January 27, 2010, Updated September 14, 2012

A new study from Israel shows that women with fertility problems who can relinquish control and go with the flow have a better chance of conceiving.

 

Dr-Nathalie-Rapoport

Women who “let go” during IFV treatment have a significantly higher chance of becoming pregnant, according to Dr. Nathalie Rapoport in her new study.

Any couple that has been trying to get pregnant for more than a year is all-too-familiar with the struggle, and the stress that ensues when conception eludes you. Often, this stress is only intensified when it’s decided that the time has come for last-resort in vitro fertilization (IVF) treatments.

A new Israeli study shows that women who cope with the stress of IVF by relinquishing control are about twice as likely to become pregnant as those who don’t have the ability to cope with the stress in this way.

While keeping calm and cool might be the kind of advice that mothers and mothers-in-law dispense to women undergoing IVF treatment, a team of Israeli researchers has found that higher success rates are achieved when the prospective mothers simply ‘let go.’ The research was conducted at the IVF and Infertility Unit at the Helen Schneider Hospital for Women in Petah Tikva in central Israel, and reported on in the medical journal Fertility and Sterility.

Project leader Dr. Nathalie Rapoport, an MD and practicing psychologist specializing in fertility, says that she and her colleagues had an intuitive hunch that there were powerful emotional factors involved in the IVF process. Their aim was to examine the issue of control and the influence of stress. Since the two are hard to measure, they chose to work with interviews and a questionnaire.

In their study, the researchers surveyed 88 women undergoing IVF treatments, 21 of whom became pregnant. Upon examining the results of their questionnaire, they found that the only factors that seemed to influence success were the women’s age (fertility declines quickly after age 35) and whether or not they had the skills for coping with stress at the start of the study.

Let the treatment take its course

In a conversation with ISRAEL21c, Rapoport explains that by the time a woman is starting her IVF treatment cycles, the major decisions that she has to confront have already been made: The doctor has been chosen, the treatment method decided upon and the center picked out. At this point, she says, there is really not much left for a woman to do, other than “let go” and allow destiny, or the IVF treatment, to take its course. This was the major point of the study.

The research identified women who weren’t able to relinquish control at this point. These women typically felt that there was still something left undone – more exercise, taking vitamins, praying and investigating alternative treatments are some examples. And it was precisely with these women that poorer IVF success rates were found.

The researchers suggest that worrying and thinking all day about ways to improve the success rate tends to take an emotional toll, which in turn has an effect on the body. They say that future research might explore the effects of meditation and of prescribing medication that may help women to relinquish control.

It’s not surprising that a study of this kind was undertaken in Israel. As Rapoport explains, “Infertility and IVF treatments are a very hot issue in Israel because family values are very central to Israeli culture. The problem is that when people get married, after one or two months they start to be distressed if the woman is not pregnant.”

Passing through the infertility wringer

Rapoport, who is affiliated with the Institute for Mind and Body Medicine at Massachusetts General Hospital, where she is on sabbatical and working on research involving frozen embryos, says that this is why in Israel one sees very young women undergoing IVF and turning to specialists for help.

While a couple may be said to have infertility problems if conception has not occurred after a year of trying, it is not uncommon for couples to approach the system within six months of marriage. “In the Arab community and in religious groups,” in particular, she says, “If a woman is not pregnant within six months, there is a lot of stress.

“Then they start focusing on getting their period, which becomes a very distressing moment. This all adds up, especially after one year.”

Not to mention the fact that the physical examinations endured by women with fertility problems are very invasive and emotionally distressing. This means that by the time a couple has passed through the infertility “wringer” and IVF treatments have begun, they are dealing with a variety of stressors.

Assessing stress by examining coping

The IVF success rate is normally 25 to 30 percent per cycle. While many people think it’s a surefire method for becoming pregnant, Rapaport explains that success rates are only about as high as they are for natural intercourse in healthy couples.

“Stress is a very important issue in health and it’s very hard to measure it. Some people will say they are stressed or not stressed at all. It may not reflect what is going on in the body. We thought that by looking at coping mechanisms, we could reflect the stress issue. We tried to measure how women are coping with the stress of IVF,” she relates.

“Coping,” she points out, is how you respond to stress. “You can try to change the situation or adjust the situation. You can regulate the heat in the room by adjusting the heater if it’s too hot,” for example, but sometimes, she recommends, you just have to relinquish control and “adjust to the new situation.”

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