Five Ways to Reduce Stress and Anxiety During the Pandemic While Improving Fertility

April 20, 2020

With fertility clinics closed in response to the coronavirus pandemic, staying positive when fertility treatments like in vitro fertilization (IVF), inseminations, and acupuncture are canceled and on hold for the foreseeable future is important to your eventual success when clinics resume normal operations.

During this time of forced isolation, learning anxiety and stress management techniques to prioritize your self-care can reduce the anxiety and uncertainty during these turbulent times.

Five strategies can be used to reduce stress and anxiety at a time when uncertainty is prevalent.

  1. Sleep
  2. Exercise
  3. Breathing
  4. Meditation
  5. Connection

Sleep

Often overlooked as a stress management too, getting adequate good quality sleep is the first area you should optimize to better handle tough times.   A good night’s sleep allows you to handle stress better.  When you’re tired, you are less patient and more irritable, causing you to react more intensely to situations which can increase stress.

Poor sleep can increase cortisol levels.  Cortisol, a hormone released in response to stress, regulates your mood and fear.  As a stimulant, it’s necessary to keep you on high alert for potential dangers.

However, the daily stresses associated with the uncertainty of new developments in response to the pandemic on top of the chronic pressures of getting pregnant as quickly as possible accumulate to keep cortisol levels elevated causing anxiety and depressing the immune system at a time when you want it at optimal capacity.

Going to bed earlier also allows you to take advantage of the many benefits of melatonin, the sleep hormone.

At around 9pm, your body starts producing melatonin to prepare for sleep.  Melatonin is a hormone that regulates sleep and wake cycles.

But melatonin is also responsible for protecting eggs when they are close to ovulation, guarding against free radicals and other harmful substances.  Sleeping with the lights on, checking your cell phone every time it buzzes at night, or having the TV on non-stop will disrupt your body’s melatonin production.  This, in turn, can prevent your eggs from getting the protection they need, resulting in poor egg quality.

The suppression of melatonin during pregnancy can harm a fetus by potentially triggering problems with a developing baby's biological clock and contribute to health issues down the line.  It’s also possible it might lead to miscarriage.

On top of that, less sleep reduces the body’s antioxidant levels so there is less protection for the eggs, sperm, and other cells.

Practice good sleep habits by getting 7-9 hours of sleep every night. The goal is to wake up refreshed without needing an alarm clock.  Go to bed and wake up at the same time every time to regulate your hormone cycles, including cortisol and fertility hormones.

Exercise

Although gyms and many public open spaces are closed now in response to the pandemic, working out can still be done at home.

As a stress reduction strategy, exercise is well-known to reduce cortisol and increase endorphins, the “happy” hormones to elevate your mood.

For older women trying to get pregnant, exercise has an added benefit in that it may also improve egg quality.

As the most important organelles in the fluid of a cell, mitochondria are crucial for normal egg maturation, fertilization, and embryonic development.  A decreased number of mitochondria contributes to aging of the egg.

After fertilization, all of the mitochondria in the sperm are broken down, and the mitochodria in the embryo come entirely from the egg. The quality of egg mitochondria thus determines the quality of the embryo.

Researchers have long suspected that the benefits of exercise extend to the cellular level, but until recently knew little about which exercises help cells rebuild mitochondria that deteriorate with aging.

A study found that exercise caused cells to make more proteins for their energy-producing mitochondria, effectively stopping aging at the cellular level.  Specifically, high-intensity interval training (HIIT) in aerobic exercises such as biking and walking seemed most effective.

HIIT involves short bursts of very intense activity, interspersed with recovery periods of lower-intensity exercise.

A study showed interval training boosted the ability of the mitochondria within cells to generate energy by 69% in older volunteers aged 65-80yo, and by 49% in a younger group of 18-30yo.

You can imitate the HIIT workout used in the study.  It includes 3 days of cycling (four, 4-minute high-intensity intervals broken up by 3-minute recovery periods), and 2 days of steady, brisk treadmill walking.

I recommend men abstain from cycling while trying to conceive.  Substitute running for cycling.  You also don’t need a treadmill - just walk outside.

Breathing

Mindful breathing is a simple technique that can be done anytime and anywhere you feel stress or anxiety.  Studies have shown deep breathing to lower cortisol levels. (study)

When stressed, a person takes shallow, fast breaths through the chest rather than the slow, deep breathing using the diaphragm characteristic of a relaxed state.

Deliberately adopting a relaxed breathing pattern calms the nervous system allows you to induce calm at will.

In addition to its relaxing benefits, deep breathing increases oxygen flow to your body and organs, including your reproductive organs such as the brain, ovaries, and uterus.

Practice the “box breath,” a Navy SEAL technique to reduce stress in intense situations.

Here’s how to do it:

  1. Find a comfortable place to sit or lie down.
  2. Take a deep breath in through your nose for a slow count of four…1, 2, 3, 4. When inhaling, sink your breath from your chest to your abdomen so that your belly expands as you draw in air.
  3. Hold your breath for a count of four
  4. Exhale through your mouth for a count of four.
  5. Hold your breath for a count of four.
  6. Repeat this process.

Try to keep the same four count tempo throughout the cycle so that you’re regulating your own breathing consciously.

Once you have practiced the basic box breathing technique and are familiar with the timing of the four seconds, you can incorporate a mantra to amplify the intention to calm down, such as silently saying “Things are always working out for me.” on the inhale.

Meditate

Meditation is another proven way to reduce stress and anxiety if practiced consistently.

A 2014 review of 47 trials in 3,515 participants suggests that mindfulness meditation programs show moderate evidence of improving anxiety and depression. (study)

Not knowing when your IVF cycle can resume or feeling anxious about being pregnant while conditions are changing on an almost daily basis can be disorienting.  The sense of losing time may cause anxiety, especially when you’re not sure when it’s “safe” to start trying again.

Meditation is a powerful way to stay connected to your purpose and dream during a time of such uncertainty and change.  The objective of meditation is clear your mind of thoughts, especially negative ones that create roadblocks on your fertility journey.

Practice meditation every day for 15-20 minutes, preferably upon waking.  Get into a comfortable seated position, close your eyes, and focus on your breath.  When your thoughts stray, concentrate on your breath again.

In the beginning, your thoughts will wander A LOT.  With practice, you’ll have more control so that you can clear your mind more quickly and for a longer period of time.

You’ll know when you’ve reached a meditative state when you feel disconnected from your body, experience sensations in different parts of your body, or the time flew by.  Congratulations!

The key to reaping the benefits of meditation is consistency, even if it’s for a few minutes at a time.

Connection

Reach out to others at this time of forced social distancing.  While limiting your personal contact with others is recommended at this time to contain the virus and slow its spread, do not isolate yourself.  As social creatures, we are hard-wired to be with others.

This is especially important if you’re a single woman trying to get pregnant since you don’t have a partner to share your life with while being holed up.  It’s important to find ways to connect socially with other people to manage your stress.

Connections are our spiritual life-blood...the umbilical cord from our internal world to the external world.

Isolation and loneliness increase stress, anxiety, and depression. These conditions can take a long time to recover from, affecting your fertility for months or years.

Women must have a close-knit community of friends and family to thrive, especially during a time when traditionally we have received a lot of support such as pre-conception and pregnancy.

Video call often to connect with others.  Don’t rely on text messages or social media platforms which are typically more superficial.   Share funny memes to decrease anxiety.

During this time of limbo when many are under stay-at-home orders, focus on getting healthier physically, emotionally, and spiritually.  Doing so will prepare you for wherever your fertility journey takes you as we adjust to our new normal.