The need to conceive is a biological instinct for many men and women, and can be described as “an uncontrollable “urge” from deep within to have children” and can represent a source of happiness and belonging (Carroll 2012).
Infertility can be a distressing medical condition, especially where it lasts for a long period and is never resolved and may extend not just to those who have never had children, but to those who have had children in previous relationships, or fewer children than hoped for (Monach 2005).
Our society is generally seen as one that places a high value on couples rearing children. Being unable to conceive and give birth to a child has been recognised as a problem for an estimated 1 in 6 couples who may experience long-lasting psychosocial problems in their personal feelings, and stigma in their relations with friends and family and the wider community (Monach 2005).
The level of distress involved for infertile people was an important factor in the decision by parliament in 1990 that all assisted conception clinics must provide a counselling service for their patients (Monach 2005).
The term infertility is defined as the “failure to produce a pregnancy that results in a live birth after one year of unprotected regular intercourse if under the age of thirty five, and after six months if over thirty five” (Domar 2002).

Age is a determining factor when it comes to conceiving with both male and female fertility declining with age and the woman’s fertility declining at a faster rate to that of a man (Sidgwick 2015). The term “biological clock” is referred to when a woman’s baby making window is starting to dwindle (Carroll 2012).

A woman is born with approximately 7 million eggs with only 400 making it to ovulation (Mustard 2009), with the quality and quantity of eggs diminishing with age (American Society 2012). Whilst men can father a child to a much later age in life, male fertility generally declines after aged forty (Sidgwick 2015).
In any 1 cycle a couple has a 25% chance of conceiving and on average it takes 8-12 months to fall pregnant (West 2015) and of those that don’t conceive in the first year, about half will do so in the second year (NICE 2013, 1.2.1.1). It is estimated that in the UK, 3.5 million people struggle with fertility (Hill 2015), affecting 9-15% of couples of childbearing age. Approximately 56% of these couples will seek medical assistance to conceive (Boivin et al 2007).
Around a third of couples where the woman is over 35 have fertility problems, rising to 2/3 when the woman is aged over 40. It is recommended that for women over 35 who have been trying for a baby for 6 months or more that they seek medical advice (Sidgwick 2015).

A diagnosis of infertility can cause much distress to a couple who may naturally assume they will get pregnant soon after trying to conceive, and whilst for some pregnancy can occur within a short time frame, for others it can be more difficult. Women are more inclined to feel stressed and worried about their fertility shortly after they start trying to conceive, this stress increases each month as conception fails and reaches its peak after 2-3 years of unsuccessful trying (Domar 2002).
Over the past 20 years there has been a significant rise in the number of people experiencing difficulties in conceiving (Allen 2012). This may be attributed to the decision for many couples to postpone starting a family until later in life whilst they pursue a career, relationships or financial stability (Sidgwick 2015).
Since at least 25% of infertile couples have more than one factor causing infertility it is important to evaluate all factors that may be affecting either couple before going down the route of fertility treatment (American Society for Reproductive Medicine 2012).

Stress and fertility.
Reproduction is one of the most delicately balanced biological systems and there is evidence to suggest that psychological distress can have a direct impact on the ability to conceive (Allen 2012). Couples struggling to conceive may experience prolonged uncertainty and be in a constant state of worry and have an inclination to think negatively about the future (Adrienne 2011). It is now accepted that physical stressors can perturb a woman’s menstrual cycle (Lynch 2014).
Stress causes the woman to over produce the reproductive hormone prolactin and prevent the hypothalamus from secreting the hormone gonadotropin, which affects the release of hormones that stimulate ovulation (Allen 2012). Stress can increase further as couples undergo tests and invasive medical procedures. Numerous research have demonstrated a link between stress and infertility, however the direction of that relationship remains unclear- that is, whether increased stress leads to lower chances of conceiving or whether failure to conceive increases stress (NHS Choices 2014) “women who are highly stressed are less likely to become pregnant, either naturally or via assisted reproductive technology (ART) (Domar 2002).
Emotions and the endocrine system central to reproduction are closely linked (Monach 2005). Many infertile women believe that emotional distress is a contributing factor to their lack of natural fertility and lack of success with fertility treatment (Lord 2005). Infertility can affect every aspect of a woman’s life, from her relationships with her family and friends to her career (Domar 2002). Despite many medical achievements of past decades in this field, there has been very little progress in treating the emotional side effects of infertility (Domar 2002). The mind can have a powerful influence on the whole process of conception with negative thoughts, emotions and behaviours leading to increased anxiety and depression and thus getting in the way of the couples goal of conceiving (West 2015).
Infertility has many emotional aspects that include feelings of anger, sadness, guilt and anxiety and may affect self-esteem. A couple’s outlook on life and their perception of the
future can change as they struggle to conceive (Domar 2002). A couple may experience difficulty in sharing their feelings which can lead to isolation (American Society for Reproductive Medicine 2012).

