- By Prerna Targhotra
- Fri, 15 Nov 2024 05:57 PM (IST)
- Source:JND
Effect Of Stress On Fertility: Stress and sleep disturbances are critical but often overlooked factors influencing both natural conception and assisted reproductive technology (ART) outcomes. Considering these aspects can significantly improve reproductive health and IVF success rates.
Dr. Supriya Puranik, Director - Obstetrics - Gynaecology and IVF, Sahyadri Hospitals MomStory, Shivajinagar, Pune explains that stress triggers a physiological response through the hypothalamic-pituitary-adrenal (HPA) axis, leading to elevated cortisol levels that disrupt hormonal balance, ovarian function, and endometrial receptivity.
Chronic stress suppresses the release of gonadotropin-releasing hormone (GnRH), reducing luteinizing hormone (LH) and follicle-stimulating hormone (FSH) production. This disruption often results in irregular menstrual cycles and ovulation issues. Prolonged stress can also negatively harm ovarian reserve markers such as anti-Müllerian hormone (AMH) and antral follicle count (AFC), which are vital for fertility. Additionally, stress-induced behavioural changes like poor dietary habits, smoking, and alcohol consumption further affect reproductive health negatively.
Sleep And Reproductive Health
Sleep is essential for regulating circadian rhythms, which are closely linked to reproductive hormones like estrogen, progesterone and melatonin. Melatonin, an antioxidant, plays a protective role for ovarian follicles against oxidative stress and poor sleep reduces its levels, impairing egg quality. Sleep disturbances can also cause irregular secretion of GnRH, leading to menstrual and ovulatory problems. Conditions like polycystic ovary syndrome (PCOS), a leading cause of infertility, are often exacerbated by poor sleep, which worsens insulin resistance and inflammation, creating further reproductive challenges.
Stress, Sleep And IVF Outcomes
Stress and sleep disturbances can have profound effects on IVF outcomes, where precise hormonal responses, egg quality and endometrial receptivity are critical. Elevated cortisol levels and sleep deprivation can reduce the number of mature oocytes retrieved and their fertilisation potential. Stress also impairs uterine blood flow and endometrial receptivity, which are crucial for embryo implantation. Women experiencing high-stress levels during an IVF cycle have been shown to have lower pregnancy rates, while poor sleep quality can reduce clinical pregnancy rates by up to 20-25%. Additionally, stress and sleep issues can lead to reduced adherence to IVF protocols, missed medications and inconsistent monitoring.
Effects Of Sleep And Stress On Fertility (Image Credits: Canva)
Dr. Arati Adhe, Consultant - IVF, Obstetrics & Gynaecology, P. D. Hinduja Hospital & Medical Research Centre, Khar, Mumbai says that sleep and stress both are responsible for irritability, mood swings, decreased libido decreased sexual desire and indirectly affect sexual as well as reproductive health. As far as sleep is concerned certain hormones usually get secreted in certain quantities at certain hours of the day this is also called as circadian rhythm of hormonal secretion. Sleep regulates these hormones' synthesis, quantity of secretion and metabolism which is required for particular reproductive functions.
To improve sleep quality, patients should practise good sleep hygiene by maintaining consistent sleep schedules, avoiding blue light (lights that are emitted by electric devices) before bed, and creating a restful sleeping environment. Melatonin supplementation may be considered in cases of poor egg quality or disrupted cycles. Addressing underlying sleep disorders such as Sleep apnea, a disorder causing breathing interruptions during sleep which affects sleep quality, can also improve reproductive outcomes. Counselling patients about the impact of stress and sleep on fertility and offering support through peer groups or fertility coaching can also normalise their experiences and reduce anxiety.