This document discusses the relationship between stress and fertility. It finds that higher levels of stress, as measured by salivary alpha amylase, are associated with increased time to pregnancy and a 29% reduction in fecundity. A 10-week stress management program was found to significantly reduce symptoms of stress and improve pregnancy rates for women undergoing in vitro fertilization. The program teaches skills to recognize and manage stress over its 10 weeks.

1. By
Antonio Rodrigues
Mandy Rodrigues

2. Preconception stress increases the risk of
infertility
Life Study CD Lynch et al
Higher levels of stress measured by high
Salivary Alpha Amylase - increased time
to pregnancy (TTP)
29% reduction fecundity- more than 2
fold reduction in fertility
1
2
3

4. Pre laparoscopic
psychological
assessment of
personality type and its
correlation with the
diagnosis of
endometriosis

6. Time urgency relates to a persistent inner feeling of being rushed in all
activities, irrespective of whether there is a need to actually do things quickly.
High expectations, value control, don’t like make mistakes, don’t like critique,
black and white thinking.
Self Blame and internalizing emotion
Blaming others and externalizing emotions

7. Real vs Self Induced
Adrenalin vs Noradrenalin/ Cortisol

9.  Validating TUPS tests
 Recognising / reporting on symptoms and diseases
 Reporting on 10-week TUPS stress management
program
 Reporting on post course results - special reference
to the dramatic, statistically significant reduction in
World Congress of Behavioural Medicine

10. Light
sensitivity
Palpitations Panic
attacks
Chest pain or
discomfort
Increased skin
temperature or
sweating
The appearance
of skin rashes
Trouble concentrating
Low self esteem
Irritability
Sexual difficulties
Self consciousness
Feelings of inadequacy
46
Symptoms
0
2
4
6
8
10
12
14
Num ber
sym ptom s
pre
intervention
Num ber
sym ptom s
post
intervention
0
5
10
15
20
25
30
35
40
45
Palpitations
Panicattacks
Chestpain/
discomfort
Sweating
Mottledskin
rashes
Raynauds-like
syndrome
Pre- intervention
Post- intervention
0
5
10
15
20
25
30
35
40
45
50
Clumsiness
Dropping
things
Forgetfulness
Concentration
difficulties
Wordfinding
difficulties
Pre- intervention
Post- intervention

11. PREGNANCY RATES
Following TUPS Stress management course:

12. The effect of a 10 week
on
pregnancy rates in women undergoing in
vitro fertilization

13. Development of an online 10 week TUP stress management program –
updated and redesigned in 2014

18.  Identifying the female patients who fit
this stress profile. High incidence
endometriosis, poor post coital tests
and autoimmune disease
 Suggesting management to increase
their pregnancy rate

19. By Mandy Rodrigues
CLINICAL PSYCHOLOGIST

20. But rather
empowering….
We want to give them more than an average
chance of conceiving

21. * Including donor/ surrogate assessments

22.  Lack of control
 Higher incidence of PTSD
 Higher incidence of depression
 Sense of isolation
 Rollercoaster effect
 Independent coping

23. Reducing TUP stress across
course
Recognizing TUP stress
and reactions (1-5)
Implementing skills to
manage stress (6-10)
1
2
3

25. HOOK

27. People don’t
know how to
drive
Scarcity reaction

29.  Workable
 Measurable
 Quantifies Hooktime
 Logical
 Can be done online/ app on smart phone

30. • Abstract definition of stress “demands exceeding
expectations”
• Example of traditional stress measure device –
divorce
• Workable components of stress cycle

31. Reducing TUP stress across
course
Recognizing TUP stress
and reactions (1-5)
Implementing skills to
manage stress (6-10)
1
2
3

33. HOOK

35. People don’t
know how to
drive
Scarcity reaction

36. AVOID THE HOOK
Predictable or Unpredictable
Real or Self Induced
Or interrupt the STRESS CYCLE at one or more points

37. From BEHAVIOURAL PSYCHOLOGY
Cognitive behavioural Therapy
Psychoneuroimmunology

38. • Interactive exercises – reading
and voice recordings
• Daily homework exercises
• Workbook
• Relaxation audio download

41. Measuring Chronic Stress in Infertility female patients presenting to
Medfem Fertility Clinic
Correlating Salivary Alpha Amylase with the Psychological TUPS testing

42. ⍺ Amylase U/ml TUPS Test Tups Screen Symptoms GAD TUP D
21,5 116 98
27,2 140 119 26 8,1 18
28,2 132 93 17 5,2 4
31 125 106 27 8 17
32 85 140 9 4
33,2 159 137 23 8,5 30
34,7 97 79 4 0,05 1
34,9 62 82 8 2,9 4
37,2 188 190 41 10 56
38,6 134 125 20 8,7 23
38,6 127
40 142 113 8 7,3 12
44 99 112 7
45 160 142 18 9 22
48 141 138 16 8,2 10
49,4 122 90
53 174 148 18 9,8 19
69 105 115 10 4 10
38 115 114 17 7 16
25Average in the Life Study

43. kim@medfem.co.za