infertility

Infertility: a whole person solution

by Barry Bittman, MD

For most people, conception is as natural as breathing. Yet for some couples, having a baby is an insurmountable experience.

You know who they are. Some women are especially easy to identify. Typically, she is in her mid thirties¾ a coworker, a friend, or a family member who usually appears tense and depressed. Avoiding conversations about babies and child rearing, she seems to always have other engagements during baby showers. Eventually, she doesn’t show up at family gatherings especially when young children are present.

Initially the problem is unnoticed as these couples look upon their situation as a painful source of embarrassment. However, as failure to conceive continues, anxiety and depression set in precipitating a cascading series of problems. Ongoing arguments and blame often serve to destroy the couple’s relationship and their lives.

It’s not surprising this occurs. Traditional fertility approaches are personally challenging at best. Some, in fact, are perceived as humiliating. The act of making love is often replaced by a scheduled and almost mechanical approach that adds extraordinary pressure to the couple’s life. Timing ovulation and reacting immediately to a temperature change produce formidable challenges for a working couple. It isn’t easy coming up with spontaneous excuses for leaving work on the spur of the moment. In many cases business travel is out of the question. In fact, some women find it impossible to hold down a job, thereby adding additional financial pressure to what progressively develops into a hopeless situation.

The cost of infertility treatment is exorbitant. From high tech procedures like in vitro fertilization (IVF) to lost work days and productivity, the actual financial burden is difficult to accurately determine. When one considers the price one pays for chronic depression and the development of stress-related disorders that develop, estimates of the overall financial drain become clearer.

In a recent interview on my NPR show, Mind-Body Matters, Alice Domar, PhD, Director of Women’s Health Services at Harvard’s Mind-Body Medical Institute discussed her cutting edge research in this arena. She brought to light years of experience and research demonstrating the seriousness and hopelessness created by infertility. One of her comments was especially important. She said that most women develop significant levels of depression after only a few months of trying to have a baby. This finding introduces important considerations and opportunities related to understanding the mind-body connection.

Based upon numerous columns I’ve written in the past, it should now be apparent that what happens in the mind is directly reflected by the body’s biological responses. It is also well established that research in psychoneuroimmunology actually demonstrates the precise links between our attitudes and beliefs and nervous, endocrine and immune function. With this in mind, (pardon the pun) it makes perfect sense that stress or depression could be associated with biological changes that affect one’s ability to conceive.

Not surprisingly, Dr. Domar’s research illustrates this point. She has shown that when infertile couples, typically failing to become pregnant for years, attended a mind-body infertility program, a phenomenally encouraging, 44% rate of conception occurred. Yes, almost one in two couples became pregnant!

It is important to realize that these are not individuals who have tried for a month or two to become pregnant. Most of her program participants had failed to conceive for years despite the latest drugs and technological advances.

A common thread that emerged from her research is the fact that depression lifted in her patients during the intervention. In fact, it appears that depression is more closely associated with infertility than anxiety. “Although at this point we don't understand the mechanism, it does seem that when you reduce depression in a group of very depressed infertile women, you increase the conception rate,” Dr. Domar reports.

You’re probably wondering what patients do in her program. Dr. Domar’s approach is straightforward. She helps couples deal with the most stressful issues, while encouraging a sense of nurturing, not only among spouses, but also within the group. Participants also practice meditation/relaxation techniques, journaling and mind-body exercises. Patients are discouraged from taking herbs, supplements or any drugs without the consent of their physician. Strenuous or intense exercise is avoided, and weight management is sometimes considered. For certain individuals, weight loss is suggested, while for others who are underweight, gaining 8 or so pounds often helps lead to conception.

It should be clearly understood that infertility begins as a biological process, and traditional medical approaches help many couples. Yet if failure to conceive ensues despite state-of-the-art medical intervention, a mind-body approach may be worth your time. Even though it cannot promise a baby in the future, you can improve the quality of your life and your marriage.

Once pressure, blame and depression are transformed into a sense of balance, nurturing and a supportive attitude, miracles can happen, one child at a time¾ Mind Over Matter!