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The Influence of Stress on Pregnancy Success

The Influence Of Stress On Pregnancy Success

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Studying stress can be complicated because the definition of stress is murky. Furthermore, for some people stress is a positive thing while it can be very destructive for others. We know that there is an association between low sperm quality and stress. In this article, we take a closer look at how stress can influence fertility and its impact on the ability to conceive.  

The Science behind Stress and Fertility  

It is still unknown precisely how stress can influence fertility or reduce fertility. Some experts have hypothesized that stress may reduce libido, leading to less frequent sex. Others have suggested that stress may dampen the immune system in a way that is bad for implantation in a female body.  

In men, researchers have theorized that stress might reduce sperm concentrations by producing a rush of glucocorticoids, a class of steroid hormones that temper the secretion of testosterone from cells in the testes. Furthermore, stress can induce more oxidative stress in the sperm cells leading to lower sperm concentration and motility.  

In women stress can disturb the balance in the sex-hormones and have an effect on ovulation.  

Scientific Studies  

Studies have suggested a link between stress and lower sperm quality, but the findings are inconsistent. Authors of one study from 2014 in the journal Fertility and Sterility interviewed 193 men between 38 and 49 and analyzed their semen samples. They found that life stress (but not work stress) was associated with reduced sperm concentration and motility, as well as higher proportion of abnormally shaped sperm. A2010 studyof 744 men published in the same journal, however, found that the 166 men who reported at least two instances of life stress had lower sperm concentration, but the same number of normally shaped sperm as those who reported less stress, so their fertility rates may not have been impacted. 

A study published in the American Journal of Reproductive Immunology in 2018 found that among 45 couples undergoingin vitro fertilization (IVF), women who had higher blood levels of a specific kind of molecule that rises with stress were less likely to get pregnant after one cycle of IVF. 

Other studies have also linked reduced fertility with increased concentrations of salivary alpha-amylase, an enzyme that’s secreted by salivary glands in response to stress. One study published in 2014 in the journal Human Reproduction, found that among nearly 400 women in the United States, those who had the highest levels of salivary alpha-amylase were 29 percent less likely to get pregnant after a year of trying — and more than twice as likely to be declared infertile — than those who had the lowest levels of the enzyme.  

Another study, out of China and published online in the journal Stress in 2019, linked higher levels of this enzyme in both men and women undergoing fertility treatments with a lower chance of pregnancy. 

Therapy to reduce stress 

In 2015, psychologist and researcher Yoon Frederiksen and colleagues conducted a systematic review and meta-analysis of 39 studies published between 1978-2014. The objective was to evaluate the effects of psychosocial interventions on distress and pregnancy rates in couples undergoing fertility treatment  

The results indicated that that those couples who practiced cognitive behavioral therapy (CBT, a type of talk therapy) and mindfulness training were more than twice as likely to get pregnant than the couples who didn’t use such stress-reducing strategies.  

This means that psychosocial interventions for couples in treatment for infertility, in particular CBT, could be beneficial both in reducing psychological distress and in improving clinical pregnancy rates. The effect was generally larger for women than for men. 


What you should do  

If you feel that infertility is a stress factor in your life, or that undergoing fertility treatment feels stressful, you are not alone. Many couples feel the same way. It is important to try to cope with the feelings you have and try some exercises to relieve the stress burden If stress can influence fertility, make sure that you destress properly. 

CBT is a psycho-social intervention that aims to improve mental health. As mentioned above, this can help couples go through fertility treatment, which can be emotionally taxing.  The purpose of CBT is to develop personal coping strategies to solve current problems. In CBT, people learn to recognize and change negative thought patterns and apply different tools that help improve their negative selftalk to be more positive. 


We recommend the following: 

  • Find someone in whom you trust (or someone with whom you feel safe) to confide your struggles with. 
  • If possible, try to de-stress with mindful-oriented apps. 
  • Try activities like exercise, yoga, acupuncture, massage, meditation. 
  • Communicate with your partner on how you feel. 
  • Write down your feelings and thoughts. 
  • Look for networks, for example online, where you can share your difficult thoughts and feelings – and be heard and understood. 
  • Seek professional counselling and advice. This could be your own general practitioner or a psychologist with specialized knowledge in fertility.

If you have tried a specific stress coping strategy before which worked, you might just start with that. For some people, doing something active like physical exercise, baking, working in the garden – or whatever their favorite hobby may be can have a great positive impact on their mental health.  

This blog was co-authored with Yoon Frederiksen, Aut. psychologist and Ph.D., from the danish patient organization Fertility Care.

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Wearing tight pants and underwear

Studies show that men who wear looser underwear have higher sperm concentration and total sperm count compared to men who wear tighter underwear. So, lose the tight clothes and wear something loose to give your testicles some air.

CONCLUSION: learn more about how heat can affect sperm quality here.


