How unhealthy habits and lifestyle choices can impact fertility.

One in every four to six couples in developing countries has been found to be affected by infertility [1,2]. And this figure remained relatively stable in 190 countries between 1990 and 2010 [1].

According to the Australian Fertility Society ‘infertility is the inability of a couple to achieve conception after a year of unprotected intercourse, or the inability to carry pregnancies to a live birth [2]. Many partners achieve fertility using medical interventions, or by making personal changes in their daily life [2]. The latter is especially important because the causes of infertility are unidentifiable in around 20% of cases [3].

Although the etiology is approximately equal (40% due to a female factor and 40% due to a male factor) the experience of infertility has been found to differ between men and women. It is reported that women find it to be much more stressful than men, and there are specific psychological factors that are more common among females i.e. low self-esteem, more depressive symptoms, lower life satisfaction, and more self-blame [4]. In one study, nearly half of the women reported that infertility was the worst experience in their lives [5].

 Unhealthy habits affecting fertility

Unhealthy lifestyle choices have been found to have a significant impact on one’s ability to conceive and maintain a healthy pregnancy. These include cigarette smoking, being overweight, and alcohol consumption.

For women who smoke (including passive smoking), infertility is higher, and the length of time it takes to conceive is longer compared to non-smokers. Smoking has also been found to be harmful to a woman’s ovaries, cause an acceleration in the loss of eggs and reproductive function, and is associated with an increased risk of spontaneous miscarriage [3,16].

Women who drink alcohol during pregnancy can cause harm to their developing babies [4]

For men, smoking can permanently damage and narrow blood vessels throughout the body, including those that carry blood to the penis, causing problems getting or maintaining an erection (impotence). Smoking and excessive drinking also cause reduced sperm count and motility, and increased abnormalities in sperm shape and function [16,17]

A woman's weight influences the levels of hormones in her body and her overall fertility. Women who are overweight (a body mass index or BMI rating of 25 to 29.9) have a 26% lower chance of conceiving, and women who are obese (a BMI of 30 and greater) have a 43% lower chance when compared to women of normal weight (a BMI of 18.5 to 24.9) [18,19, 20].

Insulin seems to play a key role in infertility. A common side effect of weight gain is an increase in insulin levels. When the body attempts to change the levels of hormones it produces in an attempt to regulate itself with this increase, there is an overcompensation, and reproductive hormones can become unbalanced. Too much (or too little) can impact the body's ability to conceive.

Stress and infertility

Stress is the process of managing circumstances that disrupt or threaten to disrupt, a person’s physical or psychological functioning [6]. Challenging events or situations e.g. severe pain, a demanding job, or a bereavement, are called stressors, to which people must react. The physical, psychological, or behavioural response to a stressor is called a stress reaction e.g. nausea, nervousness, and fatigue. These stress reactions can be physical, psychological, or behavioural. All three types can often occur together, especially as stressors become more intense.

Everyone has reactions to stress, even if we’re not aware of them e.g., the body’s natural response to its environmental changes such as being in an interview, sitting in a hot room, or hearing the sound of a burglar alarm. These may involve a change in heart rate, respiration, and perspiration which is an attempt to regulate bodily processes.

The body can generally cope quite well with brief and short-term stresses, however, when those things that are causing us to feel stressed continue over the longer term, our body finds it less able to cope. Although there may be few outward signs that anything is wrong, the body is working very hard.

Organs (adrenal glands, kidneys, the thymus, the liver) release substances that increase blood pressure, fight inflammation, enhance muscle tension and increase blood sugar levels. Among the substances are catecholamines (adrenaline and noradrenaline), and corticosteroids (cortisol). The overall effect is to generate energy. The amount of stress a person experiences and the resources needed to resist increases with the intensity, duration, and frequency of the stressor [7].

Managing maternal stress during the prenatal period is particularly important as it’s been found to affect fetal blood flow and increase fetal stress [8]. It has also been reported to increase the incidence of complications such as pre-eclampsia (high blood pressure and protein in the urine), forceps delivery, and prolonged labour [9].

