Managing Stress When TTC In A Modern World

A fertility journey can be quite challenging under the best of circumstances, but it is certainly more difficult than ever before thanks to today’s modern, fast-paced lifestyle characterised by “time urgency perfectionism syndrome” or TUPS stress, and the added difficulties resulting from the COVID-19 pandemic over a prolonged period of time. These modern realities make good stress management more important than ever when trying to conceive (TTC).

At the recent Fertility Show Africa, Dr Mandy Rodrigues, resident clinical psychologist at Medfem Fertility Clinic, explained the crucial role of good stress management when trying to conceive in the the modern world.

Dr Rodrigues has worked in the field of infertility for the past 25 years and a large part of her work focusses on the need for a multidisciplinary approach to infertility, specifically including stress management. She is an expert in this field and has presented and published various books and articles on the subject. This article summarises the highlights of her talk.

Modern stress

Undertaking a fertility journey is a stressful experience for couples under normal circumstances.

But, of course, things have not been ‘normal’ since the COVID-19 pandemic started two years ago and, even before that, the pace and demands of modern lifestyles have been taking its toll on people’s mental health – and their fertility.

Things are not the same as they were 50 or even just 30 or years ago. In the 60s, it was not uncommon for women to have six children. Even 30 years ago, many mothers had four children, but were able to stay home part of the time. In those days, moms weren’t rushing to meetings and deadlines and extra murals. Kids walked to school and back, did their homework in the afternoons and played outside. It wasn’t as competitive a society as we have today.

So, what is the modern world like? Highly competitive, with double income families not just the norm but a necessity, along with access to information 24/7, mass-produced food, a dependency on drugs and medications, sedentary lifestyles and wide-ranging lifestyle diseases. Just a few phrases that defines the modern world includes “hysterical industriousness”, “a collective madness” and “the madness of high performance”.

It led to what can be called a “time urgency perfectionism syndrome” or TUPS society, evident since the 1990s and beyond. In this high stress society, people are constantly subjected to ongoing chronic stress that affects physical health, mental health and overall wellbeing and results in “burnout”. In 2019 – even before the COVID pandemic – the World Health Organization actually recognised “burnout” as a medical condition.

As a result of this and other factors related to the modern stressful lifestyle, such as poor nutrition and substance abuse, an estimated one in six couples worldwide are also facing another medical condition – infertility.

With COVID-19, we have experienced even more added stresses, living with masks, social distancing, sanitising and extreme uncertainty, while making decisions about vaccinations, and trying to deal with new developments such as lockdowns, travel bans and remote workplaces. Over the last two years, we have seen many cases of COVID fatigue and COVID ‘burnout’.

Not all kinds of stress affect fertility

It is important to note, however, that not all kinds of stress impact our mental health and fertility.

For example, it is known that birth rates are not impacted among people in rural areas or more developing countries, even when they are facing very high stress and poverty-stricken circumstances. Also, historically, in times of war – extremely stressful circumstances – the pregnancy rate goes up, not down. Even now, during COVID – a stressful time for everyone – a number long standing patients at Medfem Fertility Clinic achieved pregnancy.

From this, it is evident that certain stresses like the pandemic, war or extreme poverty do not result in stress-related illnesses and burnout. Instead, these experiences produce adrenaline, but adrenaline per se does not impact on our ability to conceive.

So what kind of stress affects fertility?

It is “time urgency perfectionism syndrome” or TUPS stress – the daily, never-ending chronic stress of modern life – and the burnout it causes – that results in fertility challenges. Originally, burnout was only diagnosed in people in the workplace, but more and more people – even those who do not work at a formal place of employment, are showing the symptoms of burnout.

In terms of infertility, taking a look at the data reveals the impact of various types of stress on fertility.

Going through IVF (In Vitro Fertilisation) and other assisted reproduction therapies (ART) is stressful. At least a moderate increase in stress can be expected, but often it is a significant increase. However, the data shows that even acute transient stress does not necessarily impact on the success of the IVF outcome. It also does not impact on the number of eggs retrieved, or their maturity, how many viable embryos there are to transfer or what the pregnancy outcome is.

The stress that causes mental health problems and fertility is chronic stress, like daily job-related stress and the relentless pressure of ultra-competitive modern life. Time urgency perfectionism syndrome does not refer to isolated incidents of stress. It refers to the never-ending stress about time, the constant sense of urgency and the ongoing striving to be perfect. It doesn’t mean always running late, or running early all the time, but rather that there is never any time to spare – and even if there are 10 minutes extra somehere, it’s still a dash to quickly download emails, check messages or make a call.

This is what chronic stress refers to – the time urgency perfectionism that many people are subjected to 90% of the day. This chronic stress prompts the body to secrete noradrenaline and cortisol, and causes challenges with fertility.

It is the kind of chronic stress that reduces the chances of conception and results in higher pregnancy loss.

How to manage stress when TTC

Trying to conceive can be a stressful experience during the best of times, but in these modern days of time urgency perfectionism syndrome and COVID, learning how to manage stress is even more important than ever.

Learning to better manage these unique stresses through specialised counselling that provides relevant and specific coping mechanisms will certainly help you deal with the challenges and hurdles of trying to conceive in these times.

Successfully managing the unique stresses will not only increase pregnancy rates and improve the outcomes of fertility treatments, but will also improve your ability to make important decisions, provide a sense of control over your fertility journey and improve your overall long-term quality of life.

A good starting point is to determine if you or your partner has time urgency perfectionism stress. You can do this free of charge at

If you are suffering from time urgency perfectionism stress, you can download the book Faster, Better, Sicker: Time Urgency Perfectionism Stress and Your Health free at You can also follow the TUPS management program online or at Medfem Fertility Clinic. The TUPS courses are very solution-driven and practical, and the techniques implemented are simple, easy to master, and easy to apply. To find out more, please visit or the counselling section on our website

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