In one of the largest controlled yoga studies to date, Fertility Centers of Illinois and Pulling Down the Moon , a holistic health care practice focused on fertility and family wellness, collaborated in a study examining the impact of yoga practice on anxiety in fertility patients. Using the State-Trait Anxiety Inventory (STAI), a well-established self-report measure of anxiety, study results found that after a six-week yoga program, state (situational) anxiety scores were reduced by 20 percent in the yoga group vs. two percent in the control group; and trait (longstanding) anxiety scores were reduced by 12 percent in the yoga group vs. three percent in the control group. The study was presented at the American Society for Reproductive Medicine’s annual meeting in October 2015. The study was conducted by Dr. Jenny Hirshfeld-Cytron of Fertility Centers of Illinois, Beth Heller, M.S., R.Y.T. of Pulling Down the Moon, Dr. Sona Jasani of Rush University Medical Center, Lourdes Garcia, M.D. of St. Joseph Hospital, and Sue Jasulaitis, R.N., M.S. of Fertility Centers of Illinois.

Study participants completed 45 minutes of vinyasa-style yoga and 30 minutes of group discussion with other infertility patients once a week over a period of six weeks. The practice included a gentle series of flowing yoga poses. Group discussion was centered on how to apply different yoga techniques, such as breathing, meditation, working with negative thoughts, etc., to the fertility journey.

Approximately 30 percent of in vitro fertilization (IVF) patients suffer from anxiety and depression, with studies showing that an infertility diagnosis may cause the same amount of stress, anxiety, and depression as a cancer or HIV diagnosis. Emotional distress is a top reason patients discontinue treatment prior to success. Furthermore, stress has been found to negatively affect IVF outcomes. Research into stress reduction techniques has examined the utility of yoga in stress reduction and adaptation enhancement in a variety of populations. Yoga practice has been correlated with a reduction in serum markers of stress and improved immune function.

The practice of yoga is aimed at aiding the body and mind to achieve a state of relaxation by training in distinguishing between effort and rest, improving the ability to focus the mind, and enhancing the individual’s concept of herself as whole and complete even in the midst of highly stressful situations. The practice of yoga can therefore be viewed as a skills acquisition exercise that can be utilized by an individual in a multitude of different situations. If yoga is viewed in this context, one can argue that even a short intervention can teach lifelong lessons that allow the individual to continue receiving benefit over time. Implementation of yoga in patients with post-traumatic stress disorder (PTSD) has suggested improvement in resilience, stress, and anxiety. Many infertility patients present reporting symptoms that sound very similar to PTSD. Yoga interventions have been implemented specifically in the infertility population, resulting in potential benefits in higher quality of life, lower STAI scores, and a reduction in depression measures and lower general distress. The study completed by Fertility Centers of Illinois and Pulling Down the Moon was designed to test an evidence-based method to apply a specific yoga practice to the reduction of stress-related anxiety in infertility patients.

When fertility patients are told to “just relax,” this does nothing but create more self-directed negativity, stress, and anxiety. Yoga is a mindful, meditative practice that has been shown to decrease stress in other areas of medicine. Typically, during fertility treatment, stress levels rise as treatment continues. In this patient population, we would have deemed our intervention successful if stress levels had stayed the same. Completing the Yoga for Fertility program was not only effective at lowering stress; it produced drastic results in a short period of time. We hypothesize this was potentially related to the following three factors: Community Support and Reducing Isolation, Relaxation Activation via Vagus Nerve Stimulation, and Utilizing Key Relaxation Strategies of Breathing and Meditation. An important potential byproduct of this yoga experience would be the increased capacity of patients to manage the psychological burden of infertility treatment so they can continue in their treatment and reach their goal of building a family.

Beth Heller, M.S., R.Y.T. and co-founder of Pulling Down the Moon, created the Yoga for Fertility Program specifically to help fertility patients. “Over the 14 years that Pulling Down the Moon has been offering this program we have seen the results in the faces and bodies of our students, but it’s wonderful to finally be able to quantify how yoga can help with the fertility process. I think yoga teachers and students everywhere will appreciate that yoga is continuing to make inroads in the area of evidence-based medicine.” Practice the Moon Salute Sequence right now with Beth from Pulling Down the Moon!

Suggested Reading

  1. S. Jasani, B. Heller, L. Juarez, M. Davidson, S. Jasulaitis, J. Hirshfeld-Cytron. The impact of yoga on anxiety in infertility patients. Fertil Steril 2015; 104(3): e355
  2. Gameiro S, Boivin J, Peronace L, Verhaak CM. Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Hum Reprod 2012; 18: 652-69.
  3. Turner K, Reynolds-May MF, Zitek EM, Tisdale RL, Carlisle AB, Westphal LM. Stress and Anxiety Scores in First and Repeat IVF Cycles: A Pilot Study. PLOS ONE. 2013; 8(5): 1-6.
  4. Domar AD, Zuttermeister PC, Friedman R. The psychological impact of infertility: a comparison with patients with other medical conditions. J. Psychosom. Obstet. Gynaecol. 1993; 14: 45-52.
  5. Domar AD, Gross J, Rooney K, Boivin J. Exploratory randomized trial on the effect of a brief psychological intervention on emotions, quality of life, discontinuation, and pregnancy rates in in vitro fertilization patients. Fertil Steril 2015; 104(2): 440-51.
  6. Khalsa, HK. Yoga: an adjunct to infertility treatment. Fertil Steril 2003; 80: 46-51.