Psychological Factors Affecting Fertility

by Christiane Northrup, M.D.

Fertility & Birth Control

Almost all women assume that they will be able to have children someday, even if they’re not sure they want to; the potential to have them is important even to women who never intend to use that potential. The ability to conceive and bear children can profoundly affect the way a woman feels about herself on a very deep level. So when a woman finds that she is unable to have a child, she’s often thrown into great despair and feels a sense of injustice: “Why me?” Seeing teenage mothers having no problems getting pregnant becomes almost impossible to bear, unless the woman can find some meaning in the experience and come to terms with it. The pioneering work of Alice Domar, Ph.D., founder and executive director of the Domar Center for Complementary Healthcare in Waltham, Massachusetts, has clearly documented that women who’ve been diagnosed as infertile are twice as likely to be depressed as a control group, and that this depression peaks about two years after they start trying to get pregnant. And even though infertility is not life-threatening, infertile women have depression scores that are indistinguishable from those of women with cancer, heart disease, or HIV. Domar1

Though the mind/body connection in infertility has been appreciated for decades, only recently has this important link begun to be explored more seriously. As our society has become more technologically focused, the study of the mind/body connection in infertility holds the potential to help many couples, and a thorough psychological interview should be a routine part of every fertility investigation. Jeker2 When we focus only on the extremely expensive and invasive technology currently available for fertility, and forget the hearts and spirits of those going through these procedures, the results are often disappointing and even devastating.

Psychological Factors

On a personal level, many women do not get pregnant because in their hearts they really do not want to — they are afraid of the demands a child will make on them. Whenever a woman feels conflicted over birthing, children, or the restrictions that children may impose once they arrive, infertility may result. Some studies from the 1940s through the 1990s have suggested an association between infertility and ambivalence toward pregnancy and children.

The relationships between husbands and wives who are infertile have also been studied. Many of the women in these studies had an actual aversion to intercourse; they had low levels of orgasm when they did have intercourse, and they felt a marked sexual disharmony in their partnership. When these women found more suitable partners, however, they became fertile. Dunbar3 I have seen this phenomenon repeatedly in my practice, just as I have seen countless so-called infertile women conceive shortly after adopting a baby! Psychological testing done on 117 husbands in infertile couples in one study indicated that the men had a pronounced lack of self-confidence, were introverted, and had decreased social assertiveness. Hellhammer4

The fertility-stress link remains controversial in conventional science and it’s difficult to document a causal link between psychosocial distress and fertility. Though many studies do show that women with infertility are more apt to have depression and anxiety, most doctors believe that the depression and anxiety are the result of infertility, not the other way around. In any case, studies tend to be conflicting, not well-controlled, and there are no prospective studies. In their review of forty years of research on psychological distress and infertility, psychologist Dr. W. A. Fisher and his colleague A. M. Brkovich summarized the viewpoint of most conventional doctors when they wrote: “Much research has been done to try to corroborate the proposition that psychological factors may be casually related to the occurrence of infertility, but no study has been able to confirm a causal relationship to date. In fact the very assumption of a psychological distress–infertility link has become quite controversial because some feel it blames women for their inability to conceive.” Brkovich5

Despite this conventional opinion, failing to explore the psychosocial aspects of fertility is a big mistake and robs a woman of all her options. The conflicts that are associated with infertility are not at the conscious level and you can’t get at them by simply asking a woman (or a man) if she or he is conflicted about having a child! Still, there’s no doubt that subconscious fears about having a child can and do exert a powerful influence over the subtle endocrinologic processes that are required for conception. Perceived stress changes the way the hypothalamus of the brain functions, which affects ovulation. It also changes the immunologic functioning of the cells in the reproductive tract as well as elsewhere. When a woman learns how to modulate her stress effectively, her fertility can change.

