There is no doubt that infertility causes high levels of stress and anxiety. What is less discussed is the black dog of depression. Symptoms of depression can also be elevated if you are struggling to conceive.  

It makes sense.  

Witnessing your period come around month after month despite dearly wishing for conception can induce depression. Not only is your heart invested in wanting to conceive but so might your body and your wallet if you’re undergoing the expensive and invasive processes of ART (Assisted Reproductive Therapies) / IVF (Invitro Fertilization) treatments.  

It can be deflating to have done everything possible and still find yourself back to square one with the onset of each monthly bleed. 

What exactly is depression? According to the DSM (The Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition), depression can cause significant emotional distress and negatively affect daily functioning. Symptoms of depression can include, sad-mood, fatigue, changes in sleep patterns and in weight (increase or decrease), loss of interest in activities that previously brought delight, and feelings of worthlessness or guilt.  

No wonder depression and infertility go hand in hand.  

Infertility is defined as ‘an inability to conceive after at least a year of regular, unprotected intercourse’, according to the World Health Organization. After at least twelve menstrual periods signalling yet another cycle without impregnation, it’s understandable that feelings of hopelessness and worthlessness might set in.  

A 2021 study found that women struggling with infertility suffered from higher levels of depression than the general population. The study also highlighted that mental health related to fertility affected women more than men, potentially negatively impacting their health and quality of life. It’s easy to see how it becomes a catch-22 situation. The more depressed a woman becomes, the more her physical and mental health is compromised, which can contribute to her inability to conceive.  

It is vital to acknowledge the connection between stress and infertility—how stress can throw-out the delicate balance of a woman’s hormonal systems—and that’s why we recommend specific feminine yoga practices to support fertility in our Yoga for Fertility Courses . I also write in detail about the stress and hormonal connection in my book Moving with the Moon , where I suggest a number of stress-relieving practices to address menstrual imbalances.   

It is also worth looking at how symptoms of fertility-related depression might be helped with specific yoga practices.  

Physical postures to help with depression can include what I call ‘the heart-opening’ poses. These are the poses that involve active or passive (supported) back-bending, expanding the chest and increasing breath capacity as well as our joy-levels. The second, luteal phase of your cycle—from ovulation up to menstruation—is the best time to practice supported heart-openers like Supta Baddha Konasana (Reclining Groin Stretch) and Supported Bridge Pose (on a bolster).  

 

 

 

 

 

If the woman is an experienced yoga practitioner and has not recently undergone an IVF/ART procedure she might want to include some more active backbends like Camel Pose or Bow Pose to massage the internal organs and gently stimulate the sympathetic nervous system, assisting with depressions symptoms of low-energy and sluggishness. Note, these more active versions of the heart-openers should only be practised in the first phase of your cycle — from post-menstruation to ovulation.  

 

If you or your student is experiencing depression, make sure to practise these heart-opening poses regularly but do consult your health practitioner if symptoms are severe or prolonged so that you can get the clinical and mental health care you might need. Yoga should always be an adjunct and not a stand-alone for severe / chronic conditions.  

Finally, I recommend the pranayama Kapalabhati as a practice for the second half of your cycle. This is a stimulating and energising breathing practice that research has shown can help with depression. It is very important this rapid breathing exercise, focusing on strong, short exhalations, only be practised during the first phase of the menstrual cycle and definitely not after any ART/ IVF procedures. And make sure to cease the practice if there are any feelings of dizziness or discomfort.  

Here’s how to do it:  

Sit comfortably with a straight spine and make sure you do this practice on an empty stomach and bladder. Take some deep breaths down into the belly (Soft Belly Breaths) and take some time to centre and ground yourself before you begin, especially if you’re starting your yoga practice with this pranayama. When you’re ready begin Kapalabhati by taking rapid exhalations out of the nose at the same time as pumping your belly.  

It can help, especially when you’re first learning this technique, to place one or both hands on your belly and feel the abdominal wall contracting—drawing back towards the spine—as you work with a forceful exhalation. As you inhale just let the abdomen relax and let the breath draw in of its own accord. On the next exhalation, consciously pump the belly again—like a bellows—and make an audible exhale through the nose.  

Start with one round of about 10 breaths and then rest, breathing normally and totally relaxing the belly. If you still feel comfortable repeat several more rounds. As you get more experienced, you may wish to increase to rounds of 20 breaths, repeated several times.  

When you have finished, close your eyes and sit quietly, letting the breath return to normal and notice how you feel after this stimulating, energising breath. The science shows that Kapalhati works to stimulate the cognitive centres of the brain as well as positively stimulating the nervous system when followed with some conscious relaxation. You should feel calmer and more grounded after completing the practice as well as gently uplifted.  

References  

Infertility and depression: https://link.springer.com/article/10.1186/s40738-021-00098-3 

Benefits of yoga for fertility: https://journals.lww.com/ijoy/fulltext/2024/17010/yoga_and_lifestyle_changes__a_path_to_improved.3.aspx?context=latestarticles 

Benefits of Kapalabhati breathing: https://journals.lww.com/ijoy/fulltext/2024/17020/influence_of_high_frequency_yoga_breathing.7.aspx 

https://pmc.ncbi.nlm.nih.gov/articles/PMC8963645/ 

Yoga for the four phases of the menstrual cycle and for menstrual anomalies: Moving with the Moon: Yoga, Movement and Meditation for Every Phase of Your Menstrual Cycle and Beyond: https://blissbabyyoga.com/moving-with-the-moon/