Stress and outcome success in IVF: the role of self-reports and endocrine variables (original) (raw)
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Stress and Outcome Succes in IVF: the Role of Self-reports and Endocrine Variables
Human Reproduction, 2005
BACKGROUND: The aim of this study was to examine the associations between urinary levels of the stress hormones adrenaline, noradrenaline and cortisol during treatment with self reported stress, in order to investigate the mechanism for the previously observed negative association of anxiety and depression with the outcome of IVF/ICSI. METHODS: In a multicentre prospective cohort study, women entering their first cycle of IVF/ICSI treatment were asked to participate. From each participant nocturnal urine samples were collected; pre-treatment, before oocyte retrieval and before embryo-transfer (ET), to assess hormonal concentrations. Additionally, two questionnaires were administered before the start of the treatment to measure anxiety and depression. RESULTS: 168 women completed the questionnaires and collected at least two urine specimens. A significant positive correlation between urinary adrenaline concentrations at baseline and ET and the scores on depression at baseline were found. In women with successful treatment, lower concentrations of adrenaline at oocyte retrieval and lower concentrations of adrenaline and noradrenaline at ET, compared with unsuccessful women, were found. CON-CLUSIONS: The significant positive association of adrenaline concentration with pregnancy and with depression suggested that this adrenal hormone could be one of the links in the complex relationship between psychosocial stress and outcome after IVF/ICSI.
Stress and anxiety scores in first and repeat IVF cycles
Fertility and Sterility, 2010
Background: The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients.
BMC Research Notes, 2019
Objective: Women undergoing assisted reproductive technology treatment, are often anxious and depressed because of their fertility problem and the uncertainties of the treatment with which they have to deal. On the other hand, recent studies have shown that the effects of psychological distress on the IVF treatment outcome is unclear. This study aimed to examine the effects of anxiety, depression, and stress symptoms before IVF treatment on the clinical pregnancy rate, controlling for known confounders. Results: In total, 142 women undergoing IVF treatment participated in this prospective study. The clinical pregnancy rate was 26.8% in this study. Controlling for age, infertility duration, and cause of infertility, there were no relationship between IVF outcome and anxiety (relative risk (RR) = 1.00; 95% CI 0.91-1.09), depression (RR = 0.96; 95% CI 0.88-1.05), and stress (RR = 1.01; 95% CI 0.96-1.07) symptoms. High woman's age and women with both cause of infertility were independent predictors of IVF clinical pregnancy rate. In sum, we found that anxiety, depression, and stress symptoms were not associated with the IVF clinical pregnancy rate.
The effect of psychological distress on IVF outcomes: Reality or speculations?
PLOS ONE
Introduction Infertility is a problem that affects millions of people worldwide. The aim of this study was to assess the effect of stress, depression and anxiety on the IVF outcomes in Kazakhstan. Methods The prospective cohort study was performed using questionnaires to assess psychological distress in 304 infertile female in three different cities in Kazakhstan. Results The average age of participants was 33.7 years with infertility duration of 5.9 years. Regarding stress, depression and anxiety we found that more than 80% of all respondents had CES-D score higher than 16, indicating that they are at risk of developing clinical depression. On average, FPI subscales’ scores, global stress score and anxiety scale (STAI-S and STAI-T) scores were statistically significantly higher among not pregnant women than pregnant women. Similarly, in simple logistic regression analysis all FPI subscales scores, global stress scale score and anxiety scales’ scores were negatively associated with ...
The effect of anxiety and depression on the outcome of in-vitro fertilization
Human Reproduction, 2001
BACKGROUND: The study aim was to clarify the role of anxiety and depression on the outcome in assisted reproductive treatment. Previous studies on this topic have shown contradicting results, which may have been caused by population characteristics, the design of the study, or small sample sizes. METHODS: In a multicentre prospective study, 291 out of 359 (81%) consecutively invited women agreed to participate. Before down-regulation by means of gonadotrophin-releasing hormone (GnRH) analogues in a long IVF protocol, patients were asked to complete the Dutch version of the State and Trait Anxiety Inventory to measure anxiety, and the Dutch version of the Beck Depression Inventory (BDI) to measure depression. Multiple logistic regression analysis was used to analyse known predictors of pregnancy and psychological factors and their relationship with treatment outcome.
