Klippings

Clippings of various news and articles that tickle my interest of reading or knowing about it.

Tuesday, June 20, 2006

Therapy can help stress-related infertility: study

By Patricia Reaney
PRAGUE (Reuters) - Stresses of everyday life can cause infertility but behavioural therapy can help, an American researcher said on Tuesday.
Instead of resorting to expensive drugs, Professor Sarah Berga, of Emory University in Atlanta, Georgia, has shown that reducing stress through a combination of measures can restore ovulation and fertility.
"Stress really can be a cause of infertility, in men and in women, and it can be managed," Berga said at a fertility conference.
"But by managing it you improve your fertility."
Berga said a combination of small stresses can cause amenorrhea, a lack of monthly periods and ovulation, which has previously been associated with under-nutrition and excessive exercise.
"The collection of small stresses is worse for your fertility ... than one big stress," she added.
In a small pilot study, she and her team tested the impact of cognitive behavior therapy (CBT) on women of normal weight who had suffered from amenorrhea for more than six months. They confirmed the women were stressed by measuring levels of cortisol. Amounts of the hormone increase during stress.
The women were divided into two groups. Half received CBT, which consisted of coaching on nutrition, exercise and ways to reduce stress, for 20 weeks and half had no therapy.
"A staggering 80 percent of the women who received CBT started to ovulate again, as opposed to only 25 percent of those randomized to observations," said Berga, adding that their levels of cortisol had also dropped.
Two women who received CBT became pregnant shortly after finishing the treatment.
An estimated five to 10 percent of women suffer from amenorrhea, about half of which is thought to be related to stress.
"So at any one time, five percent of the women in the world of reproductive age have stress-related amenorrhea," Berga said.
She added that CBT offers a holistic treatment that is safe, cost effective and easy-to-implement. The researchers are planning a larger study to confirm their results.

Cutting stress may increase chances of pregnancy

Cutting stress may increase chances of pregnancy

· Therapy sessions helped restore fertility, says study
· Finding offers alternative to expensive treatments

Ian Sample in Prague
Wednesday June 21, 2006
The Guardian


Women who are struggling to get pregnant could improve their chances of conceiving by having stress-reducing therapy sessions, scientists claimed yesterday.
Researchers in the US found that rising levels of stress can lower a woman's fertility by disrupting her menstrual cycle, and in some cases prevent ovulation completely. But a pilot study of women who had not had a period for at least six months found that psychotherapy had a dramatic effect, lowering stress levels and restoring fertility in 80% of cases.

Scientists believe between 5% and 10% of women experience a loss of periods at some time, and in most cases the cause is poor nutrition or over-exercising. But a much larger number of women are believed to suffer a mild disruption to their periods that adversely affects their fertility.
Professor Sarah Berga, who led the study at Emory University in Atlanta, Georgia, said psychotherapy could be a viable alternative to expensive and often complex fertility treatment. She said that people often tried to deal with stress by exercising, but experiments showed that this only raised stress levels further. Likewise, lounging around at home was not enough to reduce anxiety.

In the study, the scientists monitored women with a condition called functional hypothalamic amenorrhea (FHA), which is caused by a drop in GnRH, a hormone that stimulates ovulation. None of the women had had a period for more than six months. Tests on the women revealed that they had high levels of the stress hormone cortisol. Professor Berga split the women into two groups of nine. Half received 20 weeks of cognitive behaviour therapy (CBT), a form of psychotherapy that was designed to adjust their way of thinking and reduce their stress levels. The other half did not receive any therapy.

Prof Berga said: "A staggering 80% of the women who received CBT started to ovulate again, as opposed to only 25% of those randomised to observation." Tests showed that those who had become fertile again had far lower levels of cortisol and higher levels of GnRH.

Although none of the women, who were aged 20-35, were asked whether they were trying for a baby, two became pregnant within two months of the therapy sessions ending. "People are disbelieving that stress is a cause of infertility. The nail in the coffin is that reducing cortisol causes the GnRH signal to ramp up," Prof Berga said.

Speaking at the annual meeting of the European Society of Human Reproduction and Embryology in Prague, Prof Berga said that people suffering stress often do not notice or admit to it. "These women didn't report feeling stressed. But when we spoke to them it was clear that they tend to have a loss of perspective, they think they can get more done in a day than is realistic and their sense of self-worth is linked to their achievements at work," said Prof Berga. "The therapy was targeted to what was bothering them. We teach them to love themselves."

Prof Berga is beginning a study of between 2,000 and 4,000 women to further investigate the link between stress and fertility. "If the larger scale study confirms our earlier results, we will have very strong evidence for offering stress reduction as an effective therapy for a significant group of infertile women," she said.

At a fertility clinic in Israel, an experiment suggests that laughter can help boost pregnancy rates significantly.

Dr Shevach Friedler at Assaf Harofeh Medical Centre in Zerifin graduated from a school of movement and mime in Paris before becoming a physician. "We know that laughter is good at reducing stress and IVF can be a very stressful experience, so I wanted to see if clowning could help," he said. In the study, a trained clown was sent to entertain women for 10-15 minutes shortly after they had received IVF treatment. The researchers found that the clowning boosted pregnancy rates considerably, from 20%-35%.