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The journey to conception is a long, difficult road...
New Study Links Stress to Miscarriage
Reproductive Medicine Associates of Connecticut, Norwalk, CT, January 2005 – There is little in the
world of infertility quite as stressful for patients as recurrent miscarriage. So, with the release of a
new study identifying stress itself as a possible cause of miscarriage, infertility specialists are now
examining ways in which their patients can heighten their chances of a healthy pregnancy by reducing
stress.
The study, reported in the November 17th issue of New Scientist, concluded that stress releases a
“cascade of hormones” that can lead to spontaneous abortion. It followed 864 pregnant women – 55
of whom miscarried. Those who miscarried were more likely to have identified themselves as
experiencing stress before or during pregnancy, and were also more likely to have lower levels of
progesterone and progesterone-induced blocking factor (PIBF) in their blood, than those who did not
miscarry.
Progesterone and PIBF are both critical to a healthy pregnancy, in that they prevent the immune
system from attacking the placenta and the fetus as foreign substances. In another leg of the same
study, pregnant mice that were exposed to high levels of noise responded with elevated serum levels
of cortisol, a hormone liked to progesterone suppression.
Mark Leondires, M.D., a board-certified reproductive endocrinologist and Medical Director at the
Reproductive Medicine Associates of Connecticut (RMACT) in Norwalk, agrees that stress can play a
factor in recurrent miscarriage. “It can be a vicious cycle,” he explains, “wherein each subsequent
loss can exacerbate feelings of hopelessness or anger. And these feelings can cause hormonal
imbalances.” Dr. Leondires maintains, however, that stress reduction therapies such as counseling,
support groups and even moderate physical activities must be incorporated in a full treatment plan for
recurrent infertility.
“There are many other causes of recurrent miscarriage; indeed, there are many other causes of
biochemical imbalances,” Dr. Spencer Richlin, reproductive endocrinologist at RMACT notes. For
instance, a February, 2004 study published in the Journal of Clinical Endocrinology & Metabolism
determined that women who suffered from polycystic ovarian syndrome (PCOS) – a common cause
of infertility – were more likely to miscarry due to insufficient levels of two important proteins
secreted by the endometrium during pregnancy. Women with PCOS are up to three times more likely
to miscarry than those who do not have the condition, the study also found.
What’s more, structural abnormalities involving the uterus or the cervix can also play a part in
recurrent miscarriage, as can maternal chronic disease or genetic defects. In fact, while approximately
one percent of women experience recurrent miscarriage, it is estimated that a definitive cause can be
found in only about 40% of cases. Dr. Leondires advises, “If a patient suffers from recurrent
miscarriage – defined as the loss of three or more consecutive pregnancies – she should seek out an
infertility specialist for a complete examination. It is important that we gather as much factual data as
possible about each patient’s medical history and condition, before incorporating any aspects of a
treatment regimen, be it a physical or emotional component.”
When stress is identified as a contributing factor in his patients’ history of recurrent miscarriage, Dr.
Leondires refers them to qualified counselors who specialize in infertility issues, and to local support
groups like RESOLVE or the American Fertility Association. “It’s important that patients have the
opportunity to share their concerns with a professional who can provide positive strategies for de-
stressing,” he says, “just as it is beneficial to patients when they find families going through the same
difficulties they are, so they know they are not alone.” However, he encourages patients to be sure to
choose a support group that is facilitated by a skilled professional who specializes in fertility issues. At
RMA-CT, Dr. Leondires and his colleagues have established several support groups that meet
regularly under the supervision of a certified infertility counselor.
More information about Reproductive Medicine Associates of Connecticut is available at www.rmact.
com.
About Dr. Mark P. Leondires, M.D.
Dr. Mark P. Leondires, M.D., FACOG, is a leading authority on reproductive medicine. Dr. Leondires
is board certified in Reproductive Endocrinology and Infertility. He is a member of the Society of
Reproductive Endocrinologists, the American College of Obstetrics and Gynecology, and the
American Society for Reproductive Medicine. Dr. Leondires earned his medical degree from the
University of Vermont College of Medicine and completed his residency in Obstetrics and Gynecology
at Maine Medical Center in Portland, Maine. Dr. Leondires completed a fellowship in Reproductive
Endocrinology and Infertility at the National Institutes of Health in Bethesda, Maryland. After
completion of his training, he fulfilled his military obligation by serving as the ART Director for the
largest and most successful program in the military health care system at Walter Reed Army Medical
Center. During this time he was an Assistant Professor at the Uniformed Services University of Health
Sciences and clinical faculty for the Combined Fellowship in Reproductive Endocrinology. Dr.
Leondires is currently Medical Director and lead physician with Reproductive Medicine Associates of
Connecticut in Norwalk CT. Along with numerous teaching and research activities, Dr. Leondires has
published articles in professional medical journals, national consumer magazines and newspapers, as
well as abstracts and book chapters.
