mindfulness Archives - Fertility Fact Checker

Possible benefits of mindfulness when doing IVF (including increased DHEA and melatonin)

When I learnt at a seminar I attended this week that mindfulness can increase DHEA and melatonin levels in our blood, I was intrigued.

As you may remember from the free book, ’19 ways you can contribute to increasing your chances of IVF success’, optimized melatonin levels can be associated with higher numbers and quality of eggs come IVF egg pick up day (1).

Similarly DHEA, or dehydroepiandrosterone, is a bit of a controversial IVF supplement which is believed to increase egg quality, especially for those with diminished ovarian reserve or who have been poor responders to IVF treatment. There needs to be more larger studies supporting and evaluating its use but from the preliminary evidence there is, it seems like DHEA could be beneficial to increasing the live birth rates for some women doing IVF.

For example, in a very small study with only 33 patients (2) they found that the live birth rates for women who had DHEA supplementation were 23% where as those women who did not take the supplementation had live birth rates of around 4% (remember, it was only a very small study and although an increased birth rate of 19% for taking a tablet seems great, it is ‘only’ an extra 5 births… but it is certainly a start and a step in the right direction). You absolutely need to check with your treating fertility specialist to check that DHEA would be suitable in your situation (so no off-grid, unapproved supplementation) but maybe if we can support levels naturally through mindfulness that can only be a good thing?

What about mindfulness

At the seminar, led by mindfulness expert and international best selling author, David Michie, a study which found that when people meditate for five years or more the DHEA in their blood stream is the equivalent to someone twelve years younger was discussed. DHEA depletes as we age and if we can have the DHEA of someone twelve years younger, could that lead us to the path of having eggs twelve years younger? It seems unlikely that such a direct correlation exists, but while looking for evidence to support this theory, I found other remarkable statistics linking DHEA to mindfulness. For example, did you know people who meditate have upto 44% more DHEA than those who don’t? (3)

Whilst looking for the ‘smoking gun’ linking DHEA, mindfulness and IVF, I found that the studies linking mindfulness to increasing DHEA were sometimes just only looking at male populations, sometimes it only looked as far as it impacted cardiovascular health… unfortunately I could not find any evidence that examined directly, or even indirectly, of how mindfulness impacts DHEA in women, women with fertility problems or women doing IVF.

Mindfulness Benefits for IVF

This then lead me to think, that if you want to increase your DHEA or melatonin levels, by all means giving mindfulness a go is definitely worth it for this reason alone. But ultimately, to achieve the results that you want in the quickest time possible (forget yesterday, who doesn’t want that baby, like, 3 years ago?!) with a more evidence based approach, you are best speaking to your fertility specialist to see if supplementation might be right for you.

But mindfulness has so much more to offer than just its influence on hormone levels.

For many women doing IVF, the process can become EVERYTHING. Everything you eat, everything you touch, everything you do, the plans you make, the plans you don’t make, it all becomes linked as to how it’s going to possibly increase or decrease your chances of a take home baby this cycle. It’s mentally exhausting. Practicing mindfulness gives you the opportunity to have that weight taken off your shoulders even for the shortest time while you are doing it.

We focus so much on eating right and taking the medications at the exact time in the exact way that we forget to take care of our mental health. But as David Michie highlights, when we look at our physical health, the absence of disease does not equate to health. We can be incredibly unhealthy physically, not at all ‘fit’ and still not have an actual disease process going on. Similarly, we may not have a mental health condition, such as anxiety, depression or otherwise, but that still is not to say we are actually mentally healthy either. Mindfulness is what helps you achieve a better state of mental wellbeing as exercise helps you achieve a better state of physical wellbeing.

Other benefits of mindfulness

When we are in our one thought IVF tracked mind it is hard to open up to other things and experiences. It is, understandably, easy to get resentful with the world – especially the 25 year old you share an office with who ‘boom!’ accidentally got pregnant. Giving yourself the head space to get out of that mindset even if it is just for a short period of time at first lets you feel less stressed, develop better coping strategies, become more accepting, innovative, creative and taking one more step towards living your most vivid life.

How to practice mindfulness

I’ve written about the benefits of mindfulness to IVF success rates in previous posts and also given some practical exercises for you to get started on. Although you can get benefits from day one, overall for the best results you need to practice mindfulness on a daily basis. As David Michie points out, you don’t go to the gym just the one time and then wonder why you haven’t got abs of steel. Similarly, don’t just practice mindfulness the one time before deciding it’s not for you. Like going to the gym, it seems there is direct correlation between the hours you put in and the impact it has.

But if you want a time frame to aim for, David Michie guarantees if you practice mindfulness five times a week for six weeks you’ll definitely see these rewards.

