Infertility-related stress in men and women predicts treatment outcome 1 year later.

OBJECTIVE To examine the separate and joint effects of male and female fertility problem (FP) stress and the source of stress (e.g., personal, social, marital) on treatment outcome. DESIGN Prospective, epidemiological cohort design. SETTING Fertility clinics in Denmark. PATIENT(S) Eight hundred eighteen couples who were about to begin a new course of treatment. INTERVENTION(S) An FP stress inventory was administered at the start of treatment, and the treatment outcome was evaluated 12 months later. MAIN OUTCOME MEASURE(S) Number of treatment cycles in 12-month study period and treatment outcome (i.e., success, no success). RESULT(S) Fertility problem stress was associated with a poorer treatment outcome in women (pooled within-groups [WGr] correlation,WGr = .517) and men (WGr = .392) with the effect significantly more pronounced for women (z = 3.19, P<.001). Fertility problem stress arising in the personal and marital domain showed greater associations with treatment outcome than did FP stress from the social domain. Logistic regression indicated that women who reported more marital distress required more treatment cycles to conceive (median 3) than women reporting less marital distress (median 2) (odds ratio [OR] = 1.20: Model chi2(3) = 77.21, P<.001). CONCLUSION(S) The findings provide evidence that infertility-related stress has direct and indirect effects on treatment outcome.

[1]  K. Sanders,et al.  A prospective study of psychosocial stress and fertility in women. , 1997, Human reproduction.

[2]  J. Dusek,et al.  Impact of group psychological interventions on pregnancy rates in infertile women. , 2000, Fertility and sterility.

[3]  J. Daniluk.  Reconstructing Their Lives: A Longitudinal, Qualitative Analysis of the Transition to Biological Childlessness for Infertile Couples , 2001 .

[4]  C. Tennant,et al.  Mood state as a predictor of treatment outcome after in vitro fertilization/embryo transfer technology (IVF/ET). , 1993, Journal of psychosomatic research.

[5]  S. Klock,et al.  Relationship between psychological stress and semen quality among in-vitro fertilization patients. , 1999, Human reproduction.

[6]  J. Boivin.  2. Fundamental issues in counselling 2.3 Who is likely to need counselling , 2002 .

[7]  M. Glezerman.  Two hundred and seventy cases of artificial donor insemination: management and results. , 1981, Fertility and sterility.

[9]  T. K. Jensen,et al.  Distress and reduced fertility: a follow-up study of first-pregnancy planners. , 1999, Fertility and sterility.

[10]  L. Mettler,et al.  Psychological characteristics of infertile couples: can they predict pregnancy and treatment persistence? , 1998 .

[11]  M. Ferin.  Stress and the Reproductive Cycle , 1999 .

[12]  F. M. Andrews,et al.  Gender's Role in Responses to Infertility , 1991 .

[13]  B. J. Berg,et al.  Psychological sequelae of infertility treatment: the role of gender and sex-role identification. , 1991, Social science & medicine.

[14]  B. Tabachnick,et al.  Using Multivariate Statistics , 1983 .

[15]  N. Hurwitz.  The Psychological Aspects of In-Vitro Fertilization , 1989 .

[16]  B. Tuschen-Caffier,et al.  Cognitive-Behavioral Therapy for Idiopathic Infertile Couples , 1999, Psychotherapy and Psychosomatics.

[17]  C. Bergh,et al.  Why do couples discontinue in vitro fertilization treatment? A cohort study. , 2004, Fertility and sterility.

[18]  T. Tjørnhøj‐Thomsen,et al.  High ratings of satisfaction with fertility treatment are common: findings from the Copenhagen Multi-centre Psychosocial Infertility (COMPI) Research Programme. , 2003, Human reproduction.

[19]  J. Boivin,et al.  Psychological reactions during in-vitro fertilization: similar response pattern in husbands and wives. , 1998, Human reproduction.

[20]  A. Greil,et al.  Infertility and psychological distress: a critical review of the literature. , 1997, Social science & medicine.

[21]  M. Ferin.  Clinical review 105: Stress and the reproductive cycle. , 1999, The Journal of clinical endocrinology and metabolism.

[22]  J. Boivin.  A review of psychosocial interventions in infertility. , 2003, Social science & medicine.

[23]  L. Gelberg,et al.  Severity of homelessness and adverse birth outcomes. , 2000, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[24]  K. Sanders,et al.  Psychosocial stress and treatment outcome following assisted reproductive technology. , 1999, Human reproduction.

[25]  T. Rundmo,et al.  Associations between stress, personality and smoking , 1996 .

[26]  G. Zielhuis,et al.  The effect of anxiety and depression on the outcome of in-vitro fertilization. , 2001, Human reproduction.

[27]  F. Facchinetti,et al.  Immunological changes and stress are associated with different implantation rates in patients undergoing in vitro fertilization-embryo transfer. , 2001, Fertility and sterility.

[28]  J. Boivin,et al.  Stress level across stages of in vitro fertilization in subsequently pregnant and nonpregnant women. , 1995, Fertility and sterility.

[29]  A. Genazzani,et al.  An increased vulnerability to stress is associated with a poor outcome of in vitro fertilization‐embryo transfer treatment , 1997, Fertility and sterility.

[30]  S. Stoléru,et al.  The influence of psychological factors on the outcome of the fertilization step of in vitro fertilization. , 1997, Journal of psychosomatic obstetrics and gynaecology.

[31]  S. Wasser,et al.  Reproductive Suppression Among Female Mammals: Implications for Biomedicine and Sexual Selection Theory , 1983, The Quarterly Review of Biology.

[32]  L. Natarajan,et al.  A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. , 2001, Fertility and sterility.

[33]  J. Boivin,et al.  Dispositional optimism, trait anxiety, and coping: unique or shared effects on biological response to fertility treatment? , 2005, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[34]  P. Guex,et al.  Results from a prospective, randomized, controlled study evaluating the acceptability and effects of routine pre-IVF counselling. , 2003, Human reproduction.

[35]  R. Collins,et al.  Psychological screening and the success of donor insemination. , 1994, Human reproduction.

[36]  S. Stoléru,et al.  Psychological factors in the aetiology of infertility: a prospective cohort study. , 1993, Human reproduction.

[37]  K. Demyttenaere,et al.  Coping and the ineffectiveness of coping influence the outcome of in vivro fertilization through stress responses , 1992, Psychoneuroendocrinology.

[38]  K. Demyttenaere,et al.  Anxiety and conception rates in donor insemination , 1988 .

[39]  A. Vingerhoets,et al.  Psychological aspects of in vitro fertilization: a review. , 1999, Social science & medicine.