Research has demonstrated that women with infertility who learn a variety of skills designed to lower stress, improve lifestyle habits, and reduce psychological barriers experience significantly higher pregnancy rates than women who do not learn such skills [10,11]. In particular, Domar et al’s study found significant differences in rates of conception for women treated for depression compared with those left untreated [10].

There is evidence to suggest that anxiety may play a role in infertility due to the interaction between stress, hormonal and immunological factors [12]. Aravind noted how clients with fertility problems became pregnant after seeking hypnosis for other issues such as phobias, grief, panic, depression, and chronic constipation [13].

Further research found that hypnosis significantly improved the success of the embryo transfers stage of IVF [14]. This is a critical stage of the process and if stress is high, the embryo’s chances of survival can be reduced. A further study showed hypnosis during embryo transfer to be as effective as diazepam in terms of pregnancy ratio and anxiolytic effects, but with fewer side effects [15].

So effectively managing unhealthy habits and lifestyle choices, and reducing their impact on the mind and body, increases the chance of conceiving and achieving a healthy pregnancy. 

If you found this article of interest, you might also want to view my article Hypnotherapy for infertility: eight case studies. The article details some of my case studies illustrating the interesting and varied ways in which hypnotherapy can be applied to assist people in increasing their chances of overcoming barriers to improved fertility.

References

1)       WHO (2012) ‘National, regional, and global trends in infertility prevalence since 1990: A systematic analysis of 277 health surveys’. Dec.

2)         Australian Fertility Society

3)         National Women's Health Resource Center Inc. (NWHRC).

4)       Greil, A. L. (1997) 'Infertility and psychological distress: A critical review of the literature'. Social Science and Medicine, 45: 1679-1704.

5)       Freeman, E. W., et al., (1985) 'Psychological evaluation and support in a program of in vitro fertilisation and embryo transfer'. Fertility & Sterility, 4: 48-53.

6)       Selye, H. (1976) The stress of life (2nd ed.). NY: McGraw-Hill.

7)       Sarafino, E. P., & Ewing, M. (1999) The Hassles Assessment Scale for Students in College. Measuring the frequency and unpleasantness of and dwelling on stressful events. Journal of American College Health, 48, 75-83.

8)       Simkin, P. (1986) 'Stress, pain and catecholamines in labour, Part 1: A review'. Birth, 13: 227-233.

9)        Crandon, A. (1979) 'Maternal anxiety and obstetric complications'. Journal of Psychosomatic Research. 23: 109-111.

10)      Domar, A., Zuttermeister, P., Friedman, R (1999) ‘Distress and Conception in Infertile Women: A complementary approach’. Journal of the American Medical Women's Association. 54, 4.

11)       Domar, A., Clapp, D., Slawsby, E., Dusek, J., Kessel, B., Freizinger, M (2000) ‘Impact of group psychological interventions on pregnancy rates in infertile women’. Fertility and Sterility, 73, 4. April.

12)     Edelmann, R. J., & Connolly, K. J. (1986) 'Psychological aspects of infertility'. British Journal of Medical Psychology, 59: 209-219.

13)      Heap, M., & Aravind, K. K. (2002) Hartland’s medical and dental hypnosis. (4th ed). London: Churchill-Livingston. p380.

14)     Levitas, E., et al., (2004) paper presented at the European Society of Human Reproduction and Embryology Conference.

15)     Catoirea, P. et al., (2006) ‘Hypnosis versus Diazepam for Embryo Transfer: A Randomized Controlled Study’ American Journal of Clinical Hypnosis, 55, 4. pp 378-386.

16)       NICE 2013

17)      Patient's Factsheet - Smoking and Infertility American Society for Reproductive Medicine

18)       Boyles, S., (2007) Centers for Disease Control and Prevention.

19)       BMI Index Centers for Disease Control and Prevention.

20)       BMI calculator