Abstract
Research question
What are the effects of physiological and psychological stress on fertility outcomes
for women undergoing IVF?
Design
A prospective cohort study of 72 patients undergoing IVF in 2017 and 2018. Physiological
stress was assessed by salivary cortisol measurements: (i) pretreatment, when the
patient received the IVF protocol; (ii) before oocyte retrieval (follicular cortisol
was also measured); and (iii) before embryo transfer. Emotional stress was evaluated
at each assessment with the State-Trait Anxiety Inventory and a 1–10 Visual Analogue
Scale (VAS, referred to as the ‘Stress Scale’. Correlations between cortisol concentrations,
psychological stress and IVF outcome were assessed.
Results
Salivary cortisol concentrations increased by 28% from pretreatment phase (0.46 ± 0.28 μg/dl)
to maximum concentration on oocyte retrieval day (0.59 ± 0.29 μg/dl, P = 0.029) and then decreased by 29% on embryo transfer day (0.42 ± 0.23 μg/dl, P = 0.0162). On embryo transfer day, cortisol among women in their first cycle was
higher than women who underwent more than one treatment (P = 0.024). Stress Scale score increased by 39% from pretreatment to a maximum score
on oocyte retrieval day and then decreased by 12% on embryo transfer day. Salivary
cortisol and Stress Scale were not related to subsequent embryo transfer, fertilization
rate, embryo quality or clinical pregnancy rate. Follicular cortisol concentration
was positively correlated with fertilization rate (r = 0.4, P = 0.004).
Conclusion
It can be cautiously concluded that physiological and psychological stress do not
negatively affect IVF outcomes. Moreover, high follicular cortisol concentrations
might have positive effects on pregnancy rates.
Keywords
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Biography
Dr Netanella Miller is an OBGYN Resident at Meir Medical Center, Israel. She earned her medical degree from the Technion School of Medicine and studied acupuncture at Broshim Campus, specialising in Chinese gynaecology. Her research is in obstetrics and reproductive endocrinology and she has published several papers in leading journals.Article info
Publication history
Published online: January 31, 2019
Accepted:
January 25,
2019
Received in revised form:
December 15,
2018
Received:
November 8,
2018
Declaration: The authors report no financial or commercial conflicts of interest.Identification
Copyright
© 2019 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