A total of 78 patients have accepted to evaluate and answer questions in the Beck depression questionnaire form at the beginning of their controlled ovarian hyperstimulation procedures. Among these patients; 28 (36%), 27 (34%), and 23 (30%) of them were accepted for in vitro fertilization and embryo transfer (IVF-ET) treatment due to male factor, explained infertility and poor ovarian reserve respectively. Based on the Beck depression scale; 9 (12%) patients had mild depression, 31 (39%) patients had moderate depression and 38 (49%) patients had severe depression. IVF-ET cycle outcomes of these three groups of depression levels are statistically similar. A significant negative correlation between Beck depression scores a Follicular Output Rate (FORT) ratios, but not for metaphase II (MII) oocyte numbers, has been detected among unexplained infertile and poor ovarian reserve groups. A significant relationship between increasing Beck depression scores and lower FORT ratios have also been detected for unexplained infertile and poor ovarian reserve groups. FORT ratio which is achieved during the controlled ovarian hyperstimulation (COH) process of IVF-ET procedures seems to be lowered by emotional stress among unexplained or poor responder infertile women despite lack of a clinical effect on other cycle outcomes. Further studies investigating the effect of emotional stress itself and interventions to relieve this stress on IVF-ET cycle outcomes are needed to clarify this uncertainty.
Reproductive Medicine and Biology, 2012
Purpose This study evaluated the changes in psychological stress during in vitro fertilization and embryo transfer (IVF-ET) and the relationship of such stress to the patients' background and gender. Methods Sixty couples undergoing IVF-ET were administered the State-Trait Anxiety Inventory-JYZ (STAI) test at six different points during IVF-ET procedures. Anxiety scores at each time point were recorded and analyzed according to gender, fertility status, and duration of treatment. Results The median state anxiety score for women increased following induction until oocyte collection, after which it temporarily declined and then increased again until the pregnancy test. No such changes were noted in men. Scores for women who had undergone a shorter period of IVF treatments were higher while state and trait anxiety in men increased with a prolonged treatment period. Unsuccessful treatment increased the state and trait anxiety of women. Conclusions Psychological stress changed periodically depending on the duration of the patients' treatment and fertility status also influenced anxiety levels. These findings will prove helpful in guiding psychological therapy and counseling for couples attempting to conceive by in vitro fertilization.
The Psychological Effects of Hormonal Treatment on Women Under IVF Treatment: A Comprehensive Review
National Journal of Community Medicine, 2024
This comprehensive review delves into the intricate world of assisted reproductive technologies (ART) and hormonal treatments, exploring their profound psychological effects on women undergoing IVF treatment. The psy-chological distress of infertility, combined with the demanding nature of ART, has been widely acknowledged, yet a comprehensive examination of the psychological impacts has remained elusive. This study examined the psy-chological repercussions of hormonal medications used in IVF, addressing the complex interplay of hormones and their effects in each stage of the IVF process. This review followed PRISMA guidelines and included studies from PubMed, Google Scholar, and ScienceDirect. A total of nine papers were collected. The findings of this study identified that depression, anxiety, mood swings, irritability, sleep disturbances, and cognitive changes were the most commonly seen medically induced psychological effects among the IVF patients. This review offers a holistic understanding of the psychological intricacies of IVF treatment, highlighting the imperative need for a more comprehensive approach to address the emotional wellbeing of individuals undergoing fertility procedures.
Stress and anxiety do not result in pregnancy wastage
Human Reproduction, 1998
The association between stress and reproductive outcome is unclear. In-vitro fertilization (IVF) is psychologically stressful and has been shown to alter psychological markers such as cortisol, prolactin and progesterone. This study was designed to assess prospectively psychological and physiological markers of stress and to determine if they are related to pregnancy outcome. Forty patients were recruited from Northwestern Medical Faculty Foundation (Chicago, Illinois, USA) having obtained an initial positive β-human chorionic gonadotrophin (HCG) concentration 13 days after IVF with uterine embryo transfer. Patients underwent psychological and hormonal testing on three separate occasions (13, 20 and 27 days after embryo transfer) early in pregnancy. All subjects were followed to delivery. An adverse outcome was defined as a miscarriage before or after cardiac activity (including vanishing twin) or a loss before 20 weeks gestation. There was no difference in age, duration of infertility, diagnosis between patients experiencing an adverse pregnancy outcome (n ⍧ 18) and those that did not (n ⍧ 22). All patients were found to have high stress levels although this did not differentiate between groups of patients. There was no difference in hormonal markers of stress between patients. In conclusion, there is little association between psychological scores and physiological stress hormone concentrations. Also, it does not appear that high levels of anxiety and stress result in an adverse pregnancy outcome.