Women diagnosed with infertility have traditionally sought out clinics for treatment with the aim of successfully conceiving. A range of assisted reproductive technologies, or ART, is offered to these patients, including in vitro fertilization and embryo transfer, gamete intrafallopian transfer (GIFT), tubal embryo transfer (TET) and zygote intrafallopian transfer (ZIFT).
Psychosomatic Synergy
But in addition to the traditional therapeutic options available, a Georgia fertility clinic is about to venture into new territory: managing stress by offering a holistic approach. A newly created "Mind/Body Program" is set to begin in mid-March for women with unexplained infertility, as well as for those who are currently not patients of the clinic. The approach is termed psychosomatic.
"Ask any woman who has ever undergone fertility treatment, and I am confident that she will tell you it was a very stressful point in her life," said Susan Conway, MD, a reproductive endocrinologist at Georgia Reproductive Specialists in Atlanta, which is making the program available to patients. "By partnering with local therapists and offering this Mind/Body program, we are able to treat the medical condition, as well as offer ways to help manage the stress of it all."
The program's elementary design is actually not new. The so-called "relaxation response" was developed some 30 years ago by Harvard University cardiologist Herb Benson, MD, who today heads Harvard's Mind/Body Medical Institute. Patty Goodhue O'Brien, MA, an Atlanta-area psychotherapist who was trained on the use of mind/body techniques through the Harvard program, is today harnessing the approaches she learned for infertility patients.
A Physiological/Emotional Focus
Goodhue O'Brien oversees the unique program along with clinical psychologist Linda Stamm, PsyD., who jointly have been making it available to women for the past 5 years.
"The relaxation response is really the backbone of the program," Goodhue O'Brien told Priority Healthcare, in an interview. "It's teaching our clients and patients varying ways of relaxation through meditation, yoga, progressive muscle relaxation, imagery. We teach different types of relaxation every week for 10 weeks."
When it's begun, the program will be directed at women having trouble conceiving, including those who are not currently patients of the clinic. Participants will take part in peer support group sessions. The program will also emphasize cognitive-behavioral strategies to enhance coping skills, stretching exercises, and nutrition management. Coping strategies focus on living in the moment. Infertility patients may sometimes "live in the future", explained Goodhue O'Brien, feeling stress about whether their next round of treatment will be successful or not, for example. Or they may live in the past, regretting their diagnosis.
Living in the moment includes focusing on positive aspects of one's life now by taking part in activities that are enjoyable, as well as cognitive restructuring, which involves overhauling negative thought patterns, she explained.
What effect does the relaxation response have on patients? "It counteracts and balances the physiological, as well as the emotional impact of the stressor they're going through—in this case, infertility," Goodhue O'Brien explained. Programs for patients diagnosed with cancer, HIV infection, and menopause are also available.
All in all, the program's aim is holistic—combining techniques aimed at improving the way one feels physiologically (achieving the relaxation response) with the way one feels emotionally (cognitive behavioral approaches).
Stress and Infertility
Studies have suggested that high levels of stress can actually interfere with the normal reproductive cycle. In fact it's been given a name: functional hypothalamic amenorrhea, or functional hypothalamic chronic anovulation.1 Stress, experts have suggested, can also negatively impact treatment outcomes for infertility.2
But other researchers have cautioned that treating psychological stress as a sole cause of infertility is "inadequate".3 Stress should be included solely in the context of physical effects related to a particular patient's infertility, they point out. Goodhue O'Brien concurs. "There's no research saying that stress causes infertility at all, and we're not saying that," she said. "[In contrast], we want to counteract any possible effects that stress may have on infertility."
In this context, the simple message given to program participants is that there's no evidence suggesting that stress causes infertility, but infertility does cause stress, she said.
As such, managing stress in the very least can help men and women facing this diagnosis cope and make better decisions about treatment, experts say. Stress can also interfere with work, negatively affect your relationship with your partner, and create unnatural isolation from family and friends, among other things.4
Helping patients facing infertility overcome these challenges is strongly endorsed by the clinical staff at Georgia Reproductive Specialists. "It works so significantly well for their patients," said Goodhue O'Brien. "The doctors are all for it."
How does she sum up the program's goal? "We want women to feel like they've gotten their lives back."
1. Ferin M. Stress and the reproductive cycle. J Clin Endocrinol Metab 1999 Jun;84(6):1768-74.
2. Facchinetti F, Matteo ML, Artini GP, Volpe A, Genazzani AR. An increased vulnerability to stress is associated with a poor outcome of in vitro fertilization-embryo transfer treatment. Fertil Steril 1997 Feb;67(2):309-14.
3. Wischmann TH. Psychogenic infertility—myths and facts. J Assist Reprod Genet 2003 Dec;20(12):485-94.
4. American Fertility Association. Coping with Infertility. Available at: http://www.theafa.org/faqs/afa_copingwithinfertility.html. Accessed March 1, 2005.
John Martin is a long-time health journalist and an editor for Priority Healthcare. His credits include coverage of health news for the website of Fox Television's The Health Network, and articles for the New York Post and other consumer and trade publications.
