Can I have children? is a question most women ask themselves after a certain age, particularly as we tend to have kids later on in life.
But genetic markers and age concerns aside, a new study has shown how stress impacts your ability to conceive for the first time ever.
Too much stress, it seems, can lead to infertility.
High levels of pre-conception stress more than double the chances of a woman failing to get pregnant after 12 months of trying, scientists found.
A year of not conceiving despite regular unprotected intercourse is the clinical definition of infertility.
Previous research had already highlighted an association between high stress levels and a reduced probability of pregnancy.
The new findings, linking stress to infertility, are published in the latest online edition of the journal Human Reproduction.
Story continues below the slideshow:
10 Things You May Not Know About Your Fertility
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Open Image Modal1. Your fertility is mostly determined by genetics, which influences how many eggs you are born with. Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.
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Open Image Modal2. Regular menstrual cycles are a sign of regular ovulation.Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).
(03 of10)
Open Image Modal3. Basal temperature charting does not predict ovulation.An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced. The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception. A better method is to use over-the-counter urine ovulation predictor test kits such as Clearblue Easy. These kits test for the hormone that prompts ovulation, which is called luteinizing hormone (LH).
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Open Image Modal4. Most women with blocked fallopian tubes are completely unaware they may have had a prior pelvic infection.About 10 percent of infertility cases are due to tubal disease, either complete blockage or pelvic scarring causing tubal malfunction. One major cause of tubal disease is a prior pelvic infection from a sexually transmitted disease such as chlamydia. These infections can cause so few symptoms that you may be completely unaware your tubes are affected. This is why fertility physicians will order a dye test of the tubes, called a hysterosalpingogram (HSG), if you have been trying and failing to conceive for 6 months or longer.
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Open Image Modal5. In most cases, stress does not cause infertility. Except in rare cases of extreme physical or emotional distress, women will keep ovulating regularly. Conceiving while on vacation is likely less about relaxation than about coincidence and good timing of sex.
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Open Image Modal6. By age 44, most women are infertile, even if they are still ovulating regularly. Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40s with fertility treatment are using donated eggs from younger women.
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Open Image Modal7. Having fathered a pregnancy in the past does not guarantee fertility. Sperm counts can change quite a bit with time, so never assume that a prior pregnancy guarantees fertile sperm. Obtaining a semen analysis is the only way to be sure the sperm are still healthy!
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Open Image Modal8. For the most part, diet has little or nothing to do with fertility. Despite popular press, there is little scientific data showing that a particular diet or food promotes fertility. One limited study did suggest a Mediterranean diet with olive oil, fish and legumes may help promote fertility.
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Open Image Modal9. Vitamin D may improve results of fertility treatments. A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.
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Open Image Modal10. Being either underweight or overweight is clearly linked with lowered levels of fertility. The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.
Scientists measured levels of alpha-amylase, an enzyme in saliva that provides a biological indicator of stress.
Women with high levels of the biomarker were 29% less likely to get pregnant each month than those with low levels, the researchers found.
They were also more than twice as likely to be declared infertile.
Study leader Dr Courtney Denning-Johnson Lynch, from Ohio State University in the US, said: "This is now the second study in which we have demonstrated that women with high levels of the stress biomarker salivary alpha-amylase have a lower probability of becoming pregnant, compared to women with low levels of this biomarker.
"For the first time, we've shown that this effect is potentially clinically meaningful, as it's associated with a greater than two-fold increased risk of infertility among these women."
The team tracked 373 American women aged 18 to 40 who were free from known fertility problems and had just started trying to conceive.
Their progress was followed over a period of 12 months, or until they became pregnant.
Each participant was given one saliva test on enrolment and another after the start of their first recorded menstrual cycle.
Measurements of two stress markers, alpha-amylase and cortisol, were taken.
Dr Lynch urged women having difficulty getting pregnant to consider stress-managing techniques, such as yoga and meditation.
However she pointed out that stress is not the only factor involved in fertility problems and may only play a minor role.
Co-author Dr Germaine Buck Louis, from the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Rockville, US, said: "Eliminating stressors before trying to become pregnant might shorten the time couples need to become pregnant in comparison to ignoring stress.
"The good news is that women most likely will know which stress reduction strategy works best for them, since a one-size-fits-all solution is not likely."