what impact on the design?

“Stressfrom a biological point of view, is the body’s response to any external solicitation felt as threatening, it is an adaptation reaction of the body to maintain the balance of the internal state. In the presence of an acute stressor, physiological processes respond to an emergency for survival of the individual, favoring the brain, the heart, the muscles and, in fact, less vital functions such as that of reproduction are affected. at rest. In cases of chronic stress, the body’s capacities can be overwhelmed and the regulatory system becomes ineffective. The body is constantly activated, it then enters a phase of exhaustion. explains Doctor Véronique Bellec.

“The sources of stress can be event-related, and are therefore identifiable: a move, a big trip, but above all the difficult periods to live through on an emotional level: bereavements, concerns for the health of a loved one, pressure at work, change professional”, she continues.

It can also be chronic and be linked to conscious or unconscious fears. “Their origins can be linked to an emotionally strong event experienced in childhood, adolescence, or young adult life, or transmitted on a transgenerational level”underlines the doctor. “So any form of abandonment, violence or sexual assault experienced can be at the origin of an unconscious fear of giving birth.”

In any case, all these sources of stress, whether occasional or chronic, can have an impact on the fertility of women and men. And, as we already know, this already has an influence on our mental and physical health in general.

Our busy lives, mental load, work, social life… can sometimes make us less available emotionally… and physically. “Each of us, man or woman, has been able to experience the extent to which fatigue and stress alter our libido and our sexual activity, to the point of creating “breakdowns” in men”explains Véronique Bellec.

As part of a study published in 2016 in the scientific journal Annals of Epidemiology, researchers demonstrated that stress during the period of ovulation reduces the chances of conceiving a child by 40 to 45%.

1 – Stress: what impact on female fertility?

On the women’s side, we can observe “of the changes to their cycles during a big change or when they experience intense emotions”, describes the specialist. Indeed, “when a woman is subjected to occasional stress or a prolonged period of stress, his hormonal system can go wrong to the point that ovulation does not occur, or that it occurs randomly”, she continues.

Ovulation itself is disrupted: there may be a decrease in luteinizing hormone (LH), which triggers ovulation, and follicle-stimulating hormone (FSH), which is necessary for the maturation of ovarian follicles. These elements are likely to reduce the quality of the oocytes and therefore impact the woman’s fertility.

“On a physiological level, one of the body’s responses to stress is a spasm of the wall of the capillary vessels which irrigate the ovaries and the wall of the uterus. Thus the supply of hormones carried by the blood is reduced and alters the functions of oocyte maturation, ovulation, implantation in women”, underlines the specialist.

“Stress reduces the mobility of the tubes, which disrupts the transport of the egg and sperm. In addition, stress modifies the immune responses particularly involved during the implantation of the embryo in the maternal uterus “, notes Véronique Bellec.

2 – Stress and male fertility: don’t forget men!

Men are affected too! Indeed“violent stress can cause sperm production to stop. This function will resume when the cause of stress is removed”, indicates the specialist. And, just as for women, it can prevent the proper irrigation of the capillary vessels linked to the testicles, as well as the supply of hormones carried by the blood. The flow of gonadotropin hormones, FSH and LH, secreted by the pituitary gland can be deregulated: thus spermatogenesis under the action of FSH and the production of testosterone under that of LH may be affected.

3 – What impact on medically assisted procreation (MAP) pathways?

“These physiological and biological responses to stress will be the same ones that risk impacting the performance of fertility treatments, whether artificial insemination or in vitro fertilization,” notes Véronique Bellec. And this, both on the feminine and masculine side.

Indeed, “man is also impacted: during treatment by PMA, reproductive biologists observed a statistical decrease in sperm quality when the man takes his sample on the day of his wife’s egg retrieval. This decline in quality is directly attributed to the stress experienced in this particular situation”, she specifies.

“Periods of great stress (professional, family, bereavement, etc.) do not favor the arrival of a pregnancy. It may be necessary to give yourself timein any case not to worry that a pregnancy will take a long time to arrive in such circumstances”, insists Doctor Bellec.

“Learning to listen to your needs and take care of yourself is essential. External support may be necessary”, she continues. Sometimes, postponing the conception of a baby for a few months, to give you time to refocus on yourself (and on your relationship if necessary), can be beneficial.

Managing and reducing stress requires above all a healthy lifestyle such as a balanced diet and physical activity (gentle or more active, depending on your desires). “It’s about rediscovering the pleasure of leisure, favorite sports; taking care of your body, having a massage; resuming an artistic practice; taking up meditation, yoga, qi gong; or any other activity that tempts us…”, she explains.

Eliminating 100% of your stress is utopian, but it is realistic to learn how to better manage and reduce it. For this, it is also possible to be accompanied by a mental health professional:“there are numerous resources to understand the origins of our fears and to resolve the possible “psychogenic” obstacles to our fertility”, explains Véronique Bellec. And there, several options are available to couples: psychotherapy, somatherapy or even EMDR (Eye Movement Desensitization and Reprocessing or, in French: desensitization and reprocessing by eye movements). Alternative medicines, such as hypnosis, sophrology, relaxation or cardiac coherence have also borne fruit.

Obviously, there will always be stress in our lives. It’s inevitable. The best thing is to learn how to manage it. Even though stress can cause a delay in the arrival of a child, it is not synonymous with infertility.

The Doctor Véronique Bellec is a fertility specialist in Périgny (Charente-Maritime). She is also the author of “ Giving life, science and magic “, published by Josette Lyon in 2020 (see below).