The
Fertility
Concierge

TFC is a medical grade hardware and software product that enables you to measure your Stress Resilience, which is an indication of your ability to adapt to the stressors in your life. This same technology is currently being used in an IRB approved study to quantify the impact of stress on infertility.

Once you complete your daily TFC assessment, you will receive a Stress Resilience Score and an activity plan that is adapted to your current score. Our Expert System adapts or modifies your activity based on what you are ready for on that day.

TFC will create an awareness of your physiological stress as a Stress Resilience Score. You can track your Stress Resilience daily and you can also track it as it trends over time.

Yes, the Fertility Concierge is an app inclusive of all people.

Yes, infertility has been shown to cause stress to couples trying to conceive worldwide.

“The inability to conceive a child is experienced as a stressful and traumatic situation by individuals and couples across the globe. It is estimated that 72.4 million women are currently infertile worldwide.[1] Of these, 40.5 million are currently seeking infertility medical care.[1] Approximately half of women undergoing fertility treatment rated infertility as the most stressful experience of their life.[2] The impact of infertility can have harmful social and psychological consequences on both the individual and couple. In the United States, specialists who study infertility have noted that infertile couple are one of the “most neglected and silent minorities.”[3]

Kristin L Rooney, Alice D Domar. Emotional and Social Aspects of Infertility Treatment

1. Boivin J, Bunting L, Collins J A, et al. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod. 2007;22(6):1506-12. 

2. Freeman EW, Boxer AS, Rickels K, et al. Psychological evaluation and support in a program of in vitro fertilization and embryo transfer. Fertil Steril. 1985;43(1):48-53. 

3. Domar AD, Siebel MM. Emotional aspects of infertility. In: Seibel MM (Ed). Infertility: A Comprehensive Text. Stamford: Appleton & Lange; 1997. pp. 29-44. 

Whether stress causes infertility has been the subject of controversy for years. Dr Alice Domar has been investigating the mind body connection to fertility since 1987 and has made significant progress in educating health care practitioners and clients about stress and infertility.

Read more here:

“The Mind/Body Program for Infertility was first launched in 1987 and there have been a number of RCT’s to examine its effectiveness (Domar et al., 2000 a,b, 2011). The 10-week group program includes relaxation exercises, cognitive strategies, lifestyle modification, as well as group support. Research indicates that participants experience significant reductions in psychological distress, stress-related physical symptoms such as insomnia and headaches, as well as increases in pregnancy rates. The clinical program is currently offered at numerous centers throughout the US, as well as internationally. Participants report improvements in all symptoms and approximately 55% conceive within 6 months.”

Alice D Domar & Kristin L Rooney © 2017. The Role of the Mental Health Professional in the ART Clinic Setting

Read more here:

“The relationship between stress and infertility has remained a subject of controversy for many years. Women undergoing infertility treatments exhibit high anxiety and/or high depressive scores at the start of treatment as well as over the course of treatment [1–4]. Stress may also have a negative impact on pregnancy rates in women undergoing in vitro fertilization (IVF) [5–8]. A recent large study [9] did not reveal a relationship between distress and IVF outcome, so it is possible that there might be differences among patient populations or cultural influences on emotional expression. A meta-analysis which included 14 relevant studies on this topic [10] also did not find a relationship between distress and outcome. However, patient distress in these studies was assessed only once, up to 3 months before cycle start, so the relationship between distress while actually cycling and subsequent pregnancy rates remains unknown. However, distress is the most common reason given by women who voluntarily terminate treatment [11–13], and baseline depressive symptoms can predict treatment termination after only one cycle [14].
A recent study on the impact of stress on fecundity indicated that distress significantly reduced the probability of conception in women just starting to attempt pregnancy [15].

Alice D. Domar, Ph.D., Kristin L. Rooney, B.A., Benjamin Wiegand, Ph.D., E. John Orav, Ph.D., Michael M. Alper, M.D., Brian M. Berger, M.D., and Janeta Nikolovski, Ph.D. Impact of a group mind/body intervention on pregnancy rates in IVF patients

1. Boivin, J., 2003. A review of psychosocial interventions in infertility. Social Science and Medicine 57, 2325–2341.

2. Boivin, J., Domar, A., Shapiro, D., et al., 2012. Tackling burden in ART: An integrated approach for medical staff. Human Reproduction 27, 941–950.

