A Pregnant State of Mind

For women undergoing fertility treatment, learning how to contend with stress and anxiety may improve the chances of getting pregnant

Women undergoing fertility treatment who participated in workshops where they learned how to deal with stress became pregnant at a significantly higher rate than women who did not participate in the workshops, according to a study recently published in the United States.

Some 10 percent to 15 percent of all couples suffer from infertility. For some, the problem is solved by the use of hormonal therapy, administered in tablet or injection form, but some require in vitro fertilization. Since this treatment was launched, it has considerably improved, and today, it is used to treat a variety of fertility problems. The success of the treatment is dependent on numerous variables.

A program to teach couples undergoing fertility treatment to deal with stress began recently in the In Vitro Fertilization Unit at Sheba Medical Center Tel Hashomer. The program includes techniques on positive thinking and stress reduction, as well as focusing on proper nutrition. The program is headed by Dr. Dalia Merari and is modeled after a program developed at Harvard University.

In the wake of recent infertility studies, there is growing evidence that stress is a major factor that can affect the fertility process. Fertility problems may themselves also prompt emotional stress. Soon after realizing they may have a problem, even before seeing a doctor, the couple may be assailed by feelings of anxiety, depression, guilt and stress.

Couples involved in in vitro fertilization therapy complain more of psychological stress than of the physical difficulties caused by the diagnosis and treatment. A recently published study reports that the behavioral-cognitive intervention program to develop stress-management strategies caused a significant drop in depression and anxiety among women, who at the beginning of the treatment exhibited a high stress level. There was a 55 percent success rate in the fertility treatments among the women who participated in the program for six months, compared to only 20 percent among women who did not participate.

Merari says that the therapeutic model upon which the program is based is different from that of ordinary support groups, which already exist in various hospitals and clinics. This method combines the body and spirit and it is aimed at reducing stress level among patients of different types. The program consists of 10 focused and highly structured meetings. Stress is reduced by means of therapy and by changing the patients' attitudes to their health condition. The stress experienced by women before in vitro fertilization and during the treatment itself triggers a physical reaction, such as a rise in blood pressure, quickening pulse, breathing problems and metabolic problems.

Some of the meetings are devoted to stress-reducing exercises and the patient learns that she can control her own symptoms.

The goal of the cognitive part of the therapy is to change the way the patients view their situation. The way the patient perceives her situation affects her thinking, which in turn affects her feelings and symptoms.

The treatment includes three sessions at which the women's partners are present and one meeting of the partner alone with the therapist. Some of the sessions involve yoga, nutrition and physiotherapy. The program is open to couples undergoing in vitro fertilization at Sheba Medical Center Tel Hashomer.

Maccabi Healthcare Services also has a support therapy program for women undergoing fertility treatment. Miri Gozlan, a social worker in the Maccabi Healthcare Services fertility clinic in the Women's Health Institute in the greater Tel Aviv area gives individual, couples and group therapy for women undergoing in vitro fertilization.