Does anxiety affect fertility in men and women? Doctor explains link with egg and sperm health

Trying for pregnancy? Know how to manage your stress levels for better fertility outcomes.

Anxiety and stress are widely discussed in health-related conversations, mostly because of their extensive ramifications. Stress shows up in immediate pressures, such as tracking ovulation, undergoing fertility tests and intercourse timing, while anxiety, on the other hand, is more future-focused, what-if scenarios with fears around whether they will be able to conceive, and how long the journey may take.

They are not solely emotional states, as they can affect physiological health as well, including reproductive health.

Couples trying to conceive are often already riddled with anxiety and stress, so it is important to manage their turbulent emotional state for successful fertility outcomes. So, does anxiety directly affect fertility or is the connection more nuanced?

For better clairty, Dr Manika Khanna, chairperson and managing director at Gaudium IVF, helped to break down how anxiety and stress may influence reproductive health in both men and women.

She first admitted seeing many cases where patients worry about whether stress will affect their ability to conceive.

“The majority of couples who come to my clinic are concerned about whether stress is impacting their ability to conceive," she said, implying how common mental health distress is during this stage among couples.

How does anxiety affect fertility?

For both men and women, anxiety affects their sperm and eggs. And it all begins with cortisol, as per the expert, because with chronic anxiety, the body is in a state where it produces too much cortisol.

How? She described “High cortisol in women may disrupt the gland in charge of ovulation, the hypothalamus. A stress biomarker is associated with slower natural conception time in women. Cortisol may also interfere with egg maturation by influencing the levels of two hormones that enable egg development, namely follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Similarly, chronic stress in men results in a decrease in their testosterone levels, which directly affects their sperm count and motility.”

Can it cause infertility?

Since a negative emotional state may already interfere with fertility outcomes by affecting egg and sperm health, another question arises: can anxiety directly cause infertility? To this, she believed the connection is more complex.

“Stress by itself does not usually lead to infertility. What it does is it causes hormonal abnormalities and behavioural changes,” she said.

In other words, the impact of anxiety on fertility is not limited to cortisol or hormonal changes. It can also affect the daily behaviours that matter during the conception journey, from sleep and nutrition to intimacy and medical compliance. These repeated disruptions may gradually lower fertility outcomes.

Dr Khanna further added, “I have witnessed a lot of couples who have had trouble sleeping, eating, being intimate, and even ignoring medical recommendations because of anxiety. In the background, those recurring habits are quietly responsible for a decline in fertility more than the stress hormone itself.”

How to manage anxiety?

Do yoga to manage your stress better. (Adobe Stock)

The expert stated that anxiety can be managed, and she observed that by adding small mental health practices, one can see big differences.

She recommended small but consistent mental health practices to manage anxiety, such as doing 10 minutes of mindful breathing every day, engaging in moderate physical activity like brisk walking or yoga, maintaining open communication between partners to reduce performance pressure, and seeking professional counselling when anxiety begins to feel overwhelming.

However, since zero stress is not entirely possible, Dr Khanna reminded that if you manage it well, the impact on fertility chances will be less.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.