Stress and infertility.

This review highlights new directions for research on stress and infertility. The question of whether stress causes infertility is examined, using theoretical models derived from natural history and evolution, current models of the effects of chronic stress on the hypothalamic pituitary adrenal axis, and data relating the effects of stress on the reproductive cycle. Research on the stress of infertility treatment is reviewed, with the conclusion that there is a lack of solid evidence that infertility patients demonstrate more psychopathology than controls, and that there is modest evidence for an association between distress during treatment and the outcome of the treatment itself. The effects of infertility and infertility treatment on quality of life is discussed thematically, using previous literature and previously unpublished qualitative data from infertility patients. The effects of infertility on social, interpersonal, and identity aspects of quality of life are emphasized.