Healing Alternatives

There is enormous potential for healing infertility when a woman is willing to acknowledge the role of her beliefs and commit to bringing them to consciousness and healing them. The first step—and the hardest step—in healing one’s adverse subconscious programming about anything is being willing to accept yourself fully and unconditionally right now. This process involves never beating yourself up for “failing” to conceive because you waited too long, or “failing” at anything else! It’s just the opposite of blame.

I’ve seen many women get pregnant once they committed to healing themselves on the deepest levels. On of the most striking examples of this is the story of my colleague, Julia Indichova, who, at the age of forty-three, was unable to conceive a second child. She was told that her FSH level (the follicle stimulating hormone from the pituitary gland — often used to judge whether a woman is still producing fertile eggs) was too high. But her inner wisdom told her that wasn’t true. She changed her diet, began to do some deep soul searching, read everything she could, got her FSH down naturally, and eventually conceived and delivered a healthy daughter. Her book, Inconceivable: A Woman’s Triumph over Despair and Statistics (Broadway Books, 2001), tells her story. Julia now leads workshops for women diagnosed with infertility and has helped many heal their fertility and their lives. For more information go to Julia’s Website,

Niravi Payne, author of The Whole Person Fertility Program (Three Rivers Press, 1997) is another colleague therapist who has devoted her professional life to helping couples conceive through her Whole Person Fertility Program. (See Her view of current fertility problems is both enlightening and empowering. It’s no accident, she says, that so many baby boomers have had problems with fertility. A series of complex psychological, sociological, and political factors has led to unparalled changes in our society in the last twenty-five years and has given rise to the decision of many to delay childbearing, thus altering the reproductive life patterns familiar to their parents and the thirty thousand generations before them. Niravi writes, “In the space of one generation, middle-and upper-class Americans decided to defer childbearing for ten to twenty years. This may be the most radical voluntary alteration of the lifestyle of all of them, and, unquestionably, there have been physiologic consequences.”

Spiritual and Holistic Options

If fertility is an issue that concerns you, I highly recommend that you explore the these psychological factors thoroughly. As you begin your journey, have your journal ready and write down any thoughts, feelings, or beliefs that arise. Your entries will become invaluable as you move toward healing your fertility.

Learn More — Additional Resources


  1. Domar, A. et al., 1992. The prevalence and predictability of depression in infertile women, Fertility and Sterility, vol. 58: 1158–63; Domar, A., et al., 1993. The psychological impact of infertility: A comparison with patients with other medical conditions, Journal of Psychosomatic Obstetrics and Gynecology, vol. 14:45–52.
  2. Jeker. L., et al., 1988. Wish for a child and infertility: A study of 116 Couples. I. Interview and Psychodynamic Hypotheses,” International Journal of Fertility, vol. 33, no. 6:411–20.
  3. Dunbar, H. F., 1935. Emotions and Bodily Changes, New York: Columbia University Press, p. 595; Dickerson, R. L., 1931. Medical analysis of 1000 marriages, Journal of the American Medical Association, vol. 97:529; Norris, C. C., 1912. Sterility in the Female Without Gross Pathology, Surgery, Gynecology, and Obstetrics, vol. 15:706.
  4. Hellhammer, D. H., et al., 1985. Male Infertility, Relationships Among Gonadotropins, Sex Steroids, Seminal Parameters, and Personality Attitudes,” Psychosomatic Medicine, vol. 47, no. 1:58–66.
  5. Brkovich, A. M., Fisher, W. A. 1998. Psychological distress and infertility: Forty Years of Research,” Journal of Psychosomatic Obstetrics and Gynaecology, vol. 19, no. 4: 218–28.
Last Updated: February 22, 2007

Christiane Northrup, M.D.

Christiane Northrup, M.D., is a visionary pioneer and a leading authority in the field of women’s health and wellness. Recognizing the unity of body, mind, and spirit, she empowers women to trust their inner wisdom, their connection with Source, and their ability to truly flourish.


