Carolyn E Cesta1, Anna L V Johansson1, Julius Hreinsson2, Kenny A Rodriguez-Wallberg2,3, Jan I Olofsson2,4, Jan Holte5,6,7, Håkan Wramsby8, Margareta Wramsby9, Sven Cnattingius10, Alkistis Skalkidou6, Anastasia Nyman Iliadou1. 1. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden. 2. Reproductive Medicine, Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden. 3. Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden. 4. Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden. 5. Carl von Linné Clinic, Uppsala, Sweden. 6. Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. 7. Center for Reproductive Biology in Uppsala, University of Agricultural Sciences and Uppsala University, Uppsala, Sweden. 8. IVF-kliniken Stockholm, S:t Görans sjukhus, Stockholm, Sweden. 9. Fertilitetscentrum Stockholm, Stockholm, Sweden. 10. Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden.
Abstract
INTRODUCTION: Women undergoing fertility treatment experience high levels of stress. However, it remains uncertain if and how stress influences in vitro fertilization (IVF) cycle outcome. This study aimed to investigate whether self-reported perceived and infertility-related stress and cortisol levels were associated with IVF cycle outcomes. MATERIAL AND METHODS: A prospective cohort of 485 women receiving fertility treatment was recruited from September 2011 to December 2013 and followed until December 2014. Data were collected by online questionnaire prior to IVF start and from clinical charts. Salivary cortisol levels were measured. Associations between stress and cycle outcomes (clinical pregnancy and indicators of oocyte and embryo quality) were measured by logistic or linear regression, adjusted for age, body mass index, education, smoking, alcohol and caffeine consumption, shiftwork and night work. RESULTS: Ultrasound verified pregnancy rate was 26.6% overall per cycle started and 32.9% per embryo transfer. Stress measures were not associated with clinical pregnancy: when compared with the lowest categories, the adjusted odds ratio (OR) and 95% confidence interval (CI) for the highest categories of the perceived stress score was 1.04 (95% CI 0.58-1.87), infertility-related stress score was OR = 1.18 (95% CI 0.56-2.47), morning and evening cortisol was OR = 1.18 (95% CI 0.60-2.29) and OR = 0.66 (95% CI 0.34-1.30), respectively. CONCLUSIONS: Perceived stress, infertility-related stress, and cortisol levels were not associated with IVF cycle outcomes. These findings are potentially reassuring to women undergoing fertility treatment with concerns about the influence of stress on their treatment outcome.
INTRODUCTION:Women undergoing fertility treatment experience high levels of stress. However, it remains uncertain if and how stress influences in vitro fertilization (IVF) cycle outcome. This study aimed to investigate whether self-reported perceived and infertility-related stress and cortisol levels were associated with IVF cycle outcomes. MATERIAL AND METHODS: A prospective cohort of 485 women receiving fertility treatment was recruited from September 2011 to December 2013 and followed until December 2014. Data were collected by online questionnaire prior to IVF start and from clinical charts. Salivary cortisol levels were measured. Associations between stress and cycle outcomes (clinical pregnancy and indicators of oocyte and embryo quality) were measured by logistic or linear regression, adjusted for age, body mass index, education, smoking, alcohol and caffeine consumption, shiftwork and night work. RESULTS: Ultrasound verified pregnancy rate was 26.6% overall per cycle started and 32.9% per embryo transfer. Stress measures were not associated with clinical pregnancy: when compared with the lowest categories, the adjusted odds ratio (OR) and 95% confidence interval (CI) for the highest categories of the perceived stress score was 1.04 (95% CI 0.58-1.87), infertility-related stress score was OR = 1.18 (95% CI 0.56-2.47), morning and evening cortisol was OR = 1.18 (95% CI 0.60-2.29) and OR = 0.66 (95% CI 0.34-1.30), respectively. CONCLUSIONS: Perceived stress, infertility-related stress, and cortisol levels were not associated with IVF cycle outcomes. These findings are potentially reassuring to women undergoing fertility treatment with concerns about the influence of stress on their treatment outcome.
Authors: Lana Salih Joelsson; Evangelia Elenis; Kjell Wanggren; Anna Berglund; Anastasia N Iliadou; Carolyn E Cesta; Sunni L Mumford; Richard White; Tanja Tydén; Alkistis Skalkidou Journal: PLoS One Date: 2019-08-16 Impact factor: 3.240
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