April is Stress Awareness Month and although most of us can manage small amounts of stress – which can even help you focus on achieving short-term goals – chronic stress can eventually affect how you cope with daily life. And, the longer stress lasts, it can even become a threat to your health and wellbeing.

Long-term stimulation of the stress response system means we’re overexposed to cortisol and other stress hormones, and this can lead to mental health problems, insomnia, digestive issues, muscle tension, cardiovascular disease, high blood pressure, stroke, and cognitive impairment.

It is not fully understood how stress affects fertility. Some studies have shown adverse effects, while others don’t, and most are only small-scale studies at this stage. We certainly know that the reverse is true and struggling to conceive can be very stressful. One study published in the Fertility and Sterility Journal surveyed 352 women seeking treatment for infertility and found that more than half of them showed signs of depression and three in four showed signs of anxiety.

So, whether your stress is related to your struggles conceiving or other factors, how does it affect your fertility and pregnancy outcomes?

Stress and your fertility

Stress triggers the body’s fight or flight response. In short, this means releasing stress hormones like cortisol which have an immediate physical impact such as increased heart rate, shallow breathing, high blood pressure and stress headaches.

When you are experiencing a prolonged period of extreme stress, the body will shut down any systems that it does not deem necessary for survival. This is why you can experience hair thinning a few months after a very stressful situation – telogen effluvium is a type of hair loss that results from an interruption in the normal hair growth cycle. In terms of your fertility, this can cause delayed or absent ovulation and irregular or missed periods.

In one small-scale study from 2015, women in the high stress group based on perceived stress assessments were found to have lower levels of oestrogen, progesterone and luteinising hormone. They also had higher levels of follicle-stimulating hormone during a particular stage of their cycles which meant an increased chance of anovulation which is when an egg is released from the ovary during your menstrual cycle. Chronic anovulation is a common cause of infertility.

[ext link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315337/]

Another key stress hormone, CRH or corticotrophin-releasing hormone, is present in diseases that cause inflammation. Abnormal levels of CRH can affect the uterine lining and placenta and therefore could adversely affect implantation.

However, not every study has found a link and 2019 investigation found no difference in conception rates in women based on their daily reported perceived stress levels and a 2017 study of women undergoing IVF concluded that perceived stress and high cortisol levels “were not associated with IVF cycle outcomes”.

Managing stress during IVF

At Aria Fertility, we know how important it is to find ways to manage your stress throughout your fertility journey. Our doctors, nurses and embryology team provide comprehensive patient care combined with a wealth of medical experience and expertise, so you know you are in the best possible hands.

In our Support Hub, we have brought together organisations and individuals that offer fertility support, advice and information. Methods for managing stress encompass counselling, acupuncture, reflexology, and nutritional support.

For more advice on managing stress during your fertility journey, call +44 (0) 203 263 6025 to arrange a consultation.

Chinese Medicine theory is based on the healthy functioning of the body being governed by the flow of Qi (or energy) through a system of channels (or meridians) under the skin. When this flow of Qi becomes blocked, illness occurs. When acupuncture is performed, fine needles are inserted at various points along the channels and the body’s balance can be restored and the illness is resolved.

We invited Melanie Hackwell of Ancient Roots Fertility Acupuncture to answer your questions and explain why you may want to consider acupuncture as a complementary therapy when starting your fertility journey.

“I only practice acupuncture for Fertility and Women’s Health. I have been practicing this speciality for 10 years and hold a BSc in Acupuncture, as well as receiving clinical training in China, and extensive post-graduate training in Fertility for both female and male. I am currently working on my Advanced Level Diploma in Fertility Acupuncture.”

What will happen at my first session?

“Your practitioner will conduct a detailed case history of the patient using Chinese Medicine theory, in order to gain background into how the illness arose, what patterns are evident, looking at the tongue and take the pulse, and make a diagnosis.

“Based on that diagnosis, they will put a set of acupuncture points together to use to assist with restoring health and balance to the patient. They may also use a herb called moxa to warm a certain area of the patient’s body and will also make various lifestyle and diet suggestions.”

Does Fertility Acupuncture hurt?

“When done correctly it does not hurt but the patient may feel a sensation such as a dull ache.”

Are there any side effects?

“There may occasionally be some bruising in certain areas, or the patient may feel tired after treatment (especially with the first treatment). This does not last long, and the patient normally feels refreshed a day or two days after treatment.”

How many sessions will I need?

“This is a question that is very difficult to answer until a detailed case history is conducted and the practitioner sees how the patient responds. I generally tell patients that I need about three months to clear any underlying issues that I can see.”

When should I start acupuncture for IVF?

“In order to have the best results, I will need to see you regularly for a period of months. I will often have people approach me a week before starting fertility treatment. While I am happy to help and the acupuncture will provide relief from the stress that a patient is under, more time is required to clear the underlying issues that I see so often in clinic and to work on egg quality and/or semen quality.”

What can I expect from Fertility Acupuncture?

“One of the most important aspects to be aware of is that I was once sitting where you are today. I am fully versed with the pain and intense emotions that go along with trying to conceive. A large amount of empathy is given to my patients which I feel is essential in the healing process.

“Like all acupuncturists, I will conduct a detailed case history. However, with Fertility Acupuncture I will also delve into the immune system in great detail along with any previous illnesses one may have experienced.  I will also be looking at lifestyle, and ask for certain tests to be conducted such as thyroid and vaginal microbiome.  By the time you have visited an IVF clinic, you will have already had all of your hormone levels tested so we will be looking at those as well.

“Increasingly, due to various environmental factors, I am seeing more and more men requiring treatment and we will be investigating that side of things also.