Besides higher mortality rate and various diseases, stress is associated with low sperm quality. Stress is known to be associated with lower testosterone levels and oxidative stress with both playing an essential role in producing and maintaining healthy sperm cells.

CONCLUSION: If you feel stressed, we recommend you get some help so you can have a balanced mental health. For a stress management guide, download the ExSeed app for free and start your personalized action plan today.

Physical activity

Scientific studies show that men who are physically active have better semen parameters than men who are inactive. Fertility specialists also state that regular physical activity has beneficial impact on sperm fertility parameters and such a lifestyle can enhance the fertility status of men.

Prioritizing exercise can help improve your overall health and result in healthy, fast swimming sperm cells that have good chances of fertilizing an egg.

CONCLUSION: Try incorporating exercise in your weekly schedule to you ensure exercising at least twice weekly. We recommend a combination of cardio training and strength exercise. Read more about exercise and male fertility on our blog.


Fast Food
Processed foods damage the health of sperm-producing cells and cause oxidative stress, which lead to poorer sperm quality. Heavy consumption of junk food (every week) can increase the likelihood of infertility since men who consume vast amounts of unhealthy food are at risk of having poor sperm quality. Besides harming your fertility, junk food enlarges your waistline, harms your cardiovascular system, kidneys, and more.

Eating more fruit and vegetables can increase your sperm concentration and motility. It’s important that you consume a healthy diet filled with antioxidants and that you eat vegetables every day. Foods such as apricots and red bell peppers are high in vitamin A, which improves male fertility by nurturing healthier sperm. Men who are deficient in this vitamin tend to have slow and sluggish sperm.

Sugary snacks/beverages: several times a week Excessive consumption of high sugar items can lead to oxidative stress, which negatively impacts testosterone levels and sperm motility. Sugary snacks and beverages are also highly associated with obesity and low fertility.
CONCLUSION: To boost sperm quality, stay away from fast food, processed food, and sugary snacks or beverages. You need to implement a healthy prudent diet filled with necessary superfoods needed for good sperm production. Check out our guide to Male Fertility Superfoods. For personalized guidance and support on how you can start improving your sperm health, check out the Bootcamp.


Direct heat can inhibit optimal sperm production and cause Sperm DNA damage. Sperm cells like environments that are a couple of degrees lower than body temperature. Avoid overheating from warm blankets, seat warmers, heat from your laptop, hot showers, and saunas.

Cigarette smoking

The exposure to tobacco smoke has significant negative effects on semen quality. The damage of cigarettes and nicotine of course depends on how many cigarettes you smoke per day and for how long, but even low usage (up to 10 cigarettes / day) can inhibit healthy sperm production.  

CONCLUSION: Stay as far away from cigarette smoking as possible if you care about your general health and your fertility. Read more here.

Cell phone

When you have your cell phone in your front pocket, your testicles are exposed to electromagnetic radiation, which studies have shown to damage the sperm cells. Put your phone in the back pocket of your pants or in your jacket pocket.


There is a clear association between obesity and reduced sperm quality. At least part of the reason for this is that obese men may have abnormal reproductive hormonal profiles, which can impair sperm production and lead to infertility. 

A BMI higher than 30 can lead to several processes in the body (overheating, increase in oxidative stress in the testes, sperm DNA damage, erectile dysfunction) that can have a negative impact on male fertility. This can result in problems when trying to conceive.  

CONCLUSION: BMI is one of the risk factors that influence semen quality and, for example, sperm motility.  


A beer or glass of wine now and then do not really harm sperm quality. But excess alcohol drinking (more than 20 units per week) can reduce the production of normally formed sperm needed for a successful pregnancy.

CONCLUSION: If you want to stay safe, stay under 14 units of alcohol per week. For more information on how alcohol can affect male fertility, take a look at our blog: “Alcohol and Sperm Quality”.


Studies show that women younger than 35 and men younger than 40 have a better chance of getting pregnant. Men can produce sperm cells almost through their entire life, but the sperm cell DNA is more fragile and prone to damage after the age of 40.

As men age, their testes tend to get smaller and softer resulting in a decline in sperm quality and production. These changes are partly because of an age-related decrease in testosterone level, which plays a very important role in sperm

production. Higher male age (>40 years) is not only associated with a decline in sperm production but also with increased sperm DNA fragmentation and worsened morphology (shape) and motility (movement). These negative effects make the sperm cells less qualified for egg fertilization.

CONCLUSION: with an age under 40, you shouldn’t have to worry much about age as a factor in itself. However, studies have shown a slow decline after the age of 30-35 years

and if you are above 40 years of age, your sperm quality can be affected due to increased sperm DNA damage resulting in a decrease of sperm motility and concentration. Remember that you cannot evaluate the quality of a sperm sample by just looking at it – this requires a sperm analysis.