Managing Stress 
The body’s stress response is an essential part of human survival—so why is being “stressed out” so detrimental to fertility?
THE WORLD IN WHICH WE LIVE is profoundly different from the place our grandparents, parents, and even younger versions of ourselves used to call home. The advent of the Internet, smartphones, and 24-hour news cycles have brought the pace of life up to extraordinary speed. Constant bombardment of sensory input means one thing to your fragile brain: stress. While some stress is actually a good thing, too much stress without the time or ability to recover can have detrimental effects on your health.
Managing Stress The body’s stress response is an essential part of human survival—so why is being “stressed out” so detrimental to fertility?
The answer here is simple to state and more challenging to resolve. Stress itself is not the problem. Our ability to recover from stressors quickly and efficiently, however, can make all the difference to your fertility and overall health.
In order to better understand the negative role of stress on fertility, here’s a quick lesson in brain anatomy and function: We all have a tiny, almond-shaped part of our primal brain called the amygdala. The job of the amygdala is to make sure we are safe. Whenever stress is encountered, the amygdala fires up, quickly triggering the body to release adrenaline, which starts a cascade of reactions in the body to give a surge of energy and strength—basically calling up superhuman strength to increase likelihood of survival during the emergency situation.
While this fight-or-flight response is exactly what you want while being chased by an angry grizzly bear, it’s overkill for most situations. You see, the amygdala operates from an instinctual, animal place. There’s no differentiating whether there’s really an angry grizzly bear or you’re just late for work—stress is stress. Issues begin to arise when the body’s stress mechanisms are triggered too frequently.
Each time a stressor occurs (such as public speaking, a spat with your spouse, or a car that won’t start), our stress load increases. Allostasis is a term that refers to having a low stress load (like homeostasis for the nervous system). If we generally have a low stress load, we should be able to overcome an individual stressor relatively quickly and move on with our day. When we are out of balance or overstressed, each small stressor builds upon the next, until we reach our allostatic-load breaking point. Learning skills to manage and overcome stress as it arises is the key to staying in control of your reactions to the challenges life throws your way.
Eliminating stress in our modern world is essentially impossible, but there are measures you can take to manage the stress you have. Give yourself permission to put your own needs first; choose to sit out events that might give you unwanted stress or anxiety; and make self-care a central part of your daily life. Things like gifting yourself an extra hour of sleep, getting a massage, going to acupuncture, and taking time for daily mediation and moderate exercise will all pay dividends in reducing your stress and supporting your fertility.
Meditation The idea of meditation can be so daunting that many people avoid it altogether, despite assertions that this practice can bring us better health, deeper sleep, improved cognitive function, and improved mental and physical performance.
Meditation is a term that encompasses many different techniques with the common thread of promoting a sense of inner calm, heightened awareness, and improved health. There are countless types of meditation, from sitting in silence to repeating mantras or listening to recordings of guided imagery. Taking some time to explore these different methods and finding one that feels right to you is your first step toward making meditation a part of your self-care routine. Following are a few easy meditations to get you started.
This simple meditation can help you to slow your mind and calm your inner chatter.
Sit in an upright position with your legs crossed. Put your back against the wall or sit in a chair if it’s uncomfortable to sit unsupported, or you can sit on a cushion to elevate your hips above your legs.
Start by closing your eyes and turning your attention to your breath. Begin breathing in and out through your nose. Now, begin to count, allowing one breath for each number, like this: Breathe in and out, while silently saying “one” to yourself, in and out again while saying “two,” etc. If you find your mind has wandered to other thoughts or if you lose count, simply begin again from one.
A good goal when starting out is to count from 1 to 25 and back again to zero without letting your mind wander. Increase your count each time you achieve a new goal. Set a timer while doing this so you don’t have the distraction of thinking about how long you’ve been going.
Mantras are words or groups of words that are considered capable of creating transformation.