“I will give you an honest opinion of how long I feel treatment will be required. I do however ask that you give me time to tackle the underlying issues that I see on a daily basis.

Fertility Acupuncturist“I am delighted to have a chat with anyone who needs more information or just so we get to know one another. I feel it is so important to build a close relationship to my patients, so they trust in the support and advice that I give them.”

Contact Melanie directly to make an appointment or to find out more. For more information on the individual practitioners and organisations offering support, advice, and information to those undergoing fertility treatment, please visit our Support Hub.

This week is Fertility Awareness Week in the UK. With 3.5 million people here facing fertility challenges, Fertility Network UK’s aim is to improve awareness and provide support at whatever stage of the journey you’re at.

Among other initiatives they are running a series of webinars during the week, touching on important fertility issues, finishing on Friday with a lunchtime webinar with Aria’s own Stuart Lavery. Friday’s theme will be #TalkFertility and will signpost the help available those experiencing fertility struggles so you don’t have to suffer in silence or feel unsupported.

Register for Friday’s webinar with Mr Stuart Lavery >

Yesterday’s theme was #FertilityFairness and tied into a new survey commissioned by Fertility Network UK into the postcode lottery that is fertility treatment in the UK. Only Scotland offers the recommended three full IVF cycles and almost two-thirds of respondents to the survey said they had to pay for their own treatment.

The emotional impact of IVF treatment and was also surveyed and worryingly four in 10 respondents said they experienced suicidal feelings. The vast majority at 83% said they felt sad, frustrated and worried often

Gwenda Burns, chief executive of Fertility Network UK, said: “Fertility patients encounter a perfect storm: not being able to have the child you long for is emotionally devastating.

“But then many fertility patients face a series of other hurdles, including potentially paying financially crippling amounts of money for their necessary medical treatment, having their career damaged, not getting information from their GP, experiencing their relationships deteriorate, and being unable to access the mental support they need.

“This is unacceptable. Infertility is a disease and is as deserving of medical help and support as any other clinical condition.”

The rest of the upcoming webinars this week are as follows:

Tuesday 1 November
#FertilityintheWorkplace

Most employers in the UK do not recognise fertility treatment as a necessary medical treatment and there is no legal right to time off work for fertility appointments. Fertility Network UK is calling for employers to recognise fertility treatment as a clinical necessity and to provide appropriate medical leave.

Register for Tuesday’s Webinar >

Wednesday 2 November
#HimFertility

Male factor fertility is a common reason for infertility yet often men’s fertility is not tested in the initial stages resulting in unnecessary delays. Fertility Network UK is calling for men’s fertility to be tested in a timely manner at the same time as a woman’s fertility is explored.

Register for Wednesday’s webinar >

Thursday 3 November
#FertilityEd

Fertility education in schools should be expanded in scope so teenagers and young adults understand fertility isn’t guaranteed and that treatments such as IVF and egg freezing do have some limits.

Register for Thursday’s webinar >

For more advice and support on any of the issues we’ve touched on here, call +44 (0) 203 263 6025 to discuss further.

Traditional Chinese Medicine is an ancient medical system that treats imbalances in the body at physical, mental and energetic level. It focused on the root cause of the disease. The treatments have a cumulative effect, which means that each treatment builds on the last one. That is why we always recommend having a series of 6 or 12 consecutive treatments to fully enjoy the long-lasting health benefits of Traditional Chinese Medicine.

Eca Brady, an expert physician of Traditional Chinese medicine, has run a successful practice on Harley Street for over 11 years, focusing on IVF support, infertility, pregnancy, birth and post-natal recovery.

In her treatments she will use acupuncture, Chinese herbal medicine, dietary and lifestyle advice.

“Herbal medicine has become very popular currently, and it can be a powerful force for healing when done appropriately.  Each patient, after a detailed consultation and a diagnostic, when necessary, will be prescribed a personalised formula which will target her or his own imbalances.

A lot of knowledge and experience goes into writing an herbal formula. Each plant is chosen carefully for their own benefit but also for how well they would work in the prescribed combination with the other herbs.  A wrong herb can potentially cause side effects and a lot of damage if it is used over a long period of time,” Eca explains.

“It is popular now to take herbs as supplements like ashwagandha or turmeric which are often presented as beneficial for all sorts of conditions, but sometimes taking these herbs in high doses without a proper diagnostic can do more damage than good. I have seen in clinic many new patients presenting with side effects from taking these herbs in very high quantities over long periods of time.”

Can Chinese herbal medicine boost your IVF treatment?

Chinese herbal medicine has been used for centuries to enhance fertility by regulating the endocrine system, balancing hormones, nourishing the blood and reducing stress.

Eca believes that each patient should prepare before their IVF procedure for at least one month and ideally three months, using Traditional Chinese Medicine; not only to increase the chances of a successful IVF and to achieve an easy pregnancy, but also for the health benefits for your baby.

“I always follow the lead of your fertility doctor. It is not necessarily for me to have direct contact with them, but I always request that my patients ask permission from their doctor to have the treatments.

“The herbal medication is more often used in preparation to IVF, not necessarily during.  Herbal medicine is safe but always under the supervision of a qualify herbalist.”

As Eca points out, the quantity of herbs in supplements purchased at natural food shops can often exceed what she would normally prescribe to her patients: “The amount of turmeric in one pill that you buy from Holland & Barrett can be too much. When I make up a formula, I might use 8 grams of turmeric for a monthly prescription in combination with other herbs.  If you go to H&B and take three pills in a day, you’ve taken the same amount that I would be prescribing over a month.”

To find out more about Eca and arrange a consultation, please click here. For more information on the individual practitioners and organisations offering support, advice, and information to those undergoing fertility treatment, please visit our Support Hub.

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