Stress Doesn’t Hurt Chances of Success with IVF

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Of all the factors that infertile couples worry about, they can now stop worrying about one: worry. It turns out that stress and tension, while detrimental to overall health, may have little impact on couples’ chances of getting pregnant with in vitro fertilization.

At least that’s the conclusion of a British-based study led by Jacky Boivin at Cardiff University. Boivin and her colleagues found that women who were more stressed and anxious at the start of an IVF cycle were no less likely to get pregnant than women who were more at ease. The finding contradicts a growing body of work documenting the negative health consequences of stress, and seems to fly in the face of the intuitive sense that women embarking on the difficult and often intimidating process of IVF are somehow too anxious to get pregnant.

“These findings should be reassuring to women who often worry that they are so stressed out with going to work, and coming to the clinic every day for scans and blood tests, that they are reducing their chances of getting pregnant,” says Boivin. “We showed there is no association between stress at the start of treatment and whether they became pregnant or not.” (More on Grandma Gives Birth to Her Grandchild: Weird or Wonderful?)

In fact, she says, she wonders whether stress has taken the rap for other behavioral factors that might be influencing pregnancy rates more. For example, the rigors of completing a cycle of IVF, which requires strict adherence to an intense schedule of shots, scans, tests and procedures, is simply too much for many women to take, and up to 30% of those who start one in an attempt to get pregnant don’t finish. Some women, who give up smoking in an effort to have a baby, take up the habit again, which can significantly lower the chances of pregnancy as well.

In the study, which involved an analysis of 14 studies that asked women to take tests measuring their level of distress within a month receiving IVF, anxiety seemed to have little effect on the reproductive system. That’s not a total surprise, says Dr. Zev Rosenwaks, director of the Cohen/Perelman Center for Reproductive Medicine at New York Presbyterian/Weill Cornell Medical Center, who was not involved with the study. Rosenwaks says IVF involves hijacking the body’s hormones to override its natural stress response system, making it unlikely that any stress-related hormones would have an effect on fertility during the IVF process.

“Stress, in my view never really played a great role in our treatment,” he says. In addition, the need to reproduce is such a fundamentally important process to survival that it may be immune to even intense periods of angst. “We know from other exceedingly stressful situations — wars and famines — that women were still able to reproduce,” he says. “So it’s not a surprising finding.” (More on You’re Kidding! Medical Clown Increases Pregnancy Rates with IVF)

It will certainly be reassuring, however, to infertile couples, who struggle with not just the burden of being unable to have children, but with the challenge of failure when their IVF cycles fail to produce a baby. Boivin notes that the study looked only at the effect of stress on single cycles of IVF, and that such a short snapshot may not completely capture the longer term consequences of being anxious about getting pregnant. Still, she says, “Lots of women blame themselves, and now we can say that the best evidence to date shows no association between stress and fertility with a single cycle of IVF.”

That doesn’t mean that stress shouldn’t be addressed in the IVF clinic. Added tension, whether from being childless or from the struggles of treating infertility, can adversely affect quality of life, and that in turn can impact how emotionally and physically prepared couples are to complete weeks of treatment required in one or more IVF cycles. “Situations free of stress are of course more likely to be pleasant,” says Rosenwaks. It’s just that they may not directly help infertile couples to start a family.

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