Psychosocial stress and infertility : Cause or effect?

Experimental, theoretical, psychological, and economic barriers have caused physicians to rely on biomedical treatments for infertility at the exclusion of more environmentally oriented ones (e.g., psychosocial stress therapy). An evolutionary model is described for the origin of reproductive failure, suggesting why mammals evolved to be reproductively responsive to the environment and why psychosocial stress should have an especially strong impact on fertility problems. A study of the causal role of psychosocial stress in infertility is then summarized. The paper concludes with implications for future directions for the treatment of infertility and related human reproductive problems.