Deciding to start a family is an exciting time – but it can also be a stressful one.
It is becoming increasingly clear that the physiological effects of stress can include a negative impact on fertility in both women and men.
In women, psychological stress has been independently associated with an increased time trying to conceive (>12 months), while in men, psychological stress has been associated with poorer sperm quality, including a lower percentage of motile sperm, a lower percentage of morphologically normal sperm and lower sperm density.[2,3]
As well as lifestyle changes – meditation, reducing caffeine, eating a healthy balanced diet, getting quality sleep and regular exercise – a range of adaptogenic herbs and certain nutrients can be incorporated to help the body deal with stress and improve fertility.
Withania somnifera (withania) is a traditional ayurvedic herb used as an adaptogen and as a tonic to improve the body’s response to stress and decrease serum cortisol. This improved stress response is thought to be responsible for the improvement in semen quality following treatment with withania.[5,6]
Eleutherococcus senticosus, Panax ginseng and Panax quinquefolius (Siberian, Korean and American ginseng) have all been used as adaptogens in traditional Chinese medicine (TCM), improving the body’s ability to respond to stress.
Korean ginseng has been shown to increase sperm density and motility in both men with decreased sperm motility and healthy controls; one proposed mechanism of action is through induction of CatSper (cation channel of sperm) expression, improving sperm hyperactivation and motility.
Animal studies support the use of Korean ginseng for infertility caused by polycystic ovarian syndrome (PCOS); ovarian morphology was almost normalised in rats with induced PCOS after 60 consecutive days of treatment with 200mg/kg body weight/day of Korean ginseng extract.
The B vitamins provide nutritional support for normal healthy adrenal function. In particular, vitamins B5 and B6 are useful for improving the body’s response to stress.
Poor vitamin B5, B6 and B12 status in women is associated with a decreased probability of conception. In animal models, B5 is also important in male fertility, being essential for normal sperm motility and testosterone production.
Alongside the well-known importance of folic acid in early pregnancy, it is also a key nutrient for fertility. Folic acid is important for oocyte quality and maturation.
Vitamin B12 is required for DNA and RNA synthesis, and thus is involved with healthy fertility in both men and women. In addition, B12 deficiency has been associated with reduced sperm motility and count.
Use in pregnancy
In consideration of the above herbs for treating stress and improving stress-related infertility, it is important to factor in their safety in early pregnancy. As with all CAM treatments, use in pregnancy should be tailored to the individual and closely monitored.
- Messerlian C, Plaku-Alakbarova B, Lange A, et al. Self-reported home and work stress and trying to conceive – using big data in the study of infertility. Fertil Steril 2017;108(3):e298. [Full text]
- Janevic T, Kahn LG, Landsbergis P, et al. Effects of work and life stress on semen quality. Fertil Steril 2014;102(2):530-538. [Full text]
- Li Y, Lin H, Li Y, et al. Association between socio-psycho-behavioural factors and male semen quality: systematic review and meta-analysis. Fertil Steril 2011;95(1):116-123. [Abstract]
- Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med 2012;34(3):255-262. [Full text]
- Mahdi AA, Shukla KK, Ahmad MK, et al. Withania somnifera improves semen quality in stress-related male fertility. Evid Based Complement Alternat Med 2011;2011:576962. [Full text]
- Azgomi RND, Zomorrodi A, Nazemyieh H, et al. Effects of Withania somnifera on reproductive system: a systematic review of the available evidence. Biomed Res Int 2018;2018:4076430. [Full text]
- Leung KW, Wong AST. Ginseng and male reproductive function. Spermatogenesis 2013;3(3):e26391. [Full text]
- Park EH, Kim DR, Kim HY, et al. Panax ginseng induces the expression of CatSper genes and sperm hyperactivation. Asian J Androl 2014;16(6):845-851. [Full text]
- Jung JH, Park HT, Kim T, et al. Therapeutic effect of Korean red ginseng extract on infertility caused by polycystic ovaries. J Ginseng Res 2011;35(2):250-255. [Full text]
- Braun L, Cohen M. Herbs and Natural Supplements: An Evidence Based Guide, 3rd ed, 2010. Sydney: Churchill Livingstone Elsevier. [Source]
- Hechtman L. Clinical Naturopathic Medicine, 2012. Sydney: Churchill Livingstone Elsevier. [Source]