, cites recent American research suggesting that “stress management” may yield a 15 to 20 per cent improvement in fertility rates. (The live birth rate for IVF in Britain is currently given as 10.1 per cent by the Interim Licensing Authority.) ,

The British Pregnancy Advisory Service, which includes the AIH method (artificial insemination by husband) as one of its fertility treatments, bas found that couples are more successful if the procedure is carried out at home, rather than in a clinic, suggesting that stress is an important consideration.

The idea for the Holly House Clinic grew following an experimental informal group organised by Dr Motha when a junior doctor at Whipps Cross Hospital, East London. She was supported by Mr Lindsay McMillan, a consultant gynaecologist at Whipps Cross and a consultant at Holly House.

“Over the two-year period, 40 women came along once a week,” Dr Motha explained. “They talked freely about their frustrations, anger and disappointments. By the end of the two years, 60 per cent had become pregnant. I didn’t set out to prove a link, but the results were encouraging.”

Barbara Mostyn, Chairman of the National Association For the Childless says: “Many couples feel that stress must be playing a big role in their failure to conceive. We have about 30 free support groups, and our unpublished figures show that people who belong to groups have a better fertility rate.”

Of course IVF clinics do offer some form of individual counselling. But the majority of such services are patchy and receive low priority. For example two London teachers, who have just undergone their third unsuccessful NHS attempt at St Bartholomew’s Hospital, were dismayed by the apparent lack of concern: “There is a social worker, but it’s up to you to make the first move. With hindsight, we needed help for the second arid third tries, but no-one suggested it.”

The couple agree that a course such as Dr Motha’s, whatever the effect of fertility rates, should at least begin to fill a very real need.

Holly House, Hospital, High Road, Buckhurst Hill, Essex 1G9 5HX (01-505 3311); National Association for the Childless, 318 Summer Lane, Birmingham B19 3RL (021-359 4887).

The Daily Telegraph, 11 July, 1989

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