Trying to conceive is supposed to be a hopeful chapter. But for millions, it’s anything but simple. Behind every ultrasound appointment, every carefully timed cycle, and every “faint line” moment, there’s often something harder: uncertainty. Fear. Loss. And—whether we like it or not—stress.
And yet, despite the growing awareness around fertility struggles, one message continues to echo in waiting rooms, family gatherings, and internet forums: “Just relax.”
It sounds harmless. Supportive, even. But for anyone living through infertility or pregnancy loss, it often lands as something else entirely—minimizing, dismissive, and wildly out of touch.
At Miscarriage Movement, we hear from people every day who are told that stress is what’s holding them back from conceiving or carrying to term. As if their heartbreak is self-inflicted. As if their body’s silence is simply a matter of mindset. As if they’re not already doing everything in their power.
But what does the science actually say?
To separate myth from medicine, we sat down with Dr. Bana Kashani, a reproductive endocrinologist, OB-GYN, and fertility specialist who deeply understands both the clinical and emotional weight of this journey. In this thoughtful and eye-opening Q&A, Dr. Kashani explains how stress affects key hormones tied to ovulation and conception, why the nervous system plays a bigger role than most people realize, and what kind of support really helps when someone is navigating treatment, trauma, or loss.
We also talk about the mental health gaps in fertility care, the emotional burden so many patients carry silently, and what needs to change—both culturally and clinically—to make fertility support more compassionate and complete.
Whether you’re in the thick of IVF, grieving a miscarriage, or simply wondering if stress can cause a miscarriage or if stress is making it harder to conceive, this conversation is for you.
Because infertility is not a mindset problem. It’s not something you “fix” by thinking positively or scheduling a massage. And no one should be made to feel like their grief, frustration, or exhaustion is the thing standing in the way of their family.
It’s time to stop telling people to relax—and start helping them feel seen.
To start, can you briefly explain how stress physiologically affects fertility?
What are the key hormones involved, and why are they so important for conception?
Stress activates the hypothalamic-pituitary-adrenal (HPA) axis, which increases cortisol production. This can suppress key reproductive hormones like GnRH, LH, and FSH—hormones responsible for regulating ovulation and the menstrual cycle. When these systems are out of sync, it becomes more difficult for the body to ovulate regularly or maintain an optimal environment for conception.
Many people who are trying to conceive feel like they’re constantly being told to “just relax.” What’s the difference between a toxic oversimplification and meaningful stress support?
“Just relax” is rarely helpful—it oversimplifies a complex emotional and medical experience. As a provider, I try to meet patients where they are. Meaningful support means validating their emotions, offering tangible tools, and creating a care environment where patients feel seen and heard, not blamed for what they’re going through.
Can chronic stress really delay or disrupt ovulation, and how common is that among people experiencing infertility or recurrent loss?
Chronic stress can absolutely interfere with ovulation by suppressing the hormonal signals that trigger it. It’s not the cause of every fertility issue, but we do see it compound challenges, especially in patients already navigating irregular cycles, PCOS, or unexplained infertility. In cases of recurrent loss, the emotional toll alone can be overwhelming, and stress adds another layer of complexity to treatment.
For someone who’s experienced miscarriage or is deep in fertility treatments, stress is often unavoidable. What are some realistic, science-backed strategies to manage stress that don’t require overhauling your entire lifestyle?
Managing stress doesn’t have to be all or nothing. Prioritizing sleep, incorporating short daily walks, and practicing deep breathing exercises can all make a real difference. Therapy—especially someone trained in fertility-related trauma—can also be incredibly helpful. Even small moments of calm can regulate your nervous system and support hormonal balance.
Is there a known relationship between stress and other reproductive challenges like implantation issues, miscarriage risk, or egg quality?
The science is still evolving, but chronic stress has been associated with inflammation and immune dysregulation—both of which may affect implantation. Some studies suggest that oxidative stress may also impact egg and sperm quality. That said, stress is rarely the sole factor; rather, it interacts with a range of physiological systems that support reproduction.
How can care providers better support patients who are clearly under emotional and physical stress during fertility treatments?Are there any gaps in the current system you’d like to see addressed?
We need to treat fertility care as whole-person care. That means screening for emotional distress, offering mental health referrals early, and building in time during appointments to check in on how patients are really doing. A major gap I see is the lack of integrated mental health services within fertility clinics—it shouldn’t be an afterthought.
From your experience, what kinds of stress-reduction tools or therapies (mental health support, acupuncture, sleep hygiene, etc.) actually move the needle when it comes to improving fertility outcomes?
Mindfulness-based practices, acupuncture, and even structured sleep routines can all be effective. These tools don’t necessarily “fix” fertility issues, but they can help regulate the body’s stress response, improve hormone function, and support better outcomes over time. Importantly, they also help patients feel more in control during an often unpredictable time.
What would you say to someone reading this who feels like they’re doing everything right—and still facing loss or infertility? How can they show themselves compassion through it all?
First, I’d say: you are not alone, and this is not your fault. Fertility is complex, and doing “everything right” doesn’t always lead to quick or easy results. Self-compassion means allowing yourself to grieve, to rest, and to feel without judgment. You’re doing an incredibly hard thing with strength and courage, even on the days it doesn’t feel that way.
Anything else you wish more people understood about the emotional burden of fertility struggles—and the importance of advocating for both mental and reproductive health at the same time?
Fertility struggles are not just physical—they take a deep emotional toll. We need to stop separating the body from the mind in how we treat reproductive health. Advocacy for mental health alongside fertility care isn’t a luxury; it’s essential. No one should have to navigate this alone or feel like their emotional needs are secondary.
