As many as 15 percent of the thousands of couples who try to conceive every year face infertility. That means these couples have been trying to conceive for a year without success, or six months if the woman is over 35. Infertility is defined in terms of trying to conceive, rather than the underlying causes. The same medical or other conditions that are causing the problem may be present in couples who aren’t trying to conceive, or in men or women who are not in relationships in which procreation is normally expected. Causes of infertility are evenly split between men and women, both overall and specifically in about a third of infertile couples.
A recent study suggests that stress can be a major causal factor in difficulties couples may have getting pregnant. Women who high amounts of chemical indicators of stress had twice the odds of being infertile as women with lower stress levels, and were about a third less likely to become pregnant in each month of unprotected sex. This was the second study demonstrating a link between stress and difficulties conceiving. However, researchers say that other factors are far more prominent in both men and women. While reducing stress levels, particularly the woman’s, can help a couple conceive, other approaches are also likely to be needed.
Testosterone can affect fertility, including, perhaps surprisingly, in women. There is substantial clinical evidence that testosterone helps increase the number of eggs produced by women who are using in vitro fertilization to attempt to conceive. The understanding that testosterone plays a role in reproduction in women is not new, but the precise purpose it serves in that process is not fully understood. However, recent studies suggest testosterone might be used in the development of the structures that are responsible for releasing ova so they can be fertilized.
In vitro fertilization also can get a boost from attention to psychological and social factors. Neurotic patients and people who tend to withdraw in the face of conflict had worse outcomes in the study than better rounded would-be parents. However, people with good social support—people, including each other to lean on in tough times—not only had better outcomes but also despaired less when pregnancy did not occur.