The focus of this research database is on how stress affects women's health,

and options for treatment using mind-body therapies. 

If you are not a health care professional, see new "Medical Glossary" below.  

To obtain full summaries of the articles, see "How to Get Abstracts" below. 

Infertility patients have been called the "most neglected silent minority" because they have a loss that often goes unnoticed. In addition, they face many other often unnoticed stresses, such as the difficulties of going to work while undergoing infertility testing and treatments, the fear caused by newspaper reports of possible increased risk of cancer with ovulation agents, or the ethical problems of facilities implanting the wrong embryos. Even if successful, they may continue to consider themselves "infertile", often not buying baby clothes or making preparations during their pregnancy. And if therapies do not work, they often drop out of treatment without closure or support. For all of these reasons, the author recommends a psychologist as part of an infertility team, for individual counseling as well as behavioral advice on relaxation training, stress management, and nutritional and exercise counseling.

1997 J Assist Reprod Genet 14;4:181-3

Seibel, M. M.

Thorough review of the literature on the effects of psychological distress and infertility, with lack of strong conclusion due to conflicting results and design flaws. Theoretical mechanisms by how stress can influence fertility: stress effects the limbic system, which links to GnRH pulsatility; stress and depression are associated with lower serotonin levels, which leads to increased prolactin which can negatively impact ovulation; stress can cause immune function abnormalities, which may influence fertility-related antibody problems.

1998 J Psychosom Obstet Gynaecol 19;4:218-28

Brkovich, A. M. and Fisher, W. A.

8142988 JA

Psychological symptoms associated with infertility were similar to those of patients with cancer. "Recent research indicates that chronic stressors are more strongly related to depressive symptoms than acute stressors."

1993 J Psychosom Obstet Gynaecol 14 Suppl;45-52

Domar, A. D., Zuttermeister, P. C., and Friedman, R.

10374131 JA

Infertile Belgian women had more depressed mood, memory/concentration problems and anxiety than a control population. Both the infertile group and control group agreed that infertility was a severe life event.

1999 Hum Reprod 14;1:255-61

Oddens, B. J., den Tonkelaar, I., and Nieuwenhuyse, H.

11594715 JA

Infertile women with fertile partners experienced more general health symptoms than other infertility subgroups.

2001 J Psychosom Obstet Gynaecol 22;3:143-8

Kowalcek, I., Wihstutz, N., Buhrow, G., and Diedrich, K.

1986949 JA

Both male and female infertility patients were significantly more distressed than the average population, but women showed more anxiety, depression, hostility, cognitive disturbances, stress levels and decreased self-esteem than their partners.

1991 Fertil Steril 55;1:100-8

Wright, J., Duchesne, C., Sabourin, S., Bissonnette, F., Benoit, J., and Girard, Y.

11561741 JA

Women of infertile couples rated higher on "depressional coping" than their partners. Women with infertility rated lower on "religiousness and search for meaning" than women with other chronic medical problems.

2001 Arch Gynecol Obstet 265;3:131-6

Kowalcek, I., Wihstutz, N., Buhrow, G., and Diedrich, K.

1730305 JA

For both men and women, stress was directly correlated with treatment costs and number of tests and treatments received, and did not relate to age, number of years married, or number of years of infertility. For women, attitudes about infertility treatments, importance of children, and level of social support significantly affected stress levels. Authors recommend increasing patients' sense of control, realistic optimism and social support to reduce stress.

1992 Fertil Steril 57;1:122-8

Abbey, A., Halman, L. J., and Andrews, F. M.

9443140 JA

Of 27 infertile couples who had conceived via donor insemination, 75% did not plan on disclosing this information to their child, although 85% had told at least one other person. A significant portion of patients were unsure if, when or how to disclose, and the majority had not been offered counseling on this subject.

1997 J Psychosom Obstet Gynaecol 18;4:292-300

Leiblum, S. R. and Aviv, A. L.

Of 427 Wisconsin infertile couples who conceived after donor insemination, 50% did not tell any family or friends, and 61% did not plan on telling the child. The divorce rate was 7.2%, much lower than the general population, and 2.8% had sought counseling related to the procedure.

1990 Obstet Gynecol 75;6:899-905

Amuzu, B., Laxova, R., and Shapiro, S. S.

108 Estonian women with infertility due to several conditions had significantly increased incidence of one or more common autoantibodies compared to a general population control group (40% vs. 14.8% p<.005). The most common were ANA and SMA. There were no correlations with infertility diagnosis.

2001 J Reprod Immunol 51;2:167-76

Reimand, K., Talja, I., Metskula, K., Kadastik, U., Matt, K., and Uibo, R.

11150866 R,T

Many ob/gyns and perinatologists are not aware of the reproductive impact of the immune disorder subclinical celiac disease (wheat/gluten sensitivity), which can present with an array of non-gastrointestinal symptoms, including neurological symptoms, depression, osteoporosis and anemia due to decreased absorption of nutrients such as iron, folate and vitamin K. This review of the literature reveals that untreated celiac disease is associated with delayed menarche, earlier menopause, infertility, higher miscarriage rates, increased fetal growth restriction and lower birth weights. Going on a gluten-free diet may decrease miscarriage rates and improve perinatal outcome.

2001 Gynecol Obstet Invest 51;1:3-7

Eliakim, R. and Sherer, D. M.

11228068 R,T

Review of studies showing the negative impact on many facets of women's health caused by the adult form of celiac disease. Prevalence in Western Europe is at least 1:300. This group of women may be particularly susceptible to environmental substances toxic to reproductive health.

2000 Gynecol Endocrinol 14;6:454-63

Stazi, A. V. and Mantovani, A.

Increased levels of long-lived chlorinated hydrocarbons were found in German women with fibroids, endometriosis, miscarriage and persistent infertility.

1999 Environ Res 80;4:299-310

Gerhard, I., Monga, B., Krahe, J., and Runnebaum, B.

10731544 RCT

Infertile women in a support group that included yoga, relaxation and imagery had significantly higher pregnancy rates than a control group, and higher rates of spontaneous pregnancy than a standard support group. [See Mind-Body Connection for power point slides of this study.]

2000 Fertil Steril 73;4:805-11

Domar, A. D., Clapp, D., Slawsby, E. A., Dusek, J., Kessel, B., and Freizinger, M.

11129360 RCT

Additional information from same study above. Women who participated in the groups had decreased psychological distress, whereas the control group experienced increased distress over time.

2000 Health Psychol 19;6:568-75

Domar, A. D., Clapp, D., Slawsby, E., Kessel, B., Orav, J., and Freizinger, M.

8533736 JA

Literature review of hypnosis and infertility revealed few, small case histories. Author describes two personal cases of women with lengthy infertility (one of 8 years) with no medical cause found, who both became pregnant within three months after a single hypnosis session. Abbreviated script included.

1995 Am J Clin Hypn 38;1:22-6

Gravitz, M. A.

9130065 JA

Article discusses the impact of unresolved grief on infertility. Two case histories, involving previous stillbirth and death of a parent, demonstrate successful conception after these losses were resolved.

1997 J Assist Reprod Genet 14;4:189-91

Christie, G. L.