Stressful life events are associated with a poor in-vitro fertilization (IVF) outcome: a prospective study

• Published in: Human reproduction (Oxford) Vol. 24; no. 9; pp. 2173 - 2182
• Main Authors: Ebbesen, S.M.S., Zachariae, R., Mehlsen, M.Y., Thomsen, D., Højgaard, A., Ottosen, L., Petersen, T., Ingerslev, H.J.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.09.2009; Oxford Publishing Limited (England)
• Subjects: Biological and medical sciences; Depression - complications; Female; Fertilization in Vitro - methods; Gynecology. Andrology. Obstetrics; Humans; infertility; Infertility, Female; IVF; Life Change Events; Male; Medical sciences; negative life events; Pregnancy; Pregnancy Rate; Prospective Studies; stress; Stress, Psychological - complications; Treatment Outcome; IVF; stress; infertility; negative life events; treatment outcome; In vitro fertilization embryo transfer; Vertebrata; Mammalia; Prognosis; Treatment; Assisted procreation; Sterility; Stress
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/humrep/dep185

BACKGROUND There is preliminary evidence to suggest an impact of stress on chances of achieving a pregnancy with in-vitro fertilization (IVF). The majority of the available research has focused on stress related to infertility and going through IVF-treatment, and it is still unclear whether non-fertility-related, naturally occurring stressors may influence IVF pregnancy chances. Our aim was to explore the association between IVF-outcome and negative, i.e. stressful, life-events during the previous 12 months. METHODS Prior to IVF, 809 women (mean age: 31.2 years) completed the List of Recent Events (LRE) and questionnaires measuring perceived stress and depressive symptoms. RESULTS Women who became pregnant reported fewer non-fertility-related negative life-events prior to IVF (Mean: 2.5; SD: 2.5) than women who did not obtain a pregnancy (Mean: 3.0; SD: 3.0) (t(465.28) = 2.390, P = 0.017). Logistic regression analyses revealed that the number of negative life-events remained a significant predictor of pregnancy (OR: 0.889; P = 0.02), when controlling for age, total number of life-events, perceived stress within the previous month, depressive symptoms, and relevant medical factors related to the patient or treatment procedure, including duration of infertility, number of oocytes retrieved and infertility etiology. Mediation analyses indicated that the association between negative life events and IVF pregnancy was partly mediated by the number of oocytes harvested during oocyte retrieval. CONCLUSION A large number of life-events perceived as having a negative impact on quality of life may indicate chronic stress, and the results of our study indicate that stress may reduce the chances of a successful outcome following IVF, possibly through psychobiological mechanisms affecting medical end-points such as oocyte retrieval outcome.