Your best friend calls to share those three words you dread to hear, "I am pregnant." You are conflicted because you think you should be happy for her but you feel depressed, angry, and sad. Perhaps you avoid friends or family members in fear that they will reveal they are pregnant because you know they have been trying. You might be wondering will I ever feel happy again? When am I going to have a baby? Everyone else around me is pregnant, what is wrong with me? I see women all the time in my private practice that struggle with similar thoughts and feelings, so you are not alone. According to the American Society for Reproductive Medicine 6.1 million women are coping with infertility.

It is important to be aware that infertility can be a crisis that has been compared to going through a severe illness like cancer or traumatic event like the loss of a loved one. This is not surprising given the innate drive within us to procreate. When this primal urge and desire is difficult to fulfill it can be devastating for both partners. Women in particular suffer greatly on the emotional roller coaster of infertility. They commonly grapple with feelings of frustration, anger, depression, anxiety and jealousy. Baby showers become distressing events; dinner with friends even can become difficult when you are excluded from discussions shared on birth, parenting or school choices. It is like life is passing you by as you watch the women in your life make another play date without you. Men can also experience feelings of inadequacy, shame, guilt and start doubting their manhood. Sex becomes a chore of baby making rather than the spontaneous intimate experience it once used to be. These emotional states usually are accompanied by negative thinking states that often lead to sense of hopelessness and low self-esteem that can affect every area of life. Stress builds on itself. One after another failed attempts to conceive creates a vicious cycle. No positive results leads to emotional upset and stress which can harm fertility and the cycle goes on and on.

There is no doubt that infertility causes stress but there is also evidence that stress negatively affects one's fertility. Researchers at the Department of Family and Preventive Medicine at University of California at San Diego found that women who worried about the medical aspects or the cost of their assisted reproductive technology had 20% fewer eggs retrieved when doing IVF (In Vitro Fertilization) and 19% fewer eggs fertilized than women who were less prone to worry. If they worried about missing work 30% fewer eggs were fertilized (Finello, 2006). The world-renowned Mind/Body Infertility Program, directed by Harvard Psychologist, Dr. Alice Domar has found over the last decade through many studies that not only does stress affect fertility but so does depression. One study found that women with history of depression were twice as likely to report subsequent infertility than those who did not (Domar, pg. 23).

The mind-body approach to infertility addresses how one's state of mind is connected to the physiological processes of the body. Scientists, who used to believe that the mind was located exclusively in the brain, now understand and recognize that the mind is connected to every cell bio-chemically. "To separate mind from body, to treat one without the other, is foolish and ineffective." says Dr. Domar, in her book, Conquering Infertility. The links between stress and immunity and stress and heart disease have been understood for many years in the medical community.

This is not another person telling you "just relax and you'll get pregnant." It is more complicated than that. Reproduction is one of our most delicately balanced biological systems. The same gland that calms a stressed out system, the hypothalamus, also manages the reproductive process. "ÉYour body reacts to these stressful states with surges in heart rate, respiration, and blood pressure, which are triggered by the same glands that produce the hormones you need to have a normal ovulatory cycle."(Marrs, pg.120). Hormones like cortisol, are released in response to stress, tension or anxiety and obstruct the natural production and discharge of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). With this disruption, menstruation can be irregular or ovulation may be suppressed completely; implantation of a fertilized egg maybe hindered; release of eggs maybe delayed and egg quality reduced; and sperm count can be lowered. Dr. Candice Pert, a research professor in the Department of Physiology and Biophysics at Georgetown University Medical Center, relates in her lecture series, "The Body is the Subconscious Mind," "that the cellular level, where emotions are instigated, is also where unexpressed emotions are stored." The subconscious mind is a remarkable recorder of your life experiences; it literally acts like a bio-computer storing every single thing that ever happened to you and your feelings about those experiences in the very cells of your body. So we may not be consciously aware of what we are feeling about a person or an event, but the body records our emotional responses, which can show themselves in the form of reproductive difficulties, as well as other physical problems. This information is not to be used to blame anyone for infertility but to increase awareness of the innate intelligence and healing capacity we all have within us.