3. Boivin, J., Bunting, L., Koert, E., Ieng, U.C., Verhaak, C., 2017. Perceived challenges of working in a fertility clinic: A qualitative analysis of work stressors and difficulties working with patients. Human Reproduction 32, 403–408.

4. Chen, T.H., Chang, S.P., Tsai, C.F., Juang, K.D., 2004. Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Human Reproduction 19, 2313–2318.

5. Constable, J.F., Russell, D.W., 1986. The effect of social support and the work environment upon burnout among nurses. Journal of Human Stress 12, 20–26. De Berardis, D., Mazza, M.,

6. Marini, S., et al., 2014. Psychopathology, emotional aspects and psychological counselling in infertility: A review. La Clinica Terapeutica 165, 163–169.

7. Dill, J., Erickson, R.J., Diefendorff, J.M., 2016. Motivation in caring labor: Implications for the well-being and employment outcomes of nurses. Social Science and Medicine 167, 99–106.

8. Domar, A., Zuttermeister, P., Friedman, R., 1993. The psychological impact of infertility: A comparison with patients with other medical conditions. Journal
of Psychosomatic Obstetrics and Gynecology 14, 45–52.

9. Domar, A.D., Clapp, D., Slawsby, E., et al., 2000. The impact of group psychological interventions on distress in infertile women. Health Psychology 19, 568–575.

10. Domar, A.D., Clapp, D., Slawsby, E.A., et al., 2000. Impact of group psychological interventions on pregnancy rates in infertile women. Fertility and Sterility 73, 805–811.

11. Domar, A.D., Smith, K., Conboy, L., Iannone, M., Alper, M., 2010. A prospective investigation into the reasons why insured United States patients drop out of in vitro fertilization treatment. Fertility and Sterility 94, 1457–1459.

12. Domar, A.D., Rooney, K.L., Wiegand, B., 2011. Impact of a group mind/body intervention on pregnancy rates in IVF patients. Fertility and Sterility 95, 2269–2273.

13. Domar, A.D., Rooney, K., Rich, C., et al., 2016. Burden of care is the primary reason why insured women terminate IVF treatment. Fertility and Sterility 106, e62–e63.

14. Frederiksen, Y., Farver-Vestergaard, I., Skovgård, N.G., Ingerslev, H.J., Zachariae, R., 2015. Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: A systematic review and meta-analysis. BMJ Open 28, e006592.

15. García, D., Bautista, O., Venereo, L., 2013. Training in empathic skills improves the patient–physician relationship during the first consultation in a fertility clinic. Fertility and Sterility 99, 1413–1418.

If you have been diagnosed as infertile – not able to conceive after 1 year of unprotected intercourse if you are 35 years old or less, or 6 months if you are over 35 years old, it may be beneficial to be aware of your Stress Resilience.

Quote from Dr Alice Domar:

“This is the way I explain things to patients….The vast majority of infertility has a physical cause, whether female factor, male factor, a combo of both, or unexplained. There are also many entities which can impair fertility such as weight, lifestyle factors such as smoking or alcohol, and environmental toxins. So one might be subfertile (ie: a little bit unfertile such as irregular ovulation or a low sperm count) but combine that with smoking or being obese, and one becomes infertile.

Stress is another factor which may well contribute to infertility. So if a couple tries to conceive and one or both is subfertile, the stress of trying over and over month after month may bump one or both of them into infertility.
And once they see a doctor and begin infertility treatment, even if the original physical problem is fixed by the treatment, the distress they are feeling by that time might hamper the efficacy of that treatment.”

“But there is also male factor which is 40-50% contributing. The issue is that IVF (In Vitro Fertilization) bypasses many of the actual diagnoses but not everyone conceives. Which is where I think stress comes in, with PGT (Preimplantation Genetic Testing) you are transferring a chromosomally normal blastocyst but about 40% don’t make babies. Stress?”