For people who want to get pregnant but are unable to do so, feeling stressed is a natural reaction. And yet, people who struggle with infertility are often told that being stressed will only worsen their chances of getting pregnant. It's a catch-22 situation, in which the most likely outcome seems to be… more stress.
This was the theme of last week's PET (Progress Educational Trust) event 'Fertility Treatment and Stress: Patients, Practitioners and Outcomes'. Sarah Norcross – director of PET – was joined by a panel of experts to discuss the impact of stress on patients seeking fertility treatment and also on professionals providing fertility treatment. The panel included three health professionals, plus a patient/commentator who had experience of going through fertility treatment.
'We are all bombarded with information about stress,' said Norcross in her opening address. She observed that for people going through fertility treatment, the internet is quick to advise on de-stressing tactics such as going for walks, watching your favourite TV shows, or deactivating social media accounts. And it's not just patients who are trying to combat stress in any way they can. For health professionals who are closely involved in patients' journeys, an unsuccessful outcome can also take a personal toll.
The first speaker was Dr Sinéad Currie, a psychologist who researches preconception health at the University of Stirling. She began by describing the body's hormonal response to stress, explaining how stress triggers hormonal changes that can affect multiple organs, including those involved in reproduction. However, the precise impact of this on fertility remains unclear.
Dr Currie outlined the many ways in which people can optimise their health when trying to conceive – from avoiding cigarettes, alcohol, air pollution and certain drugs to exercising, eating well and taking folic acid. She acknowledged, however, that stress can be a key barrier to engaging in any of these healthy behaviours.
Studies suggest that our ability to control our behaviour can be hampered by stress, making it harder to resist coping mechanisms such as alcohol or smoking. Dr Currie concluded by arguing that stress in fertility patients should therefore be acknowledged rather than dismissed, and might be addressed through psychosocial interventions such as mindfulness or cognitive-behavioural group approaches.
While the profound emotional impact of infertility on patients is increasingly recognised, the impact on healthcare professionals often goes unspoken. This was the message of the second panel speaker, Angela Pericleous-Smith, fertility counsellor and chair of the British Infertility Counselling Association.
Fertility is a medically, ethically and emotionally complex field in which to work. Some healthcare professionals may share in their patients' feelings of hope, uncertainty, disappointment and loss, as those patients navigate the highs and lows of fertility treatment. This is coupled with the immense pressure of making high-stakes clinical decisions, and working in a field that is subject to intense regulation.
Pericleous-Smith shared long lists of potential workplace stressors, some of which – such as high workload, competitiveness and bullying – probably apply to many fields of medicine, as well as workplaces beyond. Other stressors, however – such as repeated exposure to failed treatment, and dealing with legal challenges – may be disproportionately common in fertility care.
Outcomes of fertility treatment are often unresolved, and a patient's story doesn't end when a treatment cycle ends. When the hopes attached to fertility treatment are so great, one can only imagine the feeling of pressure – on patients and clinicians alike – for the early stages of a pregnancy established via IVF to go well.
The third speaker, Dr Angela Lawson – a psychologist specialising in women's reproductive health, and adjunct lecturer at Northwestern University's Feinberg School of Medicine in Chicago, Illinois – began by confirming that stress does not make you less fertile. 'It is an old wives' tale,' she said.
Dr Lawson's research shows that a belief that stress causes infertility is widely held among both patients and doctors. At the same time, her research shows that this belief is not backed up by evidence. Studies that have sought to establish link between stress and infertility cannot prove that there is a causal relationship, and often measure stress using surrogate parameters – such as stress hormones – which do not necessarily correlate with real-life experience of stress. Evidence that stress-reducing interventions such as yoga and acupuncture might help you get pregnant is also lacking.
Dr Lawson was adamant that these myths should be dispelled, so as to shift blame from women who are trying to get pregnant but not succeeding. 'We grow up hearing that getting pregnant is easy,' she said. 'This is a lie. For at least one in six of us it is not. Because we have this perception that it is easy, we blame ourselves when we can't do it.'
Dr Lawson concluded by urging fertility professionals to refrain from telling patients who are trying to get pregnant to 'just relax'.
Emma Haslett – a journalist with lived experience of infertility, and co-host of the infertility/IVF podcast Big Fat Negative – left us in no doubt as to how frustrating and repetitive these two words of advice can be. She showed us a picture of herself wearing a T-shirt with the words 'JUST RELAX' written in large bold letters across the front.
Haslett explained that, while going through more than four years of fertility treatment, she did everything she possibly could to 'just relax'. She tried yoga, mindfulness, acupuncture, and herbal tea, yet despite her best efforts, did not get pregnant. She even refrained from touching receipts for a year, as she'd heard they contained harmful chemicals that might hamper her attempts to conceive.
'Infertility is a strangely selfish affliction,' she said, 'because you are just in your body all the time.' After years of trying to get pregnant, she arrived at a point where she felt 'very isolated'.
Haslett argued that even if stress did cause infertility, that would not make it appropriate to tell a fertility patient to relax. What people need is more actionable ways of reducing stress and feeling more in control.
Norcross then invited questions and comments from the audience. One attendee, a fertility counsellor, asked whether – in light of Dr Lawson's mythbusting – there was any value in patients attending to their stress with breathwork or yoga. Dr Lawson suggested that such relaxation interventions should be reframed as a form of self-care, rather than something that could affect your fertility.
Haslett added a further caveat to this, saying that it can be all too easy for 'self-care' to become a full-time (and ultimately unrewarding) job. When social media seems intent on feeding our obsession with wellness and self-optimisation, there is a risk of overdoing it.
Coping with infertility requires us to relinquish control. We can eat well and take folic acid and optimise our general health, but to a large extent the success of fertility treatment is out of our hands – out of the patient's hands, and often out of the fertility professional's hands as well.
Dr Lawson concluded that we want to believe that getting pregnant is within our control, because if this is not the case, then infertility is unfair. And the truth is, infertility is unfair. But it is also unfair to blame patients for feeling stressed about their infertility, and the words we use with patients are something that we can control.
PET is grateful to the Scottish Government for supporting this event.
Register for these upcoming PET events:
- Male Infertility: Today's Insights, Tomorrow's Treatments, taking place in Edinburgh this month on Wednesday 18 March 2026 – register here.
- What Does the NICE Fertility Guideline Update Mean for You?, taking place online next month on Wednesday 15 April 2026 – register here.