I write a lot about mindfulness in Eat Think Grow. In fact, there are mindfulness or mindset suggestions for every day of your cycle and it is specifically tailored for women doing IVF. It focuses on helping you through every step of your IVF cycle and is written from the perspective of someone who has been there and knows how you might be feeling.

There are also other mindfulness resources around, including apps such as ‘Insight Timer’ and ‘Smiling Mind’ and books such as ‘Why Mindfulness is Better than Chocolate’.

Like so many practices that will ultimately influence your quality of eggs and overall health, the key is just to start. If you are not ready to take the plunge into a more detailed mindfulness program, such as Eat Think Grow, for now just start the day taking three deep breaths. Breathing in for about 3 seconds and out for around six, focus on nothing but these breaths. Pay attention to the temperature of the air, the sound your breath makes, the rise of you abdomen as you breathe in and lowering as you breathe out. Let your thoughts only focus on these three breaths… It will certainly be a start in clearing away some of the unwanted and often negative thoughts that may be swirling around your mind.

To sum it up

Although it seems that there is still so much that is unknown about the mind-body connection, there is still so much information that supports that the way we think and feel can have a direct relation to our physical health. Already they have linked serotonin, cortisol and other steroids (which all potentially impact our IVF health) and here we have mentioned DHEA and melatonin.

While it is likely that by practicing mindfulness you will see an improvement in these hormone levels in a natural way (which is theoretically a great thing for egg health during IVF) the other benefits of mindfulness on your ability to cope and get through what for many women may be some of the most challenging times of their life, is equally, if not more so, important.

PS If you have any worrying thoughts that turn towards harming yourself, those around you, or you feel have gone on just a bit too long, make sure you speak to a health professional that knows you. There are many treatments out there – and some of which will be suitable for women doing IVF or, hopefully, about to be, pregnant.

Reference

Fernando, S. & Rombauts, L. (2014) Melatonin: shedding light on infertility? – a review of the recent literature. Journal of Ovarian Research 7 98
Wiser, A., Gonen, O., Ghetler, Y., Shavit, T., Berkovitz, A and Shulman, A. (2010). Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: A randomized prospective study. Human Reproduction, 25 (10) 2496–2500
https://eocinstitute.org/meditation/immune-brain-chemicals-how-meditation-boosts-dhea-melatonin-gh/)

Stress and anxiety: does it really matter to IVF?

For some of us, anxiety feels like your brain can’t stop calculating. Calculating outcomes, calculating consequences, calculating alternatives. All bad obviously. And all meaningless. After all when does an anxious person ever think an unknown outcome is going to be positive? Never, that’s when.

There are times when I have been so, so far into my wave of anxiety, I just couldn’t see out. The triggers for my anxiety are so inconsequential that a ‘normal’ person wouldn’t understand. But if you have ever had anxiety, fertility related or not, you will get what I mean.

When your friends short text message has you obsessing all day that you have somehow offended her (when the logical part of your brain, which is taking a back seat at the moment, knows you couldn’t have), when an exchange with a colleague has you literally sick to the stomach and the thought of a team meeting has your chest tightening.

I know some people won’t know what I mean by that, but I know a lot of you will.

A barrier to IVF

Stress, anxiety, fear of uncertainty, the feeling of your life constantly being on hold, the emotional cost, having ‘had enough’ and thinking that you have a poor IVF prognosis (without doctors actually stating this) are all major reasons why women don’t continue with IVF when the issue of money has been taken out of the equation¹.

A recent small study showed that for women in the US who chose not to continue with IVF despite being insured for more cycles, 39% stated that stress was the reason why they couldn’t continue treatment. Specifically, these women stated that the toll fertility treatments took on their relationship was too much as well as simply being too anxious and depressed to continue¹.

In fact, stress and anxiety being the reason women do not continue with IVF when money isn’t the issue (because their cycles are funded by researchers or government programs) is likely to be higher than 39% with the authors citing a Swedish study where the number is thought to be around 65% and an Australian study where the number was thought to be around 54%.

Women don’t start IVF and fertility treatments lightly. That take home baby is very much wanted and much sacrifice and consideration has already gone into making it happen. Therefore if it is the stress and anxiety associated with fertility treatments that is making women stop it must be HUGE, unbearable. And if so, why isn’t it talked about more and more done to help women before they get to that point?

Impact of stress on IVF success rates

I know that some of the information out there looking at stress and IVF success rates talks about cortisol and the hypothalamic pituitary adrenal (HPA) axis and how this links with our ovaries. But ultimately, at the end of the day is this impacting our chance of a take home baby with IVF?

