Whole Person Fertility Program
BULLETIN

Harvard Medical School research (New York Times 3-11-2004) has found startling new evidence that the ovaries may be replenished with new eggs throughout a female's reproductive career. Dr. Roger G. Gosden states: "The ability to make more eggs would be a revolution in women's health."

Current Mind-Body Fertility Research
Who says you're too old?

"It's not hard to understand the fears surrounding conception. Yes, the statistics show that a woman's fertility declines as she ages, but you must keep in mind that these numbers may have nothing to do with you. In fact, over the last 20 years, births to women over age 40 have increased by 50%.... And in 1991, 92,000 women in the U.S. over age 40 had babies. That number continues to rise. A lot of forty-something women don't realize how fertile they are, which may account for the fact that they are second only to women ages 18-25 in frequency of abortions. Who says your eggs are too old? Furthermore, you should know that the vast majority of babies born to women in their forties are healthy. And in healthy women, the vast majority of pregnancies are completed without a hitch."

-Christiane Northrup, M.D., Health Wisdom
for Women (July 1997)

Chronic Stress and Infertility

"I believe that depression- often in response to chronic stress- can indeed play a part in infertility. For some infertile women, depression may be an initial trigger, which then feeds a cycle of increasing emotional upset that further reduces their chances for conception. In both instances, depression may hinder one or several biological factors crucial to fertility including maturation of the egg, ovulation and implantation. When we effectively treat women's stress and subsequent depression, we stand a chance of helping them become fertile."

-Alice Domar, Healing Mind, Healthy Woman
New York: Henry Holt, 1996: page 238

Stress and Reproductive Function

"Dr. Sarah L. Berga, associate professor of Obstetrics, Gynecology and Reproductive Sciences and Psychiatry at Magee-Women's Hospital and the University of Pittsburgh, has received a federal (NIH) grant to study the relationship between stress and irregular menstrual cycles. The aim of the study is to understand more about what kinds of stress interfere with the brain signal to the ovary. There must be healthy eggs and sperm for conception to occur. Stress can reduce the brain signal to the ovary. When this happens, ovulation either stops or becomes infrequent. Generally, this becomes apparent when menstrual cycles stop, or by a change in their patterns. If ovulation ceases, or is impaired, infertility can result."

-Magee - Woman's Hospital, Womancare (July, 1997)