“Om” is probably the most well known mantra, said to be the vibration of the universe, which elicits inner peace when repeated alone or in a group setting. Mantras sometimes have spiritual connotations, but they don’t have to. You can create a mantra for just about anything. Using a mantra to replace negative thoughts you might be having about your fertility is a great way to train your brain not to stress over things you can’t control.
Building on the concepts of a therapeutic method called cognitive behavioral therapy, think about something you frequently tell yourself that might be negative, like “I’ll never get pregnant,” or “I waited too long to try and have a baby.” Next, rewrite that sentence to reflect a positive outcome, for example: “I will become a mother; I trust that it will happen.” It may feel a bit hokey at first, but over time, replacing negative thoughts with positive mantras can be very soothing to your nervous system.
“Quickies” are our fun little term for mini meditations that you can use to reset your nervous system in a short amount of time and can be done virtually anywhere. Following are a few to try.
Mindfulness refers to the concept of accomplishing a task while paying incredible attention to detail.
For example, try eating a chocolate kiss mindfully. Do this by focusing all of your attention on the task at hand. Start by noticing the foil wrapper. How does it feel to run your fingers over it? Slowly unwrap it, noticing the way the texture of the wrapper changes as you crumple it up. Maybe even roll it into a ball and run it through your fingers.
Next, you might smell the chocolate, or touch the pointy tip. Put it in your mouth and feel it melt or notice how it feels to bite into it. You get the idea … 30 seconds of mindful eating is often enough to reduce your allostatic load.
By the way, you can do this with anything, from walking slowly around the block to making a cup of tea or examining a flower. A little focused concentration goes a long way in calming your nervous system.
A breathwork quickie will give you a quick reset by clearing your mind through focusing on your breath and reciting this simple meditation:
Go into a quiet room (even a bathroom stall at the office will work). Close your eyes and take a few slow breaths. Next, choose a word for the in-breath and a word for the out-breath. For example, you might choose to breathe in “peace” and breathe out “calm” or breathe in “receive” and breathe out “surrender.”
Continue for 30 seconds to a minute. End with a cleansing breath or two.
Qi gong is a martial art that involves gentle movement and hands-on healing. This simple quickie can be done just about anywhere.
Place the palm of your right hand just below your belly button. Place your left hand on the small of your back. Stand up straight, bend your knees slightly, and close your eyes.
Start by taking deep breaths all the way down to the space between your hands. Imagine a small ball of energy floating in the space between your hands, right in the middle of your lower abdomen. See if you can get the ball to subtly move back and forth between your hands. Do this for one to two minutes.
End with a cleansing breath.
Exercise and Mindful Movement Most folks know that exercise plays a key role in keeping stress levels under control. What’s more, you can increase the stress-busting punch of revving up your heart by choosing exercises that involve mindfulness or by adding mindful intentions to any exercise you choose.
Yoga is an obvious choice because mindfulness is built right in to almost every style you might practice. Supercharge the stress-relieving aspects of yoga by setting an intention for your practice, such as releasing some harbored frustrations, letting go of fears or anxieties around getting pregnant, or “receiving” a pregnancy (rather than achieving one).
Stay gently focused on your intention as you move through the poses, gently redirecting your thoughts should they stray toward the negative. If you find you can’t make it to a class, there are plenty of good videos available online.
Martial arts, particularly tai qi and qi gong, involve following a series of movements, which activate energy channels and can initiate specific types of healing. Find a good instructor in your area or try a video to use these ancient but relevant healing practices to activate the flow of energy throughout your body and release blockages.
Do anything you love. Whether you are walking through the woods or around your city block, sweating in a spin class, or swimming laps, bring in an element of mindfulness and give your nervous system a reset while you partake in whatever exercise you enjoy.
Some women worry that exercising too vigorously might dislodge a healthy pregnancy. Generally speaking, if a baby is going to “stick,” carrying on with your usual workouts is not going to get in the way.
The only time when a woman should completely refrain from exercise is during an IVF cycle for both the stimulation phase and the two-week wait for a pregnancy test. This is because of potential damage to the ovaries, not a threat to the embryo.
