XML Feed for RxPG News   Add RxPG News Headlines to My Yahoo!   Javascript Syndication for RxPG News

Research Health World General
 Latest Research
  Menstruation Disturbances
 Infectious Diseases
 Respiratory Medicine
 Public Health
 Clinical Trials
 Medical News
 Awards & Prizes
 Special Topics
 Odd Medical News
 World News

Last Updated: Aug 19th, 2006 - 22:18:38

Infertility Channel
subscribe to Infertility newsletter

Latest Research : Gynaecology : Infertility

   DISCUSS   |   EMAIL   |   PRINT
CBT can restore ovulation in infertile women
Jun 20, 2006, 21:39, Reviewed by: Dr. Priya Saxena

"A staggering 80% of the women who received CBT started to ovulate again, as opposed to only 25% of those randomised to observation"

Fertility can be restored in some women by the use of behavioural therapy, thus avoiding recourse to expensive medicines and complex procedures, a scientist told the 22nd annual conference of the European Society of Human Reproduction and Embryology in Prague, Czech Republic on Tuesday 20 June 2006. Professor Sarah L. Berga, from the Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia, USA, said that her work was the first to show that reducing stress through psychological intervention could restore ovulation in women whose ovarian function had previously been impaired.

"Contrary to what had previously been believed", she said, "we found that multiple small stressors that seemingly would have minimal impact on reproductive competence can play a major role in causing anovulation. Up till now it was thought that failure to ovulate was usually caused by the energy deficits induced by excessive exercise and/or undernutrition, but we asked why women undertake such behaviours. Often dieting and exercise are a way of coping with psychosocial stress, and our previous work had shown that such stress is often increased in women who do not ovulate."

Professor Berga and her team set out to study the causes of functional hypothalamic amenorrhea (FHA) in women of normal weight who had not had a menstrual period for more than six months. FHA is caused by a prolonged reduction in gonadotropin-releasing hormone (GnRH), which signals the release into the bloodstream of hormones that simulate ovulation.

Analysis of the cerebrospinal fluid in women with FHA, as opposed to women who were ovulating normally, showed increased levels of cortisol, a hormone related to stress. Chronic elevation of cortisol levels heightens the risk for other health burdens, such as depression or osteoporosis, but chronic cortisol increases can often be reversed with behavioural therapy

In a pilot study, Professor Berga's team randomised 16 women with FHA into two groups. One group received cognitive behaviour therapy (CBT) for 20 weeks; members of the other group were observed. "A staggering 80% of the women who received CBT started to ovulate again, as opposed to only 25% of those randomised to observation", said Professor Berga. "Neither group gained weight nor showed significant changes in their levels of leptin, a hormone involved in regulating body weight and metabolism. This study underlines the important contribution that lifestyle factors play in determining overall health and reproductive health in particular. To reverse stress-induced ovulation, it is not enough simply to address metabolic sources of stress."

Professor Berga told the conference that the recovery of the stress and ovarian axes appears to occur independently of major metabolic changes such as an increase in leptin or thyroxine (a hormone that affects how cells use energetic compounds). Since CBT caused a drop in cortisol and a rise in TSH, it may be that the hypothalamic-pituitary-thyroid axis, involved in the regulation of metabolism, recovers, but only later.

The current practice in the treatment of anovulatory women is to offer hormonal treatments such as oral contraceptives, if immediate fertility is not desired, or ovulation induction if it is. "Aside from cost, these approaches mask ongoing endocrine disturbance", said Professor Berga. "Since these disturbances pose a risk to overall health, it is important to use a therapy that restores the endocrine system, including the reproductive system. Cognitive behaviour therapy offers a holistic treatment that is safe, cost effective, and easy to implement."

The team now intends to analyse further data from the pilot and to follow with a multi-centre trial involving a large number of women. "If the larger scale study confirms our earlier results," said Professor Berga, "we will have very strong evidence for offering stress reduction as an effective therapy for a significant group of infertile women."

- 22nd annual conference of the European Society of Human Reproduction and Embryology


Subscribe to Infertility Newsletter
E-mail Address:


Related Infertility News

Spermatogonial stem cells could aid male infertility
Dopamine agonist can prevent ovarian hyperstimulation syndrome
CBT can restore ovulation in infertile women
New method of testing ova for abnormalities
New Hope For Preserving Future Fertility
How IVF could be causing genetic errors in embryos
Fertility drug letrozole given 'all-clear' in new study
Major birth defect risk more for IVF babies
Treatment of Men with ED Improves Women's Sexual Function
Fertility awareness-based methods of family planning & timing - Study

For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page


© Copyright 2004 onwards by RxPG Medical Solutions Private Limited
Contact Us