The placebo effect for decades now has demonstrated the power of belief and faith in healing. Hope is a potent force that many doctors understand is essential for their patient's recovery. In a presentation I attended on "Rewiring Your Brain to a New Reality", Dr. Joe Dispenza (also one of the expert speakers interviewed in the movie What the Bleep do We Know) spoke about the four qualities shared by people who have had spontaneous remissions from serious and fatal illnesses. One common factor was the expectation and belief in a divine intelligence that they assumed knew a great deal more than they did or their doctors. They understood in some way "that the same amazing intelligence that made the body and that beats the heart could heal the body." The point is that their positive expectation created a more favorable healing environment in the body. Another commonality was that these people recognized that their negative thinking had an affect on their body. Every time you have a thought you make a chemical. Negative thoughts cause the body to release chemicals that will make you feel negative. Thoughts tell your body how to feel and as Dr. Dispenza told the audience, "the body starts to think for us." A loop developsÉ thoughts create feelings which cause similar thoughts which leads to more negative feelings and on and on.

Hope, trust, relaxation all benefit the mind and body. When a woman can learn to manage the stress and anxiety of infertility and find ways to cope with her anxiety-provoking thinking, she will begin to feel better. When she starts to feel better her biochemistry starts to shift in positive ways. One of the ways to begin the healing process is start "fertile thinking." I have been using the word "infertile" in this article because it is a common way we classify couples attempting to conceive for over six months to year depending on their age. However, in my practice I never use this term because I know that thoughts and words create a cascade of chemical reactions in the body. Right now take a moment to think the thought "infertile." Say it out loud. Write it down. Notice the images that come to your mind. Notice how you feel. Now think the thought "fertile." Notice the difference in the images, thoughts and feelings that arise.

The purpose of any medical or holistic fertility treatment is about new life, joy, and a dream of possibilities. It is about two people who love each other wanting to share that love through having a family. Engaging the whole self-mind, body and spirit in your treatment process will allow you to turn this crisis into an opportunity for growth and self-awareness which can only benefit your future. Dr. Domar in the late 1970's began a ten-week group for women with unexplained infertility at the Mind-Body Institute of Harvard Medical School. This program was designed to train women in the relaxation response, guided imagery, cognitive behavioral skills, and mindfulness techniques like yoga and mediation. The focus of the program was to shift attention from the stress of conceiving to living life again in a fulfilling way. They had excellent results and continue to do so.

In Conquering Your Infertility, Dr. Domar reports a study she performed with her colleagues in 2000 that was published in the journal Fertility and Sterility. The researchers looked at 184 women who had been trying to conceive for one to two years. They placed women in one of three groups: a mind/body group that learned many, but not all of the Mind-Body Institute program's techniques; a support group that met weekly to discuss the impact of infertility; and a control group, which received no intervention at all. Within a year 55% of the mind/body and 54% of support-group participants conceived pregnancies that resulted in a baby, compared with only 20% of the control group. Not only that, but the women in the mind/body group were significantly less depressed six months later than the other two groups and more (42%) conceived their babies naturally without medical intervention, than did those in the control group (20%) and the support group (11%) (Domar, pg.28).

In my mind/body approach to fertility I share the view of Naomi Payne who states in her book the Language of Fertility, "Éfertility in its truest meaning reflects a vital sense of oneself and a relationship with the rest of the world whether one conceives or not." When women begin to enjoy and live their lives again; stop measuring themselves against others and are able to respond to stress triggers in healthy ways; the body also reaps the benefits. Mind/body programs like mine and Dr. Domar's don't claim to cure infertility, but we are teaching life management skills that help couples get off this emotional roller coaster, improving the quality of their lives, their marriage, and their fertility.

References

Domar, A. & Kelly, A.L. (2000). Conquering Infertility: Dr.Alice Domar's Mind/Body Guide to Enhancing Fertility and Coping with Infertility. New York: Viking.
Finello, K.(n.d). How Stress Affects Fertility. If you're having trouble conceiving, take a breather -- it just may help. Retrieved November 19, 2006 from http://www.parenting.com/parenting/pregnancy/article/0,19840,725712, 00.html
Marrs, R., Bloch, L.F. & Silverman, K.K. (1997). Dr. Richard Marrs' Fertility Book:America's Leading Infertility Expert Tells You Everything You Need to Know About Getting Pregnant. New York: Dell Publishing.
Payne, N.B. & Richardson, B.L. (1997). The Language of Fertility: A Revolutionary Mind-Body Program for Conscious Conception. New York: Harmony Books.
Pert, C. (2000) The Body is the Subconscious Mind [CD Series]. Boulder: Sounds True.