Evidence suggests that couples trying to conceive reduce their love making after a while because it has become associated with failure (Domar 2002). Stress can affect the couple’s relationship and is likely to reduce libido and frequency of intercourse (NICE 2013). Couples can be completely unprepared for the strain that infertility places on the relationship and can be the first crisis that many couples face together (Domar 2002).
A study by Janevic (2014) found that stress lowered sperm motility and morphology in males aged between the ages of 38-49 years. Although researchers were unable to pinpoint exactly how stress affects the quality of semen, it is suggested that stress may activate the release of glucocorticoids – steroid hormones that affect the metabolism of carbohydrates, fats and proteins which could reduce testosterone levels and sperm production (Whiteman 2014).
Many men who test having a normal sperm count at the beginning of infertility investigations can be found to have a low sperm count on retesting a year later. This suggests that the emotional strain and stress that a couple endure during infertility testing and medical procedures, appears to have serious impact on the ability to conceive (Eastburn 2006).
Stress can interfere with making rational decisions. Reducing stress can allow patients to explore and consider all options with a clearer mind-set. Having less stress in your life may not, in and of itself, result in a pregnancy, however, developing better coping strategies to manage stress related to an infertility diagnosis can help the individual feel more in control and improve their overall well-being. Coming to a joint decision with your partner about goals and acceptable therapies and setting endpoints for therapy may be advisable (American Society Reproductive Medicine 2014).

Assisted reproduction technologies (ART) are successful in overcoming many fertility problems and is implicated in 1.6% of births in Britain with 35 000 women treated every year in the UK (Nyboe-Andersen et al 2005).
Multiple cycles of ART are often required to achieve a pregnancy, and stress effects may become more pronounced after repeated treatments. Where treatment fails these couples may experience poor coping skills and a sense of hopelessness and loss. The aftermath of treatment failure is marked by intense depressive emotions (Verhaak et al 2007).
Patients expect ART to be stressful and 30% of couples end treatment prematurely because of its psychological burden. Although the chances of achieving parenthood are as high as 72% for couples undergoing treatment, many choose to discontinue treatment before achieving a live birth (Olivious 2004).

How can Hypnotherapy help?

Research has shown that fertility can be affected by mind-body therapies such as hypnosis which has shown, to increase pregnancy rates as well as reducing psychological distress (Allen 2012).
The therapist will offer an initial consultation which should involve gathering information about the client, establishing their goals and determining the best course of therapeutic intervention that is tailored to their specific needs. The therapist may work jointly or individually with the couple in addressing issues relating to their mental, emotional and physical state, with the aim of restoring balance to internal and external factors that may be affecting wellbeing (Hugo 2009). This may include addressing negative self-talk, where the client may express feelings of helplessness and hopelessness and believe that they will never conceive. A woman may express her fears about getting her hopes up and this may play into the fear and negative thinking pattern (Eastburn 2006).
The subconscious mind does not distinguish between “fact” and “fantasy” and processes negative thinking about not becoming pregnant as fact. Choosing to think “infertile” rather than “fertile” can be accepted by the unconscious mind as fact and inadvertently reinforce a hypnotic suggestion (Eastburn 2006).
During the hypnotic state there is a physiological change that occurs in the brain which balances the two hemispheres of the brain, strengthening communication pathways between them. Hypnotic suggestion can bypass the critical factor of the conscious mind allowing access to the subconscious (Eastburn 2006). Hypnotherapy can be described as a “productive state of inner absorption” and can be a “powerful tool for change” (Gilligan 1997). It has been suggested that human genes must be in a state of readiness for conception, and that hypnotic suggestion can activate specific genes (hypnofertility foundation in allen 2012).
The use of visualisation, guided imagery and mental rehearsal can affect the way a person thinks feels and behaves and can enhance fertility. Facilitating the client to visualise the future and preparing the mind and body for conception. Preparing the client for pregnancy, birth or parenthood may include mental, emotional and physical preparation for medical procedures such as IVF (Hugo 2009).

It is important to emphasise that whilst Hypnosis cannot promise a baby, hypnotherapeutic techniques can help achieve the best state of mind and body conducive to pregnancy (Eastburn 2006).

The client may believe that they are to blame for their fertility problems and place undue stress and pressure upon themselves. The therapist may engage the client in exploring and addressing limiting self-beliefs and restore a sense of perspective and balance in the client’s life. It is important to encourage the client to re-establish interests and relationships and to support them in maintaining their identity and sense of self outside of trying to conceive (Hugo 2009).
A hypno-therapeutic approach can provide emotional support and an opportunity for the client to talk openly about their feelings and ultimately enable them to develop self-coping skills and inner strengths and resources to bring about change and re-establish control over their life. This may include preparing the couple for conception by making adjustments to lifestyle, to restore confidence and self-esteem (Hugo 2009).
It is important to identify any unresolved issues that may be impacting on conception, such as emotional blocks, addressing fears, resolving past traumas and dealing with relationship problems. A previous miscarriage, abortion, abusive relationships or maybe fear of parenting mistakes are a few of the subconscious blocks that may be interfering with conception. The medical profession considers pregnancy high risk if the woman is over 35 years, which in itself can trigger a fear response for the woman, reinforcing a suggestion, the consequences of which can cause the woman to emotionally block conception (Eastburn 2006).
Hypnosis can be effective in accessing the individuals mental state, reducing stress, boosting a positive mind-set, releasing deep seated fears and anxieties and reprogramming unhelpful thoughts and habits (West 2015).

A client may have reached the end of the road in their journey to conceive and may need support in coming to terms with not conceiving and making choices about adoption or perhaps not having children. The hypnotherapist can work with the client, Offering support and guidance for this transition.

Author – Jacqueline Fitzlynam – Certified Hypnotic Fertility Practitioner

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