Psychological correlates of functional hypothalmic amenorrhea, Sarah L. Berga, M.D. et al (Fertility and Sterility, Vol.76, No.2, August 2001)
Conclusion: The findings are consistent with the hypothesis that FHA is precipitated by a combination of psychological stressors and metabolic challenges. (Fertility Sterility® 2001; 76:310-16. ©2001 by American Society for Reproductive Medicine.)
Reprint Requests: Marsha D. Marcus, Ph.D.
Western Psychiatric Institute and Clinic
3811 O'Hara Street
Pittsburgh, PA 15213
Fax: 412-624-0265
Email: marcusmd@msx.upmc.edu
Immunological changes and stress are associated with different implantation rates in patients undergoing in vitro fertilization-embryo transfer, Dr. Andrea Gallinelli et al (Fertility and Sterility, Vol.76, No.1, July 2001)
Conclusion: A prolonged condition of stress, which causes a decreased ability to adapt and a transitory anxious state, is associated with high amounts of activated T cells in the peripheral blood. Such a condition, in turn, is associated with a reduced implantation rate in women undergoing IVF-ET. (Fertility Sterility® 2001; 76:85-91. ©2001 by American Society for Reproductive Medicine.)
Reprint Requests: Fabio Facchinetti, M.D.
Dept. of Gynecology, Obstetrics, and Pediatrics
University of Modena and Reggio Emilia
Via Del Pozzo 71 41100
Modena, Italy
Fax: 0039-059-424394
Email: facchi@unimo.it
Stress and marital satisfaction among women before and after their first cycle of in vitro fertilization and intracytoplasmic sperm injection, Christianne M. Verhaak, M.Sc. et al (Fertility and Sterility, Vol.76, No.3, September 2001)
Conclusion: Differences in emotional status between pregnant and nonpregnant women were present before treatment and became more apparent after the first IVF and ICSI cycle. There were no differences in emotional status between the women who underwent IVF and those who underwent ICSI. (Fertility Sterility® 2001; 76:525-31. ©2001 by American Society for Reproductive Medicine.)
Reprint Requests: Christianne M. Verhaak, M.Sc.
University Medical Center Nijmegen St.
Radboud, 118 Dept. of Medical Psychology
PO Box 9101, 6500 HB
Nijmegen, the Netherlands
Fax: 31-24-3613425
Email: c.verhaak@cksmps.azn.nl
A longitudinal study of disturbances of the hypothalmic-pituitary-adrenal axis in women with progestin-negative functional hypothalmic amenorrhea, Yoshihito Kondoh, M.D. et al (Fertility and Sterility, Vol.76, No.4, October 2001)
Conclusion: The CRH test might be useful for evaluating the roles of stress and for estimating the period required for recovery in hypothalmic amenorrhea. (Fertility Sterility® 2001; 76:748-52. ©2001 by American Society for Reproductive Medicine.)
Reprint Requests: Yoshihito Kondoh, M.D.
Dept. of Obstetrics & Gynocology
Yokohama Minamii-Kyosai Hospital
500 Mutsuura-cho
Kanazawa-ku
Yokohama, 236-0032 Japan
Fax: 81-45-701-9159
Email: ym-kondo@pk9.so-net.ne.jp
A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer, Hillary Klonoff-Cohen, Ph.D. et al (Fertility and Sterility, Vol.76, No.4, October 2001)
Conclusion: Baseline (acute and chronic) stress affected biologic end points (i.e. number of oocytes retreived and fertilized), as well as pregnancy, live birth delivery, birth weight, and multiple gestations, whereas (procedural) stress only influenced biologic end points. (Fertility Sterility® 2001; 76:675-87. ©2001 by American Society for Reproductive Medicine.)
Reprint Requests: Hillary Klonoff-Cohen, Ph.D.
Dept. of Family and Preventive Medicine
University of California-San Diego
9500 Gilman Drive
La Jolla, CA 92093-0607
Fax: 858-822-4192
Email: hkonoffcohen@ucsg.edu
Impact of group psychological interventions on pregnancy rates in infertile women, Alice D. Domar, Ph.D. et al (Fertility and Sterility, Vol.73, No.4, April 2000)
Conclusion: Group psychological interventions appear to lead to increased pregnancy rates in infertile women. (Fertility Sterility® 2000; 73:805-12. ©2000 by American Society for Reproductive Medicine.)
Reprint Requests: Alice D. Domar, Ph.D.
110 Francis Street Suite 1A
Boston, MA 02215
Behaviorally induced reproductive compromise in women and men, Sarah L. Berga, M.D.
Conclusion: Functional hypothalmic hypogonadism is a clinical example of how attitudes, moods, and behaviors can have endocrine consequences and cause definable reproductive disorders. Although a link between brain states and gonadal function has long been hypothesized, only recently have we been able to specify some of the mechanisms mediating this relationship. This understanding not only has concrete clinical implications, but it also expands our appreciation of what it means to be healthy. Health truly depends upon developing healthy attitudes and healthy behaviors. Misattributions, negative images of self and others, unrealistic expectations, and emotional disharmony can cause neuroendocrine havoc. There are many religions and philosophical orientations that aim to guide us in the endeavor to be spiritually healthy. Whatever the route, we must seek to develop healthy mind-sets that permit us to meet life's innumerable challenges without overwhelming our coping mechanisms and without activating a chronic stress response. If we expect and learn to cope well with adversity, then we likely will have more than just good reproductive functioning.
Reprint Requests: Dr. Berga
Magee-Women's Hospital
300 Halket Street
Pittsburgh, PA 15213-3180
Neuropeptides: The Emotions and Bodymind, Candace Pert, Ph.D. (Advances, Vol. 3 No. 3 Summer 1986)
Conclusion: Neuropeptides and their receptors are a key to understanding how mind and body are interconnected and how emotions can be manifested throughout the body. (Dr. Candace Pert, a biochemist, was among the first to show opiate drugs like morphine and heroin can bind to cells in the brain. This finding, along with the discovery two years later that the body produces its own morphine-like chemicals called endorphins, has opened up a whole new approach to investigating how the brain controls emotion.)
Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy, Wolfgang E. Paulus, M.D. et al (Fertility and Sterility, Vol.77, No.4, April 2002)
Conclusion: Acupuncture seems to be a useful tool for improving pregnancy rate after ART. (Fertility Sterility® 2002; 77:721-4. ©2002 by American Society for Reproductive Medicine.)
Stress Ovarian Angst, Lois Verbrugge (July/August 1994)
Conclusion: Some anxious monkeys in North Carolina are showing medical researchers just how damaging stress can be to women's health. It goes straight to the ovaries. Like humans, monkeys show signs of stress physically and behaviorally when having to organize their social life. In the monkey world, it's a matter of jockeying for social position in groups. The stressed-out simians oversecrete stress-related hormones in their brains, which in turn throw their ovaries into hormonal disarray. They not only may become infertile, but they are at higher risk for osteoporosis and heart disease. These monkeys have reduced concentrations of estrogen and other hormones in their menstrual cycles, reports Carol Shivel, Ph.D., associate professor of comparative medicine at Bowman Gray School of Medicine. The concentrations can be low enough that the uterus couldn't support a fertilized egg or so low that a person never ovulates.

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