The Link Between Stress and Infertility

There is a long list of possible causes of infertility – including medical conditions and lifestyle factors. But did you know that infertility can be a result of chronic stress?

Recent studies have confirmed what the team at Medfem recognized more than two decades ago: that there is a very real link between stress and infertility.

What kind of stress causes infertility?

There are different types of stress.

According to the widely validated Holmes and Rahe Stress Scale, these are the top ten stressful life events for adults that can contribute to illness:

1. Death of a spouse
2. Divorce
3. Marriage separation
4. Imprisonment
5. Death of a close family member
6. Injury or illness
7. Marriage
8. Job loss
9. Marriage reconciliation
10. Retirement

It is also widely known that people with ‘Type A’ personality traits experience greater-than-average levels of stress. Generally being time-conscious, competitive and impatient, people with Type A personalities can create stress in relationships, jobs and other areas of life.

At Medfem, we address a specific stress called Time Urgency Perfectionism Stress (TUPS), which defines stress in a measurable way. “In simple terms, it describes a person who is a perfectionist, is constantly chasing deadlines, and is experiencing exceptionally high levels of stress,” explains Mandy Rodrigues, clinical psychologist at Medfem.

Time Urgency Perfectionism Stress is characterized by a persistent inner feeling of being rushed in all activities, irrespective of whether there is actually a need to do things quickly. In addition, it involves high expectations, the need to control, an aversion to small mistakes and critique, as well as black and white thinking, self-blame and a propensity to experience depression.

Time Urgency Perfectionism Stress is also chronic and learned.

Stress can be learned or unlearned. Unlearned stress caused by unusual outside factors that results in the excretion of adrenaline. Learned stress involves chronic daily stressors that lead to the excretion of noradrenaline and cortisol, which gives rise to as many of 46 different medical symptoms.

Studies confirm the link between stress and fertility

For 21 years, Medfem has been at the forefront of researching and managing the impact of stress on fertility.

“We recognised the link between stress and infertility decades ago when we realised that several of our infertility patients shared a similar personality type,” says Rodrigues. “Not only were our patients suffering from TUPS extremely hard-working, driven, and self-confessed perfectionists, they also had other symptoms of stress, including irritable bowel syndrome, spastic colon and chronic fatigue.”

As far back as 1996, Medfem participated in doctoral study involving pre-laparoscopic psychological assessment of personality type and its correlation with the diagnosis of endometriosis. The study found that women with Type A personality are at a much higher risk of endometriosis.

At the time, the question in fertility circles was always whether stress caused infertility or if it was infertility that caused stress.

In an international ESHRE study of 501 couples who planned to fall pregnant, it was found that stress indeed causes infertility. Saliva tests and measurements of cortisol levels where done at the beginning of the study and repeated one month into the study. The participants were then monitored over a period of one year while they tried to fall pregnant naturally.

The Salivary Alpha Amalyse test measures chronic autonomic response, which means it measures chronic stress, providing a measurement that could be correlated with psychological assessment.

The findings of the study were clear: preconception stress increases the risk of infertility (Life Study CD Lynch et al). The higher levels of stress among participants, as measured by Salivary Alpha Amalyse testing, the longer the time to pregnancy (TTP). In fact, the study showed a significant 29% reduction in the ability to fall pregnant – more than a twofold reduction in fertility – among those suffering from stress.

In a later study at Medfem with 20 people, 90% showed a significant correlation between Salivary Alpha Amalyse test readings and TUPS, and these participants, on average, suffered 17 different kinds of health symptoms – including infertility.

In another more recent study at Medfem, 71 patients who had experienced failed IVF cycles attended a 10-week cognitive behavioural stress management program. Of these participants, 54 went on to complete another IVF cycle and achieved 67% pregnancy rate, compared to the normal pregnancy rate for the age group of 40%.

If you would like to know more about these studies, you can watch this video: Time urgency perfectionism stress and its relationship to infertility’

How does stress affect fertility?

It is a known medical fact that stress has an integral relationship with our physical health. The more stressed we are, the more our health is at risk. In fact, there is a whole field built around this notion — psychoneuroimmunology (PNI) — which suggests that if the mind is healthy, the body is healthy.

Since fertility requires healthy sperm and healthy eggs, it stands to reason that any factor that affects your health will also affect your fertility – as well as the outcome of any fertility treatment.

Historically, the role stress plays in infertility was uncertain, despite that fact that it has long been established that when people are under ongoing stress, they secrete hormones that inhibit normal immune function and constrict blood vessels, which in turn would affect the ability to conceive.

However, international studies such as the ESHRE study has now proven that stress does affect fertility and has an impact on the ability to conceive. In addition, recent literature – as well as studies conducted under the auspices of Medfem Fertility Clinic – has shown that the reduction of stress can account for higher pregnancy rates.

The bottom line is that managing your stress will give you a better than average chance of falling pregnant.

How can you manage stress for better fertility?

Of course, having stress doesn’t mean you won’t fall pregnant, but what we know for certain from studies and experience is that you have a better chance of conceiving if you manage your stress well.

In addition to increasing pregnancy rates, successfully managing stress 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

When should you take action?

In addition to stress, there is also a long list of possible medical causes of infertility. If you are concerned about your fertility, the best course of action is to immediately contact a fertility specialist who will be able to identify the exact cause of your fertility problem and provide expert information regarding available treatment options.

Setting up a fertility consultation at Medfem is as simple as clicking here or contacting us on +27 (11) 463 2244.

We look forward to meeting you!

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