Overcoming Stress: First Acknowledge It, Then Paddle Your Own Canoe


Trying to fully understand the emotional dimensions of infertility has become something of a hobby of mine. Some people cook, knit or exercise in their spare time. Me? I’m a research hound.

I’ve warned readers in the past that I’m a bit of a study junkie. Consuming reports is my way of trying to make sense of the insensible. This morning I stumbled upon a study on lifestyle habits and what if any affects they have on IVF outcomes in the Human Reproduction Report (February 2005, the Oxford University Journal). The study takes into account data from fertility clinics around the globe. Conclusions are called out on a summary table, but here are a few highlights in particular that caught my eye:

  • Infertile women entering IVF treatment do not show signs of psychological maladjustment.
  • Half the women and 15% of the men reported that infertility was the most upsetting experience of their lives.
  • Loss of control is patients’ most stressful dimension.

This study then led me to another journal article on IVF and stress. You read it here first my friends:

“There is ample evidence that lower stress levels mean better female and male natural fertility, though there is as yet no conclusive experimental evidence that lower stress levels result in better fertility treatment outcome.”

So those of you in treatment can hopefully relax a bit with the knowledge that your stress, while personally vexing and valid in every way, is not likely to affect treatment outcome.

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This takes me to a different kind of profound stress that visited me in the aftermath of my IVF treatments: a complete sense of failure and hopelessness. While I’ve moved beyond those darker days, what riles me still is how little society is willing to accept the significant distress that comes with the infertility territory.

Witness this. At the end of the year, New York Times health reporter Tara Parker Pope produced a blog entry asking readers to comment on whether a new book on diet’s influence on infertility was hype or hope. The firestorm of attacks that followed in the comments section led Tara herself to comment that she couldn’t understand where all the hostility toward infertiles was coming from, especially when one reader compared the devastation of infertility as being comparable to a cancer diagnosis. In the end a women who had experienced both set the record straight. Thank you, Rebecca, for writing in. Your words and experience go a long way to inform and elevate this discussion.

Comment 83

Posted by Lucy — I would have to say
that I find it a bit dramatic that an infertile person would vehemently
defend the idea that infertility is as devastating as cancer. Please.
At least whatever medical treatments you seek are still entirely
optional. Tell my aunt on her 8th round of chemo for breast cancer that
being infertile is just as bad. I’m sure she would think differently.

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TPP responds — Cancer of course is devastating, but i don’t think
there is a contest here. Talk to cancer patients who have lost their
fertility due to treatment and I think they will tell you that news
they can’t have children is as life-changing and traumatic as hearing
they have cancer. The cancer didn’t kill them but their vision for
their future died anyway. I’m confounded by the hostile reaction among
commenters on this post.

Posted by Rebecca:
I think I’m qualified to respond as someone who’s had both conditions.
I was diagnosed with cancer at the age of 21, underwent surgeries,
chemo, etc. Afterwards went into early menopause, which reversed itself
a few years later (almost unheard of, according to my doctors). The
infertility issue was actually harder for me to deal with than the
cancer – I knew that the cancer I had (Hodgkin’s) had very high
survival rates, so I really wasn’t too worried about dying. However, I
also knew that the treatment I got caused infertility of up to 50% in
women my age – and that was really hard for me to deal with, especially
when menopause started. Those who haven’t gone through this should not
presume to judge those who have.

From TPP — I’m so glad you wrote.

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And, I’d like to leave you with a thought for the day, a quote by Katharine Hepburn. While folksy it makes an important point: “As one goes through life one learns that if you don’t paddle your own canoe, you don’t move.”

So, what does a set of scholarly reports, a NYT blog discussion and a folksy quote have in common?  Sometimes we have to accept that stress and intolerance, much like eddies, riffles and falls on a river, will slow us down and/or challenge us but we have to keep paddling in order to move.


19 Responses

  1. Lori

    January 16, 2008 5:44 pm

    Whenever a conversation turns to comparison of pain, it is no longer a reasonable dialog.

    Thanks for bringing this research to light. I like that you’re a research hound. With a paddle.

  2. Kami

    January 16, 2008 5:54 pm

    Thanks for sharing this. I have read at least one study that found dealing with infertility was as stressful as a life threatening diagnoses “such as heart disease or cancer.”

    As always, more people need to hear this.

  3. peesticksandstones

    January 16, 2008 7:29 pm

    Fantastic post! This is a topic that’s been on my mind a LOT these days. Although one of the nurses at my clinic said something like “half the women” doing IVF there are on meds for anxiety/depression, I still feel so guilty for taking them. Wish there was more (non-judgemental) info out there about managing your emotional health and fertility treatment.

  4. beagle

    January 16, 2008 8:11 pm

    I’m glad that the stress myth is somewhat busted. I may send this to my old RE. I always felt something like accusation in their admonition that getting all stressed out was only going to make things worse. How can relax and IVF be used in the same sentence anyway??

    Do you hire out for research? Because I really suck at it!

  5. Kate

    January 16, 2008 9:32 pm

    “Loss of control is patients’ most stressful dimension.”

