Stress and infertility

"You're just trying too hard."

"You're too stressed. Just relax and it will happen."

"You've got to calm down and let nature take its course."

If you've been trying six months or more to get pregnant, you've probably lost count of the number of times well-meaning friends and family offered this or similar advice.

Though the idea that "trying too hard" was once a popular notion, dramatic advances in infertility treatments - particularly in the past decade - all but did away with that idea.

Now, however, the wheel has turned yet again, and doctors are once more looking to the idea that stress - and sometimes "trying too hard" - may actually play a role in up to 30% of all infertility problems.

"It's becoming more and more important, in terms of what studies we do, to focus our efforts on the physiological effects of stress and how they may play a role in conception," says Dr Margareta Pisarska, a co-director of a centre for reproductive medicine and editor-in-chief of the American Society for Reproductive Medicine News.

While doctors say that right now there aren't enough data to draw a clear and obvious link, many believe it's only a matter of time before we connect all the dots and see the bigger picture.

"What we do know now is that when stress-reduction techniques are employed, something happens in some women that allows them to get pregnant when they couldn't get pregnant before," says Dr Allen Morgan, a director of an institute for reproductive medicine.

While the exact pathways between fertility and stress remain a mystery, Morgan believes hormones such as cortisol or epinephrine - which rise and often remain high during times of chronic stress - play a key role.

Morgan says that it's also possible that reducing stress may help to enhance proteins within the uterine lining that are involved in implantation. She says that stress reduction may increase blood flow to the uterus, which also affects conception.