Women using IVF more likely to conceive when stressed

Women who are stressed out when undergoing IVF may have a higher chance of falling pregnant, research suggests.
Those reporting higher stress levels had up to double the chance of a positive pregnancy test when compared with those who were more relaxed, according to a study on 217 women.
They were asked on their first appointment how much fertility-related stress they were experiencing on a scale from 1 to 10.
Those who scored 1 to 3 on the scale had a pregnancy rate of 30 per cent while those who scored 7 to 10 had a rate of 50 to 60 per cent.
Dr Robert Hunter, from Staten Island University Hospital in New York, which carried out the study, said previous research had found a similar finding. However, other studies have discovered that stress can negatively affect IVF.
'We were a little surprised by the outcome of the study - we were expecting the opposite result,' Dr Hunter said.
'It highlights the complexity of stress. There's a very complex relationship between stress pathways and the reproductive pathways.
'This is something that we're still struggling to understand and more work needs to be done.'
Dr Hunter said there was good evidence, however, that stress could actually improve how the body functions, such as the 'fight or flight' response.
Levels of key hormones rise when a person is under stress, including the adrenal hormones adrenaline and cortisol.
The team are now planning further studies, including looking at these markers of stress in the body.
Co-researcher Dr Eric Knochenhauer said questions also need to be asked about sources of stress, such as coming from a partner, worries about the costs of IVF and pressure from parents, in-laws or friends.
'Fertility-related discussions used to be something that nobody had with friends but now it's much more common,' he said.
'I think that causes stress for some patients.'
Another one of the researchers, Dr Michael Traub, said one interesting finding from the study related to older women, who reported being less stressed.
'If they are older and they think their chances of becoming a parent are very low, they might have less stress because their expectations are lower.'
All the findings held true even when factors such as depression, smoking status, age and alcohol intake were taken into account.
Tony Rutherford, chair of the British Fertility Society, said: 'This study used a questionnaire to assess stress rather than looking for biochemical markers.
'There is some evidence that increasing stress might be of benefit to patients undergoing IVF.
'In the UK we are pushing for a national trial on whether steroids improve IVF.
'It's an interesting relationship.'

Stress

Women who 'let go' may have better luck with IVF

Women who cope with the stress of infertility treatment by relinquishing control are nearly twice as likely to get pregnant as those who don't adopt this strategy, research from Israel shows.

The findings, say the researchers, suggest that techniques like meditation, which is focused on teaching people to "let go," could help improve women's chances of getting pregnant.

There is increasing evidence that stress and emotional distress can influence in-vitro fertilization (IVF) success, Dr. Nathalie Rapoport-Hubschman of the Rabin Medical Center in Petah Tikva and her colleagues note in the journal Fertility and Sterility. But evidence on the effects of other psychological factors has been inconclusive, they add.

Rapoport-Hubschman and her team theorized that coping mechanisms, rather than traits like anxiety or hostility, might play a role in IVF success. While problem-focused coping is an effective way to deal with situations that are under a person's control, so-called "emotion-focused coping," which can involve humor, denial, relaxation, and letting go, might be a less stressful way to handle infertility treatment, they suggest.

The researchers looked at 88 women undergoing IVF, 21 of whom got pregnant. The only factors that independently influenced IVF success, the researchers found, were a woman's age and whether she had high "letting go" coping levels at the beginning of the study.

IVF treatment is "highly uncontrollable," Rapoport-Hubschman and her colleagues note in their report. "When control is not possible, focusing on and regulating one's associated emotions may be more effective."

Women who don't use this approach may spend more time worrying and thinking about whether or not they will get pregnant, the researchers note; this can affect multiple systems in the body.

"The next logical step would be to test whether meditation, aimed at helping women relinquish control and improve letting go, could have positive effects on reproductive outcomes in women undergoing infertility and IVF treatments," the researchers conclude.

SOURCE: Fertility and Sterility, October 2009.