Reproductive Medicine Associates of Connecticut, Norwalk, CT, January 2005 – There is little in the
world of infertility quite as stressful for patients as recurrent miscarriage. So, with the release of a
new study identifying stress itself as a possible cause of miscarriage, infertility specialists are now
examining ways in which their patients can heighten their chances of a healthy pregnancy by reducing
stress.
The study, reported in the November 17th issue of New Scientist, concluded that stress releases a
“cascade of hormones” that can lead to spontaneous abortion. It followed 864 pregnant women – 55
of whom miscarried. Those who miscarried were more likely to have identified themselves as
experiencing stress before or during pregnancy, and were also more likely to have lower levels of
progesterone and progesterone-induced blocking factor (PIBF) in their blood, than those who did not
miscarry.
Progesterone and PIBF are both critical to a healthy pregnancy, in that they prevent the immune
system from attacking the placenta and the fetus as foreign substances. In another leg of the same
study, pregnant mice that were exposed to high levels of noise responded with elevated serum levels
of cortisol, a hormone liked to progesterone suppression.
Mark Leondires, M.D., a board-certified reproductive endocrinologist and Medical Director at the
Reproductive Medicine Associates of Connecticut (RMACT) in Norwalk, agrees that stress can play a
factor in recurrent miscarriage. “It can be a vicious cycle,” he explains, “wherein each subsequent
loss can exacerbate feelings of hopelessness or anger. And these feelings can cause hormonal
imbalances.” Dr. Leondires maintains, however, that stress reduction therapies such as counseling,
support groups and even moderate physical activities must be incorporated in a full treatment plan for
recurrent infertility.
“There are many other causes of recurrent miscarriage; indeed, there are many other causes of
biochemical imbalances,” Dr. Spencer Richlin, reproductive endocrinologist at RMACT notes. For
instance, a February, 2004 study published in the Journal of Clinical Endocrinology & Metabolism
determined that women who suffered from polycystic ovarian syndrome (PCOS) – a common cause
of infertility – were more likely to miscarry due to insufficient levels of two important proteins
secreted by the endometrium during pregnancy. Women with PCOS are up to three times more likely
to miscarry than those who do not have the condition, the study also found.
What’s more, structural abnormalities involving the uterus or the cervix can also play a part in
recurrent miscarriage, as can maternal chronic disease or genetic defects. In fact, while approximately
one percent of women experience recurrent miscarriage, it is estimated that a definitive cause can be
found in only about 40% of cases. Dr. Leondires advises, “If a patient suffers from recurrent
miscarriage – defined as the loss of three or more consecutive pregnancies – she should seek out an
infertility specialist for a complete examination. It is important that we gather as much factual data as
possible about each patient’s medical history and condition, before incorporating any aspects of a
treatment regimen, be it a physical or emotional component.”
When stress is identified as a contributing factor in his patients’ history of recurrent miscarriage, Dr.
Leondires refers them to qualified counselors who specialize in infertility issues, and to local support
groups like RESOLVE or the American Fertility Association. “It’s important that patients have the
opportunity to share their concerns with a professional who can provide positive strategies for de-
stressing,” he says, “just as it is beneficial to patients when they find families going through the same
difficulties they are, so they know they are not alone.” However, he encourages patients to be sure to
choose a support group that is facilitated by a skilled professional who specializes in fertility issues. At
RMA-CT, Dr. Leondires and his colleagues have established several support groups that meet
regularly under the supervision of a certified infertility counselor.
More information about Reproductive Medicine Associates of Connecticut is available at www.rmact.
com.
About Dr. Mark P. Leondires, M.D.
Dr. Mark P. Leondires, M.D., FACOG, is a leading authority on reproductive medicine. Dr. Leondires
is board certified in Reproductive Endocrinology and Infertility. He is a member of the Society of
Reproductive Endocrinologists, the American College of Obstetrics and Gynecology, and the
American Society for Reproductive Medicine. Dr. Leondires earned his medical degree from the
University of Vermont College of Medicine and completed his residency in Obstetrics and Gynecology
at Maine Medical Center in Portland, Maine. Dr. Leondires completed a fellowship in Reproductive
Endocrinology and Infertility at the National Institutes of Health in Bethesda, Maryland. After
completion of his training, he fulfilled his military obligation by serving as the ART Director for the
largest and most successful program in the military health care system at Walter Reed Army Medical
Center. During this time he was an Assistant Professor at the Uniformed Services University of Health
Sciences and clinical faculty for the Combined Fellowship in Reproductive Endocrinology. Dr.
Leondires is currently Medical Director and lead physician with Reproductive Medicine Associates of
Connecticut in Norwalk CT. Along with numerous teaching and research activities, Dr. Leondires has
published articles in professional medical journals, national consumer magazines and newspapers, as
well as abstracts and book chapters.