Add comment
  1. Aimee Levens
    7 years ago

    I love all your other work Dr Northrup but blaming infertile women for their infertility because of psychological reasons has GOT to stop. This is the one section in WBWW that, even before my own infertility was diagnosed, just was so incredibly offensive and dismissive of what women truly go through. Until you’ve been through it, you have NO IDEA and your advice comes across condescending and dismissive of the facts of what men and women are struggling with. One in eight couples deal with infertility, as you know, and to tell them that they just need to heal their psyche in order to get pregnant and/or inferring that they’ve just got to want it bad enough and that will somehow repair their reproductive systems is just plain garbage. Tell that to my friend’s husband whose pituitary issues mean his sperm is useless, or tell that to me who stopped ovulating years ago and, even with 6 rounds of donor egg IVF from age 41-43 from a proven donor, moving 9 embryos altogether into my then-incredibly-healthy body (2.5 solid years of brutal DEIVF treatments have led to a level of PTSD that is beyond anything I ever expected – another thing you don’t address in your infertility discussions – leading to physical manifestations in me after the heartbreaking failures of treatment).

    Focusing almost solely in your book and on your website here about how women are supposedly in control of their fertility and just need to get their hearts and minds in order is pure and simple victim shaming and so incredibly disrespectful to those who try for years and have to end the journey. Anyone who’s been through infertility treatments will tell you how incredibly rude it is when people come up to you and say “oh just relax and it will happen”, inferring that we don’t know what we’re doing and we’re somehow at fault for why we’re not parents.

    Read “Cracked Open” by Miriam Zoll and the blog Infertility Honesty, and please reconsider your oversimplification of infertility and how you are communicating to your readers about the realities of infertility…not to mention the glorification of mothers as if those of us who are childless could not possibly compare.

    1. Laurie
      7 years ago

      Aimee, I find your remarks incredibly offensive. I re-read the blog and I didn’t see any comments from Dr. Northrup that blame infertile women. Infertility, whether mental or physical, is associated with an individual. Acknowledging the role of beliefs is no more “victim-blaming”, than detecting low levels of sperm or poor quality eggs. Sure, there mayn’t be adequate data to indicate that thinking a certain way can predispose you to get pregnant, but to suggest that the advice here is victim shaming is yet another dumb feminist arguments. Please take your feminism elsewhere, it’s not welcome here.

  2. Mary K.
    15 years ago

    We love pleasure and joy! I just wanted to pass along potato info that I learned this past week from a potato farmer in Vermont. She grows a delicious purple potato that is actually certified high anti-oxidant. Have to love it!

  3. Elektra G.
    15 years ago

    i woke up this morning with breakfast on bed, and a remark from my husband: “Did you know that there is a third gender out there nowadays?” “No…”, i replied sleepy. He continued: “It’s called E-Male”….. Hahahaha!!!!! It’s the little things that count. Wish more people would be less uptight and did not wear the grim mask all day long. There’s a true Muse for loosening your muscles (in whatever area…) her name is Loretta LaRoche. Check her out! She is a gem!!!

  4. Coleen - Savannah GA
    15 years ago

    I absolutely agree. We can easily get so absorbed in busy days and demands from other people that we just forget to enjoy the delights in life that are all around us. Life should not always be so serious. We can even laugh at a mistake. Pump up that nitric oxide that warms the soul. When you look around, you realize that someone needs to smile – let it begin with me!
    Thank you for the reminder!

  5. Betty-Ann H.
    15 years ago

    I’m an Aries with my rising sun a Saggitarius and my moon in Capricorn. So you can see why it is difficult for me to relax a bit and find the joy. But this post was a great reminder. I’ve been doing the Yoni dance ever since I saw you in Toronto. I even had all the women do it at my birthday dinner. I think you are a total inspiration. I called my sister to be sure she sees you when you are in Chicago and I have blogged about my great experience at your Toronto speech. It can be found at It is my April 6 post. Thanks! Betty-Ann

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