The impact of stress and anxiety on IVF success rates is mixed, to say the least. One meta analysis reports that emotional stress is unlikely to have an impact on IVF pregnancy rates² and that feelings of tension, worry or depression experienced as a result of a woman’s fertility problems, its treatment, or other co-occurring life events are unlikely to further reduce chances of pregnancy. *phew*

On the other hand, there is a study that suggests that women who experience emotional distress and receive psychological intervention are twice as likely to become pregnant than those that do not³. Whilst there is a number of reasons to NOT take this statistic as a fact it highlights the potential untreated anxiety can possibly have. Although the authors report that the effect size of psychological treatments may not be as big as doubling success rates, they do nonetheless believe that larger reductions in anxiety are associated with improved pregnancy outcomes.

Whether or not stress and anxiety does hinder IVF success rates is yet to be determined. Personally, I think it is not as straight forward as just being ‘anxious’ or not and there are far more significant factors that possibly impact the success of an IVF cycle.

Regardless of whether or not anxiety does impact success rates, I think we are all agreed that when stress and anxiety are better managed, quality of life improves along with the quality of our relationships and just the general ability to feel a little bit ‘normal’.

To sum it up, although its impact on IVF success rates is conflicted, overall, better managing our stress and anxiety can only be a good thing.

What is the best way to manage stress and anxiety when doing IVF?

Mind body interventions, such as yoga, web based interventions, cognitive behavioral therapy, acupuncture, online support groups, education sessions, guided relaxation and mindfulness classes are just some of the ways that have been studied in an effort to try and determine what best helps women doing IVF to reduce their stress and anxiety⁴. On top of this there is the more traditional methods such as exercising and eating a healthy diet.

Just as we all have different triggers and symptoms of stress and anxiety the ‘best’ way to manage it is likely to be unique to everyone.

For me, and many women, mindfulness does the trick to providing that small gap to disrupt the never ending thoughts that run around and around your mind. There has been some early studies that show that women who participated in a particular mindfulness course had improved quality of life measures and also increased pregnancy rates (44% of women in the mindfulness group had a pregnancy versus 26% of women from the control group who did not do mindfulness activities)⁵.

DIY Mindfulness

Although we cannot always be lucky enough to be asked to participate in a mindfulness based study for women doing IVF (!) we can embrace the mindful way of thinking and incorporate it into our everyday lives. We can get the benefits of unwinding and slowing our mind without the need to spend hours lying down to relax or taking time to attend particular courses and classes.

Next time you are in your anxiety wave, try this. When you have a shower (or are doing the tidying or waiting for your train or any number of mundane tasks where you notice your thoughts running away from you), list five things.

Five things that you can see (such as the soap sitting on the soap dish or the tap being twisted slightly off center). Five things that you can hear (such as the water going down the drain or the exhaust fan going around) and five things that you can feel (the tiles under your feet or the water on your back). As you get more practiced at doing this you will start to notice the details in what you are doing more, becoming more absorbed in the task that is at hand and more distanced from the ruminating thoughts in your head.

Mindfulness. Try it. And if you want additional mindfulness exercises have a look at this previous post. If nothing else, at least for a couple of minutes you will have the head space to feel just a little clearer, breaking that negative thought cycle and have the weight lifted from your chest. It does for me. And who knows, it may even improve IVF success rates.

** As always though, this article is just for general information. If your feelings of stress or anxiety is preventing you from living your life and you just don’t find enjoyment in things the way that you used to or if you have ANY feelings of self-harm or harming others, speak to your health professional immediately. They will be able to help you access treatments that you didn’t even know about so it is well worth the conversation**

References

Domar, A., Smith, K., Conboy, L., Iannone, M. & Alper, M. (2010). A prospective investigation into the reasons why insured United States patients drop out of in vitro fertilisation treatments. Fertility and Sterility. 94 (4) 1457 – 1459.
Boivin, J., Griffiths, E. & Venetis, C. (2011) Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. British Medical Journal. 342:d223 doi:10.1136/bmj.d223
Frederkisen, Y., Farver-Vestergaard, I., Skovgård, N., Ingerslev, H. & Zachariae, R. (2010) Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis. BMJ Open ;5:e006592. doi:10.1136/bmjopen-2014006592
LoGiudice, J. & Massaro, J. (2018). The impact of complementary therapies on psychosocial factors in women undergoing in vitro fertilization (IVF): A systematic literature review. Applied Nursing Research 39 220 -228.
Li, J., Long, L., Liu, Y., He, W. and Li, M. (2016). Effects of a mindfulness based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilisation treatment. Behaviour Research and Therapy 77 96 – 104.