    Hah! I love that one. I do often feel that not being able to make my body do what so many other bodies have done for millions of years is based on my personal control issues. I was raised (as were many women my age) to believe that virtually anything was within my grasp if I just tried hard enough. I was raised to think that I could have a career and a family. And what I’ve found is that the career-family issue that I fretted over so much in my mid-20s is laughable now in face of the fact that I can no more control a crazy work situation than I can a crazy set of hormones. And for someone who was raised to do it all, to set her own “fate”, etc. watching that “fate” being disproven every month is almost surreal. And coming to terms with the lack of control has been one of the most difficult things so far.

  6. loribeth

    January 17, 2008 12:12 am

    I think Alice Domar has made the cancer/infertility comparison in some of her books, which I thought were great.

    We had a woman come to our support group last year after the loss of her baby. Shortly afterward, she learned she had breast cancer, & needed a mastectomy. She told us that breast cancer was nothing, the loss of her baby was what kept her up at night. She was 40 & didn’t know whether she’d have another chance at pregnancy. She didn’t return after her surgery & I often wonder how she’s doing.

  7. Deathstar

    January 17, 2008 2:39 am

    I started IVF when my mum had been in residential care for only a few months. It was incredibly stressful trying to deal with her, trying to stay relaxed, trying to get pregnant. I often wonder if I had not have had to deal with all that, if any of the treatments would have worked. I thought about that a great deal, but I’m glad to know you found a study that stress didn’t play much of a factor. Now I can stop torturing myself.

  8. luna

    January 17, 2008 4:20 am

    another great post (thinking, we are!).

    I hope reports like this will allow women whose treatments failed to let go of the notion that if they had just been less stressed out maybe it would have worked… (if stress caused infertility, women in war-torn nations and under great duress would never birth children, yet they do.) sure severe stress may cause some physiological reaction. but we all know that stress does not cause infertility; infertility causes stress… ~luna

  9. motherofnone

    January 17, 2008 5:40 am

    Though I would never presume to be able to weigh the comparative suffering entailed by two conditions when I’ve only dealt with one of them, I can say with confidence that society really doesn’t have any empathy for infertiles. Not an ounce. Zilch. If you say anything about it, it’s a “too much information” moment. It’s like you’re sharing the gory details of a gynecological malady or something. It embarrasses people a lot. I have also felt at times that people really don’t think it’s a problem or disappointment at all, as in, “It could be a lot worse!” I don’t know how we can harvest compassion from others if it just isn’t there, but it sure would’ve made it easier at times. I wanted to take off a couple of weeks from work when I did IVF. Nothin’ doin’. I wanted to seek therapy but somehow didn’t feel entitled.

  10. Nessa

    January 17, 2008 2:58 pm

    Wow. Thanks for linking to that. What an interesting thread! I don’t think that we will ever eliminate the closed-mindedness people have regarding infertility as a disease and something you just don’t “get over”.

    I love reading your insightful posts and that fact that you have done your research. Thank you for being able to do this for others (as well as yourself) even after such a hard journey. It means a lot to me.

  11. Mel

    January 17, 2008 6:32 pm

    This post came at an absolutely perfect time for me where stress and decision-making has reached a fever pitch. And this post made me realize how much I haven’t been paddling my own canoe. I’ve been letting infertility paddle it for me and create the time table. And that really sucks.

  12. Liana

    January 17, 2008 10:36 pm

    Interesting comparison between cancer and infertility. My sister is a breast cancer survivor who is currently going through infertility treatments. For her the cancer is much, much worse than the infertility treatments. She is downright zen about her failed cycles. But death, and the fear that her cancer might recur? Something completely different.

    It helps that she is completely pragmatic (not big on the emotions I went through with infertility) and is open to adoption if things don’t work out the way she hoped. She just wants to be a mom who is alive to see whatever children may one day be hers grow up.

  13. Bea

    January 18, 2008 3:02 am

    Some interesting stuff there. And yes – at the end of the day, it’s all paddling your own canoe.


  14. shinezhil

    January 18, 2008 3:25 pm

    I think your beautifully written post really gets at the heart of most people’s reaction strategies: push the feared state (IF) away by shoving the blame back on to the sufferers or dismissing their suffering as trivial. If we can recognize this lame tactic, we can protect ourselves.

    I’m so glad you’re getting the word out about stress. It’s still so vaguely defined and understood in Western medicine, and yet it’s often used as a catch-all explanation for illness or treatment failure. This isn’t helpful or health promoting, I feel.

  15. chicklet

    January 18, 2008 4:10 pm

    You made me cry my friend. Not in a bad way, just in that way that’s a bit relief (Rebecca CAN compare them both) and a bit happiness (TPP caved). Thx for this.

  16. May

    January 18, 2008 4:46 pm

    I loved this post. Made me go ‘aha!’ and also feel relieved. I am always being told to ‘r-word’ by clueless relations, who think I am making a big deal over nothing and need to chill out and – what was it? oh yes – go on a sea-weed fast. I don’t take them at all seriously, except in those wakeful moments at 5am of course. But being made to feel that my sadness is trivial, self-inflicted, and something I have control over, even when I haven’t even brought the damned subject up, let alone demanded lots and lots of sympathy and understanding, just burns me. It all makes more sense if I can think of how my family must be scared silly by me, undermining their cherished beliefs on the perfection of our genetics like that.

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