During IVF stimulation, the ovaries swell considerably. The more developing follicles there are, the greater the risk that the ovaries might become very swollen, or hyperstimulated (a condition called ovarian hyperstimulation syndrome, or OHSS). You can read more about OHSS on page 205.
Finally, there is such a thing as too much exercise when it comes to protecting your fertility. In fact, some women actually shut off their body’s menstrual cycles from overexertion. From our perspective, exercise boot camps for weight loss are not ideal for women trying to conceive. This is also not the time to train for an Ironman or run a marathon, unless you’re very accustomed to doing so already with no effects on your menstrual cycle.
The point here is moderation. Definitely keep moving, but don’t overdo it. Exercise so that you feel healthy and balanced. If you feel fatigued, injured, or unwell after working out, it is a sign that you are doing too much. This is not the time to start a brand-new routine of vigorous, high-impact exercise. If you’re not at your fitness prime, DO exercise, but choose moderate activities such as walking, gentle swimming, or yoga.
Why Sleep Is So Important Sleeping is often overlooked as just a means of rest that can be compensated for with a cup of joe, but there’s a lot of important biological stuff that goes on while catching your zzz’s. According to the National Sleep Foundation, the average adult woman gets only 6 hours 41 minutes of sleep, when she really needs 7 to 9 hours. A consistent lack of sleep can have detrimental consequences, both physically and mentally, and may directly impact your ability to conceive.
Sleep deprivation has a powerful influence on the endocrine system, which can directly disrupt a woman’s cycle and ovulation.
Chronic lack of sleep also leads to low leptin levels, which plays a role in normal ovulation and menstruation, and may contribute to weight gain and a slowed metabolism.
Sleep deprivation can spike the stress hormones cortisol and adrenocorticotropic hormone (ACTH), both of which can suppress a healthy fertility cycle in both men and women.
Finally, according to a 2012 study, Effects of Shiftwork on Sleep and Menstrual Function in Nurses, irregular sleep patterns disrupt the circadian rhythm, which can also disrupt healthy reproductive function. Women who work night shifts tend to experience more “menstrual irregularities, reproductive disturbances, [and] risk of adverse pregnancy outcome.”
A Danish study published in the American Journal of Epidemiology surveyed 953 healthy young men over a two-and-a-half-year period. Men with poor sleep or insufficient sleep had sperm counts an average of 29 percent lower than those men who slept well and enough.
Another study published in the Journal of the American Medical Association in 2011 found that sleep restriction leads to low testosterone. After just one week of sleeping five hours a night or less, men had significantly lower testosterone levels (up to 15 percent) than their well-rested peers.
The bottom line: Don’t skimp on sleep. Prospective parents should aim for at least eight hours per night, and if you have difficulty sleeping, be sure to tell your acupuncturist so you can work together on getting you some better rest.
Living Your Life Let’s face it—dealing with fertility challenges can be very consuming. You may wake up one day only to find that your life has been completely overrun by your menstrual cycle, timed sex, avoidance of friends and family, and an overall sense of having lost yourself to the hopes of parenthood. If this is you, you are not alone.
Many women complain of losing themselves to the fertility journey, and for good reason. While it’s perfectly reasonable that months on end of baby-making efforts can lead to feeling like you have no life, you actually aren’t doing yourself any favors by staying on the hamster wheel. We’re not suggesting that you should stop trying, but you certainly can scoot your efforts over just a tad to make room for your life that is happening right now.
Consider resuming a hobby, or meeting a friend for lunch and NOT bringing up your struggles, or going on a date or a weekend getaway with your spouse and just enjoying each other’s company. All of these ideas and any others you can come up with will actually help you in your efforts to conceive, as your nervous system takes things down a notch while you enjoy the things in life that you already have.
The process of cultivating good self-care is not something that magically happens overnight. It’s a practice that must be nurtured and tended. While your ultimate goal is having a family, the first step is really learning how to love and care for yourself. Ideally, your future baby should not be filling an empty space in your life, but joining the rich and full life that you’re already living.