Patients often worry that stress and anxiety of infertility treatment will reduce their chances of becoming pregnant, but a new study from Sweden shows this fear to be unfounded.
Researchers assessed stress levels among women undergoing their first in vitro fertilization treatment and found similar pregnancy rates in women reporting high levels of anxiety and depression and women who did not.
"This is a positive message we can give our patients to help decrease their stress at this time," says researcher Lisbeth Anderheim, who is a midwife and PhD candidate at Sahlgrenska University Hospital in Gothenburg, Sweden.
Previous studies evaluating the role of stress in the success or failure of infertility treatments have been mixed, with some suggesting a strong link and others finding no link at all.
Though the latest study doesn't provide a definitive answer to the question of whether stress affects IVF outcome, its large size and prospective design make it one of the strongest ever to address the issue, researchers say.
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IVF Findings Reassuring
IVF is a high-tech and widely used infertility treatment. The procedure involves removing eggs from the body and fertilizing them in the laboratory. Once the embryo or embryos form they are implanted in the uterus.
The Swedish study surveyed 166 women about their emotional well-being and social support one month prior to starting IVF treatment and again one week before undergoing egg retrieval.
Of the 139 women who had embryos available for transfer, 58 became pregnant and 81 did not. The researchers show there was no difference in the emotional status during treatment in women who became pregnant and those who didn't.
The number of good-quality embryos transferred back into the uterus was the only variable linked to successfully achieving a pregnancy.
The study is published in the upcoming issue of the journal Human Reproduction.
"Stress is something that many patients ask about. It is a big concern," study co-author Anders Moller tells WebMD. "IVF is stressful enough, and thinking that success or failure depends on how you react emotionally just adds to the burden."
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Questions Remain
American Society of Reproductive Medicine President Robert Schenken, MD, says while studies like the Swedish one are important, the role of stress in IVF outcome remains unknown.
"Some of the studies are reassuring while others suggest that stress may be detrimental to IVF success rate," he tells WebMD. "One of the problems is that it is difficult to measure the impact of stress with the tools we have."
Cost is not a concern of infertile women undergoing IVF in Sweden, where the procedure is paid for by the government-run health care system. But it is a big concern in the U.S., where insurance rarely covers the procedure and most patients end up paying for it out of pocket. The average cost of an IVF cycle is $12,000.
Schenken says severe stress needs to be addressed, regardless of its impact on infertility treatment outcome.
Some studies have reported that acupuncture, which can help reduce stress, increases pregnancy success.
"Everyone undergoing IVF and other infertility procedures has a certain level of stress. It is unavoidable," he says. "But when that stress disrupts our patients' daily lives, we strongly recommend that they get counseling."
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By Salynn Boyles, reviewed by Brunilda Nazario, MD
SOURCES: Anderheim, L. Human Reproduction, Aug. 25, 2005; online edition. Anders Moller, Nordic School of Public Health, Gothenburg, Sweden. Robert Schenken, MD, president, American Society of Reproductive Medicine; professor and chairman, University of Texas Health Science Center, San Antonio.
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