Q: What question do you get asked most often by people trying to conceive and how do you answer it?
Dr. Domar: The most frequent question I get is "what is the relationship between stress and infertility?" My answer is that it is a complex relationship. We know that infertility causes a lot of stress – women with infertility have equivalent levels of anxiety and depression as do women with heart disease, cancer, and HIV+ status. Infertility has an impact on every area of one’s life, including their relationship with their partner, their sex life, their relationships with family and friends, their job/career, their financial stability, and their relationship with God. So it isn’t surprising that individuals and couples experiencing infertility feel highly distressed. The impact of stress on fertility is more controversial. We don’t know how stress impacts the outcome of treatment since the research done thus far is inconclusive but we do know that women who learn stress management strategies have higher pregnancy rates, even with IVF.
Q: What is the most misunderstood thing about infertility or fertility, in your experience?
Dr. Domar: “Just relax and you will get pregnant”. A survey that I was involved in showed that this is the most common unwanted piece of advice that infertile couples hear. A whopping 78% of the respondents said that this is the piece of advice they least wanted to hear. A close second has to be “just adopt.” The fact is, infertility is a disease, and relaxing or adopting is not going to change the organic problem which is causing the infertility, whether it be with the man, the woman, or both. Conversely, distress levels in the woman as she undergoes treatment may be an issue but watching TV or having a glass of wine isn’t going to help. The research on psychological interventions shows that the interventions that are associated with increases in pregnancy rates are at least six sessions and include specific coping skills training.
Q: What’s the best piece of advice you offer (or have heard someone else offer) women and couples trying to have a baby?
Dr. Domar: Don’t wait. In the same survey, 91% of the people in treatment wished that they had seen an infertility specialist sooner. If the woman is under 35, don’t try for more than a year before seeking help and if she is over 35, wait no more than six months. More advice: Don’t blame yourself, seek out support, and be hopeful. Most individuals and couples who get infertility treatment end up with a healthy baby.
Alice D. Domar, Ph.D., is the executive director of the Domar Center for Mind/Body Health at Boston IVF, an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and the author of Conquering Infertility. For more information about her work, go to www.domarcenter.com